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Liem JF, Subekti I, Mansyur M, Soemarko DS, Kekalih A, Suyatna FD, Suryandari DA, Malik SG, Pangaribuan B. The determinants of thyroid function among vegetable farmers with primary exposure to chlorpyrifos: A cross-sectional study in Central Java, Indonesia. Heliyon 2023; 9:e16435. [PMID: 37251483 PMCID: PMC10220374 DOI: 10.1016/j.heliyon.2023.e16435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 04/20/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023] Open
Abstract
Objectives Occupational pesticide exposure, chlorpyrifos (CPF) in particular, may adversely affect the thyroid. The purpose of this study was to evaluate the determinants of thyroid function as indicated by the serum concentration of thyroid-stimulating hormone (TSH) among Indonesian vegetable farmers with primary exposure to CPF. Methods A total of 151 vegetable farmers participated in this study. The sociodemographic and occupational characteristics of the participants were obtained using a structured interviewer-administered questionnaire. A validated quantitative method was used to estimate the cumulative exposure level (CEL). Serum TSH, thyroglobulin (Tg), free thyroxine (FT4), and urinary iodine excretion (UIE) were measured in the laboratory. The difference in TSH concentrations according to CEL and other characteristics were analysed using the Mann-Whitney U test. A multiple linear regression model was used to evaluate the potential determinants of TSH. Results The mean age was 50 (SD 9.4) years. The median concentrations of TSH, FT4, and Tg/FT4 ratio were 1.46 mIU/L, 1.17 ng/dL, and 6.23 × 102, respectively. We observed that higher TSH concentrations were found among those with a higher Tg/FT4 ratio, were classified as high CEL, and had lower UIE or FT4. Conclusions Our findings show that Tg/FT4 ratio, CEL, FT4, UIE concentrations, and post-spraying days were determinants of TSH concentrations among farmers with primary exposure to CPF. These results indicate that farmers are exposed to agents with thyroid-disrupting properties, thus supporting previous evidence showing the potential for thyroid disorders in agricultural populations exposed to pesticides.
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Affiliation(s)
- Jen Fuk Liem
- Department of Occupational Health and Safety, Faculty of Medicine and Health Sciences, Universitas Kristen Krida Wacana, Kota Jakarta Barat, DKI Jakarta, Indonesia
- Doctoral Program, Faculty of Medicine Universitas Indonesia, Kota Jakarta Pusat, DKI Jakarta, Indonesia
| | - Imam Subekti
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Kota Jakarta Pusat, DKI Jakarta, Indonesia
| | - Muchtaruddin Mansyur
- Community Medicine Department, Faculty of Medicine Universitas Indonesia, Kota Jakarta Pusat, DKI Jakarta, Indonesia
| | - Dewi S. Soemarko
- Community Medicine Department, Faculty of Medicine Universitas Indonesia, Kota Jakarta Pusat, DKI Jakarta, Indonesia
| | - Aria Kekalih
- Community Medicine Department, Faculty of Medicine Universitas Indonesia, Kota Jakarta Pusat, DKI Jakarta, Indonesia
| | - Franciscus D. Suyatna
- Department of Pharmacology and Therapeutics, Faculty of Medicine Universitas Indonesia, Kota Jakarta Pusat, DKI Jakarta, Indonesia
| | - Dwi A. Suryandari
- Department of Biology, Faculty of Medicine Universitas Indonesia, Kota Jakarta Pusat, DKI Jakarta, Indonesia
| | - Safarina G. Malik
- Eijkman Institute for Molecular Biology, National Research and Innovation Agency, Kota Jakarta Pusat, DKI Jakarta, Indonesia
| | - Bertha Pangaribuan
- Prodia Occupational Health Indonesia, Kota Jakarta Pusat, DKI Jakarta, Indonesia
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Pesticide use safety practices and associated factors among farmers in Fogera district wetland areas, south Gondar zone, Northwest Ethiopia. PLoS One 2023; 18:e0280185. [PMID: 36626384 PMCID: PMC9831305 DOI: 10.1371/journal.pone.0280185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
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.
