Impact of household pesticide exposure on respiratory disease mortality in adults: A prospective cohort study

Occupational pesticide exposure is known to cause respiratory disease. However, evidence regarding household pesticide exposure remains unclear. This study examines the link between self-reported household pesticide exposure, urinary metabolites, and respiratory disease mortality in adults, utilizing data from the National Health and Nutrition Examination Survey collected between 2007 and 2014. Data on household pesticide application and related urinary metabolites were collected for analysis. We assessed the risks associated with household pesticide exposure and urinary metabolites on subsequent respiratory disease mortality using Cox proportional hazards regression models. The indirect effects of urinary metabolites and effect modifications were examined. Participants who reported exposure to household pesticides showed a greater risk of respiratory disease mortality, with an adjusted hazard ratio (HR) of 1.318 (95% confidence interval: 1.311 to 1.325). Per1-log10 increase in urinary N,N-diethyl-m-toluamide related to household insect repellents was associated with a higher risk of incident respiratory disease death (adjusted HR 1.524, 95% confidence interval 1.504–1.544). Urinary N, N-diethyl-m-toluamide explained 3.36% of the total association between household pesticide exposure and respiratory disease death risk. Exposure to household pesticides, particularly insect repellents, was consistently associated with an increased risk of respiratory disease mortality in adults.