Application of improved approach to evaluate a community intervention to reduce exposure of young children living in farmworker households to organophosphate pesticides

An Evaluation of a Pesticide Training Program to Reduce Pesticide Exposure and Enhance Safety among Female Farmworkers in Nan, Thailand

BACKGROUND

Although exposure to chemical pesticides is known to cause negative effects on human health, farmers in Ban Luang, Nan, Thailand, continue to use them regularly to protect crops. This study focused on mothers who were engaged in farm tasks and had children between the ages of 0 to 72 months, with the objective of reducing pesticide exposure.

METHODS

This study was conducted from May 2020 to October 2020 in the Ban Fa and Ban Phi sub-districts in Ban Luang due to the high use of pesticides in these areas. A systematic random sampling technique was used to recruit 78 mothers exposed to pesticides. Thirty-nine mothers from Ban Fa district were randomly assigned to the intervention group and 39 from Ban Phi to the control group over a 3-month period. This study applied a pesticide behavioral change training program for the intervention group. To assess the effectiveness of the program, the study compared the results of a questionnaire regarding knowledge, attitude, and practice (KAP) and health beliefs related to pesticide exposure as well as the levels of acetylcholinesterase (AChE) and butyryl cholinesterase (BChE) enzymes, biomarkers of exposure to pesticides, before and after the intervention using ANCOVA statistical test. Furthermore, to evaluate the effectiveness of the intervention program, a paired t-test was used to investigate the in-home pesticide safety assessment.

RESULTS

After the intervention, we observed no significant change in AChE; however, a significant improvement in BChE (p < 0.05), a marker of short-term recovery, was observed. Pesticides can cause a reduction in AChE and BChE, however, after eliminating pesticides, BChE takes a shorter time (about 30-50 days) to recover than AChE (around 90-120 days). Therefore, increases in the measured concentrations of AChE and/or BChE suggest the presence of less chemicals from pesticides in the human body. The study also found a significant improvement in KAP and beliefs about chemical pesticide exposure after the intervention (p < 0.05). Furthermore, using a paired t-test, we found a significant increase in pesticide safety practices (p < 0.05) in the intervention group and a borderline significant increase regarding in-home safety (p = 0.051) in the control group.

CONCLUSIONS

Based on the results, the constructs of the intervention program were effective and could be applied in other agricultural areas in less developed countries. However, due to time limitations during the COVID-19 pandemic, further studies should be conducted to enable data collection over a longer time, with a larger number of subjects providing the ChE levels for the non-agricultural season.

Cultural appropriateness in randomized controlled trials (RCTs) aimed at reducing pesticide exposure among farmers and farmworkers: a systematic review

OBJECTIVE

The widespread use of pesticides poses serious health hazards to farmers and their families. Some evidence shows that culturally sensitive interventions could be associated with improved outcomes; however, little is known about the effectiveness of cultural adaptations in interventions among farmers and farmworkers. Therefore, the purpose of this study was to summarize strategies used in the cultural adaptation interventions addressing the reduction of pesticide exposure in farmers and farmworkers, as well as assessing the effects of these strategies.

METHODS

A comprehensive systematic literature search was conducted on PubMed, Embase, Clarivate Web of Science, Scopus, NIOSHTIC, Agricola, Agris, as well as reference lists to identify randomized controlled trials (RCTs) published in English from January 2000 until March 2022. Data were extracted to examine the characteristics of interventions in terms of the cultural adaptation strategies and their effectiveness by two independent reviewers.

RESULTS

Eleven articles from ten trials met the inclusion criteria. The majority of studies were conducted in the USA (n = 7) and were ranked as poor quality (n = 5). Four of the ten studies were rated moderate, and six were rated weak. The socio-cultural and constituent-involving strategies were the most commonly reported across the included studies, followed by linguistic strategy. Six studies (seven articles) were tailored for subgroups or individuals. Overall, 8 of 10 studies reported significant changes in whole and some outcomes in the intervention groups over controls. Seven studies received moderate cultural adaptation scores which may reflect the moderate effectiveness of the interventions.

CONCLUSION

Our review underscored the paucity and low quality of existing studies investigating the culturally adapted interventions in reducing farmers' and farmworkers' pesticide exposure. Future high-quality culturally sensitive studies could increase our knowledge regarding the culture's role in reducing pesticide exposure in farmers and farmworkers.

Seeing the workers for the trees: exalted and devalued manual labour in the Pacific Northwest craft cider industry

Craft food and beverage makers regularly emphasize transparency about the ethical, sustainable sourcing of their ingredients and the human labour underpinning their production, all of which helps elevate the status of their products and occupational communities. Yet, as with other niche ethical consumption markets, craft industries continue to rely on employment conditions for agricultural workers that reproduce inequalities of race, class, and citizenship in the dominant food system. This paper interrogates the contradiction between the exaltation of craft cidermakers' labour and the devaluation of farmworker labour by assessing how craft beverage actors make sense of inequalities facing manually skilled agricultural workers. Through a focus on the emerging craft cider industry, this paper draws on in-depth interviews and ethnographic data with a range of urban and rural cider actors in the Pacific Northwest (British Columbia, Oregon, and Washington State). I find that actors in the craft cider industry engage with inequalities affecting farmworkers through three main patterns: (1) Justifications of the status quo; (2) Supply chain fog; and (3) Misgiving/critique. By using an analytical framework that integrates critical agrarianism and the politics of sight, this study provides insights into both barriers and opportunities to redistribute social recognition and material rewards across food supply chains.

