Consequences of respiratory exposures in the farm environment

Depending on the type of farming practice, respiratory symptoms are common among agricultural workers. Farmers are at risk for pulmonary illnesses, including chronic bronchitis, organic dust toxic syndrome, farmer's lung diseases, allergic and nonallergic asthma, nasal irritation and polyps, and chemical pneumonitis.

Depressive symptoms and sleepiness among Latino farmworkers in eastern North Carolina

Depression and sleepiness are both risk factors for occupational accidents and unintentional injury. Relatively little is known about the experiences of these risk factors in the immigrant Latino farmworker population. This analysis uses prospective panel data from a sample of Latino farmworkers in eastern North Carolina that were collected at monthly intervals during the 2008 agricultural season to (1) describe depressive symptoms and daytime sleepiness among immigrant Latino farmworkers across the agricultural season; (2) delineate associations of depressive symptoms with sleepiness across time; and (3) determine whether depressive symptoms precede sleepiness, or if sleepiness precedes depressive symptoms. Results indicated that 45% of farmworkers experienced elevated depressive symptoms across the season, whereas 20% experienced elevated sleepiness. Elevated depressive symptoms were more common among farmworkers living in barracks, and less common among those living in trailers. Sleepiness was more common among women than men. There was no evidence that depressive symptoms contributed to sleepiness, or that sleepiness contributed to depressive symptoms. The pattern of results suggests that a substantial proportion of Latino farmworkers experience levels of depressive symptoms or sleepiness that places them at risk for occupational accident or unintentional injury. The results also suggest that depressive symptoms and sleepiness do not cause each other; rather, the association of depressive symptoms with sleepiness hints at the possibility of a common physiologic mechanism such as circadian disruption.

Acute pesticide illnesses associated with off-target pesticide drift from agricultural applications: 11 States, 1998-2006

BACKGROUND

Pesticides are widely used in agriculture, and off-target pesticide drift exposes workers and the public to harmful chemicals.

OBJECTIVE

We estimated the incidence of acute illnesses from pesticide drift from outdoor agricultural applications and characterized drift exposure and illnesses.

METHODS

Data were obtained from the National Institute for Occupational Safety and Health's Sentinel Event Notification System for Occupational Risks-Pesticides program and the California Department of Pesticide Regulation. Drift included off-target movement of pesticide spray, volatiles, and contaminated dust. Acute illness cases were characterized by demographics, pesticide and application variables, health effects, and contributing factors.

RESULTS

From 1998 through 2006, we identified 2,945 cases associated with agricultural pesticide drift from 11 states. Our findings indicate that 47% were exposed at work, 92% experienced low-severity illness, and 14% were children (< 15 years). The annual incidence ranged from 1.39 to 5.32 per million persons over the 9-year period. The overall incidence (in million person-years) was 114.3 for agricultural workers, 0.79 for other workers, 1.56 for nonoccupational cases, and 42.2 for residents in five agriculture-intensive counties in California. Soil applications with fumigants were responsible for the largest percentage (45%) of cases. Aerial applications accounted for 24% of cases. Common factors contributing to drift cases included weather conditions, improper seal of the fumigation site, and applicator carelessness near nontarget areas.

CONCLUSIONS

Agricultural workers and residents in agricultural regions had the highest rate of pesticide poisoning from drift exposure, and soil fumigations were a major hazard, causing large drift incidents. Our findings highlight areas where interventions to reduce off-target drift could be focused.

[Risk of multiple myeloma and agricultural exposures]

We analyzed risk associated with exposure to pesticides and contact with livestock in 277 multiple myeloma (MM) cases and 2434 controls who participated in the multicentre European EPILYMPH study. Ever exposure to organic pesticides or contact with any species of livestock was not associated with an increase in risk of MM. However, risk associated with ever exposure to pesticides was elevated after adjusting for contact with sheep (OR = 2.0, 95% CI 1.2-3.3). The finding of an excess risk associated with ever exposure to any pesticides after adjusting for contact with breeding animals is most likely due to chance.

Prevalence of low back pain among rice farmers in a rural community in Thailand

OBJECTIVE

To determine the prevalence of low back pain (LBP) among rice farmers in a rural community in Phitsanulok, Thailand.

