Pesticides and respiratory symptoms among farmers

Respiratory system: Highly exposed yet under-reported organ in pyrethrin and pyrethroid toxicity

Pyrethrin and pyrethroid are a relatively new class of pesticides with potent insecticidal properties. Pyrethrins are naturally occurring pesticides obtained from the Chrysanthemum cinerariaefolium flower, while pyrethroids are their synthetic derivatives. They are widely used as the insecticides of choice in agriculture, veterinary medicine, public health programs, and household activities. Pyrethrin, being a broad-spectrum insecticide kills a wide range of pests, while pyrethroids last longer in the environment owing to low susceptibility to sunlight, and greater stability and efficacy than parent molecules. Humans can be exposed through inhalation, ingestion, and dermal routes. Indoor usage of an insecticide poses a serious risk to human health, especially to women, children, and stay-at-home people. Although pyrethrin and pyrethroid are generally considered safe, sustained skin or inhalation exposure or direct contact with open wounds results in higher toxicity to mammals. There is a paucity of data on the impact of pyrethrin and pyrethroid on overall pulmonary health. The respiratory system, from the nose, nasal passages, airways, and bronchi to the pulmonary alveoli, is vulnerable to environmental contaminants such as pesticides because of its anatomical location as well as being a highly blood profused organ. Under and over-functioning of the respiratory system triggers diverse pathologies such as serious infections, allergies, asthma, metastatic malignancies, and auto-immune conditions. While the association between workplace-related pesticide exposures and respiratory diseases and symptoms is well documented, it is important to understand the adverse health impact of pyrethrin and pyrethroid on the general population for awareness and also for better regulation and implementation of the law.

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.

Association of pesticide exposure with respiratory health outcomes and rhinitis in avocado farmworkers from Michoacán, Mexico

BACKGROUND

A growing literature suggests associations between occupational pesticide exposure and respiratory health. In this study, we aimed to examine the association of exposure to insecticides, fungicides, and herbicides, individually and as a mixture, with respiratory health outcomes and rhinitis in avocado farmworkers from Michoacán, Mexico.

MATERIAL AND METHODS

We conducted a cross-sectional study of 105 avocado farmworkers between May and August 2021. We quantified 12 insecticide, fungicide, and herbicide metabolites in urine samples collected during two study visits (8-10 weeks apart). We collected survey data on self-reported pesticide use during the 12 months prior to the baseline survey and estimated annual exposure-intensity scores (EIS) using a semi-quantitative exposure algorithm. We also assessed respiratory symptoms, including wheezing, chest tightness, wheezing after exercise, and night cough. We used generalized linear regression models to examine associations of individual urinary metabolite concentrations and annual EIS with respiratory health outcomes and rhinitis. Mixture effects were assessed using Bayesian Weighted Quantile Sum (BWQS) regression.

RESULTS

After adjusting for multiple comparisons, we observed mostly null associations of individual pesticide metabolite concentrations and annual EIS with the outcomes of interest. However, in BWQS analyses, we found evidence of a mixture association of urinary pesticide metabolites with increased odds of night cough (OR: 5.34, 95 % CrI: 1.67, 20.62). Pyrethroid metabolites 3-phenoxybenzoic acid and cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropanecarboxylic acid were the main contributors to this association (43 %).

CONCLUSIONS

Our findings indicate that exposure to a mixture of pesticides, particularly pyrethroid insecticides, may be associated with night cough in avocado farmworkers.

EAACI guidelines on environmental science for allergy and asthma: The impact of short-term exposure to outdoor air pollutants on asthma-related outcomes and recommendations for mitigation measures

The EAACI Guidelines on the impact of short-term exposure to outdoor pollutants on asthma-related outcomes provide recommendations for prevention, patient care and mitigation in a framework supporting rational decisions for healthcare professionals and patients to individualize and improve asthma management and for policymakers and regulators as an evidence-informed reference to help setting legally binding standards and goals for outdoor air quality at international, national and local levels. The Guideline was developed using the GRADE approach and evaluated outdoor pollutants referenced in the current Air Quality Guideline of the World Health Organization as single or mixed pollutants and outdoor pesticides. Short-term exposure to all pollutants evaluated increases the risk of asthma-related adverse outcomes, especially hospital admissions and emergency department visits (moderate certainty of evidence at specific lag days). There is limited evidence for the impact of traffic-related air pollution and outdoor pesticides exposure as well as for the interventions to reduce emissions. Due to the quality of evidence, conditional recommendations were formulated for all pollutants and for the interventions reducing outdoor air pollution. Asthma management counselled by the current EAACI guidelines can improve asthma-related outcomes but global measures for clean air are needed to achieve significant impact.

The impact of outdoor pollution and extreme temperatures on asthma-related outcomes: A systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma

Air pollution is one of the biggest environmental threats for asthma. Its impact is augmented by climate change. To inform the recommendations of the EAACI Guidelines on the environmental science for allergic diseases and asthma, a systematic review (SR) evaluated the impact on asthma-related outcomes of short-term exposure to outdoor air pollutants (PM2.5, PM10, NO2, SO2, O3, and CO), heavy traffic, outdoor pesticides, and extreme temperatures. Additionally, the SR evaluated the impact of the efficacy of interventions reducing outdoor pollutants. The risk of bias was assessed using ROBINS-E tools and the certainty of the evidence by using GRADE. Short-term exposure to PM2.5, PM10, and NO2 probably increases the risk of asthma-related hospital admissions (HA) and emergency department (ED) visits (moderate certainty evidence). Exposure to heavy traffic may increase HA and deteriorate asthma control (low certainty evidence). Interventions reducing outdoor pollutants may reduce asthma exacerbations (low to very low certainty evidence). Exposure to fumigants may increase the risk of new-onset asthma in agricultural workers, while exposure to 1,3-dichloropropene may increase the risk of asthma-related ED visits (low certainty evidence). Heatwaves and cold spells may increase the risk of asthma-related ED visits and HA and asthma mortality (low certainty evidence).

[Pesticide exposure and chronic respiratory diseases]

INTRODUCTION

Pesticides are used worldwide, mainly in agriculture as a means of controlling pests and protecting crops. That said, the entire world population is ultimately subject to pesticide exposure (consumption of fruits and vegetables, living near treated fields…), with varying degrees of toxicity involved.

STATE OF THE ART

In recent decades, epidemiological studies have contributed to the identification of chemical pesticide families with detrimental effects on human health: cognitive disorders, Parkinson's disease, prostate cancer… and impairment in respiratory functioning. Current scientific evidence points to the implication of the active substances in insecticides, herbicides and fungicides in chronic respiratory diseases, two examples being chronic obstructive pulmonary disease (COPD) in exposed workers, and asthmatic wheezing in children during prenatal or postnatal exposure.

PERSPECTIVES

The safety of individuals exposed to pesticides is of key importance in public health. Further epidemiological investigations are needed to identify the chemical families affecting certain populations.

CONCLUSIONS

The scientific literature suggests strong links between pesticide exposure and respiratory health. Whether it be environmental or occupational, pesticide exposure can lead to respiratory disorders and symptoms of varying severity.