Relation between organophosphate pesticide metabolite concentrations with pesticide exposures, socio-economic factors and lifestyles: A cross-sectional study among school boys in the rural Western Cape, South Africa

Evidence on the relationship between lifestyle, socio-economic factors and pesticide exposure and urinary concentrations of organophosphate (OP) pesticide metabolites among children is generally incomplete. This study investigated the relationship between socio-economic factors and reported pesticide exposures and the sum of three urinary concentrations of dialkyl phosphate metabolites (DAP) among boys living in the rural areas of the Western Cape, South Africa. Data was collected during a cross-sectional study of 183 boys from three agricultural intense areas. Measurements included a questionnaire on socio-economic and pesticide exposures and urinary DAP concentrations. Most boys (70%) lived on farms with a median age of 12 years (range: 5.0-19.5 years). Children aged >14 years had lower DAP urine concentrations (median = 39.9 ng/ml; β = -68.1 ng/ml; 95% CI: -136.8, 0.6) than children aged 9 years and younger (median = 107.0 ng/ml). DAP concentrations also varied significantly with area, with concentrations in the grape farming area, Hex River Valley (median = 61.8 ng/ml; β = -52.1; 95% CI: -97.9, -6.3 ng/ml) and the wheat farming area, Piketberg (median = 72.4 ng/ml; β = -54.2; 95% CI: 98.8, -9.7 ng/ml) lower than those in the pome farming area, Grabouw (median = 79.9 ng/ml). Other weaker and non-significant associations with increased DAP levels were found with increased household income, member of household working with pesticides, living on a farm, drinking water from an open water source and eating crops from the vineyard and or garden. The study found younger age and living in and around apple and grape farms to be associated with increased urinary DAP concentrations. Additionally, there were other pesticide exposures and socio-economic and lifestyle factors that were weakly associated with elevated urinary DAP levels requiring further study. The study provided more evidence on factors associated to urinary DAP concentrations especially in developing country settings.

Determinants of non-dietary exposure to agricultural pesticides in populations living close to fields: A systematic review

BACKGROUND

There is growing evidence in the scientific literature that individuals living near fields are more exposed to agricultural pesticides than people living further away.

OBJECTIVE

The main objective of this systematic review was to identify the non-dietary determinants of pesticide exposure related to the drift pathway in residents living in agricultural areas, including spatial indictors related to agricultural activities, hygiene practices, behaviors and sociodemographic parameters.

METHODS

Three databases were consulted (PubMed, Web of sciences, Scopus). At least two experts selected the eligible studies.

RESULTS

A total of 27 original studies (2002-2020) fulfilled the eligibility criteria of this review. These publications explored pesticide exposure of individuals through measurements in biological samples (n = 13), environmental samples (n = 11) or both (n = 3). Spatial indicators, including residential proximity to fields, crop acreage around the residence and amounts of pesticides applied in the vicinity were identified as determinants of pesticide exposure in many studies (n = 17), including publications considered to be of very good or good quality (n = 12). Season of spraying tended to increase the levels of pesticides measured in five publications out of seven. Meteorological parameters and physical barriers showed an inconsistent and complex influence on the presence and levels of pesticides in urine samples and house dust. Frequent housekeeping reduced the presence of pesticides at home and consequently in biological matrices in three studies out of six. Finally, the effect of the occupants' sociodemographic characteristics, behaviors, and hygiene practices on the exposure measurement was less well documented and results were fairly inconsistent.

DISCUSSION AND CONCLUSION

This study consolidates our knowledge of the determinants influencing pesticide exposure levels in people living in agricultural areas. Nevertheless, the available scientific data is still too limited to serve as a basis for developing risk management measures. More research is needed to improve knowledge of the determinants of exposure.

Association of activities related to pesticide exposure on headache severity and neurodevelopment of school-children in the rural agricultural farmlands of the Western Cape of South Africa

OBJECTIVE

Children and adolescents living in agricultural areas are likely to be exposed to mixtures of pesticides during their daily activities, which may impair their neurodevelopment. We investigated various such activities in relation to headache severity and neurodevelopment of school-children living in rural agricultural areas in the Western Cape of South Africa.

METHOD

We used baseline date from 1001 school-children of the Child Health Agricultural Pesticide Cohort Study in South Africa (CapSA) aged 9-16 from seven schools and three agriculture areas in the Western Cape. Questionnaires were administrated to assess activities related to pesticide exposure and health symptoms addressing four types of activities: 1) child farm activities related to pesticide handling, 2) eating crops directly from the field, 3) contact with surface water around the field, and 4) seen and smelt pesticide spraying activities. Neurocognitive performance across three domains of attention, memory and processing speed were assessed by means of an iPad-based cognitive assessment tool, Cambridge Automated NeuroPsychological Battery (CANTAB). Headache severity was enquired using a standard Headache Impact Test (HIT-6) tool. Cross-sectional regression analysis was performed.