MATERIAL AND METHOD

A cross-sectional survey was conducted among 283 rice farmers in Wangnamkhu subdistrict, Muang district, Phitsanulok province, a rural community in Lower Northern Thailand. Face-to-face interviews with a structured closed-end questionnaire were performed to collect information on the presence of LBP in lifetime, within the last 12 months prior to and at the time of the present study.

RESULTS

The lifetime, 1-year (12-month) and point prevalence rates of LBP were 77%, 56% and 49%, respectively. No relationship between age and LBP was found. However women (61%) had significantly greater 1-year prevalence than men (51%). Ninety-five percent of LBP rice farmers were chronic (experiencing pain longer than 12 weeks) with a mean duration of 292 weeks (5.6 years).

CONCLUSION

The prevalence of LBP among Thai rice farmers is high. Further research should investigate risk factors among this group of the population to design appropriate preventive measures.

Respiratory health of two cohorts of terminal grain elevator workers studied 30 years apart

INTRODUCTION

We evaluated the respiratory health of two cohorts of grain terminal elevator workers who participated in one of either respiratory health surveys undertaken in 1978 and 2008.

METHODS

Questionnaire and spirometry data from 584 workers from the 1978 survey and 215 workers from the 2008 survey were compared using logistic regression and general linear modeling.

RESULTS

The geometric means of area samples of grain dust averaged 8.28 mg/m(3) in 1978 and 2.06 mg/m(3) in 2008. Workers in the 1978 survey had a significantly higher prevalence of respiratory symptoms (with the largest adjusted odds ratio of 3.78, 95% CI 2.07-7.25, for shortness of breath), a lower prevalence of atopic conditions and lower mean lung function.

CONCLUSION

Current grain workers had a lower risk of respiratory health consequences and a greater prevalence of atopic conditions than workers surveyed 30 years prior, most likely associated with reduced exposure to grain dust in the terminal elevator environment.

Actinic cheilitis among agricultural workers in Campinas, Brazil

OBJECTIVE

To assess the prevalence of Actinic Cheilitis (AC) among agricultural workers and analyze its risk factors.

DESIGN

A cross sectional epidemiological study. A lip lesion was defined as an abnormal change on the lip mucosa surface, such as erythematous pigmented, ulcerative or swelling (Cataldo and Doku, 1981). Data were gathered according to age group, gender, ethnicity-time and frequency of occupational sunlight exposure, smoking habits, drinking habits and socio-economic status.

SETTING

Sugar-cane plantation farms in Brazil.

PARTICIPANTS

Full-time workers of both genders employed at sugar-cane plantation farms for at least six months.

OUTCOME MEASURES

Correlations between AC prevalence, demographic and socioeconomic risk factors.

RESULTS

202 people were examined and the prevalence of AC was 39.6%. Results revealed that being black (0.15-0.88- 95% CI; OR = 0.36; p = 0.025) or mulatto (0.21-0.82- 95% CI; OR = 0.42; p =0.011) decreased the risk for AC, while age and gender sex had no effect. In relation to socioeconomic variables, formal education and more than four years of education (0.07-0.68- 95% CI; OR = 0.22; p = 0.009) decreased the risk for AC. Moreover, drinking alcohol was a risk for AC (1.05-3.37- 95% CI; OR = 1.88; p = 0.034), while tobacco smoking was not (0.60-2.02- 95% CI; OR = 1.10; p = 0.763).

CONCLUSIONS

The prevalence of AC is high in agricultural workers who were fairskinned, had low education and high alcohol intake. Prevention and early diagnosis are required for workers exposed to sunlight.