Influence of pesticide mixture on their heterogeneous atmospheric degradation by ozone and OH radicals

Pesticides in the atmosphere can exist in both gaseous and particulate phases due to their semi-volatile properties. They can undergo degradation when exposed to atmospheric oxidants like ozone and hydroxyl radicals. The majority of studies on the atmospheric reactivity of pesticides study them in combination, without considering potential mixture effects that could induce uncertainties in the results. Therefore, this study aims to address this gap, through laboratory studies using a flow reactor, and by evaluating the degradation kinetics of pendimethalin mixed with folpet, tebuconazole, and S-metolachlor, which were simultaneously adsorbed on hydrophobic silica particles that mimic atmospheric aerosols. The comparison with other mixtures, including pendimethalin, from the literature has shown similar reactivity with ozone and hydroxyl radicals, indicating that the degradation kinetics of pesticides is independent of the mixture. Moreover, the degradation rates of the four pesticides under study indicate that they are not or slightly degraded by ozone, with half-lives ranging from 29 days to over 800 days. In contrast, when exposed to hydroxyl radicals, tebuconazole exhibited the fastest reactivity, with a half-life of 4 days, while pendimethalin had a half-life of 17 days.

Obstructive Lung Disease Linked to Occupational Exposures in Malawian Tobacco Farmers

Nicotine and pesticide exposure in agricultural settings have been linked to the development of chronic respiratory disease in workers. However, this has not been extensively studied in Africa. The aim of this study was therefore to determine the prevalence of obstructive lung disease and its relationship to concurrent nicotine and pesticide exposure among small-scale tobacco farmers in Malawi. For this purpose, sociodemographic characteristics, occupational and environmental exposures were evaluated in relation to work-related respiratory symptoms and lung function impairment. A cross-sectional study was conducted enrolling 279 workers in flue-cured tobacco farms in Zomba, Malawi. The study instruments used for assessing the health outcomes were a standardised European Community Respiratory Health Survey II (ECRHS) questionnaire and Spirometry testing. The questionnaires were aimed at collecting relevant data on sociodemographic factors and self-reported respiratory health outcomes. Data were also collected on potential pesticide and nicotine exposures. Spirometry was done to evaluate objective respiratory impairment in accordance with American Thoracic Society guidelines. The mean age of participants was 38 years with 68% being male. The prevalence of work-related ocular nasal symptoms, chronic bronchitis, and work-related chest symptoms was 20%, 17%, and 29%, respectively. Airflow limitation (FEV1/FVC <70%) was found in 8% of workers. Self-reported exposure to pesticides varied from 72%- to 83%, whilst the prevalence of recent green tobacco sickness was 26%. Tasks linked to nicotine exposure, such as sowing (OR: 2.5; CI 1.1-5.7) and harvesting (OR: 2.6; CI 1.4-5.1), were significantly associated with work-related chest symptoms. Pesticide application (OR:1.96; CI 1.0-3.7) was associated with an increased risk of work-related oculonasal symptoms. Duration of pesticide exposure was also associated with obstructive impairment FEV1/FVC Collapse

Key Words

• Obstructive lung disease
• nicotine
• pesticides
• tobacco farming

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MESH Headings

• Humans
• Male
• Adult
• Female
• Tobacco
• Farmers
• Nicotine
• Cross-Sectional Studies
• Risk Factors
• Occupational Exposure/adverse effects
• Pesticides/adverse effects
• Spirometry
• Lung Diseases, Obstructive/chemically induced
• Lung
• Prevalence

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Grants

• D43 TW009609 FIC NIH HHS

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Affiliation(s)

Yotam M Moyo Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Mohamed F Jeebhay Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Roslynn Baatjies Occupational Medicine Division and Centre for Environmental & Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa Department of Environmental and Occupational Studies, Faculty of Applied Sciences, Cape Peninsula University of Technology (CPUT), Cape Town, South Africa
Sufia Dadabhai Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, USA
Shahieda Adams Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

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Biomarkers of organophosphate insecticides exposure and asthma in general US adults: findings from NHANES 1999-2018 data

The limited evidence linking exposure to organophosphate insecticides (OPIs) and asthma in the general population prompted us to investigate this association. Our study focused on US adults and utilized representative samples from the National Health and Nutrition Examination Survey (NHANES). From the 7 NHANES waves (1999-2018), we detected OPIs exposure using the urinary concentrations of six metabolites of dialkyl phosphates (DAPs). To evaluate the relationship between these OPIs and asthma, we employed three statistical methods: survey-multivariable logistic regression (SMLR), generalized weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR). Stratified analyses were done based on the relevant variable subgroups, and sensitivity analyses were carried out to evaluate the robustness of findings. A total of 6009 adults aged from 20 to 85 years old, representing the 313.5 million adults in the non-institutionalized US population, were included in our analyses. Among them, 842 participants were determined as asthma patients with an age-adjusted prevalence of 14.2%. Our results showed that dimethyl phosphate (DMP) (adjusted odd ratio (AOR) = 1.471, 95% CI: 1.086, 1.993), diethyl phosphate (DEP) (AOR = 1.453, 95% CI: 1.118, 1.888), dimethyl thiophosphate (DMTP) (AOR = 1.454, 95% CI: 1.071, 1.973), and dimethyl dithiophosphate (DMDTP) (AOR = 1.478, 95% CI: 1.119, 1.953) had a positive correlation with asthma in adults. This association was stronger in females, non-Hispanic White populations and those with a small amount of physical activity. Our study findings indicated that exposure to OPIs may elevate the risk of asthma in US general adults. Specifically, females, individuals from non-Hispanic White backgrounds, and those with lower levels of physical activity are more susceptible to developing asthma when exposed to OPIs.

Acute Pesticide Poisoning in Tobacco Farming, According to Different Criteria

BACKGROUND

Brazil is one of the world's largest pesticide consumers, but information on pesticide poisoning among workers is scarce.

OBJECTIVE

To evaluate acute pesticide poisoning among tobacco growers, according to different criteria.

METHODS

This was a two-step cross-sectional study with 492 pesticide applicators. It used a 25 question pesticide-related symptoms (PRS) questionnaire and medical diagnosis for comparison with toxicological assessment. Associations were evaluated using Poisson regression.

RESULTS

10.6% reported two or more PRS, while 8.1% reported three or more. Furthermore, 12.2% received a medical diagnosis of poisoning. According to toxicologists, possible cases accounted for 14.2% and probable cases for 4.3%. PRS increased during the period of greater exposure. Those exposed to dithiocarbamates, sulfentrazone, pyrethroids, fipronil and iprodione exhibited more PRS. The number of exposure types, multi-chemical exposure, clothes wet with pesticides and spillage on the body/clothes were associated with acute poisonings. All criteria showed sensitivity greater than 79% for probable cases but only greater than 70% for medical diagnosis when compared to possible cases, presenting substantial Kappa agreement.

CONCLUSION

The prevalence of acute pesticide poisoning is much higher than officially recorded. Trained physicians can screen for pesticide poisoning. It is necessary to improve workers' education to reduce pesticide use and exposure to them.

Ever and cumulative occupational exposure and lung function decline in longitudinal population-based studies: a systematic review and meta-analysis

OBJECTIVES

Adverse occupational exposures can accelerate age-related lung function decline. Some longitudinal population-based studies have investigated this association. This study aims to examine this association using findings reported by longitudinal population-based studies.

METHODS

Ovid Medline, PubMed, Embase, and Web of Science were searched using keywords and text words related to occupational exposures and lung function and 12 longitudinal population-based studies were identified using predefined inclusion criteria. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Lung function decline was defined as annual loss of forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC) or the ratio (FEV₁/FVC). Fixed and random-effects meta-analyses were conducted to calculate pooled estimates for ever and cumulative exposures. Heterogeneity was assessed using the I² test, and publication bias was evaluated using funnel plots.

