Neurobehavioural symptoms and acute pesticide poisoning: a cross-sectional study among male pesticide applicators selected from three commercial farming systems in Ethiopia

Chronic exposures to cholinesterase-inhibiting pesticides adversely affects the health of agricultural workers in India

Biomonitoring of pesticide exposure has become a public concern because of its potential health effects. The present study investigated the acetylcholinesterase (AChE) inhibitory levels and their associated health effects in agricultural areas in Telangana, India. This cross-sectional included 341 exposed participants and 152 control participants from agricultural areas. A structured questionnaire was completed and blood and urine samples were collected to measure pesticides, dialkyle phosphate (DAP) metabolites, and AChE activity using liquid chromatography-tandem mass spectrometry and reversed-phase high-performance liquid chromatography. twenty-eight pesticides were detected in blood samples at concentrations ranging 0.42-45.77 ng/mL. Six DAP metabolites were also measured in urine, and all DAP metabolites were significantly higher in the exposed group. AChE activity is significantly reduced in individuals exposed for >10 years, raising concerns regarding possible neurological disorders. These results emphasise the urgent need to investigate the health effects of pesticides exposure, especially in agriculture.

Organochlorine pesticides in Ethiopian waters: Implications for environmental and human health

Despite the global ban on organochlorine pesticides (OCPs) since the 1970s, their use continues in many developing countries, including Ethiopia, primarily due to the lack of viable alternatives and weak regulations. Nonetheless, the extent of contamination and the resulting environmental and health consequences in these countries remain inadequately understood. To address these knowledge gaps, we conducted a comprehensive analysis of reported concentrations (n=398) of OCPs (n=30) in distinct yet interconnected water matrices: water, sediment, and biota in Ethiopia. Our analysis revealed a notable geographical bias, with higher concentrations found in sediments (0.074-1161.2 µg/kg), followed by biota (0.024-1003 µg/kg) and water (0.001-1.85 µg/L). Moreover, DDTs, endosulfan, and hexachlorohexenes (HCHs) were among the most frequently detected OCPs in higher concentrations in Ethiopian waters. The DDT metabolite p,p'-DDE was commonly observed across all three matrices, with concentrations in water birds reaching levels up to 57 and 143,286 times higher than those found in sediment and water, respectively. The findings showed a substantial potential for DDTs and endosulfan to accumulate and biomagnify in Ethiopian waters. Furthermore, it was revealed that the consumption of fish contaminated with DDTs posed both non-carcinogenic and carcinogenic risks while drinking water did not pose significant risks in this regard. Importantly, the issue of OCPs in Ethiopia assumes even greater significance as their concentrations were found to be eight times higher than those of currently used pesticides (CUPs) in Ethiopian waters. Consequently, given the ongoing concerns about OCPs in Ethiopia, there is a need for ongoing monitoring, implementation of sustainable mitigation measures, and strengthening of OCP management systems in the country, as well as in other developing countries with similar settings and practices.

Assessing the Human Health Benefits of Climate Mitigation, Pollution Prevention, and Biodiversity Preservation

Background

Since the Industrial Revolution, humanity has amassed great wealth and achieved unprecedented material prosperity. These advances have come, however, at great cost to the planet. They are guided by an economic model that focuses almost exclusively on short-term gain, while ignoring natural capital and human capital. They have relied on the combustion of vast quantities of fossil fuels, massive consumption of the earth's resources, and production and environmental release of enormous quantities of chemicals, pesticides, fertilizers, and plastics. They have caused climate change, pollution, and biodiversity loss, the "Triple Planetary Crisis". They are responsible for more than 9 million premature deaths per year and for widespread disease - impacts that fall disproportionately upon the poor and the vulnerable.

Goals

To map the human health impacts of climate change, pollution, and biodiversity loss. To outline a framework for assessing the health benefits of interventions against these threats.

Findings

Actions taken by national governments and international agencies to mitigate climate change, pollution, and biodiversity loss can improve health, prevent disease, save lives, and enhance human well-being. Yet assessment of health benefits is largely absent from evaluations of environmental remediation programs. This represents a lost opportunity to quantify the full benefits of environmental remediation and to educate policy makers and the public.