Chronic obstructive pulmonary disease in farmers and agricultural workers - an overview

Chronic obstructive pulmonary disease (COPD) is a common inflammatory disease of the airways characterized by airflow obstruction that is not fully reversible. It is most often caused by smoking, but other factors including exposure to biological agents can play a significant role in its development. It is one of the leading causes of morbidity and mortality among the adult population worldwide. In Poland, symptoms of chronic impairment of airflow are present in 8.5% of males and 4.9% of females. Livestock farmers have an increased risk of chronic bronchitis, COPD, and reduced forced expiratory volume (FEV1). COPD in farmers working inside confinement buildings is related to organic dust exposure and may become severe. The management of COPD is aimed at improving the patient's quality of life and functional status. Currently, apart from lung transplantation, there is no treatment that would significantly improve lung function and decrease mortality. This led us to the conclusion that we should study the problem further, and cautiously monitor patients to help efforts aimed at the prevention of respiratory diseases among farmers and agricultural workers.

Factors associated with self-reported symptoms of acute pesticide poisoning among farmers in northwestern Jamaica

Pesticide poisoning is a major public health concern in developing countries. The authors conducted a population survey among farmers in 3 parishes of northwestern Jamaica to determine the occurrence of acute pesticide poisoning and to identify factors associated with pesticide poisoning. Approximately 16% of 359 farmers who participated in the study reported 1 or more incidents of acute pesticide poisoning within the last 2 years. Only 25% of the farmers reported ever receiving training in pesticide handling or safety. The majority (68%) of farmers who reported pesticide poisoning never sought medical attention for poisoning. The factors found to be associated with pesticide poisoning in this study indicate that implementation of specific intervention strategies and education of farmers is needed in order to improve safe handling, use, and disposal of pesticides and reduce incidents of acute pesticide poisoning.

Job activities and respiratory symptoms among farmworkers in North Carolina

Respiratory health is an important component of the ability to perform physically demanding work. The authors assessed respiratory symptom prevalence among Latino farmworkers engaged in crop production, and investigated work activities as risk factors for respiratory symptoms. During June to September 2008, 122 farmworkers completed up to 3 questionnaires. The authors estimated associations between work activities and wheezing symptoms using alternating logistic regression, controlling for age and smoking. At the first data collection, 29 (24%) farmworkers reported ever wheezing and 10 (8%) reported wheezing within the past month. Though not statistically significant, the odds of wheezing were elevated for individuals who reported performing tobacco-related work in the last 3 days. The odds were decreased among individuals who reported harvesting activities (odds ratio: 0.3, 95% confidence interval: 0.1, 1.0). Among Latino farmworkers, respiratory symptoms may be associated with work activities.

[Low back pain among farmers exposed to whole body vibration: a literature review]

A literature review was performed for the years 1990-2007. It covered reports addressing the problems associated with the prevalence of low back pain and musculoskeletal disorders among farmers. In addition, the anticipated relationship between low back pain and whole body vibration in farmers was evaluated based on 12 reports for the years 1987-2009. The review confirmed that the prevalence of back pain is significantly higher in farmers exposed to whole body vibration than in the control group (not exposed to vibration). The frequency of back pain is related with whole body vibration, as well as with prolonged sitting position, wrong body posture and physical work load (especially lifting and carrying loads). The prevalence of these symptoms increases with the increased vibration dose and duration of exposure. Disorders in the lower section of the spine were associated with age, accidents (concerning the back), cumulative dose of whole body vibration, and overload due to wrong body posture. Long-term exposure affecting the whole body is harmful to the skeletal system (degeneration of the spine). The results of the study suggest that the repeated or constant exposure to mechanical shocks may increase the risk of low back pain. The investigations confirmed that there is a dose-response type of relationship between exposure to whole body vibration and pain in the lumbar section of the spine.

Physician recognition of work-related asthma among US farm operators

BACKGROUND AND OBJECTIVES

The occupational history of every adult patient with asthma provides information critical to the proper diagnosis and effective prevention of work-related asthma. This study determined the proportion of farm operators that reported an asthma attack while doing farm work that required the use of an inhaler or other medical treatment but who had not been told by a doctor, nurse, or other health professional that their asthma was related to work on the farm.

METHODS

Asthma and asthma attack prevalences were estimated using data on a nationally representative sample of 12,278 active farm operators who participated in the 2006 Farm and Ranch Safety Survey.

RESULTS

An estimated 4.9% of operators reported current asthma. Of these, an estimated 24.8% had been told that their asthma was related to work on the farm. Of those not so informed, 21.6% reported an asthma attack at work in the 12 months prior to the interview.

