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Hyland C, Meierotto L, Som Castellano RL, Curl CL. Mixed-Methods Assessment of Farmworkers' Perceptions of Workplace Compliance with Worker Protection Standards and Implications for Risk Perceptions and Protective Behaviors. J Agromedicine 2024; 29:355-371. [PMID: 38284770 DOI: 10.1080/1059924x.2024.2307483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
INTRODUCTION The Environmental Protection Agency (EPA)'s Worker Protection Standards is the primary set of legislation aimed at protecting farmworkers from occupational pesticide exposure in the United States. Previous studies suggest that worker adoption of Pesticide Protective Behaviors (PPBs) promoted by WPS is associated with lower urinary pesticide concentrations. However, adoption of PPBs is often outside of the control of individual farmworkers and dependent on workplace factors such as employer provisioning of Personal Protective Equipment (PPE) and access to trainings/resources. METHODS We conducted a mixed-method study including urinary pesticide biomonitoring, surveys, and interviews with 62 Latinx farmworkers in southwestern Idaho from April to July 2022. We integrated findings across the various data sources to identify emergent themes relating to farmworkers' perceptions of workplace compliance with WPS and potential implications for their pesticide risk perceptions, protective behaviors, and urinary pesticide concentrations. RESULTS Participants reported some indications of poor workplace compliance with WPS regulations, notably inconsistent access to clean handwashing stations and notification of pesticide applications. Some farmworkers, particularly pesticide applicators, viewed herbicides to be categorically safer than other classes of pesticides such as insecticides; these perceptions appeared to influence protective behaviors, such as the relatively low use of PPE while applying herbicides. These findings are underscored by the higher concentrations of biomarkers of herbicides, but not insecticides, among pesticide applicators compared with non-applicators (e.g. median 2,4-D concentrations = 1.40 µg/L among applicators and 0.69 µg/L among non-applicators). Participants further reported concerns regarding the inadequacy of pesticide safety training, pesticide drift, and the lack of communication regarding pesticide applications on and near fields where they are working. DISCUSSION Participants' perceptions that herbicides are categorically safer than other pesticide classes is in direct conflict with WPS training, raising concerns about discrepancies between WPS instruction and other on-the-job training, as well as the inadequate provisioning of PPE during the application of certain pesticides. Our findings also suggest that current WPS regulations may not sufficiently address farmworkers' concerns, particularly in regard to pesticide drift.
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Affiliation(s)
- Carly Hyland
- School of Public and Population Health, Boise State University, 1910 University Drive, Boise, ID, USA
- School of Public Health, Division of Environmental Health Sciences, University of California Berkeley, Berkeley, CA, USA
- University of California Agriculture and Natural Resources, University of California Berkeley, Berkeley, CA, USA
| | - Lisa Meierotto
- School of Public Service, Boise State University, 1910 University Drive, Boise, ID, USA
| | - Rebecca L Som Castellano
- Department of Sociology, Boise State University, 1910 University Drive, Boise, ID, USA
- Department of Human-Environment Systems, School of the Environment, Boise State University, Boise, ID, USA
| | - Cynthia L Curl
- School of Public and Population Health, Boise State University, 1910 University Drive, Boise, ID, USA
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Hyland C, Hernandez A, Gaudreau É, Larose J, Bienvenu JF, Meierotto L, Som Castellano RL, Curl CL. Examination of urinary pesticide concentrations, protective behaviors, and risk perceptions among Latino and Latina farmworkers in Southwestern Idaho. Int J Hyg Environ Health 2024; 255:114275. [PMID: 37866282 DOI: 10.1016/j.ijheh.2023.114275] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Studies have documented high levels of pesticide exposure among men farmworkers; however, few have examined exposures or the experiences of women farmworkers. Data gaps also exist regarding farmworkers' perceived risk and control related to pesticides, information that is critical to develop protective interventions. OBJECTIVE We aimed to compare urinary pesticide biomarker concentrations between Latino and Latina farmworkers and examine associations with occupational characteristics, risk perceptions, perceived control, and protective behaviors. METHODS We enrolled a convenience sample of 62 farmworkers (30 men and 32 women) during the pesticide spray season from April-July 2022 in southwestern Idaho. Participants were asked to complete two visits within a seven-day period; at each visit, we collected a urine sample and administered a questionnaire assessing demographic and occupational information. Urine samples were composited and analyzed for 17 biomarkers of herbicides and of organophosphate (OP) and pyrethroid insecticides. RESULTS Ten pesticide biomarkers (TCPy, MDA, PNP, 3-PBA, 4-F-3-PBA, cis- and trans-DCCA, 2,4-D, Glyphosate, AMPA) were detected in >80% of samples. Men and women had similar urinary biomarker concentrations (p = 0.19-0.94); however, women worked significantly fewer hours than men (p = 0.01), wore similar or greater levels of Personal Protective Equipment (PPE), and were slightly more likely to report having experienced an Acute Pesticide Poisoning (26% of women vs. 14% of men; p = 0.25). We observed inconsistencies in risk perceptions, perceived control, and protective behaviors among men. DISCUSSION Our study is one the first to examine pesticide exposure and risk perceptions among a cohort of farmworkers balanced on gender. Taken with previous findings, our results suggest that factors such as job tasks, biological susceptibility, or access to trainings and protective equipment might uniquely impact women farmworkers' exposure and/or vulnerability to pesticides. Women represent an increasing proportion of the agricultural workforce, and larger studies are needed to disentangle these findings.
