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Buralli RJ, Albuquerque PLMM, Santo CDE, Calice-Silva V, Nerbass FB. Occupational risks associated with chronic kidney disease of non-traditional origin (CKDnt) in Brazil: it is time to dig deeper into a neglected problem. J Bras Nefrol 2024; 46:e20230123. [PMID: 38591822 DOI: 10.1590/2175-8239-jbn-2023-0123en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/14/2023] [Indexed: 04/10/2024] Open
Abstract
In the past decades, an epidemic of chronic kidney disease (CKD) has been associated with environmental and occupational factors (heat stress from high workloads in hot temperatures and exposure to chemicals, such as pesticides and metals), which has been termed CKD of non-traditional origin (CKDnt). This descriptive review aims to present recent evidence about heat stress, pesticides, and metals as possible causes of CKDnt and provide an overview of the related Brazilian regulation, enforcement, and health surveillance strategies. Brazilian workers are commonly exposed to extreme heat conditions and other CKDnt risk factors, including increasing exposure to pesticides and metals. Furthermore, there is a lack of adequate regulation (and enforcement), public policies, and strategies to protect the kidney health of workers, considering the main risk factors. CKDnt is likely to be a significant cause of CKD in Brazil, since CKD's etiology is unknown in many patients and several conditions for its development are present in the country. Further epidemiological studies may be conducted to explore causal associations and estimate the impact of heat, pesticides, and metals on CKDnt in Brazil. Moreover, public policies should prioritize reducing workers´ exposure and promoting their health and safety.
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Affiliation(s)
- Rafael Junqueira Buralli
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, São Paulo, SP, Brazil
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Lozano-Paniagua D, Parrón T, Alarcón R, Requena M, Lacasaña M, Hernández AF. Renal tubular dysfunction in greenhouse farmers exposed to pesticides unveiled by a panel of molecular biomarkers of kidney injury. ENVIRONMENTAL RESEARCH 2023; 238:117200. [PMID: 37769834 DOI: 10.1016/j.envres.2023.117200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
Growing evidence suggests that chronic exposure to pesticides may cause adverse effects on the health of the exposed population leading to organ-specific toxicity, including kidney damage. Traditional markers used to assess renal function (glomerular filtration rate (GFR), and serum creatinine and cystatin C -Cys-C-) are inadequate to evaluate a potential subclinical renal impairment linked to occupational exposure to pesticides, since levels above the upper limit of normal only occur when renal damage is very extensive. The use of more sensitive biomarkers is therefore needed. This study investigated novel urinary biomarkers of kidney function (microalbuminuria, osteopontin (OPN), trefoil factor 3 (TFF3), β-2-microglobulin, neutrophil gelatinase-associated lipocalin (NGAL), and Cys-C), together with the aforementioned traditional serum biomarkers, to assess potential kidney damage in farmers exposed to pesticides in an intensive agriculture setting. The study population consisted of 175 greenhouse workers and 91 healthy control subjects from Almeria (Southeastern Spain), a major hub of greenhouse agriculture. Data were collected at two different time-points of the same crop season: a period with greater pesticide use (high exposure period) and another with lower pesticide use (low exposure period). Significantly higher urinary levels of OPN and TFF3 were found in greenhouse workers than in controls, and in the high pesticide exposure period compared to that of low exposure. These changes suggest a subclinical tubular damage linked to pesticide exposure. In contrast, microalbuminuria, GFR, serum creatinine and Cys-C failed to be associated with pesticide exposure, suggesting that glomerular function was spared. Increased OPN and TFF3 levels over time may suggest a gradual progression from tubular dysfunction to chronic kidney disease in the exposed population.
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Affiliation(s)
| | - Tesifón Parrón
- University of Almería School of Health Sciences, Almería, Spain
| | - Raquel Alarcón
- University of Almería School of Health Sciences, Almería, Spain
| | - Mar Requena
- University of Almería School of Health Sciences, Almería, Spain
| | - Marina Lacasaña
- Escuela Andaluza de Salud Pública, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Biosanitaria, Granada (ibs.GRANADA), Spain; Andalusian Health and Environment Observatory (OSMAN), Granada, Spain
| | - Antonio F Hernández
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Biosanitaria, Granada (ibs.GRANADA), Spain; Department of Legal Medicine and Toxicology, University of Granada School of Medicine, Granada, Spain.