CONCLUSIONS

A large proportion of farm operators who had not been told that their asthma was related to work on the farm experienced an asthma attack that occurred while doing farm work. These results suggest the need for improving clinicians' occupational health practices and clinician-patient communication.

Benedictine monastery on the Island of Rab hides the mystery of sunlight influence on development of macular degeneration (AMD). Is a harmful sunlight, risk factor or cause of macular degeneration?

Benedictine Monastery of St. Andrew is probably the oldest existing Benedictine monastery in this area. According to hundreds of years of legend, it was founded in 1018 year. In clinical examination about the possibility of the macular degeneration occurrence in 15 Benedictine sisters, we found the age-related macular degeneration (AMD) in two cases only. In 13 other sisters aging 27, 60, 67years, the fundus picture was like in a baby, vision, visual field and meridian thresholds were normal. What is the explanation for this phenomenon? Two sisters with AMD work and live as the farm workers, but the other sisters live in closed monastery with very low natural sunlight, approximately 300-500 lx. In conclusion, the earlier author's experimental and clinical works follow the consequence that without exposure of eyes to harmful higher doses of sunlight, it is not possible to develop AMD. The harmful cumulative dose of sunlight is not the risk factor but the cause, including the inheritance, for AMD development.

Assessment of annual exposure of private farmers to whole body mechanical vibration on selected family farms of plant production profile

The objective of the study was evaluation of an annual exposure of private farmers to whole body mechanical vibration on selected family farms of plant production profile. The study covered 15 family farms, using arable land of the size of 10-50 ha (22.3 ha on average), engaged mainly in plant production, and equipped with tractors, tractor-mounted agricultural machinery, with a partial contribution of self-propelled machines. The scope of the study covered the carrying out of time schedules of agricultural activities, and measurements of effective values (RMS) for vibration acceleration (equivalent), frequency corrected, on the seats of farm vehicles in 3 spatial directions of vibration (X, Y, Z). The measurements were made while performing various basic field and transport work activities during the period of the whole year. The study showed (plant production) that the degree of whole body mechanical vibration load among farmers during the whole year depends on the vibration level and duration of exposure to this factor. The highest values of the total vibration dose (d) occur both during summer-autumn months (August, September, October and November), and in spring (April, May). The mean equivalent of daily vibration acceleration shows the highest values during 4 months of the year: April and May (0.52 m/s(2)), and in August and September (0.56-0.57 m/s(2)); the average value of this parameter, for the whole year, reaches the level of 0.45 m/s(2). Considering the fact of the occurrence of mechanical shocks in agricultural vehicles (high maximum accelerations values registered: 0.81-1.01 m/s(2); standard exceeding), and exceeding of the daily exposure action value, proper steps should be undertaken with respect to the protection of private farmers against risk resulting from exposure to mechanical vibration while performing work activities.

Coumaphos exposure and incident cancer among male participants in the Agricultural Health Study (AHS)

BACKGROUND

Coumaphos is an organophosphate livestock insecticide. Previous research in the Agricultural Health Study (AHS) cohort observed a positive association between coumaphos and prostate cancer in men with a family history of prostate cancer.

OBJECTIVES

This study was performed to determine the association between coumaphos and other major cancer sites and to explore the consistency of the association with prostate cancer early (1993-1999) and later (2000-2005) in AHS follow-up.

METHODS

This study included 47,822 male licensed pesticide applicators. Incident cases were ascertained by linkage to state cancer registries, and exposure data were collected by enrollment questionnaire. Poisson regression was used to estimate rate ratio (RR) and 95% confidence interval (CI) of cancer for coumaphos exposure controlling for potentially confounding variables.

RESULTS

Approximately 8% of applicators reported use of coumaphos; 8.5% reported a family history of prostate cancer. Cumulative exposure to coumaphos was not associated with cancer risk overall or with any major cancer site including prostate. In men with a family history of prostate cancer, we observed a positive association between ever use of coumaphos and prostate cancer in both early (RR = 2.07; 95% CI, 1.19-3.62, p-interaction = 0.005) and later (RR = 1.46; 95% CI, 0.89-2.40; p-interaction = 0.11) periods of follow-up. Across all years, this association was statistically significant (RR = 1.65; 95% CI, 1.13-2.38; p-interaction = 0.004).

