Mortalidade por intoxicação ocupacional relacionada a agrotóxicos, 2000-2009, Brasil

Pesticide contamination of lactating mothers' milk in Latin America: a systematic review

OBJECTIVE

To identify the prevalence of contamination by pesticides and their metabolites in the milk of lactating mothers in Latin America.

METHODS

In this systematic review, the PubMed, LILACS, Embase, and Scopus databases were searched up to January 2022 to identify observational studies. The Mendeley software was used to manage these references. The risk of bias assessment was evaluated according to the checklist for prevalence studies and writing design, by the Prisma guidelines.

RESULTS

This study retrieved 1835 references and analyzed 49 studies. 69.38% of the analyzed studies found a 100% prevalence of breast milk contamination by pesticides among their sample. Main pesticides include dichlorodiphenyltrichloroethane (DDT) and its isomers (75.51%), followed by the metabolite dichlorodiphenyldichloroethylene (DDE) (69.38%) and hexachlorocyclohexane (HCH) (46.93%). This study categorized most (65.30%) studies as having a low risk of bias.

CONCLUSIONS

This review shows a high prevalence of pesticide contamination in the breast milk of Latin American women. Further investigations should be carried out to assess contamination levels in breast milk and the possible effects of these substances on maternal and child health.

Redox imbalance and inflammation: A link to depression risk in brazilian pesticide-exposed farmers

This study aims to elucidate the mechanisms linking occupational pesticide exposure to depression among rural workers from Maravilha, Brazil. We assessed the mental health, oxidative, and inflammatory profiles of farmers exposed to pesticides (N = 28) and compared them to an urban control group without occupational exposure to pesticides (N = 25). Data on sociodemographic, occupational history, and clinical records were collected. Emotional states were evaluated using the State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). Biochemical, hematological, inflammatory, and redox parameters were examined in blood samples from both groups. Results showed educational disparities between groups and unveiled a concerning underutilization of personal protective equipment (PPEs) among farmers. Glyphosate was the predominant pesticide used by farmers. Farmers exhibited higher BDI scores, including more severe cases of depression. Additionally, elevated levels of creatinine, ALT, AST, and LDH were observed in farmers, suggesting potential renal and hepatic issues due to pesticide exposure. Oxidative stress markers, such as increased lipid peroxidation and superoxide dismutase (SOD) activity, along with decreased catalase (CAT) activity and ascorbic acid levels, were noted in the pesticide-exposed group compared to controls. Elevated levels of inflammatory cytokines, particularly IL-1β, IL-6 and TNF-α, were also observed in pesticide-exposed group. Our findings suggest that inflammation, oxidative distress and lower educational levels may be associated with depression in pesticide-exposed farmers. This study highlights the impact of occupational pesticide exposure on the mental health of rural workers. The underuse of PPEs and the link between depressive symptoms, inflammation, and oxidative stress underscore the urgent need for improved safety measures in agricultural practices. Addressing these issues will contribute to a deeper understanding of the intricate relationship between environmental exposures and mental health outcomes.

Could pesticide exposure be implicated in the high incidence rates of depression, anxiety and suicide in farmers? A systematic review

Pesticide exposure and poisoning may rise the risk of mental health problems and suicidal tendencies. To explore the potential connection between chronic occupational exposure to pesticides and depression, anxiety, and suicide-related outcomes in farmers, a systematic review was performed. Systematic review protocol is available in PROSPERO registration number CRD42022316285. A total of fifty-seven studies met inclusion criteria: twenty-nine on depression or other mental disorders, twelve on suicide (two of them on both depression and suicide), and fourteen on pesticide poisoning or self-poisoning and death. Among the fifty-seven selected studies, eighteen were conducted in Asia, seventeen in North America, fourteen in South America, seven in European Union, one in Africa, and one in Australia/Oceania. Selected studies demonstrated an increased prevalence of depressive disorders in farmworkers exposed to pesticides as well as an increased self-reported prevalence of depression in this population. Moreover, previous pesticide poisoning increased the risk estimates for depression or other mental disorders as compared with chronic pesticide exposure. Severe pesticide poisoning and multiple poisoning showed increased risks of depressive symptoms compared with milder cases. In addition, financial difficulties and poor health were positively correlated with depression. Among studies on suicide, nine of them found that suicide rates increased in areas devoted to agriculture with intensive pesticide consumption. Moreover, studies demonstrate a higher suicide risk among farmers. The present review suggests more attention to the farmer's mental health and more detailed studies on occupational exposure to the mixture of these compounds.