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Prevalence of Work-Related Health Hazard and Associated Factors among Health Workers in Public Health Institutions of Gambella Town, Western Ethiopia: Cross-Sectional Survey. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:6224280. [PMID: 36072494 PMCID: PMC9444462 DOI: 10.1155/2022/6224280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022]
Abstract
Background Many health-related occupational hazards confront healthcare workers. Examining the prevalence of hazards enables to search for better risk management for healthcare workers because these workers are often the first point of interaction, particularly in resource-limited settings like Ethiopia. Therefore, this study assessed the prevalence of work-related occupational hazards and identified related factors among healthcare workers in public health facilities of Gambella town, Western Ethiopia. Methods Institution-based cross-sectional study was conducted among 260 randomly selected healthcare workers from June 1-21, 2021. A semi structured tool was used to collect data and data analysis was performed using SPSS version 25. Multivariable logistic regression was used to identify the predictors of outcome variable and the significance of associations was declared by using a 95% CI and a p-value of <0.05. Results The prevalence of occupational health hazards among healthcare workers was 36.5% (95% CI: 31, 42). The absence of immediate treatments for injured health workers (AOR = 8.86, 95% CI: 2.5, 31.4), lack of personal protective equipment (AOR = 3.6, 95% CI: 1.5, 8.4), working greater than eight hours per day (AOR = 7.9, 95% CI: 3.1, 19.7), working in the night shifts (AOR = 8.1, 95% CI: 2.5, 26.1), and absence of effective leadership in the health facility (AOR = 5.2, 95% CI: 1.9, 14.5) were factors associated with the prevalence of occupational hazards. Conclusions There was a relatively high degree of occupational health hazard exposure among health workers in the study area compared to kinds of literature from other settings. Health workers were exposed to a wide range of occupational hazards, and risk reduction mechanisms and safety actions were inadequately implemented. Therefore, the health workers' occupational health and safety needs should be prioritized and appropriate measures should be taken to mitigate the problems.
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Tamene A. Occupational Contact Dermatitis in Employees of Large-Scale Narcotic Crop Farms of Ethiopia: Prevalence and Risk Factors. A Self-Reported Study Using the Nordic Occupational Skin Questionnaire. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211048378. [PMID: 34658622 PMCID: PMC8511918 DOI: 10.1177/11786302211048378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Occupational skin diseases are the second leading occupational disease, accounting for almost 25% of all missed workdays. Occupational contact dermatitis (OCD) accounts for 70% to 90% of all skin disorders in the workplace. Only a few occupational epidemiology studies have looked into the prevalence and risk factors of occupation-induced dermatitis among narcotic crop farm workers around the world. Related studies in Ethiopia are even fewer. METHODS A cross-sectional survey was conducted in the Dirashe district of Southern Ethiopia from March 23 to April 12, 2021. Data was collected using a standardized interviewer-administered questionnaire. The history of contact dermatitis was determined using the standardized Nordic Occupational Skin Questionnaire version 2002 (NOSQ-2002). A total of 578 farm laborers took part in the study, which was conducted using a systematic random sampling. Descriptive statistics and multivariable regression were used to characterize the data and identify factors associated with occupational contact dermatitis. RESULT The prevalence of self-reported occupational contact dermatitis in the past 12 months among workers of large-scale Khat farms was (AOR: 67.80%, 95% CI [61.00, 76.23]). In the multivariable regression, being older (AOR: 5.51, 95% CI [1.79, 7.24]), working as a bundle binder (AOR: 5.74, 95% CI [2.12, 15.55]), not wearing personal protective equipment (PPE) (AOR: 2.50, 95% CI [1.64, 3.81]), and having poor knowledge of pesticides use, storage, and disposal methods (AOR: 2.50, 95% CI [1.64, 3.81]) were associated with occupational contact dermatitis. CONCLUSION Contact dermatitis caused by work is very common among Khat farm laborers. Measures to promote safe practices and reduce exposure to hazards, such as removing expired and/or banned chemicals, purchasing alternative pesticides that meet legislative requirements, job rotation and routine training of staff on safe practices, increasing safety signage, and performing risk assessments, as well as improving the quantity and quality of institutional protective equipment supplies may thus contribute to the enhancement of safe work practices.