RESULTS

Ever exposures to gases/fumes, vapours, gases, dusts, fumes (VGDF) and aromatic solvents were significantly associated with FEV₁ decline in meta-analyses. Cumulative exposures for these three occupational agents observed a similar trend of FEV₁ decline. Ever exposures to fungicides and cumulative exposures to biological dust, fungicides and insecticides were associated with FEV₁ decline in fixed-effect models only. No statistically significant association was observed between mineral dust, herbicides and metals and FEV₁ decline in meta-analyses.

CONCLUSION

Pooled estimates from the longitudinal population-based studies have provided evidence that occupational exposures are associated with FEV₁ decline. Specific exposure control and respiratory health surveillance are required to protect the lung health of the workers.

Occupational factors affecting the decline in pulmonary function among male farmers using occupational pesticide in Gyeonggi-do, South Korea

Background

Occupational pesticide exposure is a potential risk for respiratory health effects. Most clinical studies on pesticide exposure were related to acute exposure, and only a few studies on chronic exposure have been conducted. This study investigated the chronic respiratory health status and the chronic effects of occupational pesticide exposures of farmers in Gyeonggi-do.

Methods

Surveys and pulmonary function tests were conducted on 1,697 farmers in 16 regions of Gyeonggi-do. The structured questionnaire included demographic characteristics, medical history, recent respiratory symptoms and diseases, and work-related conditions, and was conducted through one-on-one interviews. The prevalence of respiratory diseases was compared by the odds ratios (ORs) at 95% confidence intervals (CIs) estimated by logistic regression analysis. Additional multivariate logistic regression analysis was also conducted.

Results

Pesticide work groups showed significant association with an obstructive pattern in the lung function test (unadjusted OR, 2.38; 95% CI, 1.17-5.52). Selected work-related variables of pesticide exposure were 'start age,' 'cumulative duration,' 'mixing pesticides,' and 'protection(goggle).' The obstructive pattern of lung function test showed significant associations with mixing pesticides (OR, 2.30; 95% CI,1.07-5.46), and protection (goggle) use (OR, 0.34; 95% CI, 0.12-0.79).

Conclusions

Mixing two or more pesticides showed a significant association. Wearing goggles can be seen as an indicator of awareness of the protective equipment and proper wearing of protective equipment, and loss of pulmonary function can be prevented when appropriate protection is worn.

Allergic and non-allergic wheeze among farm women in the Agricultural Health Study (2005-2010)

BACKGROUND

Farms represent complex environments for respiratory exposures including hays, grains and pesticides. Little is known about the impact of these exposures on women's respiratory health. We evaluated the association of farm exposures with allergic and non-allergic wheeze among women in the Agricultural Health Study, a study of farmers and their spouses based in Iowa and North Carolina.

METHODS

We used self-reported data (2005-2010) on current use (≤12 months) of 15 pesticides (selected based on frequency of use) and occupational farm activities from 20 164 women. We defined allergic wheeze as reporting wheeze and doctor-diagnosed hay fever (7%) and non-allergic wheeze as wheeze but not hay fever (8%) in the past 12 months. Using polytomous logistic regression, we evaluated associations of wheeze subtypes with pesticides and other farm exposures (eg, raising farm animals) using no wheeze/hay fever as the referent, adjusting for age, body mass index, state, current asthma, glyphosate use and smoking.

RESULTS

Current use of any pesticide, reported by 7% of women, was associated with both allergic (OR: 1.36, 95% CI: 1.10 to 1.67) and non-allergic (OR: 1.25, 95% CI: 1.04 to 1.51) wheeze. Four pesticides were associated with at least one wheeze subtype: glyphosate, with both wheeze subtypes; diazinon and fly spray with only allergic wheeze; carbaryl with only non-allergic wheeze. Working weekly with mouldy hay was associated with allergic (OR: 1.88, 95% CI: 1.26 to 2.80) and non-allergic wheeze (OR: 1.69, 95% CI: 1.18 to 2.42).

CONCLUSION

Use of specific pesticides and certain farm activities may contribute to wheeze among farm women.

Respiratory and allergic health effects in children living near agriculture: A review

BACKGROUND

Exposure to pesticides and agricultural burning are likely to co-occur in agricultural communities, but these exposures have remained distinct bodies of research. We reviewed epidemiological studies to identify the respiratory health effects of children exposed to pesticides and agricultural burning through a systematic evaluation of peer-reviewed publications of children living in industrial agricultural areas.

METHODS

Two academic search databases (PubMed and Scopus) were queried for all available studies published in English before May 31st, 2021. The initial search combining both exposure metrics (pesticides and agricultural burning) yielded zero publications and thus the queries were performed and presented separately.

RESULTS

Studies were categorized based on main exposure of interest (i.e., pesticides or agricultural burning) and by respiratory health outcome assessment (i.e., self-reported asthma, acute respiratory symptoms, and lung function measurements). In total we identified 25 studies that focused on pesticide exposures and children's respiratory health, and 12 studies that focused on exposure to agricultural burning and children's respiratory health. A majority of the pesticide studies (18/25) reported a positive association between exposure to pesticides and adverse childhood respiratory health effects. Similarly, most (11/12) of the agricultural burning studies also reported a positive association between exposure to agricultural burning and adverse respiratory health effects.

CONCLUSION

The most frequently studied health outcomes in these publications were acute respiratory symptoms (n = 11 pesticides, n = 3 agricultural burning), followed by asthma (n = 9 pesticides, n = 3 agricultural burning), and lung function measurements (n = 5 pesticides, n = 6 agricultural burning). Although health outcome assessment differed between pesticide studies and agricultural burning studies, similar adverse respiratory health effects were observed across the majority of studies.

Pesticides and farmers' health: an analysis of variables related to management and property

The objective is to verify the effects of pesticides on the health of farmers in the southern region of Brazil, as well as the possible symptoms and cases of intoxication. This study has a quantitative, descriptive and exploratory approach, carried out in 12 agricultural locations in the municipality of Serra Catarinense. This research was approved by the research ethics committee and was applied through a structured questionnaire to 79 farmers who grow grains in the conventional cultivation system. The pesticide most used by farmers was glyphosate, followed by acephate. Of the individuals, 21.5% reported that they had suffered poisoning by pesticides by the respiratory route (58.8%). In addition, 28% had three symptoms of intoxication, demonstrating possible probable cases of intoxication. And 41% of workers reported headaches as a predominant symptom in applications with the use of pesticides, followed by dizziness/vertigo (16%). Farmers who use PPE during the preparation of the pesticide spray are neither chronic diseases (p<0.003) nor psychological problems (p<0.000). All four individuals who had cancer, all also eat while applying pesticides (p<0.049). The exposure to pesticides causes changes in the organism of those exposed, using them more vulnerable to health problems.

Environmental Substances Associated with Chronic Obstructive Pulmonary Disease-A Scoping Review

Chronic obstructive pulmonary disease (COPD) is a slowly developing non-communicable disease (NCD), causing non-reversible obstruction and leading to marked morbidity and mortality. Besides traditional risk factors such as smoking, some environmental substances can augment the risk of COPD. The European Human Biomonitoring Initiative (HBM4EU) is a program evaluating citizens’ exposure to various environmental substances and their possible health impacts. Within the HBM4EU, eighteen priority substances or substance groups were chosen. In this scoping review, seven of these substances or substance groups are reported to have an association or a possible association with COPD. Main exposure routes, vulnerable and high-exposure risk groups, and matrices where these substances are measured are described. Pesticides in general and especially organophosphate and carbamate insecticides, and some herbicides, lead (Pb), and polycyclic aromatic hydrocarbons (PAHs) showed an association, and cadmium (Cd), chromium (Cr and CrVI), arsenic (As), and diisocyanates, a possible association with COPD and/or decreased lung function. Due to long latency in COPD’s disease process, the role of chemical exposure as a risk factor for COPD is probably underestimated. More research is needed to support evidence-based conclusions. Generally, chemical exposure is a growing issue of concern, and prompt action is needed to safeguard public health.