Acute Kidney Failure among Brazilian Agricultural Workers: A Death-Certificate Case-Control Study

Recent evidence suggests that pesticides may play a role in chronic kidney disease. However, little is known about associations with acute kidney failure (AKF). We investigated trends in AKF and pesticide expenditures and associations with agricultural work in two Brazilian regions with intense use of pesticides, in the south and midwest. Using death certificate data, we investigated trends in AKF mortality (1980–2014). We used joinpoint regression to calculate annual percent changes in AKF mortality rates by urban/rural status and, in rural municipalities, by tertiles of per capita pesticide expenditures. We then compared AKF mortality in farmers and population controls from 2006 to 2014 using logistic regression to estimate odds ratios and 95% confidence intervals adjusted by age, sex, region, education, and race. AKF mortality increased in both regions regardless of urban/rural status; trends were steeper from the mid-1990s to 2000s, and in rural municipalities, they were higher by tertiles of pesticide expenditures. Agricultural workers were more likely to die from AKF than from other causes, especially at younger ages, among females, and in the southern municipalities. We observed increasing AKF mortality in rural areas with greater pesticide expenditures and an association of AKF mortality with agricultural work, especially among younger workers.

[Challenges and strides in the control of pesticide residues in Brazil: 15 years of the Program for Analysis of Pesticide Residues in Food Products]

In Brazil, since 2001, pesticides in food products have been monitored by the Program for Analysis of Pesticide Residues in Food Products (PARA, in Portuguese). The study aimed to analyze the challenges and strides in the control of pesticide residues in food products in Brazil based on the program's results from 2001 to 2015. A descriptive-analytical document review was conducted that used data from reports by the PARA, available at the website of the Brazilian Health Regulatory Agency. The program's main challenges feature the wide variation in the number of samples and active ingredients analyzed, as well as the reports' format. There is a need for more in-depth discussions of the criteria used for classification and authorization of active ingredients in Brazil, as well as the information's transparency to society. A total of 25 types of foods were analyzed, with more than 30,000 samples, since the PARA has been in force, but the maximum number of active ingredients analyzed was 228. The presence of active ingredients unauthorized for crops and unauthorized in the country was the principal cause of irregularities diagnosed in the foods. Although the program still faces various challenges, it helps spawn debate on the issue in society. Given the current government context of greater flexibility in the authorization of active ingredients in Brazil, it is necessary to strengthen the PARA.

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 Primary Health Care for rural workers exposed to pesticides

OBJECTIVE

To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators.

METHODS

Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae.

RESULTS

Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed.

CONCLUSIONS

Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.

[Diseases neglected by the media and strategies for visibility from the viewpoint of key actors]

Although health is a recurrent topic in newspapers, some diseases are visibly excluded from this coverage, originating diseases neglected by the media. The goal of this study was to identify - based on the opinion of journalists, press officers, health managers, and government health advisors - these diseases along with strategies for dealing with media neglect. The qualitative study was based on 19 semi-structured interviews with key actors. Data was submited to thematic content analysis using Maxqda software. The neglected diseases include infectious and parasitic diseases, rare diseases, periodontal diseases, cancer, and work-related illnesses.

