Introduction There is considerable interest in the potential relation of suicide with the pesticide. Agriculture is the leading professional sector for pesticide use in the world with a turnover of about 40 billion US dollars in 2010. According to the WHO report in 2014, autointoxication with agricultural pesticides contributes greatly to the global burden of suicide. The aim of this study is to evaluate whether suicide of farmers was associated with the use of pesticide in different areas during the period 2001–2011 in Spain.

Methods The cohort study followed 9.5 million men in Spain from 2001 to 2011. Participants aged 20–64 years were employed in 2001. The study subjects were grouped as farmers and non-farmers. We divided Spain into two areas depending on both geographical location and the mean annual amount of pesticides used: southeast Spain and the rest of Spain. The southeast Spain shows higher use of pesticides than the rest of Spain. For three major causes of death (suicide, unintentional accidents and rest of causes of death), we estimated the age-standardized mortality rates per 1000,000 person-years of follow-up, the ratio of age-standardized mortality rates with 95% confidence intervals (CI) between farmers and non-farmers in two areas were calculated.

Results With respect to the rest area of Spain, farmers in the southeast showed a lower mortality rate of suicide and unintentional accidents, which mortality rate ratios were 0.74 (95% CI 0.65–0.85) and 0.57 (95% CI 0.52–0.62).

Conclusion Our findings do no support a possible association between pesticide use and suicide of farmers in Spain.