Recommendations

We recommend that national governments and international agencies implementing interventions against climate change, pollution, and biodiversity loss develop metrics and strategies for quantifying the health benefits of these interventions. We recommend that they deploy these tools in parallel with assessments of ecologic and economic benefits. Health metrics developed by the Global Burden of Disease (GBD) study may provide a useful starting point.Incorporation of health metrics into assessments of environmental restoration will require building transdisciplinary collaborations. Environmental scientists and engineers will need to work with health scientists to establish evaluation systems that link environmental and economic data with health data. Such systems will assist international agencies as well as national and local governments in prioritizing environmental interventions.

Neurologic symptoms among solar greenhouse workers and field workers in China

It has been widely reported that the farmers were at increased risk of neurologic disorders, which probably be related with agricultural risk factors. The intensity of agricultural risk factors was rather high in the solar greenhouse than those in the agricultural farm, while the risk and prevalence of neurologic symptoms among solar greenhouse workers are unclear, which may provide evidence of neurologic dysfunction before clinically measurable signs are evident. This study aimed to evaluate the association among solar greenhouse working, field working, and neurologic symptoms. A cross-sectional study was conducted in China, and 986 Chinese Han population consisting 711 solar greenhouse workers (greenhouse worker group) and 275 field farmers (field worker group) were included. Participants provided information on demographic information, number of solar greenhouses owned (only solar greenhouse workers), working lifetime, and neurologic symptoms through an established questionnaire Q16 to assess the impact of occupational exposure to neurotoxicants, and the total scores were calculated. Multiple linear regression models were used to analyze the association among solar greenhouse working, field working, and neurologic symptoms. The total scales of the neurologic symptoms were higher in the solar greenhouse worker group (20.29 ± 4.79) than those in the field worker group (19.44 ± 4.22) (p < 0.05). Multivariate multiple linear regression showed that solar greenhouse working was positively associated with the scales of the neurologic symptoms (β = 0.248, 95% CI: (0.112, 0.383)). And the age, working lifetime, and current smoking were also positively associated with the scores of the neurologic symptoms, β = 0.007, 0.006 and 0.485 respectively (All p < 0.05). Solar greenhouse workers probably be at an increased risk of neurologic symptoms scores, and the age, working lifetime, and current smoking were also risk factors.

Pesticide use safety practices and associated factors among farmers in Fogera district wetland areas, south Gondar zone, Northwest Ethiopia

BACKGROUND

Farmers in developing countries, including Ethiopia, are exposed to agricultural pesticides, including pesticides that are restricted or banned in developed countries. There is little information available on pesticide use safety practices and associated factors among Ethiopian farmers, particularly in the study area.

OBJECTIVE

To assess pesticide use safety practices and associated factors among farmers in Fogera district wetland area, Amhara region, Northwest Ethiopia.

METHODS

A community-based cross-sectional study design that employs quantitative and qualitative methods was used from August 25 to September 30, 2021. Four hundred thirty participants were included by using a stratified random sampling technique. Pre-tested interview questionnaires, observational checklists, and key informant and in-depth interview guides were used to collect data. The quantitative data were collected by face-to-face interviews of farmers, whereas the qualitative data were collected by in-depth interviews of selected farmers and key informant interviews of responsible stalk holders. The data were entered into Epi data version 4.6 and analyzed using SPSS version 21. Bi-variable logistic regression was used to identify factors associated with the dependent variable. A p-value of less than 0.05 was used as a cut-off point to declare a statistically significant association between factors and outcome variables. The odds ratio and 95% CI were calculated to describe the strength of the association between factors and outcome variables. The qualitative study included 35 respondents from various backgrounds and levels of expertise, which were analyzed using thematic analysis by open-code 4.03 version software.