CONCLUSION

Coumaphos was not associated with any cancer evaluated here. In men with a family history of disease, there was evidence of an association between coumaphos and prostate cancer, possibly due to genetic susceptibility; however, other explanations, including chance, are plausible.

[Assessment of annual exposure of private farmers to the whole body mechanical vibration on selected family farms of animal production profile]

BACKGROUND

Besides noise, mechanical vibration of a general effect (whole body vibration), is an important physical risk factor that occurrs in the farmers' work environment. The vibration occurs on the seats of agricultural vehicles in motion, during the performance of specified field and transportation work tasks.

MATERIAL AND METHOD

The study covered the measurements of time schedules of agricultural activities, and effective values (RMS) for frequency of weighted vibration acceleration (equivalent), frequency corrected, on the seats of farm vehicles in three spatial directions of vibration (X,Y,Z) throughout the year. The basic vibration parameter was the dose (d). The following values were determined: total monthly vibration dose, mean equivalent daily vibration dose and mean equivalent daily vibration acceleration.

RESULTS

The highest values of the total monthly vibration dose occur both during summer-autumn months (August, September), and in spring (April, May). The mean equivalent daily vibration acceleration shows the highest values during four months of the year: April and May (0.50-0.53 m/s2), and August and September (0.47-0.50 m/s2); the average value of this parameter, for the whole year, reaches the level of0.37 m/s2.

CONCLUSIONS

Considering the fact that mechanical shocks occur in agricultural vehicles (mean maximum accelerations values registered: 0.86-0.99 m/s2; standard exceeding), and the threshold level of vibration exceeds the required values, adequate steps should be undertaken to protect private farmers against the risk resulting from exposure to mechanical vibration while performing their work.

[Fertility changes in women working in greenhouses]

BACKGROUND

Greenhouse workers (GW) are exposed to environmental contaminants, including pesticides, that may not only cause known immediate effects such as acute poisoning, but also long-term effects related to chronic exposure to low dosages, a problem that has not been extensively studied This study investigated the relationship between fertility changes and exposure to pesticides in a group of women working in greenhouses.

STUDY GROUP AND METHODS

The analysis is based on a retrospective cohort of 145 women working in greenhouses located in the province of Latina, Lazio Region, Italy, who were exposed to pesticides at the time of their first pregnancy. Information on health status, lifestyle, work activity, reproductive history and some confounding factors (age, smoking, alcohol abuse, drug consumption) were collected using a questionnaire. Exposure to pesticides was classified in two levels (high or low) according to the work task and the length of exposure. Changes in fertility were measured in terms of time to pregnancy (TTP), that is the number of non-contraceptive cycles that it takes a couple to conceive. A control group was selected among public administration employees in the same province. The difference in average TTP between exposed and non-exposed groups was analysed by using Student t-test. A Cox proportional hazard model was used to compare TTP between the two groups after correction for confounding factors.

RESULTS

In the high-level exposure group average TTP was 10.8 months (+/- 2.0), among the non-exposed average TTP was 6.2 months (+/- 1.0). The difference between exposed and non-exposed was thus 4.6 months (p<0.05). Comparison of the distribution of TTP between the high-level exposure group and nonexposed resulted in a hazard ratio of 1.27 (I.C. 95%: 1.03-1.79); the same analysis using the low-level exposure group and non-exposed group yielded a hazard ratio of 1.12 (I.C. 95%: 0.67-1.87).

DISCUSSION

The study showed reduced fertility, in terms of TTP, in the population exposed to pesticides. Among GW, TTP was as much as 50% higher than for the control group. Controlling for confounding factors, the study confirmed an increase in risk for the exposed group. The issue under investigation, however, is complex as health status is not the only factor that needs to be taken into account in studies of reproductive health; emotional status as well as congenital and acquired factors may also have a notable impact on women's fertility. Occupational exposure, therefore, can be said to be a condition requiring careful analysis while bearing in mind that other factors may influence the outcome.

