Socio-environmental approach in nursing: focusing on rural labor and the use of pesticides

Respiratory and allergic outcomes among farmworkers exposed to pesticides in Costa Rica

AIM

We examined the association of exposure to a pesticide mixture with respiratory and allergic outcomes among farmworkers from Costa Rica.

METHODS

We conducted a cross-sectional study of 299 farmworkers between May and August 2016. We collected information on sociodemographic factors, pesticide use, and the presence of respiratory and allergic symptoms during the last 12 months via questionnaire. We calculated specific gravity-adjusted average concentrations of 15 pesticide biomarkers measured in urine samples collected during two visits (4-5 weeks apart). We fitted "traditional" Bayesian and Bayesian Weighted Quantile Sum (BWQS) regression models to assess the association of exposure to independent and summed pesticide mixture components with the outcomes of interest. We adjusted all models for age and smoking status.

RESULTS

In "traditional" Bayesian analyses, higher urinary concentrations of 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY, metabolite of organophosphate insecticide diazinon) were associated with increased odds of a higher asthma symptom score [adjusted OR per two-fold increase in concentrations = 1.15; 95 % credible interval (CrI): 1.04, 1.27)], asthma symptoms or medication use (aOR = 1.37; 95 % CrI: 1.13, 1.67), and rhinitis (aOR = 1.34; 95 % CrI: 1.15, 1.56). Higher urinary concentrations of boscalid-5-hydroxy (metabolite of fungicide boscalid) were associated with increased odds of asthma symptoms or medication use (aOR = 1.24; 95 % CrI: 1.00, 1.55), whereas higher concentrations of 4-hydroxypyrimethanil (metabolite of the fungicide pyrimethanil) were associated with increased odds of eczema (aOR = 1.11; 95 % CrI: 0.99, 1.24). Several inverse associations of herbicide concentrations with respiratory and allergic outcomes were observed. In BWQS analyses, a positive association was found between exposure to the pesticide mixture and increased odds of rhinitis (aOR = 1.96; 95 % CrI: 1.14, 3.20), with IMPY being the largest contributor.

CONCLUSION

Our findings indicate that exposure to pesticides may have both independent and summed mixture effects on respiratory and allergic health among farmworkers.

Health Effects of Pesticide Exposure in Latin American and the Caribbean Populations: A Scoping Review

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.

A nursing socio-environmental approach for acute pesticide poisoning: A qualitative focus group study

AIM

To explore the experiences and perceptions of final-year nursing students in assessing and managing acute pesticide poisoning using a socio-environmental care approach in a primary health care simulation-based scenario.

DESIGN

A qualitative descriptive study was conducted using focus groups.

METHODS

Twelve focus groups were held, with 114 fourth-year nursing students. The study was carried out from September to November 2021. To grant an in-depth analysis of the collected data, a thematic analysis was used.

RESULTS

After our data analysis, three main themes emerged: (i) experiences of an acute pesticide poisoning case in a simulation-based scenario; (ii) environmental health nursing competencies for a culturally competent practice and (iii) social factors in prevention strategies.

CONCLUSIONS

Using a socio-environmental care approach with a primary care simulation-based poisoning case can provide a realistic public health clinical experience for local problems and prepare the context for the development of global citizenship values, as well as offer numerous opportunities to facilitate transformative learning, including Sustainable Development Goals (SDGs) into local nursing clinical practice.

IMPACT

Nurse managers, policymakers and educators must collaborate together to broaden their reach in teaching the role of the environment and social determinants of health through evidence-based care models, as well as actively contributing to the achievement of the SDGs to promote "glocal" competencies among nursing professionals.

Work conditions and their repercussions on the quality of life of rural workers

OBJECTIVE

To assess the context of work and analyze their repercussions on the quality of life of rural workers in soybean agribusiness.

METHOD

Cross-sectional study, with an intentional sample of rural workers, conducted between the months of October and December 2019, with the application of the instruments World Health Organization Quality Life-bref and Scales of Assessment of Context and Human Cost of Work. The data were analyzed through bivariate and multivariate descriptive statistics.

RESULTS

The participants amounted to 299 rural workers. The scores of Work Conditions and Socioprofessional Relations were satisfactory and Organization of Work was critical. The scores of Physical and Cognitive costs were considered critical and of the Affective Cost was satisfactory. The Socioprofessional Relations have negatively impacted the overall quality of life and the Physical and Psychological, the Social Relations and the Environmental Domains, whereas Cognitive Cost positively impacted the Physical and the Environmental Domain and the Affective Cost positively impacted the Social Relations Domain.

CONCLUSION

Although the Work Context and Human Cost indicated adverse conditions, only the Socioprofessional Relations exerted negative influences on the quality of life of rural workers.