Evidence on Human Exposure to Pesticides and the Occurrence of Health Hazards in the Brazilian Population: A Systematic Review

Brazil is among the biggest pesticide consumers in the world, with its population severely exposed to tons of such substances, both because of environmental contamination and occupational use. The health consequences of pesticide exposure are well-documented, but still sparse regarding Brazilian population. This study systematically reviewed the Brazilian studies published that address the relationship between exposure to pesticides and health problems in the Brazilian population. Also, information about pesticide use in Brazil is provided. The included studies showed that exposure to pesticides has a relevant impact on the health of the Brazilian population, regardless of age and gender, and on workers in rural areas or not. Most poisoning events seem to result from the continuous use of pesticides, whether occupationally or environmentally, characterizing a public health problem. The major consequences reported in literature were damage to the central nervous system, cancer, deleterious effects on rural workers' health, intoxications, malformations, and endocrine changes. These findings point out the need to understand the impact of chronic exposure to pesticides on severely exposed people and highlight the importance of creating public policies to protect them and avoid disease occurrence.

Insecticide Exposure and Risk of Asthmatic Symptoms: A Systematic Review and Meta-Analysis

The incidence of respiratory disease is increasing. In relation to this, in addition to infection, factors associated with working with chemical insecticides are a cause for concern. Some of the chemicals involved have been shown to affect the respiratory system, and consequentially workers are at increased risk of conditions such as asthma. However, medical opinion around this area is still controversial; therefore, the objective of this study is to investigate the association between exposure to insecticides and asthma by means of a systematic review of the relevant literature. Relevant literature was identified, and a systematic review was conducted to investigate the association between exposure to insecticides and asthma. A total of five studies (three cross sectional and two cohort) including 45,435 subjects were identified as relevant. The summary odds ratios related to the impact of exposure to specific insecticides on asthma were organophosphates 1.31 (95%CI = 1.17–1.48, I² = 27%, p = 0.172), carbamates 1.44 (95%CI 1.08–1.92, I² = 56.7%, p = 0.031) and organochlorines 1.31 (95%CI 1.19–1.64, I² = 37.3%, p = 0.131). Farmers exposed to certain insecticides may have an increased risk of asthma and asthmatic symptoms, but further research on that issue is urgently needed.

Factors associated with respiratory symptoms among herbicide applicators and assistant applicators in maize field

A cross-sectional study was conducted with 3,291 maize farmers enrolled whose main roles were herbicide applicators and assistant applicators. This study aimed to compare the prevalence of respiratory symptoms and the use of personal protective equipment (PPE) between herbicide applicators and assistant applicators, and determine factors associated with respiratory symptoms. Our results suggest that wheeze and dyspnea were associated with the task on the farm (adj. OR = 10.33 for wheeze and 24.13 for dyspnea), amount of herbicide use (adj. OR = 1.95 for wheeze and 1.41 for dyspnea), frequency of herbicide use (adj. OR = 2.87 for wheeze and 4.08 for dyspnea), not always wearing a mask (adj. OR = 1.49 for wheeze and 3.17 for dyspnea), not always wearing gloves (adj. OR = 2.63 for wheeze and 2.44 for dyspnea), and not always wearing goggles (adj.OR = 2.01 for dyspnea) after adjusting for confounding factors.

Conhecimentos, atitudes e práticas de agricultores familiares brasileiros sobre a exposição aos agrotóxicos

Resumo O artigo discute conhecimentos, atitudes e práticas (CAP) de agricultores familiares brasileiros a respeito dos impactos na saúde e no ambiente gerados pelo uso de agrotóxicos. Trata-se de um estudo transversal misto, realizado em 2014 em São José de Ubá, RJ. A pesquisa é composta por uma etapa qualitativa, baseada em observações em campo e entrevistas com 25 participantes sobre CAP, no que se refere ao uso de agrotóxicos. A etapa quantitativa abrange avaliação sociodemográfica e de exposição aos agrotóxicos de 78 agricultores. Apesar de reconhecerem parcialmente os perigos dos agrotóxicos, os agricultores enfrentam os riscos da exposição e comumente adotam práticas laborais inadequadas. Fatores como a carência de apoio técnico e treinamento laboral, baixa escolaridade, dificuldade de compreensão das orientações de bulas e rótulos dos agrotóxicos, valor elevado e desconforto causado pelo equipamento de proteção individual (EPI), além da crença da dependência do uso de agrotóxicos, explicam parcialmente as atitudes não seguras. É preciso promover práticas agrícolas mais sustentáveis, fortalecer o apoio técnico e treinamento laboral, melhorar a comunicação e o gerenciamento dos riscos e reduzir as desigualdades de gênero entre os agricultores brasileiros, como a forma mais eficaz e imediata de prevenir os agravos relacionados ao trabalho com agrotóxicos.

Specific work activities and exposure to respiratory hazards - predictors of lung function impairment among crop farmers

OBJECTIVE: The objective of the study was to evaluate the specific work activities and occupational exposure to respiratory hazards as predictors of chronic respiratory symptoms development, lung function decline, and respiratory health impairment among crop farmers. METHODS: A cross-sectional survey was performed, including 87 crop farmers (mean age: 53.4 ± 7.8 years; and mean exposure duration: 22.9 ± 7.8 years) and 80 office workers as a control group (mean age: 52.7 ± 8.2 years) matched for age, smoking habits, and socioeconomic status. Subjects were evaluated by a questionnaire on respiratory symptoms in the past 12 months and spirometry testing. RESULTS: Crop farmers had a significantly higher prevalence of cough (41.4), phlegm (28.7%), and dyspnea (21.8%), than controls (p < 0.05). All mean baseline spirometric parameters were lower in crop farmers, but statistical significance was confirmed only for MEF25, MEF50, and MEF75 (p = 0.003, p = 0.000, and p = 0.001, respectively). Most of the respiratory symptoms were significantly associated with common work activities of crop farmers and all-day exposure to certain respiratory hazards. Age, exposure duration, and their combined effect with smoking habit had a significant effect on forced expiratory volume in one second FEV1 and FEV1/forced vital capacity. CONCLUSION: The results confirm that occupational exposure among crop farmers is associated with higher prevalence of respiratory symptoms and lung function decline and, together with specific workflow activities, may not only be a predictors of respiratory health impairment, but also a key tool in the creation of preventive strategies.

Respiratory and Allergic Effects in Children Exposed to Pesticides-A Systematic Review

Pesticide exposure may affect children’s respiratory and allergic health, although results from epidemiological studies have not reached consensus. This review aims to analyze the scientific evidence on respiratory and allergic effects of exposure to agricultural pesticides in children aged up to 12 years old. The databases PubMed, Web of Science, Scielo, and Lilacs were screened to select articles published in English, Spanish, or Portuguese, and 21 articles were included in this review. Most investigations were conducted in North America (mostly in the United States), while no studies conducted in Latin America or Africa were found, despite their intensive use of pesticides. Children are exposed to pesticides through multiple pathways from the prenatal period throughout later developmental stages and may experience several respiratory effects. Most studies (79%) found positive associations with pesticide exposure and children’s respiratory and allergic effects such as asthma, wheezing, coughs, acute respiratory infections, hay fever, rhinitis, eczema, chronic phlegm, and lung function impairments. Contrastingly, 21% of the studies found no associations between pesticide exposure and children’s respiratory health. The vast differences among the characteristics of the studies hamper any comparison of the results. Exposure to pesticides may have several impacts on childhood respiratory health. More studies must be conducted, especially in low- and middle-income countries, preferably with comparable research protocols adapted to local realities. Efforts should be made to develop comprehensive risk mitigation strategies and behavioral interventions to reduce children’s exposure to pesticides used in agriculture and respiratory health effects, and to ensure healthy childhood growth.