RESULT

The proportion of good pesticide use safety practices in the study area was 24.4% (95% CI: 21.4%-29.3%). Educational status (adjusted odds ratio (AOR): 3.19, 95% CI: 1.44-6.71), experience of pesticide spraying (AOR: 6.85. 95% CI: 2.426-9.35), knowledge of pesticide usage (AOR: 3.40, 95% CI: 1.459-7.855), access to safety materials (AOR: 2.06, 95% CI: 1.198-3.536), and ever having received training (AOR: 4.93, 95% CI: 2.88-8.59) were factors associated with good safety practice in pesticide use. Qualitatively, limited material access, lack of government attention, insufficient training opportunities, absence of media coverage, weak enforcement of laws, and limited guideline access barred good safety practices for pesticide use.

CONCLUSION

The study revealed that good safety practices were low in the study area. Being educated, having experience with pesticide spraying, having good knowledge of pesticide usage, having access to safety materials, and having received pesticide use training all increased the likelihood of good pesticide use practice. Insufficient training opportunities and material access, weak law enforcement, limited access to guidelines, and a shortage of media coverage were challenges identified qualitatively.

Neurotoxicity of pesticides in the context of CNS chronic diseases

Following the introduction and application of pesticides in human life, they have always been along with health concerns both in acute poisoning and chronic toxicities. Neurotoxicity of pesticides in chronic exposures has been known as one of the most important human health problems, as most of these chemicals act through interacting with some elements of nervous system. Pesticide-induced neurotoxicity can be defined in different categories of neurological disorders including neurodegenerative (Alzheimer, Parkinson, amyotrophic lateral sclerosis, multiple sclerosis), neurodevelopmental (attention deficit hyperactivity disorder, autism spectrum disorders, developmental delay, and intellectual disability), neurobehavioral and neuropsychiatric (depression/suicide attempt, anxiety/insomnia, and cognitive impairment) disorders some of which are among the most debilitating human health problems. In this review, neurotoxicity of pesticides in the mentioned categories and sub-categories of neurological diseases have been systematically presented in relation to different route of exposures including general, occupational, environmental, prenatal, postnatal, and paternal.

Evaluation of two-year recall of self-reported pesticide exposure among Ugandan smallholder farmers

OBJECTIVES

To evaluate smallholder farmers' recall of pesticide use and exposure determinants over a two-year period in a low-income country context.

METHODS

The Pesticide Use in Tropical Settings (PESTROP) study in Uganda consists of 302 smallholder farmers who were interviewed in 2017. In the same season in 2019, these farmers were re-questioned concerning pesticide use (e.g., use of active ingredients) and exposure information (e.g., crops, personal protective equipment [PPE], hygienic behaviours) they had previously provided. The extent of recall bias was assessed by comparing responses at follow-up in 2019 with practices and behaviours reported from the baseline interview in 2017.

RESULTS

An 84% (n = 255) follow-up response rate was attained. We found instances of better recall (e.g., overall agreement >70% and Area Under the Curve (AUC) values > 0.7) for the use of some active ingredients, commonly used PPE items, and washing clothes after application, whereas only 13.3% could correctly recall their three major crops. We observed a trend where more individuals reported the use of active ingredients, while fewer reported the use of PPE items, two years later. In general, we found better agreement in the recall of years working with pesticides compared to hours per day or days per week in the field, with no apparent systematic over or under reporting by demographic characteristics.

CONCLUSIONS

While some of these findings provide consistency with those from high-income countries, more research is needed on recall in poorly educated agriculture communities in low- and middle-income settings to confirm these results.

Pesticide Research on Environmental and Human Exposure and Risks in Sub-Saharan Africa: A Systematic Literature Review

On the African continent, ongoing agriculture intensification is accompanied by the increasing use of pesticides, associated with environmental and public health concerns. Using a systematic literature review, we aimed to map current geographical research hotspots and gaps around environmental and public health risks research of agriculture pesticides in Sub-Saharan Africa (SSA). Studies were included that collected primary data on past and current-used agricultural pesticides and assessed their environmental occurrence, related knowledge, attitude and practice, human exposure, and environmental or public health risks between 2006 and 2021. We identified 391 articles covering 469 study sites in 37 countries in SSA. Five geographical research hotspots were identified: two in South Africa, two in East Africa, and one in West Africa. Despite its ban for agricultural use, organochlorine was the most studied pesticide group (60%; 86% of studies included DDT). Current-used pesticides in agriculture were studied in 54% of the study sites (including insecticides (92%), herbicides (44%), and fungicides (35%)). Environmental samples were collected in 67% of the studies (e.g., water, aquatic species, sediment, agricultural produce, and air). In 38% of the studies, human subjects were investigated. Only few studies had a longitudinal design or assessed pesticide's environmental risks; human biomarkers; dose-response in human subjects, including children and women; and interventions to reduce pesticide exposure. We established a research database that can help stakeholders to address research gaps, foster research collaboration between environmental and health dimensions, and work towards sustainable and safe agriculture systems in SSA.