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Affiliation(s)
- Carly Hyland
- School of Public and Population Health, Boise State University, Boise, ID, USA; Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Division of Agriculture and Natural Resources, University of California, Berkeley, USA.
| | - Alejandra Hernandez
- School of Public and Population Health, Boise State University, Boise, ID, USA; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Éric Gaudreau
- Centre de Toxicologie Du Québec (CTQ), Institut National de Santé Publique Du Québec, Québec, QC, Canada
| | - Jessica Larose
- Centre de Toxicologie Du Québec (CTQ), Institut National de Santé Publique Du Québec, Québec, QC, Canada
| | - Jean-François Bienvenu
- Centre de Toxicologie Du Québec (CTQ), Institut National de Santé Publique Du Québec, Québec, QC, Canada
| | - Lisa Meierotto
- School of Public Service, Boise State University, Boise, ID, USA
| | | | - Cynthia L Curl
- School of Public and Population Health, Boise State University, Boise, ID, USA
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Ard K, Fisher-Garibay D, Bonner D. Particulate Matter Exposure across Latino Ethnicities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105186. [PMID: 34068230 PMCID: PMC8153132 DOI: 10.3390/ijerph18105186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/03/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
The Hispanic/Latino health paradox is the well-known health advantage seen across the Hispanic/Latino racial category in the US. However, this racial category collapses several distinct ethnic groups with varying spatial distributions. Certain populations, such as Dominicans and Cubans, are concentrated in specific areas, compared to more dispersed groups such as Mexicans. Historical peculiarities have brought these populations into contact with specific types of environmental exposures. This paper takes a first step towards unraveling these diverse exposure profiles by estimating how exposure to particulate matter varies across demographic groups and narrows down which types of industries and chemicals are contributing the most to air toxins. Exposure to particulate matter is estimated for 72,271 census tracts in the continental US to evaluate how these exposures correlate with the proportion of the population classified within the four largest groups that make up the Hispanic population in the US: Mexican, Puerto Rican, Cuban, and Dominican. Using linear mixed models, with the state nested within US Environmental Protection Agency regulatory region, and controls for population density, we find that the Dominican population is significantly less exposed to PM2.5 and PM10 compared to non-Hispanic Whites. Moreover, those tracts with a higher proportion of Cuban residents are significantly less exposed to PM2.5. However, those tracts with a higher proportion of foreign-born, Mexicans, and Puerto Ricans had significantly higher levels of exposure to all sizes of particulate matter. We discuss the need to consider the chemical components of these particles to better understand the risk of exposure to air pollution.
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Mueangkhiao P, Siviroj P, Sapbamrer R, Khacha-Ananda S, Lungkaphin A, Seesen M, Jaikwang P, Wunnapuk K. Biological variation in kidney injury and kidney function biomarkers among farmers in Lamphun province, Thailand. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:12386-12394. [PMID: 31989504 DOI: 10.1007/s11356-020-07661-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/07/2020] [Indexed: 06/10/2023]
Abstract
Frequent and long-term exposure to pesticides can induce acute kidney injury and subsequent chronic kidney diseases. In this study, we aimed to investigate the correlation between kidney injury, kidney function biomarkers, and pesticide use in farmers from the Pasang district, Lamphun province, Thailand. A cross-sectional study was performed in 59 farmers occupationally exposed to various types of pesticides. The levels of urinary neutrophil gelatinase-associated lipocalin (uNGAL), serum creatinine (sCr), urinary microalbumin-to-creatinine ratio (ACR), serum cystatin C (sCys-C), estimated glomerular filtration rate (eGFR), and exposure intensity index (EII) were evaluated. Spearman's correlation and a linear regression analysis were carried out to investigate the association between age, pesticide use, EII, kidney injury markers, and kidney function biomarkers. The most common pesticide used in this study area was glyphosate, followed by paraquat and iprodione. Urinary NGAL levels showed a significant correlation with sCys-C levels, EII, and eGFR Cr-Cys. In addition, the sCr levels were associated with glyphosate use (B = 0.08) and EII (B = 0.01). In conclusion, occupation exposure to pesticides is likely to be linked to kidney injury and dysfunction. Pesticide mix status, pesticide application method, equipment repair status, and personal protective equipment (PPE) use are all involved in changes in kidney markers.
