Case report: three farmworkers who gave birth to infants with birth defects closely grouped in time and place-Florida and North Carolina, 2004-2005

Pesticides and environmental injustice in the USA: root causes, current regulatory reinforcement and a path forward

Many environmental pollutants are known to have disproportionate effects on Black, Indigenous and People of Color (BIPOC) as well as communities of low-income and wealth. The reasons for these disproportionate effects are complex and involve hundreds of years of systematic oppression kept in place through structural racism and classism in the USA. Here we analyze the available literature and existing datasets to determine the extent to which disparities in exposure and harm exist for one of the most widespread pollutants in the world – pesticides. Our objective was to identify and discuss not only the historical injustices that have led to these disparities, but also the current laws, policies and regulatory practices that perpetuate them to this day with the ultimate goal of proposing achievable solutions. Disparities in exposures and harms from pesticides are widespread, impacting BIPOC and low-income communities in both rural and urban settings and occurring throughout the entire lifecycle of the pesticide from production to end-use. These disparities are being perpetuated by current laws and regulations through 1) a pesticide safety double standard, 2) inadequate worker protections, and 3) export of dangerous pesticides to developing countries. Racial, ethnic and income disparities are also maintained through policies and regulatory practices that 4) fail to implement environmental justice Executive Orders, 5) fail to account for unintended pesticide use or provide adequate training and support, 6) fail to effectively monitor and follow-up with vulnerable communities post-approval, and 7) fail to implement essential protections for children. Here we’ve identified federal laws, regulations, policies, and practices that allow for disparities in pesticide exposure and harm to remain entrenched in everyday life for environmental justice communities. This is not simply a pesticides issue, but a broader public health and civil rights issue. The true fix is to shift the USA to a more just system based on the Precautionary Principle to prevent harmful pollution exposure to everyone, regardless of skin tone or income. However, there are actions that can be taken within our existing framework in the short term to make our unjust regulatory system work better for everyone.

Associação entre malformações congênitas e a utilização de agrotóxicos em monoculturas no Paraná, Brasil

RESUMO O objetivo deste artigo é analisar a associação entre o uso de agrotóxicos e as malformações congênitas em municípios com maior exposição aos agrotóxicos no estado do Paraná, Brasil, entre 1994 e 2014. Estudo de abordagem quantitativa, ecológico, conduzido com informações dos nascidos vivos (Sinasc/Ministério da Saúde), elaborando-se taxas de malformações ocorridas de 1994 a 2003 e de 2004 a 2014. Foi encontrada uma tendência crescente nas taxas de malformação congênita no estado do Paraná, com destaque aos municípios de Francisco Beltrão e Cascavel. Essas malformações congênitas podem ser advindas da exposição da população a agrotóxicos, sendo uma sinalização expressiva nos problemas de saúde pública.

A systematic review of Mancozeb as a reproductive and developmental hazard

BACKGROUND

The potential adverse reproductive and developmental effects of Mancozeb, especially in sensitive subpopulations, have not been fully reviewed for this widely used fungicide.

OBJECTIVE

To review the experimental and epidemiologic evidence for the association between exposure to Mancozeb and reproductive and developmental health outcomes using an adaptation of the National Toxicology Program's Office of Health Assessment and Translation (OHAT) systematic review framework.

DATA SOURCES

Four databases (PubMed, TOXNET, Web of Science, Google Scholar) were searched for published studies on Mancozeb. Of 403 identified articles, 30 met our inclusion criteria for systematic review.

RESULTS

Results from in vitro studies provide evidence that Mancozeb may indirectly disrupt or impair reproduction at the cellular level and should be regarded as a reproductive toxicant. Animal studies confirm reproductive and developmental toxicity in mammals and suggest that males chronically exposed to Mancozeb experience significant changes in physiological, biochemical, and pathological processes that may lead to infertility. Epidemiological studies were limited to indirect methods of exposure assessment and examined the effect of fungicides more broadly during pre-conception, pregnancy, and birth, yielding mixed results.

CONCLUSIONS

High confidence ratings from in vitro and animal studies, in combination with moderate confidence ratings from epidemiologic studies employing indirect methods of exposure assessment, provide evidence that Mancozeb should be regarded as a suspected developmental hazard and a presumed reproductive hazard in humans. More population-based studies linking direct measures and/or biomarkers of exposure to adverse effects on male and female fertility, as well as in utero and early life development, are needed to improve the quality of the evidence base concerning the human reproductive and developmental consequences of Mancozeb exposure.