Long-Term Neurological and Psychological Distress Symptoms among Smallholder Farmers in Costa Rica with a History of Acute Pesticide Poisoning

Studies suggest that acute pesticide poisonings (APP) may be linked with long-term neurological effects. To examine long-term neurological and psychological distress symptoms associated with having experienced an APP, we conducted a cross-sectional study of 300 conventional and organic smallholder farmers from Zarcero County, Costa Rica, May–August 2016. We collected self-reported data on sociodemographic characteristics, occupational history, pesticide exposure, APPs, neurological and psychological distress symptoms (using the Brief Symptom Inventory (BSI)). Adjusted logistic regression models were fit. A total of 14% of the farmers (98% male) reported experiencing at least one APP during their lifetime. Self-reported APP was associated with neurological symptoms during the 12 months prior to interview (e.g., fainting (Odds Ratio: 7.48, 95% Confidence Interval: 1.83, 30.74), shaking hands (3.50; 1.60, 7.60), numbness/tingling in hands or feet (3.23; 1.66, 6.32), insomnia (2.53; 1.34, 4.79), accelerated heartrate (2.42; 1.03, 5.47), dizziness (2.38; 1.19, 4.72), increased irritability/anger (2.37; 1.23, 4.55), low energy (2.33; 1.23, 4.46), and difficulty concentrating (2.01; 1.05, 3.85)). Farmers who reported an APP in the ten years prior to interview experienced increased odds of abnormal BSI scores for hostility (4.51; 1.16, 17.70) and paranoid ideation (3.76; 0.99, 18.18). Having experienced an APP may be associated with long-term neurological and psychological distress symptoms.

Environmental and Health Risks of Pesticide Use in Ethiopia

BACKGROUND

There are frequent reports of unsafe pesticide use in many parts of Africa. Ethiopia is the second most populous nation in Africa with around 80% of the population still depending on agriculture which intensively uses pesticides. A number of studies have examined pesticide-related health and environmental risks in Ethiopia. However, most of these studies have been small in scale and it is therefore challenging to get a general overview of the extent of health risks and level of environmental contamination in the country.

OBJECTIVES

The aim of the present study was to synthesize and summarize contemporary knowledge on pesticide-related risks and relevant gaps in Ethiopia.

METHODS

An electronic database search and gathering of grey literature were done to collect information on the risks of pesticide use in Ethiopia. The electronic search was conducted using MEDLINE (via PubMed) without any publication date or language specifications. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) checklist was used as guide in the creation of this review.

DISCUSSION

A synthesis of the reviewed studies showed evidence of health risks due to occupational pesticide exposure, surface water pollution with pesticides that could cause chronic health risks to the public, evidence of pesticide contamination of the environment (e.g., soil organisms, fish, bee colonies and wildlife) and local as well as international consumer risks due to pesticide residues in food items. In addition, there have been frequent reports of health and environmental hazards in association with cut-flower farms. There is also evidence of direct use of DDT (dichlorodiphenyltrichloroethane) on food crops and detection of DDT residues in surface water, soil and human breast milk. Those reported risks might be due to lack of knowledge among farm workers, negligence of farm owners, absence of post-registration monitoring systems and poor implementation of both national and international regulations in Ethiopia due to poor institutional capacity.

CONCLUSIONS

The health and environmental risks of inappropriate use of pesticides requires action by all concerned bodies. Improved institutional arrangements for enforcement of regulations, awareness and further intervention studies could lessen the high risks of pesticide misuse.

COMPETING INTERESTS

The authors declare no competing financial interests.