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Bunsri S, Muenchamnan N, Naksen W, Ong-Artborirak P. The Hematological and Biochemical Effects from Pesticide Exposure on Thai Vegetable Farmers. TOXICS 2023; 11:707. [PMID: 37624212 PMCID: PMC10458049 DOI: 10.3390/toxics11080707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
Pesticide-related health concerns are a global public health issue. Few studies in Thailand have explored the hematological and biochemical effects of occupational pesticide exposure. The goal of this study was to investigate the effects of pesticides on the hematology, hepatic, and renal function of Thai vegetable farmers. A cross-sectional study was carried out in Chiang Mai, northern Thailand. A total of 124 apparently healthy vegetable farmers were interviewed about their lifetime exposure to agricultural pesticides. Blood samples were collected via venipuncture to be tested for complete blood count (CBC), liver function, and kidney function. Approximately 46% of the farmers were pesticide users who reported a history of pesticide use for their crops, while 54% were non-pesticide users. In the male farmers, the activities of aspartate aminotransferase (AST), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly higher in the pesticide users compared to the non-pesticide users, while the estimated glomerular filtration rate (eGFR), hematocrit (HCT), and red blood cells (RBC) were significantly lower (p < 0.05). In the females, the pesticide users had significantly higher levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and MCHC than the non-pesticide users (p < 0.05). Pesticide use among Thai vegetable farmers may cause hematological alterations and increase the risk of hepatic and renal dysfunction. Some hematological and biochemical parameters may be used for monitoring to protect them from the adverse health effects of occupational exposure to pesticides.
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Affiliation(s)
- Siriphan Bunsri
- Faculty of Public Health, Chiang Mai University, Chiang Mai 50200, Thailand; (S.B.); (N.M.)
| | | | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai 50200, Thailand; (S.B.); (N.M.)
| | - Parichat Ong-Artborirak
- Faculty of Public Health, Chiang Mai University, Chiang Mai 50200, Thailand; (S.B.); (N.M.)
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
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García-Niño WR, Ibarra-Lara L, Cuevas-Magaña MY, Sánchez-Mendoza A, Armada E. Protective activities of ellagic acid and urolithins against kidney toxicity of environmental pollutants: A review. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2022; 95:103960. [PMID: 35995378 DOI: 10.1016/j.etap.2022.103960] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/07/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
Oxidative stress and inflammation are two possible mechanisms related to nephrotoxicity caused by environmental pollutants. Ellagic acid, a powerful antioxidant phytochemical, may have great relevance in mitigating pollutant-induced nephrotoxicity and preventing the progression of kidney disease. This review discusses the latest findings on the protective effects of ellagic acid, its metabolic derivatives, the urolithins, against kidney toxicity caused by heavy metals, pesticides, mycotoxins, and organic air pollutants. We describe the chelating, antioxidant, anti-inflammatory, antifibrotic, antiautophagic, and antiapoptotic properties of ellagic acid to attenuate nephrotoxicity. Furthermore, we present the molecular targets and signaling pathways that are regulated by these antioxidants, and suggest some others that should be explored. Nevertheless, the number of reports is still limited to establish the efficacy of ellagic acid against kidney damage induced by environmental pollutants. Therefore, additional preclinical studies on this topic are required, as well as the development of well-designed clinical trials.
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Affiliation(s)
- Wylly Ramsés García-Niño
- Department of Cardiovascular Biomedicine, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico.