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Affiliation(s)
- Patthawee Mueangkhiao
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Penprapa Siviroj
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Supakit Khacha-Ananda
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Anusorn Lungkaphin
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mathuramat Seesen
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pittaya Jaikwang
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Klintean Wunnapuk
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Bhandari G, Atreya K, Yang X, Fan L, Geissen V. Factors affecting pesticide safety behaviour: The perceptions of Nepalese farmers and retailers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 631-632:1560-1571. [PMID: 29727980 DOI: 10.1016/j.scitotenv.2018.03.144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 05/11/2023]
Abstract
Indiscriminate use of pesticides in vegetable farming is an emerging problem resulting in increasing health and environmental risks in developing countries including Nepal. As there are limited studies focusing on farmers' and retailers' knowledge related to pesticide use and associated risks as well as safety behaviour, this study assesses their perceptions of pesticide use, associated impacts on human and environmental health and safety behaviours. This study is also intended to quantify pesticide use in vegetable farming. We used the Health Belief Model (HBM) to evaluate farmers' and retailers' safety behaviour associated with pesticides. We interviewed 183 farmers and 45 retailers. The study revealed that farmers applied pesticides at an average of 2.9kga.i./ha per crop per season; and insecticides, especially pyrethrins and pyrethroids as well as organophosphate, were the most frequently used. Retailers were more aware of the threats surrounding pesticide use and were thus more aware of the risks to their own health as well as to the health of animals, birds, fishes, and honey bees. Headache (73.8%) was the most commonly reported acute health symptom of pesticide use. Farmers often did not adopt the appropriate safety measures when handling pesticides sighting the constrained perceived barriers (direct path coefficient, DPC=-0.837) such as feeling uncomfortable and the unavailability of safety measures. Likewise, retailers lacked the incentive (direct path coefficient, DPC=0.397) to adopt the necessary safety measures while handling pesticides. Training and awareness programs addressing safe handling practices and safety measures as well as education concerning the long-term risks of pesticide exposure on health and the environment, through radio, television and posters, may improve the safety behaviour of farmers and retailers.
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Affiliation(s)
- Govinda Bhandari
- Soil Physics and Land Management Group, Wageningen University and Research, Wageningen, The Netherlands; Progressive Sustainable Developers Nepal (PSD-Nepal), Kathmandu, Nepal.
| | - Kishor Atreya
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Kathmandu, Nepal
| | - Xiaomei Yang
- Soil Physics and Land Management Group, Wageningen University and Research, Wageningen, The Netherlands; College of Natural Resources and Environment, Northwest A&F University, Yangling, China
| | - Liangxin Fan
- School of Surveying and Land Information Engineering, Henan Polytechnic University, Jiaozuo, China
| | - Violette Geissen
- Soil Physics and Land Management Group, Wageningen University and Research, Wageningen, The Netherlands
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Sharifzadeh MS, Damalas CA, Abdollahzadeh G. Perceived usefulness of personal protective equipment in pesticide use predicts farmers' willingness to use it. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 609:517-523. [PMID: 28755601 DOI: 10.1016/j.scitotenv.2017.07.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/09/2017] [Accepted: 07/13/2017] [Indexed: 06/07/2023]
Abstract
Personal protective equipment (PPE) can substantially reduce the risk exposure from pesticide spraying, but compliance is rather low, particularly among small-scale farmers. In this study the connection between farmers' willingness to use PPE in pesticide handling and perceptions of PPE usefulness was examined through a survey of 341 small-scale farmers in Gorgan county of Golestan Province, Iran. Farmers who were not using PPE when working with pesticides were purposively selected to better serve the objective of the study. Multinomial logit regression models were employed to examine differences in farmers' willingness to use PPE in the future. Almost four out of ten farmers (38.1%) showed willingness to use PPE. However, 36.7% of the farmers showed unwillingness and 25.2% were unsure about using PPE. The average score of farmers' perceptions of PPE disadvantages (x=0.55) was significantly higher than the corresponding score of PPE advantages (x=0.38). Low availability and high price were considered the most important constraints in PPE use by the majority of farmers (75.4% and 74.8% of the farmers, respectively). Farmers who perceived usefulness of PPE, such as effectiveness, safety, and ease of use, were more willing to use PPE in the future. Those who perceived non-usefulness of PPE, driven by unavailability, high price, lack of use by neighbors or colleagues, and ignorance of PPE in extension trainings, were less likely to use PPE in the future. Findings revealed that willingness to use PPE among small-scale farmers when working with pesticides is strongly linked to their perception of PPE usefulness. Findings raise our understanding of the important role of farmers' knowledge in PPE acceptance and use and can motivate policy-makers to pay more attention to the role of farmers' perceptions and awareness in the success or failure of health and safety programs. It is necessary to incorporate farmers' preferences in extension programs to promote safety measures during working with pesticides.
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Affiliation(s)
- Mohammad Sharif Sharifzadeh
- Department of Agricultural Extension and Education, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran.
| | - Christos A Damalas
- Department of Agricultural Development, Democritus University of Thrace, GR-682 00 Orestiada, Greece.