Acute pesticide poisoning amongst adolescent girls and women in northern Tanzania

BACKGROUND

Acute pesticide poisoning (APP) is reported to affect community health worldwide but its burden in Tanzania is unknown particularly in women. This study examines APP involving adult females and adolescent girls 10 to 19 years in 3 regions of Tanzania which are famous for coffee and vegetable production.

METHODS

Over the period of 12 months, health facility-based surveillance for cases of APP was implemented in 10 Tanzanian healthcare facilities in 2006.

RESULTS

The study identified 108 APP cases of whom 31 (28.7%) occurred amongst adolescent girls. Suicide was the leading poisoning circumstances (60.2%) and the most vulnerable women were 20-29 years old who comprised 38.4% of all cases with suicide as circumstance. Organophosphates (OPs), zinc phosphide, paraquat and endosulfan were common amongst known reported poisoning agents. The annual APP incidence, mortality and Case Fatality Rate for women were 5.1/100,000, 0.2/100,000 and 3.7/100, respectively.

CONCLUSION

APP amongst women in Tanzania is common and this call for diverse preventive interventions to reduce poisoning incidents.

Effects of glyphosate exposure on human health: Insights from epidemiological and in vitro studies

Glyphosate (GLY) is a broad-spectrum, post-emergent, non-selective and synthetic universal herbicide, whose commercial formulations are referred to as glyphosate-based-herbicides (GBHs). These chemicals and their metabolites can be found in soil, air, water, as well as groundwater and food products. This review summarizes to summarize current in vitro and epidemiological studies investigating the effects of GLY exposure on human health. Recent human cell studies have reported several GLY and GBH toxicological effects and have contributed to a better understanding of the deleterious consequences associated with their exposure. However, these detrimental effects are dependent on the cell type, chemical composition, as well as magnitude and time of exposure, among other factors. Moreover, the deleterious effects of GLY exposure on human health were observed in epidemiological studies; however, most of these studies have not determined the GLY dosage to confirm a direct effect. While GLY toxicity is clear in human cells, epidemiological studies investigating individuals exposed to different levels of GLY have reported contradictory data. Therefore, based on currently available in vitro and epidemiological data, it is not possible to confirm the complete safety of GLY use, which will require additional comprehensive studies in animal models and humans.

Alimentação saudável e sustentável: uma revisão narrativa sobre desafios e perspectivas

Resumo Parte-se do princípio que um sistema alimentar insustentável não é capaz de produzir alimentos saudáveis para o consumo. A alimentação só pode ser considerada saudável se for também sustentável, devendo ultrapassar a perspectiva nutricional. Assim, realizou-se uma revisão narrativa de literatura acerca de sistemas alimentares saudáveis e sustentáveis, englobando aspectos de produção, processamento, comercialização e consumo, visando levantar seus desafios e perspectivas de consolidação. A alimentação saudável e sustentável deve estar relacionada à produção de alimentos que protejam a biodiversidade e promovam o consumo variado, resgatando alimentos, preparações e hábitos culturais tradicionais. Deve ser acessível e disponível a todos, em quantidade e qualidade, baseada em alimentos produzidos e processados na região, por agricultores familiares, de maneira agroecológica, fundamentada na comercialização justa, aproximando a produção do consumo. Além disso, deve ser isento de contaminantes físicos, biológicos ou químicos que causem malefícios a todos os envolvidos, de maneira aguda ou crônica.

Pesticide use, allergic rhinitis, and asthma among US farm operators

OBJECTIVE

The objective of the study is to examine associations between use of specific pesticides and lifetime allergic rhinitis and current asthma in US primary farm operators.

METHODS

The 2011 Farm and Ranch Safety Survey data from 11,210 primary farm operators were analyzed. Pesticide use on the farm was determined using an affirmative response to the question of whether the operator ever mixed, loaded, or applied pesticides on their farm in the 12 months prior to the interview. Operators who answered "yes" were further asked about the specific trade name and formulation identifiers of the product they used and personal protective equipment (PPE) used. Data were weighted to produce national estimates. Adjusted prevalence odds ratios (PORs) were calculated using logistic regression. The referent group included operators who did not use any pesticides in the 12 months prior to the interview.

RESULTS

Of an estimated 2.1 million farm operators, 40.0% used pesticides, 30.8% had lifetime allergic rhinitis, and 5.1% had current asthma. Insecticide and herbicide use were significantly associated with lifetime allergic rhinitis and current asthma. The use of 2,4-dichlorophenoxyacetic acid (POR = 1.5; 95% CI 1.2-1.9) and carbaryl (POR = 2.3; 1.4-3.7) was significantly associated with lifetime allergic rhinitis. Of operators using pesticides, 64.9% used PPE the last time they mixed, loaded, or applied pesticides.

CONCLUSIONS

Pesticide use was associated with lifetime allergic rhinitis and current asthma among farm operators. Further studies are needed to clarify the dose-response relationship between pesticide use and adverse respiratory health effects.

Respiratory Condition of Family Farmers Exposed to Pesticides in the State of Rio de Janeiro, Brazil

Pesticide exposure is a growing public health concern. Although Brazil is the world’s largest consumer of pesticides, only a few studies have addressed the health effects among farmers. This study aimed to evaluate whether pesticide exposure is associated with respiratory outcomes among rural workers and relatives in Brazil during the crop and off-seasons. Family farmers (82) were interviewed about occupational history and respiratory symptoms, and cholinesterase tests were conducted in the crop-season. Spirometry was performed during the crop and off-season. Respiratory outcomes were compared between seasons and multiple regressions analysis were conducted to search for associations with exposure indicators. Participants were occupationally and environmentally exposed to multiple pesticides from an early age. During the crop and off-season, respectively, they presented a prevalence of 40% and 30.7% for cough, 30.7% and 24% for nasal allergies, and 24% and 17.3% for chest tightness. Significant associations between spirometry impairments and exposure indicators were found both during the crop and off-season. These findings provide complementary evidence about the association of pesticide exposure with adverse respiratory effects among family farmers in Brazil. This situation requires special attention as it may increase the risk of pulmonary dysfunctions, and the morbidity and mortality burden associated with these diseases.

Symptoms of asthma and associated factors in adolescents from Salvador, Bahia

OBJECTIVE

Identify the factors associated with asthma symptoms in adolescents.

METHODS

Cross-sectional study with the participation of 1,176 students between the ages of 11 and 17 years old, in Salvador, Bahia, Brazil. The asthma symptoms were identified by using the standardized questionnaire from The International Study of Asthma and Allergies in Childhood Program (ISAAC), phase III. The subjects' food intake data were collected by a semiquantitative food frequency questionnaire (FFQ) comprised of 97 food items. All of the information was collected during a single interview. Anthropometric, socioeconomic, and demographic data were collected from the study population. The robust Poisson model was adopted to obtain the raw and adjusted PR (prevalence ratio).