Human intoxication by agrochemicals in the region of South Brazil between 1999 and 2014

The objective of this study was to evaluate pesticide poisonings in the southern region of Brazil between years 1999 and 2014. Data were collected from the database Sinitox. Intoxications and deaths were evaluated according to the distribution by gender (female and male), age group (≤14, 15-59 and ≥60 years), area of occurrence (urban and rural), circumstance (accident, occupational and suicide attempt) and evolution of the cases over time (cure, unconfirmed cure, death and sequelae). In the evaluated period, 21,305 cases of intoxication were registered. The results show that males between the ages of 15 and 59 years are more affected; and there is a greater representativeness in the urban area. These results are related to the application of agrochemicals being carried out by individuals between 15 and 59 years of age. The great correlation of urban area possibly occurs in function of the air currents brought from the field and as a result, population has been more affected and the consumption of contaminated food. It was observed that women handling pesticides more cautiously, in this way the accidents with male gender are more frequent, however, many women use the product intentionally to provoke suicide.

Análise das notificações de intoxicações agudas, por agrotóxicos, em 38 municípios do estado do Paraná

RESUMO O Paraná é o segundo maior consumidor de agrotóxicos no Brasil, e sua notificação de intoxicações agudas não corresponde a esta realidade. Objetivou-se verificar a correlação entre consumo de agrotóxicos em municípios do Paraná e notificação de intoxicações agudas. Analisaram-se bancos de dados do consumo de agrotóxicos e da ocorrência de intoxicações. Foram realizadas entrevistas com agentes da vigilância epidemiológica, para compreender o processo de identificação e notificação dos casos. Não se evidenciou correlação entre consumo e notificação de intoxicação aguda. Concluiu-se que há subnotificação de intoxicações por agrotóxicos no Paraná, devida a fragilidades estruturais dos serviços de saúde.

Acute pesticide poisoning and related factors among farmers in rural Western Iran

Although acute pesticide poisoning (APP) is known to be a major health concern among farmers in developing countries, knowledge of its prevalence and risk factors is limited. The purpose of this study was to investigate the prevalence and a broad range of potential work-related risk factors of APP among Iranian farmers and farm workers. This cross-sectional study was conducted in rural areas of the Twiserkan County in Iran. In this study, there were 474 farmers and farm workers who had used pesticide 1 week before data collection. Participants were selected from 104 villages. Data were gathered using a questionnaire and analyzed using STATA (version 14.2 SE). Binary logistic regression and multinomial logistic regression were employed. The results of this study showed that 286 (60.3%) farmers and farm workers who applied pesticides suffered from work-related APP. Most frequent APP symptoms were runny nose (29.8%) and headache (25.1%). Five risk factors were identified, including annual income ( p < 0.05), number of farming years (odds ratio (OR) = 0.31), number of spraying years (OR = 2.40), place of pesticide storage (OR = 2.69), and type of sprayer ( p < 0.05). The results of this study indicated that APP is prevalent among the studied farmers. Some work-related factors play an important role in APP among Iranian rural farmers. In addition, the magnitude of these risk factors differed significantly by severity of acute and somatic pesticide poisoning.

[Analysis of deaths by intoxication that occurred in Brazil from 2010 to 2015 based on the Mortality Information System (SIM)]

Many studies analyze the epidemiological profile of deaths caused by a single toxic agent. However, broader mortality analyses can be obtained by evaluating multiple agents over the same period of time. For this purpose, a retrospective descriptive study was carried out of the deaths by intoxication registered in the Mortality Information System that occurred in Brazil from 2010 to 2015. Deaths were selected according to ICD-10 codes related to intoxication. There were 18,247 deaths and an increase of 3% of rates of mortality by intoxication during the period. The agents that caused the most deaths were pesticides (24%) followed by medication (23%) and street drugs (22%). With the exception of medication, where the female participation was 52%, there was a higher concentration of males for all agents and in most of the age groups. Only in the case of medication and pesticides was suicide the main circumstance of deaths. The results presented made it possible to define a mortality profile for each of the major toxic agents studied.

Agrotóxicos e seus impactos na saúde humana e ambiental: uma revisão sistemática

RESUMO Atualmente, o Brasil é o maior consumidor de agrotóxicos do mundo. Diversos estudos comprovam os malefícios para a saúde humana e ambiental da exposição aos agrotóxicos. Realizou-se uma revisão sistemática no período de 2011 a 2017 acerca desse tema em bases de dados científicos. Foram incluídos 116 estudos que demonstraram o impacto negativo para a saúde humana e ambiental. É essencial a realização de estudos sobre os efeitos da exposição crônica e simultânea a diversos agrotóxicos, além de estudos sobre os nexos de determinação estrutural do uso dos venenos e suas consequências.