| | - Gholamhossein Abdollahzadeh
- Department of Agricultural Extension and Education, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
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Walton AL, LePrevost CE, Linnan L, Sanchez-Birkhead A, Mooney K. Benefits, Facilitators, Barriers, and Strategies to Improve Pesticide Protective Behaviors: Insights from Farmworkers in North Carolina Tobacco Fields. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E677. [PMID: 28644414 PMCID: PMC5551115 DOI: 10.3390/ijerph14070677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/12/2017] [Accepted: 06/14/2017] [Indexed: 11/17/2022]
Abstract
Pesticide exposure is associated with deleterious health effects. Prior studies suggest Latino farmworkers perceive little control over their occupational health. Using the Health Belief Model as a theoretical guide, we explored the perceptions of Latino farmworkers working in tobacco in North Carolina (n = 72) about benefits and facilitators of pesticide protective behaviors as well as barriers, and strategies to overcome barriers to their use. Interviews were conducted with participants at farmworker housing during non-work time. Qualitative data were analyzed using ATLAS.ti. Farmworkers recognized pesticide protective behaviors as helping them to not get sick and stay healthy. Farmworkers perceived work experience as facilitating protective behaviors. Wetness in the field was the most commonly cited barrier to protective behavior use. To overcome this barrier, farmworkers suggested use of water-resistant outerwear, as well as packing a change of clothes for mid-day, with space and time to change provided by employers. Examination of the efficacy and feasibility of farmworkers' suggestions for addressing barriers is warranted. Training and behavior modeling by experienced peers may improve behavior adoption and perceived control.
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Affiliation(s)
- AnnMarie Lee Walton
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Catherine E LePrevost
- Department of Applied Ecology, North Carolina State University, Raleigh, NC 27695, USA.
| | - Laura Linnan
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | | | - Kathi Mooney
- College of Nursing, The University of Utah, Salt Lake City, UT 84112, USA.
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Walton AL, LePrevost C, Wong B, Linnan L, Sanchez-Birkhead A, Mooney K. Pesticides: Perceived Threat and Protective Behaviors Among Latino Farmworkers. J Agromedicine 2017; 22:140-147. [PMID: 28129083 PMCID: PMC5493139 DOI: 10.1080/1059924x.2017.1283278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the knowledge and beliefs of 72 Latino farmworkers in North Carolina about the threat of health effects of pesticides, including cancer. It sought to explore relationships between threat perceptions and pesticide protective behaviors observed in the field. METHODS/RESULTS Utilizing stepwise multiple regression, the authors found that years worked in agriculture in the United States was associated with decreased use of protective clothing. CONCLUSION Pesticide protective behaviors in the field may be improved by utilizing moderately experienced farmworkers (<10 years) as lay advisors to reinforce training.
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Affiliation(s)
- AnnMarie Lee Walton
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Catherine LePrevost
- Department of Applied Ecology, North Carolina State University, Raleigh, North Carolina, USA
| | - Bob Wong
- College of Nursing, The University of Utah, Salt Lake City, Utah, USA
| | - Laura Linnan
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Kathi Mooney
- College of Nursing, The University of Utah, Salt Lake City, Utah, USA
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Walton AL, LePrevost C, Wong B, Linnan L, Sanchez-Birkhead A, Mooney K. Observed and self-reported pesticide protective behaviors of Latino migrant and seasonal farmworkers. ENVIRONMENTAL RESEARCH 2016; 147:275-283. [PMID: 26918841 PMCID: PMC4821669 DOI: 10.1016/j.envres.2016.02.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/27/2016] [Accepted: 02/16/2016] [Indexed: 05/30/2023]
Abstract
Agricultural pesticide exposure has potential adverse health effects for farmworkers that may be reduced by pesticide protective behaviors (PPBs). The Environmental Protection Agency's (EPA) Worker Protection Standard (WPS) requires PPBs be taught to farmworkers prior to field work. Studies to date have not utilized observational methods to evaluate the degree to which PPBs are practiced by Latino migrant and seasonal farmworkers in the United States. The purpose of this study was to describe, compare, and contrast observed and self-reported PPBs used by Latino farmworkers; both PPBs that the WPS requires be taught and other PPBs were included. Observed and self-reported data were collected from 71 Latino farmworkers during the 2014 tobacco growing season in North Carolina. Participants were consistent in reporting and using long pants and closed shoes in the field most of the time. In addition, gloves, hats/bandanas, and water-resistant outerwear were frequently observed, although they are not required to be taught by the WPS. Farmworkers reported more long-sleeve (p=.028) and glove use (p=.000) than what was observed. It was uncommon to observe washing behavior before eating or drinking, even when washing supplies were available. Washing behaviors were significantly overreported for hand (p=.000; p=.000) and face (p=.000; p=.058) washing before eating and drinking in the field. This study documents that protective clothing behaviors that the WPS requires be taught, plus a few others are commonly practiced by Latino migrant and seasonal farmworkers, but washing behaviors in the field are not. Targeted strategies to improve washing behaviors in the field are needed.
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Affiliation(s)
- AnnMarie Lee Walton
- The University of North Carolina at Chapel Hill, School of Nursing, 4008 Carrington Hall, CB# 7460, Chapel Hill, NC 27599-7460, USA.
| | | | - Bob Wong
- The University of Utah, College of Nursing, USA
| | - Laura Linnan
- The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, USA
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Effectiveness of pesticide safety training and knowledge about pesticide exposure among Hispanic farmworkers. J Occup Environ Med 2013; 54:1550-6. [PMID: 23169274 DOI: 10.1097/jom.0b013e3182677d96] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pesticide poisoning rates remain high among farmworkers despite programs aimed at reducing pesticide exposure. METHODS A cross-sectional study was conducted among 187 Hispanic farmworkers in North Carolina. Farmworkers were interviewed to determine the association between pesticide safety training and knowledge about pesticides and use of personal protective equipment (PPE). RESULTS Use of PPE was higher among farmworkers who reported wearing gloves reduced the harmful effects of pesticides (adjusted odds ratio, 5.73; 95% confidence interval, 2.20-14.92) and those who received pesticide safety training at the extension office or growers association (adjusted odds ratio, 44.62; 95% confidence interval, 3.96-503.33). CONCLUSION Some farmworkers are still not using PPE. Evaluation of Environmental Protection Agency Worker Protection Standards pesticide safety training and requirements for providing PPE are crucial to encourage farm workers to use PPE.