RESULTS

From the total number of adolescents, 57.6% are female and 83.71% of them were between 13 and 17 years old. The prevalence of asthma symptoms was of 7.6%, being higher among males (9.62%). The prevalence of wheezing in the last 12 months was 8.6%. Among the adolescents with rhinitis and eczema, the prevalence of asthma symptoms was of 15.2 and 14.3%, respectively. After an adjusted analysis, the following factors were identified: females PR = 0.64 (95%CI 0.42 - 0.96), rhinitis PR = 3.23 (95%CI 2.17 - 4.83) and the 2nd tertile of the healthy pattern (moderate consumption) PR = 0.61 (95%CI 0.37 - 0.99).

CONCLUSION

Rhinitis and eczema were presented as risk factors for asthma symptoms. The healthy food intake pattern that had been stratified in tertiles, presented the 2nd tertile as a protector for asthma symptoms.

Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age

RATIONALE

Population-based studies have found evidence of a relationship between occupational exposures and Chronic Obstructive Pulmonary Disease (COPD), but these studies are limited by the use of prebronchodilator spirometry. Establishing this link using postbronchodilator is critical, because occupational exposures are a modifiable risk factor for COPD.

OBJECTIVES

To investigate the associations between occupational exposures and fixed airflow obstruction using postbronchodilator spirometry.

METHODS

One thousand three hundred and thirty-five participants were included from 2002 to 2008 follow-up of the Tasmanian Longitudinal Health Study (TAHS). Spirometry was performed and lifetime work history calendars were used to collect occupational history. ALOHA plus Job Exposure Matrix was used to assign occupational exposure, and defined as ever exposed and cumulative exposure unit (EU)-years. Fixed airflow obstruction was defined by postbronchodilator FEV₁/FVC <0.7 and the lower limit of normal (LLN). Multinomial logistic regressions were used to investigate potential associations while controlling for possible confounders.

RESULTS

Ever exposure to biological dust (relative risk (RR)=1.58, 95% CI 1.01 to 2.48), pesticides (RR=1.74,95% CI 1.00 to 3.07) and herbicides (RR=2.09,95% CI 1.18 to 3.70) were associated with fixed airflow obstruction. Cumulative EU-years to all pesticides (RR=1.11,95% CI 1.00 to 1.25) and herbicides (RR=1.15,95% CI 1.00 to 1.32) were also associated with fixed airflow obstruction. In addition, all pesticides exposure was consistently associated with chronic bronchitis and symptoms that are consistent with airflow obstruction. Ever exposure to mineral dust, gases/fumes and vapours, gases, dust or fumes were only associated with fixed airflow obstruction in non-asthmatics only.

CONCLUSIONS

Pesticides and herbicides exposures were associated with fixed airflow obstruction and chronic bronchitis. Biological dust exposure was also associated with fixed airflow obstruction in non-asthmatics. Minimising occupational exposure to these agents may help to reduce the burden of COPD.

Pesticide exposures and respiratory health in general populations

Human exposures to pesticides can occur in the workplace, in the household and through the ambient environment. While several articles have reviewed the impact of pesticide exposures on human respiratory health in occupational settings, to the best of our knowledge, this article is the first one to review published studies on the association between pesticide exposures and human respiratory health in the general populations. In this article, we critically reviewed evidences up to date studying the associations between non-occupational pesticide exposures and respiratory health in general populations. This article also highlighted questions arising from these studies, including our recent analyses using the data from the Canadian Health Measures Survey (CHMS), for future research. We found few studies have addressed the impact of environmental pesticide exposures on respiratory health, especially on lung function, in general populations. In the studies using the data from CHMS Cycle 1, exposures to OP insecticides, pyrethroid insecticides, and the organochlorine pesticide DDT were associated with impaired lung function in the Canadian general population, but no significant associations were observed for the herbicide 2,4-D. Future research should focus on the potential age-specific and pesticide-specific effect on respiratory health in the general population, and repeated longitudinal study design is critical for assessing the temporal variations in pesticide exposures. Research findings from current studies of non-occupational pesticide exposures and their health impact in general population will help to improve the role of regulatory policies in mitigating pesticide-related public health problems, and thereafter providing greater benefit to the general population.

Occupational pesticide exposure and respiratory health: a large-scale cross-sectional study in three commercial farming systems in Ethiopia

RATIONALE

In the last decade, due to expansion of greenhouses and irrigated farms, the use of pesticides in Ethiopia has increased 6-13-fold leading to potential health risks.

OBJECTIVE

To investigate if occupational exposure to pesticides is associated with respiratory health effects in farmers and farm workers from commercial farming systems.

METHODS

We performed two cross-sectional surveys comprising different farming systems. In the first survey we studied respiratory symptoms among 1104 subjects of which 601 were occupationally exposed to pesticides (ie, 256 pesticide applicators, 345 re-entry workers) and 503 unexposed individuals. The second survey, carried out 2 years later in the same farming regions, additionally included lung function measurement and comprised a total of 387 study subjects of which 206 were occupationally exposed to pesticides (142 applicators and 64 re-entry workers) and 180 unexposed individuals.

RESULTS

We observed increased risks for chronic cough and shortness of breath (OR=3.15, 95% CI 1.56 to 6.36 and OR=6.67, 95% CI 2.60 to 17.58) among the exposed subjects as compared with unexposed individuals in the first survey. These results were corroborated in the second survey where we also observed reductions in FEV₁ (140 mL), forced expiratory flow 25%-75% (550 mL/s) and risk of FEV₁/FVC ratio <0.8 (OR=4.31, 95% CI 2.11 to 8.81) among pesticide exposed workers.

CONCLUSIONS

These findings indicate an increased risk of adverse respiratory health among workers exposed to pesticides. As those effects occurred in young workers (mean age 27 years) and within a relative short duration of exposure (4 years) implementation of stringent occupational health measures are warranted.

Occupational exposure to pesticides and respiratory health

This article aims to review the available literature regarding the link between occupational exposure to pesticides and respiratory symptoms or diseases. Identification of epidemiological studies was performed using PubMed. 41 articles were included, 36 regarding agricultural workers and five regarding industry workers. Among the 15 cross-sectional studies focusing on respiratory symptoms and agricultural pesticide exposure, 12 found significant associations with chronic cough, wheeze, dyspnoea, breathlessness or chest tightness. All four studies on asthma found a relationship with occupational exposure, as did all three studies on chronic bronchitis. The four studies that performed spirometry reported impaired respiratory function linked to pesticide exposure, suggestive of either obstructive or restrictive syndrome according to the chemical class of pesticide. 12 papers reported results from cohort studies. Three out of nine found a significant relationship with increased risk of wheeze, five out of nine with asthma and three out of three with chronic bronchitis. In workers employed in pesticide production, elevated risks of chronic obstructive pulmonary disease (two studies out of three) and impaired respiratory function suggestive of an obstructive syndrome (two studies out of two) were reported. In conclusion, this article suggests that occupational exposure to pesticides is associated with an increased risk of respiratory symptoms, asthma and chronic bronchitis, but the causal relationship is still under debate.

Wheezing in tobacco farm workers in southern Brazil

BACKGROUND

Tobacco workers are exposed to several respiratory occupational sensitizers.

METHODS

A representative cross-sectional study was carried out on 2469 tobacco family farming growers. Gender-stratified multivariate analyses evaluated the association between wheezing and socio-demographic, behavioral, and occupational variables.

