PROJECT SUMMARY/ABSTRACT Workers in poultry-slaughtering and -processing plants have one of the highest human exposures to many microbial and chemical agents that can cause diseases in chickens (e.g., avian leukosis/sarcoma and reticuloendothelosis viruses, which can cause cancer; Mareks's disease virus, which can cause atherosclerosis). These poultry transmissible agents can infect humans and might increase the risks for cancer and nonmalignant diseases. Poultry workers are also exposed to many chemicals—e.g. polycyclic aromatic hydrocarbons (PAH), benzene, and phthalates—which may play a role in the occurrence of chronic diseases in these workers. We have been studying mortality among these workers for many years, and have found they have an elevated risk for non-malignant (e.g. cardiovascular, diabetes mellitus), neurological, and malignant chronic diseases. These risks were based on small numbers of causes of death. In 2011, we conducted a large case- cohort study nested within a cohort of 30,411 poultry workers and 16,405 non- poultry workers identified from rosters of the United Food & Commercial Workers (UFCW) unions in Baltimore, MD and Marshall, MO, and the UFCW Chicago Union Pension Fund. The Baltimore cohort has been followed up from 1950 through 2010, the Marshall cohort from 1969 through 2010, and the Chicago cohort from 1972 through 2010. During these periods, a total of 12,638 deaths from all causes occurred in the combined group of 46,816 poultry and non-poultry workers. Cases in the case-cohort study were defined as all deaths from 7 cancer sites (lung, liver, pancreas, brain, blood, buccal, and ovary) observed to occur in excess in the poultry workers through 2010. In 2019, we secured funding to study the correlation of working for poultry plants and cervical, esophageal, and colon cancers. To identify new deaths in our three cohorts we obtained mortality files from the National Death Index, which revealed that we can add 4,164 new deaths to 12,638 deaths, bringing the new total to 16,802 deaths. In the proposed study, our expected outputs and outcomes are to add the new cause-specific mortalities that occurred in these cohorts to confirm previous findings, and examine with greater statistical power the relation of poultry and non-poultry workplaces with causes of death from malignant and non-malignant diseases. Demonstration of these risks will lead to steps being taken to implement measures to protect not only these workers, but also the general population. This will contribute to the NIOSH strategic goal to reduce occupational cancer, cardiovascular disease, adverse reproductive outcomes, and other chronic diseases. The proposed research falls under the National Occupational Research Agenda (NORA) Sector Agenda for Manufacturing, and Cross-Sector Agenda for Cancer, Reproductive, Cardiovascular and Other Chronic Disease Prevention (CRC). The proposed research also contributes to the NIOSH Research to Practice (r2p) initiative ...