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Weigel MM, Armijos RX, Beltran O. Musculoskeletal Injury, Functional Disability, and Health-Related Quality of Life in Aging Mexican Immigrant Farmworkers. J Immigr Minor Health 2013; 16:904-13. [DOI: 10.1007/s10903-013-9788-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Grzywacz JG, Quandt SA, Vallejos QM, Whalley LE, Chen H, Isom S, Barr DB, Arcury TA. Job demands and pesticide exposure among immigrant Latino farmworkers. J Occup Health Psychol 2010; 15:252-66. [PMID: 20604632 DOI: 10.1037/a0019303] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The goal of this study was to understand the potential threat of job stressors to farmworker health. To accomplish this goal we studied pesticide exposure, an issue with immediate and long-term health consequences, and predictions from the Demands-Control model of occupational stress. Longitudinal, self-report data and urine samples were collected at monthly intervals from a cohort of Latino farmworkers (N = 287) during the 2007 agricultural season. The primary hypothesis was that greater exposure to psychological demands, physical exertion, and hazardous work conditions are associated with greater odds of detecting dialkylphosphate (DAP) urinary pesticide metabolites, biomarkers indicating exposure to pesticides. Contrary to this hypothesis, results indicated that none of the elements of the Demands-Control model were independently associated with detection of DAP urinary pesticide metabolites. However, analyses produced several interaction effects, including evidence that high levels of control may buffer the effects of physical job demands on detection of DAP urinary pesticide metabolites.
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Affiliation(s)
- Joseph G Grzywacz
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1084, USA.
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Quandt SA, Chen H, Grzywacz JG, Vallejos QM, Galvan L, Arcury TA. Cholinesterase depression and its association with pesticide exposure across the agricultural season among Latino farmworkers in North Carolina. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:635-9. [PMID: 20085857 PMCID: PMC2866678 DOI: 10.1289/ehp.0901492] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Accepted: 01/19/2010] [Indexed: 05/21/2023]
Abstract
BACKGROUND Farmworkers can be exposed to a wide variety of pesticides. Assessing cholinesterase activity over time can be used to monitor exposure to organophosphorus and carbamate pesticides. OBJECTIVES The goal of this study was to document patterns and variation in cholinesterase levels across the agricultural season (May-August) among field-workers, and to explore the association of cholinesterase depression with pesticide exposure across the agricultural season. METHODS Dried blood samples collected from 231 migrant farmworkers sampled from camps in eastern North Carolina up to four times across a summer agricultural season were analyzed for cholinesterase activity, and urine samples were analyzed for metabolites of organophosphorus and carbamate pesticides. Reductions of >or= 15% from an individual's highest value were identified and considered evidence of meaningful cholinesterase activity depression. RESULTS The average cholinesterase activity levels were lowest in June, with significantly higher mean values in July and August. When adjusted for age, sex, minutes waited to shower, and days worked in the fields, the number of organophosphorus and carbamate pesticides detected in urine predicted reductions in cholinesterase activity. CONCLUSIONS These data demonstrate that workers are experiencing pesticide exposure. Greater enforcement of existing safety regulations or strengthening of these regulations may be warranted. This study demonstrates that serial measurements of cholinesterase activity across an agricultural season can detect exposure to pesticides among field-workers.
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Affiliation(s)
- Sara A Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157 , USA.
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Abstract
OBJECTIVE Pesticide aerosols are frequently toxic irritants associated with respiratory symptoms and lung function impairment. METHODS A cross-sectional study examined the prevalence of acute and chronic respiratory symptoms and lung function abnormalities in 82 workers employed in processing pesticides and in 60 control workers not exposed to irritants and employed in a soft drink bottling plant. RESULTS The prevalence of almost all chronic respiratory symptoms was greater among pesticide workers than among controls. A logistic regression analysis shows differences between men and women. There was a high prevalence of acute symptoms during the work shift in pesticide workers. The data on ventilatory capacity indicates significant reductions in all tests compared to predicted. Multivariate analysis of lung function showed differences in smoking and work exposure effects in men and women. CONCLUSION Our data indicate that duration of work exposure in the pesticide processing industry may be associated with the development of acute and chronic respiratory symptoms and lung function changes. These effects appear to be aggravated by smoking.