[Health effects of occupational endotoxin exposure: a review and relevance to veterinary practice]

Endotoxins are cell-wall components of Gram-negative bacteria that are commonly present in plants and plant products and in faecal matter. This review presents an overview of endotoxin exposure levels, associated health effects, and relevance regarding veterinary practice. Exposure to airborne endotoxin is especially high in the agricultural sector and among veterinarians, and in particular among those working with horses or farm animals. Inhalation of endotoxins may cause acute airway inflammation and respiratory symptoms that can lead to (non-allergic) asthma and chronic obstructive pulmonary disease in individuals with prolonged exposure to high levels of endotoxins. Interestingly, recent studies have shown that individuals exposed to high levels of endotoxin also have a lower risk of allergic conditions such as hay fever. Although endotoxin may protect against allergies, it is essential to reduce exposure levels in the agricultural sector in order to prevent workers from developing chronic non-allergic respiratory disorders.

[Hypersensitity pneumonitis in a greenhouse rose grower]

A 54-year-old woman presented with chronic cough. She had been engaged in growing roses in plastic greenhouses. Chest CT scan showed bilateral diffuse ground-glass attenuation. Bronchoalveolar lavage fluid demonstrated the increase of total cell counts with predominant lymphocyte cells, and transbronchial lung biopsy specimen revealed lymphocyte alveolitis with granuloma. Precipitating antibody against the extract of the Penicillium species obtained in the greenhouses was detected by the double immunodiffusion test, which led to a diagnosis of hypersensitivity pneumonitis caused by Penicillium species. This case suggests the risk of hypersensitivity pneumonitis caused by fungi in closed spaces with high temperature and humidity such as greenhouses.

Caterpillar stings: a case study

Lepidoptera can cause serious injury from toxic envenomation to humans. This case study involves a report of a caterpillar stinging a greens keeper foreman while working.

[Hypersensitivity pneumonitis induced by Hypsizigus marumoreus]

We present the case of a 53-year-old woman who was employed at a mushroom (Pleurotus eryngii and Hypsizigus marumoreus) cultivation factory for 15 years. She was admitted to our hospital because of fever and dry cough. Chest radiography and CT scanning revealed diffuse ground glass opacity and centrilobular nodules in both lung fields. Serum KL-6 was elevated. In the bronchoalveolar lavage fluid, the CD4/CD8 ratio was reduced, and the lymphocyte fraction was very high. Transbronchial lung biopsy specimens showed lymphocyte alveolitis. After admission, the patient's symptoms improved rapidly without medication. Although these findings are compatible with hypersensitivity pneumonitis, it was difficult to identify a causative antigen. Serum antibody against Trichosporon was positive. A lymphocyte stimulation test of the peripheral blood was positive against extracts of P. eryngii and H. marumoreus. Furthermore, precipitins against the extracts of H. marumoreus were detected by a double immunodiffusion test. Therefore, we decided to conduct a challenge test using H. marumoreus. As an inhalation provocation test with H. marumoreus conducted in a sickroom caused the same clinical symptoms and signs as experienced in the workplace, we diagnosed hypersensitivity pneumonitis caused by H. marumoreus. A provocation test, in which antigen exposure is limited using a closed space, such as a sickroom, was simple, safe and effective for determining the antigen causing hypersensitivity pneumonitis.

[PCR rDNA 16S used for the etiological diagnosis of blood culture negative endocarditis]

We report the case of a 55 year-old man presenting with a double aortic and mitral endocarditis for which resected valve culture was repeatedly negative. Specific PCR made on valves because of highly positive blood tests for Bartonella henselae remained negative. A molecular approach was made with 16S rDNA PCR, followed by sequencing. Bartonella quintana was identified as the etiology of endocarditis. B. quintana, "fastidious" bacteria, even if hard to identify in a laboratory, is often reported as a blood culture negative endocarditis (BCNE) agent. Molecular biology methods have strongly improved the diagnosis of BCNE. We propose a review of the literature focusing on the interest of broad-spectrum PCR on valve for the etiological diagnosis of BCNE.