Occupational exposure to pesticides and health symptoms among family farmers in Brazil

OBJECTIVE:

To explore the association of occupational pesticide exposure with acute and mental health symptoms.

METHODS:

Cross-sectional survey carried out with 78 Brazilian family farmers, who were pesticide applicators and helpers conveniently selected. Symptoms and exposure data were collected by interviews, and mental health outcomes by the Self-Reporting Questionnaire. Blood samples were analyzed to assess cholinesterase levels. Exposure indicators and symptoms were compared between applicators and helpers, and Poisson regression was performed to estimate prevalence ratios.

RESULTS:

Farmers reported exposure to multiple pesticides from early ages; they worked without safety training, technical support, and full protective equipment, and they had a high prevalence of acute and mental health symptoms (e.g., headache, mucosal irritation, tachycardia, and depressive signs). Applicators had more cholinesterase changes than helpers, but less symptoms. Helpers used less personal protection and had significantly higher prevalence ratio of headache, dyspnea, wheezing, cough, poor digestion, tiredness, and feeling worthless, after adjustment.

CONCLUSIONS:

Acute and mental health symptoms were observed, both among farmers and helpers. Thus, surveillance actions must be reinforced in Brazil, technical support and safety training improved, focused on applicators and helpers, who are occupationally and environmentally exposed to pesticides. Agricultural practices of these groups with less pesticide use should receive incentive.

The global distribution of acute unintentional pesticide poisoning: estimations based on a systematic review

BACKGROUND

Human poisoning by pesticides has long been seen as a severe public health problem. As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticide poisonings occur annually, leading to approximately 20,000 deaths. Thirty years on there is no up-to-date picture of global pesticide poisoning despite an increase in global pesticide use. Our aim was to systematically review the prevalence of unintentional, acute pesticide poisoning (UAPP), and to estimate the annual global number of UAPP.

METHODS

We carried out a systematic review of the scientific literature published between 2006 and 2018, supplemented by mortality data from WHO. We extracted data from 157 publications and the WHO cause-of-death database, then performed country-wise synopses, and arrived at annual numbers of national UAPP. World-wide UAPP was estimated based on national figures and population data for regions defined by the Food and Agriculture Organization (FAO).

RESULTS

In total 141 countries were covered, including 58 by the 157 articles and an additional 83 by data from the WHO Mortality Database. Approximately 740,000 annual cases of UAPP were reported by the extracted publications resulting from 7446 fatalities and 733,921 non-fatal cases. On this basis, we estimate that about 385 million cases of UAPP occur annually world-wide including around 11,000 fatalities. Based on a worldwide farming population of approximately 860 million this means that about 44% of farmers are poisoned by pesticides every year. The greatest estimated number of UAPP cases is in southern Asia, followed by south-eastern Asia and east Africa with regards to non-fatal UAPP.

CONCLUSIONS

Our study updates outdated figures on world-wide UAPP. Along with other estimates, robust evidence is presented that acute pesticide poisoning is an ongoing major global public health challenge. There is a need to recognize the high burden of non-fatal UAPP, particularly on farmers and farmworkers, and that the current focus solely on fatalities hampers international efforts in risk assessment and prevention of poisoning. Implementation of the international recommendations to phase out highly hazardous pesticides by the FAO Council could significantly reduce the burden of UAPP.

Assessment of relationship between farmer's syndrome and neurotoxic symptoms in farming couples

The purpose of this study was to evaluate the relationship between farmer’s syndrome and neurotoxic symptoms in farming couples. The study was conducted on 348 farmers (174 couples) in Chungnam Province of South Korea. We obtained information on general and agricultural characteristics, farmer’s syndrome, and neurotoxic symptoms through face-to-face surveys from 2014 to 2019. The Korean version of the diagnostic standard scale was used for farmer’s syndrome, and the Swedish Q16 questionnaire was used for neurotoxic symptoms. Logistic regression analysis was used to identify neurotoxic symptoms affected by farmer’s syndrome. The prevalence of ‘positive’ neurotoxic symptoms was higher in wives (72.4%) than in husbands (56.9%). Compared with husbands with ‘negative and probable’ farmer’s syndrome (reference), husbands with ‘positive’ farmer’s syndrome were more likely to have ‘positive’ neurotoxic symptoms (odds ratio [OR] = 5.37, 95% confidence interval [CI] = 2.01–14.30). Compared with wives with ‘negative and probable’ farmer’s syndrome (reference), wives with ‘positive’ farmer’s syndrome were more likely to have ‘positive’ neurotoxic symptoms (OR = 7.07, 95% CI = 2.58–19.38). Therefore, neurotoxic symptoms in both husbands and wives were significantly associated with farmer’s syndrome. However, wives had a higher risk of neurotoxic symptoms than husbands. The findings of this study might be useful as important data for establishing and training agricultural safety and health policy.