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Salvatore AL, Bradman A, Castorina R, Camacho J, López J, Barr DB, Snyder J, Jewell NP, Eskenazi B. Occupational behaviors and farmworkers' pesticide exposure: findings from a study in Monterey County, California. Am J Ind Med 2008; 51:782-94. [PMID: 18702096 DOI: 10.1002/ajim.20622] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We studied the relationship between behaviors promoted through the US Environmental Protection Agency Worker Protection Standard (WPS) and other programs and agricultural pesticide exposures in 73 strawberry fieldworkers employed in Monterey County, California. METHODS Farmworkers' behaviors were assessed via self-report and organophosphorus (OP) pesticide exposure was measured using dimethyl alkylphosphate (DMAP) and malathion dicarboxylic acid (MDA) urinary metabolite levels. RESULTS Wearing WPS-recommended clothing, wearing clean work clothes, and the combination of handwashing with soap and wearing gloves were associated with decreases in DMAP and MDA metabolite levels. Despite these protective behaviors, however, participants had significantly higher levels of exposure as compared with a national reference sample. CONCLUSIONS Interventions that facilitate compliance with these behaviors may be effective in decreasing fieldworkers' pesticide exposures. However, further efforts are needed to reduce the exposure disparities experienced by farmworkers and decrease the potential for "take home" exposures to farmworkers' families.
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Affiliation(s)
- Alicia L Salvatore
- Center for Children's Environmental Health Research, School of Public Health, University of California, Berkeley, California 94720-7380, USA
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17
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Strong LL, Thompson B, Koepsell TD, Meischke H. Factors associated with pesticide safety practices in farmworkers. Am J Ind Med 2008; 51:69-81. [PMID: 18033725 DOI: 10.1002/ajim.20519] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Farmworkers and their families are exposed to pesticides through multiple pathways. Few studies have examined the frequency with which farmworkers engage in pesticide safety practices and the factors associated with their adoption. METHODS Using a large sample of farmworkers (n = 554), we evaluated relationships between pesticide safety behaviors and farmworkers' beliefs, training history, handling of pesticides at work, perceived occupational exposure, and employers' provision of personal protective equipment. RESULTS Performing behaviors at work was determined largely by whether personal protective equipment was provided. For home behaviors, female gender, living in a labor camp, being trained in the last 5 years, handling pesticides directly, and not perceiving organizational barriers to protecting oneself were associated with taking more precautions. CONCLUSIONS These findings call for interventions that involve and engage multiple stakeholders to increase adoption of pesticide safety behaviors and reduce pesticide exposure in farmworkers.
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Affiliation(s)
- Larkin L Strong
- School of Public Health and Community Medicine, University of Washington, USA.
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18
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Abstract
Farmworkers are low-paid, uninsured employees in an extremely hazardous industry, and they provide an essential service for U.S. society. This review evaluates the delivery of health services to farmworkers. It describes the farmworker population in the United States, noting characteristics (e.g., migratory and immigration status) that limit their access to and utilization of health services. It describes the health services needs of this population, including occupational health, mental health, oral health, and chronic disease treatment. Cultural, structural, legal, financial, and geographic barriers to health services utilization are described. Existing research on health services utilization among farmworkers is discussed. Programs that have been developed to address the barriers to health services utilization among farmworkers are reviewed. Finally, research needed to improve knowledge of farmworker health services utilization is suggested. These research needs include formal evaluations of existing programs and basic research to characterize the health services utilization patterns of farmworkers.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
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Trujillo KA, Castañeda E, Martínez D, González G. Biological research on drug abuse and addiction in Hispanics: current status and future directions. Drug Alcohol Depend 2006; 84 Suppl 1:S17-28. [PMID: 16777354 DOI: 10.1016/j.drugalcdep.2006.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Impressive progress has been made in the understanding of biological contributions to drug abuse and addiction. An area that has only recently begun to receive attention is potential ethnic and racial differences in biological systems that contribute to, or protect from, problem drug use. This article reviews recent research on drug abuse and addiction in Hispanics in which biological questions have been addressed, including work on genes, gene products (proteins), physiology and pharmacotherapy. Taken together, work to date suggests that there are both similarities and differences between Hispanics and other ethnic groups in biological factors related to drug abuse and addiction. Although the results are intriguing, relatively few studies have been done, and those that have been done have often been inconclusive due to low numbers of Hispanic subjects. Moreover, studies have often failed to recognize the complexity and heterogeneity of Hispanic populations in the United States and around the world. After reviewing the current status of the field, recommendations are given for future research in both humans and relevant animal models that will lead to a better understanding of drug abuse and addiction in Hispanics.
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Affiliation(s)
- Keith A Trujillo
- Department of Psychology and Office for Biomedical Research and Training, California State University San Marcos, San Marcos, CA 92096, USA.