RESULTS

Wheezing prevalence was 11.0% with no difference between genders. Among men, age, smoking, strenuous work, pesticide use, contact with vegetable dust and dried tobacco dust, lifting sticks with tobacco leaves to the curing barns, and green tobacco sickness (GTS) were risk factors for wheezing. Among women, family history of asthma, tying hands of tobacco, strenuous work, contact with chemical disinfectants, and GTS were positively associated with wheezing. Harvesting lower tobacco leaves was a protective factor for the outcome in both genders.

CONCLUSIONS

Pesticides, dusts exposure, and GTS were risk factors for wheezing. The synergic effect of these factors needs to be better evaluated to improve prevention.

Gender in occupational health research of farmworkers: a systematic review

Background

Farmwork is one of the most hazardous occupations for men and women. Research suggests sex/gender shapes hazardous workplace exposures and outcomes for farmworkers. This paper reviews the occupational health literature on farmworkers, assessing how gender is treated and interpreted in exposure-outcome studies.

Methods

The paper evaluates peer-reviewed articles on men and women farmworkers' health published between 2000 and 2012 in PubMed or SCOPUS. Articles were identified and analyzed for approaches toward sampling, data analysis, and use of exposure indicators in relation to sex/gender.

Results

18% of articles reported on and interpreted sex/gender differences in health outcomes and exposures. Sex/gender dynamics often shaped health outcomes, yet adequate data was not collected on established sex/gender risk factors relating to study outcomes.

Conclusion

Research can better incorporate sex/gender analysis into design, analytical and interpretive approaches to better explore its mediation of health outcomes in light of emerging calls to mainstream gender research. Am. J. Ind. Med. 57:1344–1367, 2014. © 2014 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Asthma associated with pesticide exposure among women in rural Western Cape of South Africa

BACKGROUND

Few studies have investigated asthma and pesticides among women farm workers in developing countries.

METHODS

A cross-sectional study was conducted to investigate the association between pesticides and asthma among rural women (n = 211). Outcome measurements included respiratory symptoms (European Community Respiratory Health Survey questionnaire), immunological status (Phadiatop, serum IgE to mite allergens) and lower airway inflammation (fractional exhaled nitric oxide (FeNO) levels). Exposure variables included self-reported pesticide exposure and whole blood cholinesterase (ChE).

RESULTS

The prevalence of ocular-nasal symptoms (ONS), doctor-diagnosed asthma and current asthma was 24%, 11%, and 6% respectively. ONS was positively associated with re-entering a sprayed field (OR = 2.97; CI: 0.93-9.50). Asthma symptom score was associated with low ChE (OR = 1.93; CI: 1.09-3.44). Participants with high FeNO (>50 ppb) also had an elevated odds of having low ChE (OR = 4.8; CI: 0.80-28.00).

CONCLUSION

Pesticide exposure among women farm workers is associated with increased risk of ocular nasal symptoms and an elevated asthma symptom score.

Pesticide use and cholinesterase inhibition in small-scale agricultural workers in southern Brazil

A controlled cross-sectional study of family growers of fruit and vegetables was conducted between October 2009 and October 2010 to characterize the use of pesticides, establish the socio-demographic profile, and analyze cholinesterase activity in small-scale agricultural workers in Southern Brazil. Data was collected for 173 workers and 179 controls. A structured questionnaire was applied collecting socio-demographic information and determining knowledge and work practices in relation to pesticide use. The benchmarks for total cholinesterase (ChEs) and butyrylcholinesterase (BuChE) were obtained from the average enzymatic activity of the occupationally unexposed group (control). The mean age of the exposed population was 40.0 ± 11.2 years. The symptoms differed significantly (p<0.05) between the exposed and unexposed populations. Forty (23.1%) workers showed symptoms associated with exposure to pesticides. The average value of enzymatic activity in the occupationally unexposed group for ChEs was 6.3 μmol/mL/min among males and 5.6 μmol/mL/min among females while for BuChE was 2.4 μmol/mL/min among males and 2.0 μmol/mL/min among females. Eight (4.6%) workers had high inhibition (>30%) of ChEs activity, whereas no workers showed high inhibition (>50%) of BuChE. Potential factors involved include gender, education, pesticide orientation, exposure, and hygiene measures.

Respiratory Symptoms among Crop Farmers Exposed to Agricultural Pesticide in Three Rural Communities in South Western Nigeria: A Preliminary Study

Background:

The improper use of pesticide is associated with respiratory morbidity in many developing countries.

Aim:

The purpose of this study was to determine the prevalence of respiratory symptoms and its association with the use of agricultural pesticide among crop farmers in three rural communities in Ekiti State, South Western Nigeria.

Subjects and Methods:

This was a cross-sectional study conducted in Ijero local government in Ekiti State, Nigeria from June 2009 to August 2009. Pre-tested structured questionnaire was administered by trained interviewers to obtain clinical information and exposure to pesticide and this was followed by peak expiratory flow rate (PEFR) measurement using wright peak flow meter. The data were analyzed using SPSS version 15 (SPSS Corp., Chicago, IL, USA).

Results:

A total of 228 farmers participated in the study and 8.3% (19/228)of the farmers reported a lifetime exposure to pesticides. Recurrent breathlessness (odds ratio [OR] = 4.28; 95% confidence interval [CI]: 1.65-10.86), chronic cough (OR = 2.96; 95% CI: 1.21-7.23), chronic sputum (OR = 2.64; 95% CI: 1.12-6.24) and nasal symptoms (OR = 2.96; 95% CI: 1.21-7.25) were independently associated with pesticide exposure. Mean PEFR was lower in farmers using pesticide (323 [217] L/min) when compared with those not using pesticide (467 [189] L/min) P < 0.01. All the 228 (100.0%) respondents in this study were aware of the adverse effect of pesticide and only 2 (10.5%) of those exposed used a respiratory protective device. Previous pesticide education was not significantly associated with lower occurrence of respiratory symptoms.

Conclusion:

The use of pesticide among crop farmers is associated with increased respiratory symptoms and airflow limitations. Our results support the need for continuing pesticide education and promotion of safe practices among the farmers as the majority of them do not use protective devices.

Occupational pesticide exposures and respiratory health

Pesticides have been widely used to control pest and pest-related diseases in agriculture, fishery, forestry and the food industry. In this review, we identify a number of respiratory symptoms and diseases that have been associated with occupational pesticide exposures. Impaired lung function has also been observed among people occupationally exposed to pesticides. There was strong evidence for an association between occupational pesticide exposure and asthma, especially in agricultural occupations. In addition, we found suggestive evidence for a link between occupational pesticide exposure and chronic bronchitis or COPD. There was inconclusive evidence for the association between occupational pesticide exposure and lung cancer. Better control of pesticide uses and enforcement of safety behaviors, such as using personal protection equipment (PPE) in the workplace, are critical for reducing the risk of developing pesticide-related symptoms and diseases. Educational training programs focusing on basic safety precautions and proper uses of personal protection equipment (PPE) are possible interventions that could be used to control the respiratory diseases associated with pesticide exposure in occupational setting.