Occupational exposure to pesticides and associated health effects among greenhouse farm workers

The number and production capacities of greenhouse farms have been increased across the globe, driven by an effort for addressing food security problems related to the rapid population growth and the effects of climate change. As a result, there was a large increase in the number of greenhouse farm workers who are typically involved in chemical preparations and pesticide sprayings, crop harvesting, and greenhouse maintenance activities. Considering the enclosed architecture of the greenhouse farm design and the frequent application of pesticides, the objective of this review was to characterize pesticide exposure levels and resultant health effects among greenhouse farm workers. While most health assessment studies were mainly based on self-reported symptoms, this review showed limited epidemiological and clinical studies on the assessment of the health effects of pesticide exposure on greenhouse workers' health. Reproductive disorders, respiratory symptoms, neurological symptoms, and skin irritations were the most reported health effects among greenhouse farm workers. Additionally, there were limited studies on respirable pesticide-borne fine and ultrafine particulate matters in greenhouse farms. Ventilation systems and indoor environmental conditions of greenhouse farms were not designed according to specifications of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE). Among recommendations provided, long-term exposure assessments of pesticide effects on children born by greenhouse farm workers should be considered in future research. Also, compliance with ASHRAE indoor ventilation and environmental standards will be very important in reducing pesticide exposure and health effects among greenhouse farm workers.

Environmental Health Research in Africa: Important Progress and Promising Opportunities

The World Health Organization in 2016 estimated that over 20% of the global disease burden and deaths were attributed to modifiable environmental factors. However, data clearly characterizing the impact of environmental exposures and health endpoints in African populations is limited. To describe recent progress and identify important research gaps, we reviewed literature on environmental health research in African populations over the last decade, as well as research incorporating both genomic and environmental factors. We queried PubMed for peer-reviewed research articles, reviews, or books examining environmental exposures and health outcomes in human populations in Africa. Searches utilized medical subheading (MeSH) terms for environmental exposure categories listed in the March 2018 US National Report on Human Exposure to Environmental Chemicals, which includes chemicals with worldwide distributions. Our search strategy retrieved 540 relevant publications, with studies evaluating health impacts of ambient air pollution (n=105), indoor air pollution (n = 166), heavy metals (n = 130), pesticides (n = 95), dietary mold (n = 61), indoor mold (n = 9), per- and polyfluoroalkyl substances (PFASs, n = 0), electronic waste (n = 9), environmental phenols (n = 4), flame retardants (n = 8), and phthalates (n = 3), where publications could belong to more than one exposure category. Only 23 publications characterized both environmental and genomic risk factors. Cardiovascular and respiratory health endpoints impacted by air pollution were comparable to observations in other countries. Air pollution exposures unique to Africa and some other resource limited settings were dust and specific occupational exposures. Literature describing harmful health effects of metals, pesticides, and dietary mold represented a context unique to Africa. Studies of exposures to phthalates, PFASs, phenols, and flame retardants were very limited. These results underscore the need for further focus on current and emerging environmental and chemical health risks as well as better integration of genomic and environmental factors in African research studies. Environmental exposures with distinct routes of exposure, unique co-exposures and co-morbidities, combined with the extensive genomic diversity in Africa may lead to the identification of novel mechanisms underlying complex disease and promising potential for translation to global public health.

Variability and predictors of weekly pesticide exposure in applicators from organic, sustainable and conventional smallholder farms in Costa Rica

Objective

Estimates of pesticide exposure among applicators from low- and middle-income countries (LMICs) are scarce, and exposure assessment methods are sometimes costly or logistically unfeasible. We examined the variability in weeklong pesticide exposure among applicators in Costa Rica and its predictors.