Multiple biomarker responses in Prochilodus lineatus subjected to short-term in situ exposure to streams from agricultural areas in Southern Brazil

In order to assess the quality of streams susceptible to contamination by pesticides we apply biochemical and genotoxic biomarkers in the Neotropical fish Prochilodus lineatus submitted to in situ tests. Fish were caged, for 96 h, in two streams located in areas with intensive use of pesticides, the Apertados (AP) and the Jacutinga (JC), and in a small stream (Godoy stream — GD) found inside a forest fragment adjacent to a State Park. Biochemical parameters, such as biotransformation enzymes 7-ethoxyresorufin-O-deethylase (EROD) and glutathione-S-transferase (GST), non-protein thiols (NPSH), lipoperoxidation (LPO), protein carbonylation (PCO) and acetylcholinesterase (AChE) were evaluated in various fish organs, as well as genotoxic biomarkers (damage to DNA and occurrence of micronuclei and erythrocyte nuclear abnormalities). Samples of water and sediment were collected for analysis of metals (Cu, Cr, Pb, Ni, Mn, Cd and Zn), organochloride pesticides, and triazine and glyphosate herbicides. We observed an increase in liver GST activity in fish at AP and gill GST activity in fish at JC. An increase in liver LPO was also observed in fish exposed to AP and JC. The same animals also exhibited increased DNA damage and erythrocyte nuclear abnormalities (ENAs) compared to the fish kept in GD. A number of compounds showed concentrations higher than the permitted levels, in particular, dichlorodiphenyltrichloroethane (DDT), its metabolites dichlorodiphenyldichloroethylene (DDE) and dichlorodiphenyldichloroethane (DDD), hexachlorocyclohexanes (HCH), heptachloride, diclofluanid and aldrins. These pesticides were detected at higher concentrations in water and sediment samples from AP, followed by JC and GD. The Integrated Biomarker Response Index (IBR) indicated that AP and JC (AP: 21.7 > JC: 18.5 > GD: 12.6) have the worst environmental quality. Integrated biomarker analysis revealed that the alterations observed related well with the levels of environmental contaminants, demonstrating the effectiveness of this biomonitoring approach.

Persistence of chlorpyrifos in greenhouse air

ABSTRACT: Organophosphate pesticides are among those with the highest acute toxicity and are available on the market and used in several regions of Brazil. The concentration and residence time of the organophosphate pesticide, chlorpyrifos, in the air after application in a greenhouse were investigated. For more than 24 h, the chlorpyrifos remained in the greenhouse air at concentrations three times above the occupational exposure limit and was still detectable four days later.

Mortalidade por acidentes de trabalho entre trabalhadores da agropecuária no Brasil, 2000-2010

Resumo: Estima-se a mortalidade anual por acidentes de trabalho na agropecuária, 2000-2010, no Brasil. Empregou-se o Sistema de Informações sobre Mortalidade (SIM), para identificar os casos. Dados faltantes para ocupação e acidente de trabalho foram recuperados com informações individuais disponíveis, e incorporados casos ao total. Dados da população são dos Censos Demográficos. Foram identificados 8.923 óbitos por acidentes de trabalho, sendo 44,8% destes resultantes da recuperação. Em 2000, a mortalidade bruta por acidentes de trabalho foi estimada em 6,4/100 mil trabalhadores, aumentando para 8,1/100 mil em 2003, quando declinou para 7,3/100 mil em 2010. Entre os homens, "projeções de animais ou veículos de tração animal" foram as circunstâncias mais comuns, mas em mulheres foram as intoxicações por agrotóxicos. A mortalidade geral por acidentes de trabalho na agropecuária foi baixa quando comparada à de outros países, sugerindo sub-registro residual apesar da recuperação, o que requer melhoria da qualidade dos registros. Medidas de prevenção sensíveis a diferenças de gênero são necessárias.