| | - Luz Ibarra-Lara
- Department of Pharmacology, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico
| | - Mayra Yael Cuevas-Magaña
- Department of Cardiovascular Biomedicine, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico
| | - Alicia Sánchez-Mendoza
- Department of Pharmacology, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico
| | - Elisabeth Armada
- Department of Plant Molecular Biology, Institute of Biotechnology, National Autonomous University of Mexico, Cuernavaca 62210, Morelos, Mexico
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Zúñiga-Venegas LA, Hyland C, Muñoz-Quezada MT, Quirós-Alcalá L, Butinof M, Buralli R, Cardenas A, Fernandez RA, Foerster C, Gouveia N, Gutiérrez Jara JP, Lucero BA, Muñoz MP, Ramírez-Santana M, Smith AR, Tirado N, van Wendel de Joode B, Calaf GM, Handal AJ, Soares da Silva A, Cortés S, Mora AM. Health Effects of Pesticide Exposure in Latin American and the Caribbean Populations: A Scoping Review. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:96002. [PMID: 36173136 PMCID: PMC9521041 DOI: 10.1289/ehp9934] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Multiple epidemiological studies have shown that exposure to pesticides is associated with adverse health outcomes. However, the literature on pesticide-related health effects in the Latin American and the Caribbean (LAC) region, an area of intensive agricultural and residential pesticide use, is sparse. We conducted a scoping review to describe the current state of research on the health effects of pesticide exposure in LAC populations with the goal of identifying knowledge gaps and research capacity building needs. METHODS We searched PubMed and SciELO for epidemiological studies on pesticide exposure and human health in LAC populations published between January 2007 and December 2021. We identified 233 publications from 16 countries that met our inclusion criteria and grouped them by health outcome (genotoxicity, neurobehavioral outcomes, placental outcomes and teratogenicity, cancer, thyroid function, reproductive outcomes, birth outcomes and child growth, and others). RESULTS Most published studies were conducted in Brazil (37%, n = 88 ) and Mexico (20%, n = 46 ), were cross-sectional in design (72%, n = 167 ), and focused on farmworkers (45%, n = 105 ) or children (21%, n = 48 ). The most frequently studied health effects included genotoxicity (24%, n = 62 ) and neurobehavioral outcomes (21%, n = 54 ), and organophosphate (OP) pesticides were the most frequently examined (26%, n = 81 ). Forty-seven percent (n = 112 ) of the studies relied only on indirect pesticide exposure assessment methods. Exposure to OP pesticides, carbamates, or to multiple pesticide classes was consistently associated with markers of genotoxicity and adverse neurobehavioral outcomes, particularly among children and farmworkers. DISCUSSION Our scoping review provides some evidence that exposure to pesticides may adversely impact the health of LAC populations, but methodological limitations and inconsistencies undermine the strength of the conclusions. It is critical to increase capacity building, integrate research initiatives, and conduct more rigorous epidemiological studies in the region to address these limitations, better inform public health surveillance systems, and maximize the impact of research on public policies. https://doi.org/10.1289/EHP9934.
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Affiliation(s)
- Liliana A. Zúñiga-Venegas
- Centro de Investigaciones de Estudios Avanzados del Maule, Universidad Católica del Maule, Talca, Chile
| | - Carly Hyland
- Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, Berkeley, California, USA
- School of Public Health and Population Science, Boise State University, Boise, Idaho, USA
| | - María Teresa Muñoz-Quezada
- Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - Lesliam Quirós-Alcalá
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, USA
- Maryland Institute of Applied Environmental Health, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Mariana Butinof
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Rafael Buralli
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil
| | - Andres Cardenas
- Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Ricardo A. Fernandez
- Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Córdoba, Argentina
| | - Claudia Foerster
- Instituto de Ciencias de la Agroalimentarias, Animales y Ambientales, Universidad de O’Higgins, San Fernando, Chile
| | - Nelson Gouveia
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Juan P. Gutiérrez Jara
- Centro de Investigaciones de Estudios Avanzados del Maule, Universidad Católica del Maule, Talca, Chile
| | - Boris A. Lucero
- Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - María Pía Muñoz
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Muriel Ramírez-Santana
- Departamento de Salud Pública, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Anna R. Smith
- Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Noemi Tirado
- Instituto de Genética, Facultad de Medicina, Universidad Mayor de San Andrés, Louisiana Paz, Bolivia
| | - Berna van Wendel de Joode
- Infants’ Environmental Health Study, Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia, Costa Rica
| | - Gloria M. Calaf
- Instituto de Alta Investigación, Universidad de Tarapacá, Arica, Chile
- Columbia University Medical Center, New York, New York, USA
| | - Alexis J. Handal
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | | | - Sandra Cortés
- Centro Avanzado de Enfermedades Crónicas (ACCDiS), Centro de Desarrollo Urbano Sustentable, Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ana M. Mora
- Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, Berkeley, California, USA
- Infants’ Environmental Health Study, Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia, Costa Rica
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