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20
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Quandt SA, Hernández-Valero MA, Grzywacz JG, Hovey JD, Gonzales M, Arcury TA. Workplace, household, and personal predictors of pesticide exposure for farmworkers. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:943-52. [PMID: 16759999 PMCID: PMC1480506 DOI: 10.1289/ehp.8529] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2005] [Accepted: 11/03/2005] [Indexed: 05/05/2023]
Abstract
In this article we identify factors potentially associated with pesticide exposure among farmworkers, grade the evidence in the peer-reviewed literature for such associations, and propose a minimum set of measures necessary to understand farmworker risk for pesticide exposure. Data sources we reviewed included Medline, Science Citation Index, Social Science Citation Index, PsycINFO, and AGRICOLA databases. Data extraction was restricted to those articles that reported primary data collection and analysis published in 1990 or later. We read and summarized evidence for pesticide exposure associations. For data synthesis, articles were graded by type of evidence for association of risk factor with pesticide exposure as follows: 1 = association demonstrated in farmworkers; 2 = association demonstrated in nonfarmworker sample; 3 = plausible association proposed for farmworkers; or 4 = association plausible but not published for farmworkers. Of more than 80 studies we identified, only a third used environmental or biomarker evidence to document farmworker exposure to pesticides. Summaries of articles were compiled by level of evidence and presented in tabular form. A minimum list of data to be collected in farmworker pesticide studies was derived from these evidence tables. Despite ongoing concern about pesticide exposure of farmworkers and their families, relatively few studies have tried to test directly the association of behavioral and environmental factors with pesticide exposure in this population. Future studies should attempt to use similar behavioral, environmental, and psychosocial measures to build a body of evidence with which to better understand the risk factors for pesticide exposure among farmworkers.
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Affiliation(s)
- Sara A Quandt
- Division of Public Health Sciences, Dept. of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1063, USA.
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21
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Gaffney SH, Curriero FC, Strickland PT, Glass GE, Helzlsouer KJ, Breysse PN. Influence of geographic location in modeling blood pesticide levels in a community surrounding a U.S. Environmental protection agency superfund site. ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:1712-6. [PMID: 16330352 PMCID: PMC1314910 DOI: 10.1289/ehp.8154] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In this study we evaluated residential location as a potential determinant for exposure to organochlorine compounds. We investigated the geographic distribution characteristics of organochlorine levels in approximately 1,374 blood samples collected in 1974 from residents of a community with a potential organochlorine source. Street addresses of Washington County, Maryland, residents were obtained and geocoded in a geographic information system. We used multivariate linear regression models to characterize the blood organochlorine levels of these residents that had been analyzed as part of previous studies using both environmental- and individual-level covariates. This was done to evaluate if the geographic distribution of blood levels in participants was related to the environmental source in the community. Model inference was based on generalized least squares to account for residual spatial variation. A significant inverse relationship was found between blood dieldrin levels and residential distance from the potential source. For every mile of distance from the source, blood dieldrin levels decreased 1.6 ng/g in study participants (p-value = 0.042), adjusting for age, sex, education level, smoking status, and drinking water source. 1,1-Dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) levels in the blood did not change significantly based on residential distance from the source, taking the same covariates into account. However, these results are limited by the inability to account for several potential confounders. This study demonstrates that spatially distributed covariates may play an important role in individual exposure patterns. Spatial information may enable researchers to detect a potential exposure pattern that may not be revealed with only nonspatial variables.
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Affiliation(s)
- Shannon H Gaffney
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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22
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Jurewicz J, Hanke W, Makowiec-Dabrowska T, Sobala W. Exposure to pesticides and heavy work in greenhouses during pregnancy: does it effect birth weight? Int Arch Occup Environ Health 2005; 78:418-26. [PMID: 15883817 DOI: 10.1007/s00420-005-0614-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2004] [Accepted: 01/15/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Work in greenhouses is performed in warm microclimate during the most time of the year, involves usually moderately intense or heavy work. The working conditions in greenhouses might involve also indirect exposure to pesticides resulting from contact with pesticide-treated flowers and vegetables. The aim of the study was to investigate whether the work in greenhouse during pregnancy adversely influenced infant birth weight and, if so, which of the two main potential hazards typical for such environment (heavy physical work or exposure to pesticides) played the major role in this process. METHODS The list of 14 major greenhouses (each above 5 ha) growing vegetables (cucumbers and tomatoes) was obtained from the Polish Chamber of Horticulture. Between January 2001 and December 2003, 460 women at the age below 45 years, married or who lived with a partner and who had been working for a period of at least 2 years in greenhouses in Poland were asked to participate in the project. We classified pregnancies of women working in, and out of, greenhouses on the basis of energy expenditure during mother's work into three groups: A (200-700 kcal/shift); B (701-1000 kcal/shift); and C (1001-1200 kcal/shift). Information about application of pesticides in 1997-2001 was received from persons responsible for chemical protection in each examined greenhouse. Trade names of pesticides, names and amounts of the active ingredients, type of cultivation and its area were abstracted from pesticide application registers run by each greenhouse operator. Pesticides were classified as reproductive and developmental (RD) toxins according to Pan American Pesticide Database classification. RESULTS The mean birth weight of infants whose mothers worked in greenhouse during pregnancy (work expenditure >1000 kcal/shift) was 177 g lower than that of those whose mothers worked out of greenhouse (light work <700 kcal/shift) (p = 0.05). Mothers who during work in greenhouse were potentially exposed to RD pesticides, delivered infants with birth weight lower by about 70 g. than infants' mothers not working at places where pesticides RD were applied, but these findings were not statistically significant. CONCLUSION Our results indicate that infants of mothers performing heavy work inside greenhouse during pregnancy had lower mean birth weight than infants of mothers working out of greenhouse. No similar effects of current exposure to pesticides was observed.
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Affiliation(s)
- Joanna Jurewicz
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 8 Teresy Street, 90-950 Lodz, Poland.