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Affiliation(s)
- Aiggan Tamene
- Aiggan Tamene, Environmental Health Unit,
School of Public Health, College of Medicine and Health Sciences, Wachemo
University, P.O. Box 667, Hosaena, B51, Ethiopia.
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Liem JF, Mansyur M, Soemarko DS, Kekalih A, Subekti I, Suyatna FD, Suryandari DA, Malik SG, Pangaribuan B. Cumulative exposure characteristics of vegetable farmers exposed to Chlorpyrifos in Central Java - Indonesia; a cross-sectional study. BMC Public Health 2021; 21:1066. [PMID: 34090393 PMCID: PMC8178818 DOI: 10.1186/s12889-021-11161-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Agriculture is a major economic sector in Indonesia. Chemical pesticides are widely being used in agriculture for controlling pest. There is a growing concern that pesticide exposure, particularly chlorpyrifos (CPF) exposure, combined with other occupational characteristics that determine the level of exposure, can lead to further health impacts for farmers. Our objective was to evaluate the cumulative exposure characteristics among farmers exposed to CPF by using a validated algorithm. Methods We conducted a cross-sectional study of 152 vegetable farmers aged 18–65 who actively used CPF for at least 1 year in Central Java, Indonesia. Subject characteristics were obtained using a structured interviewer-administered questionnaire, addressed for sociodemographic and work-related characteristics. The cumulative exposure level (CEL) was estimated as a function of the intensity level of pesticide exposure (IL), lifetime years of pesticide use and the number of days spraying per year. CEL was subsequently classified into two groups, high and low exposure groups. The difference in characteristics of the study population was measured using Chi-square, independent-t or Mann-Whitney test. Association between CEL and its characteristics variables were performed by multiple linear regression. Results Seventy-one subjects (46.7%) were classified as the high exposure group. The use of multiple pesticide mixtures was common among our study population, with 94% of them using 2 or more pesticides. 73% reported direct contact with concentrated pesticides product, and over 80% reported being splashed or spilt during preparation or spraying activity. However, we found that the proportion of proper personal protective equipment (PPE) use in our subjects was low. Higher volume of mixture applied (p < 0.001) and broader acres of land (p = 0.001) were associated with higher cumulative exposure level, while using long-sleeved clothes and long pants (p < 0.05) during pesticide spraying were associated with lower cumulative exposure after adjusted for age and gender. Conclusions These findings indicate an inadequate knowledge of using pesticides properly. Thus, we recommend comprehensive training on pesticide usage and encourage proper PPE to reduce the exposure level.
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Affiliation(s)
- Jen Fuk Liem
- Doctoral Program, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia. .,Department of Occupational Health and Safety, Faculty of Medicine and Health Science Universitas Kristen Krida Wacana, Jakarta, 11510, Indonesia.
| | - Muchtaruddin Mansyur
- Community Medicine Department, Faculty of Medicine Universitas Indonesia, Jakarta, 10320, Indonesia
| | - Dewi S Soemarko
- Community Medicine Department, Faculty of Medicine Universitas Indonesia, Jakarta, 10320, Indonesia
| | - Aria Kekalih
- Community Medicine Department, Faculty of Medicine Universitas Indonesia, Jakarta, 10320, Indonesia
| | - Imam Subekti
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Franciscus D Suyatna
- Department of Pharmacology and Therapeutics, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Dwi A Suryandari
- Department of Biology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Safarina G Malik
- Eijkman Institute for Molecular Biology, National Research and Innovation Agency, Jalan Diponegoro No. 69, Kota Jakarta Pusat, Jakarta, Indonesia
| | - Bertha Pangaribuan
- Prodia Occupational Health Institute International, Jakarta, 10430, Indonesia
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