Pesticide use and application: an Indian scenario

Agricultural development continues to remain the most important objective of Indian planning and policy. In the process of development of agriculture, pesticides have become an important tool as a plant protection agent for boosting food production. Further, pesticides play a significant role by keeping many dreadful diseases. However, exposure to pesticides both occupationally and environmentally causes a range of human health problems. It has been observed that the pesticides exposures are increasingly linked to immune suppression, hormone disruption, diminished intelligence, reproductive abnormalities and cancer. Currently, India is the largest producer of pesticides in Asia and ranks twelfth in the world for the use of pesticides. A vast majority of the population in India is engaged in agriculture and is therefore exposed to the pesticides used in agriculture. Although Indian average consumption of pesticide is far lower than many other developed economies, the problem of pesticide residue is very high in India. Pesticide residue in several crops has also affected the export of agricultural commodities in the last few years. In this context, pesticide safety, regulation of pesticide use, proper application technologies, and integrated pest management are some of the key strategies for minimizing human exposure to pesticides. There is a dearth of studies related to these issues in India. Therefore, the thrust of this paper was to review the technology of application of pesticides in India and recommend future strategies for the rational use of pesticides and minimizing the problems related to health and environment.

Exposure to farm crops, livestock, and farm tasks and risk of glioma: the Upper Midwest Health Study

Some studies of brain cancer have found an excess risk for farmers. The National Institute for Occupational Safety and Health previously found no increased glioma risk for ever (vs. never) being exposed to pesticides on a farm among 798 cases and 1,175 population-based controls (adult (ages 18-80 years) nonmetropolitan residents of Iowa, Michigan, Minnesota, and Wisconsin). For this analysis (1995-1998), 288 cases and 474 controls (or their proxies) who had lived on farms at age 18 years or after were asked about exposure to crops, livestock, and farm tasks. Logistic regression was used to calculate odds ratios adjusted for age, age group, sex, state, and education. Never immediately washing up (adjusted odds ratio (OR) = 3.08, 95% confidence interval (CI): 1.78, 5.34) or changing clothes (OR = 2.84, 95% CI: 1.04, 7.78) after applying pesticides was associated with increased glioma risk. Living on a farm on which corn, oats, soybeans, or hogs were raised was associated with decreased risk (corn-OR = 0.37, 95% CI: 0.20, 0.69; oats-OR = 0.63, 95% CI: 0.40, 1.00; soybeans-OR = 0.69, 95% CI: 0.48, 0.98; hogs-OR = 0.63, 95% CI: 0.43, 0.93). Negative associations may be due to chance or a "healthy farmer" effect. Farmers' increased risk of glioma may be due to work practices, other activities, or an inverse association with allergies (reported by other investigators).

Pesticide exposure and respiratory health of indigenous women in Costa Rica

A cross-sectional study was conducted in 2007 to evaluate the relation between pesticide exposure and respiratory health in a population of indigenous women in Costa Rica. Exposed women (n = 69) all worked at plantain plantations. Unexposed women (n = 58) worked at organic banana plantations or other locations without pesticide exposure. Study participants were interviewed using questionnaires to estimate exposure and presence of respiratory symptoms. Spirometry tests were conducted to obtain forced vital capacity and forced expiratory volume in 1 second. Among the exposed, prevalence of wheeze was 20% and of shortness of breath was 36% versus 9% and 26%, respectively, for the unexposed. Prevalence of chronic cough, asthma, and atopic symptoms was similar for exposed and unexposed women. Among nonsmokers (n = 105), reported exposures to the organophosphate insecticides chlorpyrifos (n = 25) and terbufos (n = 38) were strongly associated with wheeze (odd ratio = 6.7, 95% confidence interval: 1.6, 28.0; odds ratio = 5.9, 95% confidence interval: 1.4, 25.6, respectively). For both insecticides, a statistically significant exposure-effect association was found. Multiple organophosphate exposure was common; 81% of exposed women were exposed to both chlorpyrifos and terbufos. Consequently, their effects could not be separated. All findings were based on questionnaire data. No relation between pesticide exposure and ventilatory lung function was found.