Fatores associados aos óbitos entre homens envenenados por carbamato (“chumbinho”)

RESUMO Objetivo Determinar os fatores associados aos óbitos em vítimas de envenenamento por carbamato (“chumbinho”). Método Estudo retrospectivo, epidemiológico tipo caso-controle, baseado nas fichas de notificação de intoxicação do centro de controle de intoxicações localizado na região metropolitana do Rio de Janeiro. Foram utilizadas 24 fichas de notificação de intoxicações de homens dos 20 aos 59 anos com história de envenenamento por carbamato entre 2005 e 2009. As fichas foram sorteadas aleatoriamente, respeitando-se a razão de 1:3 (um caso para três controles). A faixa etária variou de 23 a 58 anos; a média 43,83 anos. Resultados Os sintomas mais recorrentes foram: miose (OR = 1.0; IC 95%: 0,27 – 3,69. p= 1.0), sialorreia (OR = 0,83; IC 95%: 0,22 – 3,12. p= 0,78), dispneia (OR = 0,66; IC 95%: 0.14 – 3,03. p= 0,59). Conclusão Os óbitos apresentaram associação com sialorreia, miose e dispneia e uma forte associação com estertores pulmonares, broncoespasmos e os roncos pulmonares.

O agricultor familiar e o uso (in)seguro de agrotóxicos no município de Lavras/MG

Resumo Introdução: o paradigma do "uso seguro" de agrotóxicos sustenta-se em medidas de controle dos riscos envolvidos na manipulação desses produtos. No entanto, estudos realizados no Brasil revelam um quadro de exposição e danos à saúde de trabalhadores rurais. Objetivo: realizar uma análise da viabilidade de cumprimento das medidas de "uso seguro" de agrotóxicos no contexto socioeconômico da agricultura familiar. Métodos: estudo transversal com aplicação de questionário em 81 pequenas propriedades rurais do município de Lavras/MG, em 2013. Resultados: constatou-se que os funcionários do comércio são os responsáveis pela indicação para o uso e aquisição desses produtos; o transporte e o armazenamento são realizados em veículos e construções não adaptados às exigências de segurança; existe inviabilidade técnica para seguir as medidas relacionadas aos Equipamentos de Proteção Individual (EPI) e às regras de preparo e aplicação do agrotóxico; as dificuldades e os custos envolvidos para a devolução das embalagens vazias são os principais motivos para a sua não realização; a lavagem das vestimentas e EPIs contaminados é feita como atividade doméstica sem infraestrutura de segurança. Conclusão: a tecnologia agroquímica não pode ser utilizada sob o conceito de controle de riscos na estrutura geral das unidades produtivas de agricultura familiar.

Trabalho rural e riscos à saúde: uma revisão sobre o "uso seguro" de agrotóxicos no Brasil

O paradigma do "uso seguro" de agrotóxicos sustenta-se em medidas de controle dos riscos na manipulação desses produtos. No entanto, estudos realizados em diversas regiões do País revelam um quadro de exposição e danos à saúde de trabalhadores rurais, evidenciando a ineficácia deste paradigma. Este trabalho apresenta uma revisão crítica sobre a abordagem do "uso seguro" de agrotóxicos nos artigos científicos publicados nos últimos 15 anos no Brasil. Os resultados apontaram que esses estudos não abordam, simultaneamente, todas as atividades de trabalho que envolvem exposição e risco de intoxicação (aquisição, transporte, armazenamento, preparo e aplicação, destino final de embalagens vazias e lavagem de roupas/EPI contaminados), tampouco abordam de maneira abrangente as diversas medidas de "uso seguro", descritas pelos manuais de segurança, obrigatórias para cada atividade. No total, 25 artigos foram selecionados e analisados, evidenciando-se a concentração de resultados e análises nas atividades de preparo e aplicação e destino final de embalagens vazias. A abrangência das abordagens se mostrou pontual nas seis atividades. Para futuros trabalhos, sugere-se uma abordagem ampliada do "uso seguro" de agrotóxicos, buscando-se revelar a completa inviabilidade deste paradigma de segurança.