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23
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Kamel F, Hoppin JA. Association of pesticide exposure with neurologic dysfunction and disease. ENVIRONMENTAL HEALTH PERSPECTIVES 2004; 112:950-8. [PMID: 15198914 PMCID: PMC1247187 DOI: 10.1289/ehp.7135] [Citation(s) in RCA: 333] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2004] [Accepted: 05/19/2004] [Indexed: 05/19/2023]
Abstract
Poisoning by acute high-level exposure to certain pesticides has well-known neurotoxic effects, but whether chronic exposure to moderate levels of pesticides is also neurotoxic is more controversial. Most studies of moderate pesticide exposure have found increased prevalence of neurologic symptoms and changes in neurobehavioral performance, reflecting cognitive and psychomotor dysfunction. There is less evidence that moderate exposure is related to deficits in sensory or motor function or peripheral nerve conduction, but fewer studies have considered these outcomes. It is possible that the most sensitive manifestation of pesticide neurotoxicity is a general malaise lacking in specificity and related to mild cognitive dysfunction, similar to that described for Gulf War syndrome. Most studies have focused on organophosphate insecticides, but some found neurotoxic effects from other pesticides, including fungicides, fumigants, and organochlorine and carbamate insecticides. Pesticide exposure may also be associated with increased risk of Parkinson disease; several classes of pesticides, including insecticides, herbicides, and fungicides, have been implicated. Studies of other neurodegenerative diseases are limited and inconclusive. Future studies will need to improve assessment of pesticide exposure in individuals and consider the role of genetic susceptibility. More studies of pesticides other than organophosphates are needed. Major unresolved issues include the relative importance of acute and chronic exposure, the effect of moderate exposure in the absence of poisoning, and the relationship of pesticide-related neurotoxicity to neurodegenerative disease.
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Affiliation(s)
- Freya Kamel
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709, USA.
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24
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Hanke W, Romitti P, Fuortes L, Sobala W, Mikulski M. The use of pesticides in a Polish rural population and its effect on birth weight. Int Arch Occup Environ Health 2003; 76:614-20. [PMID: 12955525 DOI: 10.1007/s00420-003-0471-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2003] [Accepted: 08/05/2003] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The risk of adverse reproductive outcomes related to pesticide exposure has been investigated in few studies; however, the results have not been consistent. The goal of the present study was to evaluate the influence of maternal residual exposure to pesticides on birth weight among women in an agricultural district in Central Poland. METHOD Subjects included 104 women who delivered a single, live infant between 1 January 1994 and 31 December 2000. Based on maternal reports, the type of farming (crops, orchards, non-farming jobs), involvement in field work and the trade names of pesticides used within last pregnancy were established. Birth weight for the most recent pregnancy was abstracted from the medical data of the local maternity unit. RESULTS Mothers who reported involvement in field work had a similar pregnancy duration but delivered infants with a significantly higher birth weight than mothers not reporting such activities in the first or second trimester of pregnancy (P=0.04). However, after controlling for pregnancy duration and other factors affecting birth weight, we found that maternal exposure to synthetic pyrethroids in the first or second trimester was associated with a small but statistically significant decrease in birth weight (P=0.02). CONCLUSIONS We postulate that the observed effect of pyrethroids exposure was related to a slower pace of foetal development corresponding to the small-for-gestational-age (SGA) birth.
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Affiliation(s)
- Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 8 Teresy St., 90-950 Lodz, Poland.
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25
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Settimi L, Masina A, Andrion A, Axelson O. Prostate cancer and exposure to pesticides in agricultural settings. Int J Cancer 2003; 104:458-61. [PMID: 12584743 DOI: 10.1002/ijc.10955] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Our study evaluates the association between prostate cancer and exposure to pesticides in agricultural settings in Italy. The data were derived from a hospital-based multi-site case-control study carried out in 5 rural areas between 1990-92. In our study, 124 new cases of prostate cancer were ascertained and interviewed, along with 659 cancer controls. A team of agronomists assessed past exposure to pesticides by using a checklist of 100 chemical families and 217 compounds applied from 1950-85 in the areas considered. The association between prostate cancer and different occupational risk factors was measured by maximum likelihood estimation of the odds ratio, controlling for potential confounders. "Ever been employed in agriculture" was associated with a 40% increased risk (OR = 1.4, 95% CI = 0.9-2.0). Prostate cancer was also related positively to food and tobacco (OR= 2.1, 95% CI = 1.1-4.1), and chemical products (OR = 2.2, 95% CI = 0.7-7.2) industries. The analyses carried out to estimate the association between different types of pesticides and prostate cancer showed increased risks among farmers exposed to organochlorine insecticides and acaricides (OR = 2.5, 95% CI = 1.4-4.2), more specifically to the often contemporary used compounds DDT (OR = 2.1, 95% CI = 1.2-3.8), and dicofol (OR = 2.8, 95% CI = 1.5-5.0), whose effects could not be well separated.
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Zahm SH, Blair A. Assessing the feasibility of epidemiologic research on migrant and seasonal farmworkers: an overview. Am J Ind Med 2001; 40:487-9. [PMID: 11675617 DOI: 10.1002/ajim.10006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S H Zahm
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20892-7242, USA.
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