Methods

We conducted a cross-sectional survey among 221 pesticide applicators from organic, sustainable and conventional farms in 2016. We administered structured questionnaires to assess pesticide application practices at two time points (4–6 weeks apart). We adapted an existing algorithm to fit the context of smallholders and derive weekly pesticide exposure scores. We used linear mixed-effect models to examine within-worker and between-worker score variability. We then identified sociodemographic and occupational predictors of weekly pesticide exposure scores.

Results

We observed high within-worker and between-worker variability in weekly pesticide exposures (eg, up to 180-fold and 70-fold differences in average weekly exposures within and between workers, respectively; intraclass correlation coefficient=0.4). Applicators working on conventional and sustainable farms had exposure scores twofold and 1.5-fold higher than those working in organic farms, respectively. Farm workers who received training on pesticide use had weekly pesticide exposure scores of 33% (95% CI 1% to 55%) lower than those who did not receive any training.

Conclusions

In this study of applicators from smallholder farms in Costa Rica, we determined the importance of collecting questionnaire data on self-reported pesticide use repeatedly due to its high variability within workers and absence of application records. Our questionnaire-based exposure algorithm could allow the calculation of semiquantitative estimates of average pesticide exposure for applicators from other LMICs.

The association between awareness and behavior concerning the need for protection when using pesticide sprays and neurologic symptoms: A latent class cluster analysis

Pesticide exposure is a major health risk factor among agricultural workers, and poor protective behavior and a lack of awareness concerning the risks of pesticide use in developing countries may increase the intensity of pesticide exposure. This cross-sectional study aimed to explore the relationship between neurologic symptoms and protective behavior and awareness in relation to pesticide use in China. Latent class cluster analysis was used to categorize participants into 3 latent cluster subgroups, namely, a poor protective behavior subgroup, an excellent protective awareness and behavior subgroup, and a poor protective awareness subgroup, using a person-centered approach. Multivariate regression models were used to detect the association between the latent class cluster subgroups and self-reported neurologic symptoms. The results showed that poor protective behavior in pesticide use was an important negative predicator of neurologic symptoms such as reduced sleep quality, frequency of nightmares, debility, hypopsia, and hypomnesis. These findings suggest that targeted interventions for agricultural workers, especially local greenhouse farmers, are urgently needed to improve pesticide protection behavior.

Association between pesticide exposure intensity and self-rated health among greenhouse vegetable farmers in Ningxia, China

Background

Self-rated health (SRH) has been shown to be a stronger comprehensive predictor of health status than the clinical record. Although an association between specific pesticide exposures and health conditions has been reported in different populations, data on the relationship between pesticides exposure intensity (PEI) and SRH in greenhouse farmers is scarce. The aim of the current study was to evaluate this association among vegetable greenhouse farmers in Yinchuan City, western China.

Methods

Three consecutive cross-sectional studies were conducted in the years 2015, 2016 and 2017. Face-to-face interviews by trained investigators, using questionnaires, were performed. PEI was calculated by a validated method and then categorized into high, middle and low groups. SRH was measured via a single ten-point scale question and then divided into excellent (score >5) and poor SRH (score ≤5). A multivariable logistic regression model was used to evaluate the association. Meanwhile, the dose-response and interaction effects were estimated.

Results

A steady association between high PEI and poor SRH (OR: 1.55, 95% CI: 1.05–2.28 in the full model) was identified. Although high PEI was significantly associated with poor SRH in males and the Han ethnicity group, no significant association was found with poor SRH in females or those of Hui ethnicity. Interaction effects of education level and frequency of breakfast with PEI were determined (P_interaction = 0.04 and 0.02, respectively); synergistic enhanced effects for poor SRH were observed.

Conclusion

These findings indicate that high PEI might be associated with poor SRH among vegetable greenhouse farmers. A lower education level and never eating breakfast contributed to an increased likelihood of poor SRH in those with high PEI. The local government should be making great efforts to promote healthy behaviors and improve protection awareness.