RESULTS

About 50% of the cohort report to have ever been engaged in activities related to pesticide exposure including farm activities, eating crops directly from the field and leisure activities. Headache severity score was consistently increased in relation to pesticide-related farm activities (score increase of 1.99; 95% CI: 0.86, 3.12), eating crops (1.52; 0.41, 2.67) and leisure activities of playing, swimming or bathing in nearby water (1.25; 0.18, 2.33). For neurocognitive outcomes, an overall negative trend with pesticide exposure-related activities was observed. Among others, involvement in pesticide-related farm activities was associated with a lower multi-tasking accuracy score (-2.74; -5.19, -0.29), while lower strategy in spatial working memory (-0.29; -0.56; -0.03) and lower paired associated learning (-0.88; -1.60, -0.17) was observed for those who pick crops off the field compared to those who do not pick crops off the field. Eating fruits directly from the vineyard or orchard was associated with a lower motor screening speed (-0.06; -0.11, -0.01) and lower rapid visual processing accuracy score (-0.02; -0.03, 0.00).

CONCLUSIONS

Children who indicate activities related to pesticide exposure may be at higher risk for developing headaches and lower cognitive performance in the domains of attention, memory and processing speed. However, self-reported data and cross-sectional design are a limitation. Future research in CapSA will consider pesticide exposure estimations via urinary biomarkers and longitudinal assessment of cognitive functions.

Characterizing the Neurodevelopmental Pesticide Exposome in a Children's Agricultural Cohort

The exposome provides a conceptual model for identifying and characterizing lifetime environmental exposures and resultant health effects. In this study, we applied key exposome concepts to look specifically at the neurodevelopmental pesticide exposome, which focuses on exposures to pesticides that have the potential to cause an adverse neurodevelopmental impact. Using household dust samples from a children's agricultural cohort located in the Yakima Valley of Washington state, we identified 87 individual pesticides using liquid chromatography-tandem mass spectrometry. A total of 47 of these have evidence of neurotoxicity included in the Environmental Protection Agency (EPA) (re)registration materials. We used a mixed effects model to model trends in pesticide exposure. Over the two study years (2005 and 2011), we demonstrate a significant decrease in the neurodevelopmental pesticide exposome across the cohort, but particularly among farmworker households. Additional analysis with a non-parametric binomial analysis that weighted the levels of potentially neurotoxic pesticides detected in household dust by their reference doses revealed that the decrease in potentially neurotoxic pesticides was largely a result of decreases in some of the most potent neurotoxicants. Overall, this study provides evidence that the neurodevelopmental pesticide exposome framework is a useful tool in assessing the effectiveness of specific interventions in reducing exposure as well as setting priorities for future targeted actions.

Systematic Literature Review of the Take-Home Route of Pesticide Exposure via Biomonitoring and Environmental Monitoring

BACKGROUND

Exposure to pesticides via take-home can be an important pathway for farmworkers' families.

OBJECTIVE

The aim of this review was to summarize and analyze the literature published during the last decade of exposure to pesticides via take-home pathway in farmworkers' families.

METHODS

We conducted a systematic review to identify peer-reviewed articles of interest; only articles related to take-home pathway that included some sort of pesticide monitoring were considered for inclusion. Systematic reviews, literature reviews, and meta-analyses were excluded, resulting in a total of 39 articles elected for analysis. The articles were summarized based on the location of the study, population (sample size), pesticide analyzed, and type of sample.

RESULTS

The majority of the reviewed studies were conducted in the U.S., but there seems to be an increase in literature on pesticide take-home pathway in developing countries. Most of the articles provided evidence that farmworkers' families are exposed to pesticides at higher levels than non-farmworkers' families. The levels may depend on several factors such as seasonality, parental occupation, cohabitation with a farmworker, behavior at work/home, age, and gender. Community-based interventions disrupting the take-home pathway seem to be effective at reducing pesticide exposure.

DISCUSSION/CONCLUSION

The take-home pathway is an important contributor to overall residential exposures, but other pathways such as pesticide drift, indoor-residential applications, and dietary intake need to be considered. A more comprehensive exposure assessment approach is necessary to better understand exposures to pesticides.

An Occupational Health Education Program for Thai Farmers Exposed to Chlorpyrifos

The majority of the farmers in this sample of Thai farmers did not use sufficient self-protective behaviors when using the organophosphate insecticide chlorpyrifos. Most were directly exposed to chlorpyrifos, potentially leading to illnesses. The aim of this study was to improve safety behaviors when using chlorpyrifos by an occupational health education program. A controlled trial (n = 70) of an occupational health education program was undertaken in rural Thailand prior to the occupational health education program. There were no differences in behavior between experimental and control groups. Completion of the program led to a significant improvement in safe working practices and in the amount of the metabolite. However, significant differences were noticed after participating in the occupational health education program on both safety behaviors and the amount of the metabolite 3,5,6-trichloro-2-pyridinol present in urine.