Objective To describe cause-specific mortality patterns of banana plantation workers in the French West Indies.

Methods The study included 11221 farmers and farm workers who had work in banana cultivation in the French West indies (Guadeloupe or Martinique) between 1973 and 1993, followed up from January 1981 to December 2017. We calculated standardized mortality ratios (SMRs), causal mortality ratios (CMRs) and relative standardized mortality ratios (rSMRs) using regional reference rates.

Results SMR analyses showed mortality deficits in overall mortality and for almost all causes of deaths. In contrast, analyses using CMRs revealed a significant excess in overall mortality. The CMRs were significantly elevated for all cancers combined and for stomach cancer, colorectal cancer, prostate cancer and hematopoietic malignancies, as well as for several non- cancer causes of death, including diabetes mellitus, Parkinson’s disease, Alzheimer’s disease, non-ischemic heart diseases, pneumonia and diseases of the skin and subcutaneous tissue. rSMRs were in general consistent with CMRs.

Conclusion The CMR approach showed an elevated mortality for several causes of death, for which work in banana farming and/or exposure to pesticides are plausible explanations.

The authors have declared no competing interest.

This work was funded by Sante Publique France.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Institutional Review Board of the French National Institute of Health and Medical Research (IRB-INSERM, 15-193) gave ethical approval for this work

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