Avaliação in situ da genotoxicidade de triazinas utilizando o bioensaio Trad-SHM de Tradescantia clone 4430

O bioensaio da mutação do pelo estaminal de Tradescantia clone 4430 (Trad-SHM) foi utilizado para avaliar a genotoxicidade de um herbicida composto por triazinas (atrazina e simazina) após exposição in situ. Trinta vasos da planta foram expostos durante a aplicação do herbicida (grupo teste) mantendo-se um grupo controle em casa de vegetação. A genotoxicidade foi expressa em termos de eventos mutantes pink (EMP) e a análise dos dados foi realizada por meio do teste t de Student em oito dias de avaliação (C8D = controle 8 dias; T8D = teste 8 dias) e no dia de pico (CPD = controle dia de pico; TPD = teste dia de pico). A exposição ao herbicida causou um número significativamente maior de EMP no grupo teste (T8D = 2,27; TPD = 4,69) do que no controle (C8D = 0,71; CPD = 0,62), demonstrando a existência de risco genotóxico associado ao uso das triazinas, sendo o bioensaio Trad-SHM uma eficiente ferramenta para avaliar o potencial genotóxico destes contaminantes ambientais causadores de efeitos adversos à saúde humana.

Pesticides and human chronic diseases: evidences, mechanisms, and perspectives

Along with the wide use of pesticides in the world, the concerns over their health impacts are rapidly growing. There is a huge body of evidence on the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson, Alzheimer, and amyotrophic lateral sclerosis (ALS), birth defects, and reproductive disorders. There is also circumstantial evidence on the association of exposure to pesticides with some other chronic diseases like respiratory problems, particularly asthma and chronic obstructive pulmonary disease (COPD), cardiovascular disease such as atherosclerosis and coronary artery disease, chronic nephropathies, autoimmune diseases like systemic lupus erythematous and rheumatoid arthritis, chronic fatigue syndrome, and aging. The common feature of chronic disorders is a disturbance in cellular homeostasis, which can be induced via pesticides' primary action like perturbation of ion channels, enzymes, receptors, etc., or can as well be mediated via pathways other than the main mechanism. In this review, we present the highlighted evidence on the association of pesticide's exposure with the incidence of chronic diseases and introduce genetic damages, epigenetic modifications, endocrine disruption, mitochondrial dysfunction, oxidative stress, endoplasmic reticulum stress and unfolded protein response (UPR), impairment of ubiquitin proteasome system, and defective autophagy as the effective mechanisms of action.

Promoção da Saúde, Sustentabilidade e Agroecologia: uma discussão intersetorial

Analisando a abordagem conceitual dos ideários de Agroecologia e da Promoção da Saúde, percebe-se a aproximação desses campos científicos e práticos a partir de suas diretrizes comuns de fomentar a democracia, promover a cidadania, o empowerment, a autonomia e a participação comunitária dos atores sociais, resgatar saberes e práticas tradicionais e populares, além de promover saúde, qualidade de vida e sustentabilidade nos níveis ambiental, social e econômico. Entretanto, apesar de suas interfaces comuns, esses dois campos não têm dialogado. A Agroecologia e sua potencial ação de promoção de saúde no meio rural não têm sido discutidas na Saúde Pública e na Promoção da Saúde; por sua vez, tais áreas tampouco têm produzido conhecimentos que possam contribuir para o fortalecimento da Agroecologia enquanto estratégia de promoção da saúde. Esse artigo pretende ressaltar a relação entre esses dois campos de estudos, explorando-os conceitualmente. Além disso, o artigo sinaliza a Agroecologia como uma estratégia intersetorial de promoção da saúde, de sustentabilidade e de segurança alimentar e nutricional.

Job activities and respiratory symptoms among farmworkers in North Carolina

Respiratory health is an important component of the ability to perform physically demanding work. The authors assessed respiratory symptom prevalence among Latino farmworkers engaged in crop production, and investigated work activities as risk factors for respiratory symptoms. During June to September 2008, 122 farmworkers completed up to 3 questionnaires. The authors estimated associations between work activities and wheezing symptoms using alternating logistic regression, controlling for age and smoking. At the first data collection, 29 (24%) farmworkers reported ever wheezing and 10 (8%) reported wheezing within the past month. Though not statistically significant, the odds of wheezing were elevated for individuals who reported performing tobacco-related work in the last 3 days. The odds were decreased among individuals who reported harvesting activities (odds ratio: 0.3, 95% confidence interval: 0.1, 1.0). Among Latino farmworkers, respiratory symptoms may be associated with work activities.

Association of chronic pesticide exposure with serum cholinesterase levels and pulmonary functions

The present study focused on the analysis of serum cholinesterase levels and the pulmonary function tests in seasonal farm workers who were chronically exposed to pesticides, mostly organophosphorus, in comparison with non-farm workers in the farming areas of Cukurova region, Turkey. Serum cholinesterase levels and pulmonary function tests using spyrometer in 50 male seasonal farm workers (study group) were compared to 50 male non-farm workers (control group) in this cross-sectional study. The mean serum cholinesterase enzyme level in the farm worker group (7095.5 ± 1699.4 U/L) was significantly lower than those of the control group (9716.4 ± 1484.4 U/L) (p < .001). There was no significant difference between pulmonary function tests of 2 groups (p > .05). These results show that chronic environmental organophosphorus exposure caused a decrease in the serum cholinesterase enzyme levels in farm workers, emphasizing the importance of primary prevention.

Lung function and respiratory symptoms in male Palestinian farmers

In a cross-sectional study of 250 farmers aged 22 to 77 years, of whom 36.4% are smokers, the authors aimed at describing lung function and respiratory symptoms and to estimate associations with exposures to pesticides and dust. Lung function was measured using a spirometer. Respiratory symptoms and exposure levels were self-reported based on a modified standardized questionnaire. Mean forced vital capacity (FVC) was 4.20 L (SD = 0.93 L), 95.51% of predicted as compared to European standards. Mean forced expiratory volume in one second (FEV(1)) was 3.28 L (SD = 0.80 L), 91.05% of predicted. The authors found high symptom prevalences: 14.0% for chronic cough; 26.4% for wheeze; and 55.2% for breathlessness. There was no clear association between exposure to pesticides or dust and lung function or between such exposures and respiratory symptoms. However, a significant association was found between smoking and respiratory symptoms such as chronic cough, cough with phlegm, and wheezes. The lack of farm exposure associations could be due to improvement in farmers' awareness to pesticides hazards as well as regulations of pesticide import, or because of inherent problems with the experimental design. Farmers who kept animals and poultry seem to have less respiratory symptoms and better lung function.

Pesticide exposure and respiratory health of indigenous women in Costa Rica

A cross-sectional study was conducted in 2007 to evaluate the relation between pesticide exposure and respiratory health in a population of indigenous women in Costa Rica. Exposed women (n = 69) all worked at plantain plantations. Unexposed women (n = 58) worked at organic banana plantations or other locations without pesticide exposure. Study participants were interviewed using questionnaires to estimate exposure and presence of respiratory symptoms. Spirometry tests were conducted to obtain forced vital capacity and forced expiratory volume in 1 second. Among the exposed, prevalence of wheeze was 20% and of shortness of breath was 36% versus 9% and 26%, respectively, for the unexposed. Prevalence of chronic cough, asthma, and atopic symptoms was similar for exposed and unexposed women. Among nonsmokers (n = 105), reported exposures to the organophosphate insecticides chlorpyrifos (n = 25) and terbufos (n = 38) were strongly associated with wheeze (odd ratio = 6.7, 95% confidence interval: 1.6, 28.0; odds ratio = 5.9, 95% confidence interval: 1.4, 25.6, respectively). For both insecticides, a statistically significant exposure-effect association was found. Multiple organophosphate exposure was common; 81% of exposed women were exposed to both chlorpyrifos and terbufos. Consequently, their effects could not be separated. All findings were based on questionnaire data. No relation between pesticide exposure and ventilatory lung function was found.