Occupational risks and pregnancy and infant health outcomes in Florida farmworkers

The agricultural industry has some of the highest incidence rates and numbers of occupational injuries and illnesses in the United States. Injuries and illnesses in agriculture result from accidents, falls, excessive heat, repetitive motion and adverse pesticide exposure. Women working in agriculture are exposed to the same hazards and risks as their male counterparts, but can face additional adverse impacts on their reproductive health. Yet, few occupational risk assessment studies have considered the reproductive health of female farmworkers. The objective of this community-based participatory research study was to conduct a retrospective, cross-sectional survey to collect information on workplace conditions and behaviors and maternal, pregnancy and infant health outcomes among a sample of female nursery and fernery farmworkers in Central Florida. Survey results showed that nursery workers were more likely to report health symptoms during their pregnancy than fernery workers. We also observed a self-reported increased risk of respiratory illness in the first year of life for infants whose mothers worked in ferneries. Our findings confirm that agricultural work presents potential reproductive hazards for women of childbearing age.

Pesticide risk perception and biomarkers of exposure in Florida female farmworkers

OBJECTIVE

To compare workplace characteristics, workplace behaviors, and the health beliefs of female farmworkers of childbearing age with actual biomarkers of exposure to organophosphate pesticides and to the fungicide mancozeb.

METHODS

Hispanic and Haitian farmworkers between the ages of 18 and 40 years working in nursery or fernery operations were recruited to participate in a cross-sectional survey, examining demographics, work practices, work-related hygiene, and pesticide exposure beliefs. Single-void (spot) urine samples were analyzed for organophosphate and ethylenethiourea metabolites.

RESULTS

Women in nurseries worried less frequently about the effects of pesticides on their health than those in fernery operations. In summary, organophosphate and ethylenethiourea levels in nursery workers were significantly higher than levels in fernery workers and the control group.

CONCLUSIONS

Results showed that perceived pesticide exposure did not correspond to actual metabolite levels within differing agricultural subpopulations.

Female farmworkers' health during pregnancy: health care providers' perspectives

Pregnant farmworkers and their fetuses are at increased risk of negative health outcomes due to environmental and occupational factors at their workplaces. Health care providers who serve farm communities can positively affect workers' health through the informed care they deliver. Yet, interviews with rural health care providers reveal limited knowledge about agricultural work or occupational and environmental health risks during pregnancy. Professional associations, government organizations, academic institutions, and practice settings must renew their efforts to ensure that environmental and occupational health education, especially as it relates to women and their children, is incorporated into academic and practice environments.

Effectiveness of pesticide safety training and knowledge about pesticide exposure among Hispanic farmworkers

BACKGROUND

Pesticide poisoning rates remain high among farmworkers despite programs aimed at reducing pesticide exposure.

METHODS

A cross-sectional study was conducted among 187 Hispanic farmworkers in North Carolina. Farmworkers were interviewed to determine the association between pesticide safety training and knowledge about pesticides and use of personal protective equipment (PPE).

RESULTS

Use of PPE was higher among farmworkers who reported wearing gloves reduced the harmful effects of pesticides (adjusted odds ratio, 5.73; 95% confidence interval, 2.20-14.92) and those who received pesticide safety training at the extension office or growers association (adjusted odds ratio, 44.62; 95% confidence interval, 3.96-503.33).

CONCLUSION

Some farmworkers are still not using PPE. Evaluation of Environmental Protection Agency Worker Protection Standards pesticide safety training and requirements for providing PPE are crucial to encourage farm workers to use PPE.

Evaluating the effectiveness of a lay health promoter-led, community-based participatory pesticide safety intervention with farmworker families

Pesticide safety training is mandated for migrant and seasonal farmworkers. However, none is required for family members, who implement home sanitation to protect against pesticide exposure and need to control pests in substandard housing. Controlled studies have demonstrated the efficacy of pesticide education programs for farmworker families, but no carefully evaluated demonstration projects have shown effectiveness in public health settings. This project evaluates a lay health promoter program to improve pesticide-related knowledge and practices. Promotoras from six agencies recruited families with children to deliver a six-lesson, in-home, culturally and educationally appropriate curriculum. Independently conducted pre- and posttests evaluated changes in knowledge and practices. Adults in 610 families completed the study. Most were from Mexico, with low levels of formal education. Significant improvements in knowledge were observed for all six lessons. Significant improvements were observed in practices related to para-occupational exposure and residential pest control. Lay health promoters with limited training and supervision can have significant impacts on families' knowledge and practices. They represent a workforce increasingly recognized as a force for reducing health disparities by providing culturally appropriate health education and other services. This study adds to the literature by demonstrating their effectiveness in a public health setting with rigorous evaluation.

Promoting and protecting worker health and safety in the Republic of Korea agricultural sector

With the exception of agriculture, all other Republic of Korea industrial sectors have comprehensive systems in place for workplace surveillance (i.e., disease, injury, and exposure), research, and targeted interventions. However, because few statistics are available on the occupational health and safety conditions in the Republic of Korea agricultural sector, there is little information to guide interventions to prevent hazardous agricultural exposures. The scant information that is currently available suggests that agriculture ranks among the most hazardous industries in the Republic of Korea. Building on information obtained at the International Symposium on Development of Prevention Strategies for Agricultural Health and Safety held in Suwon, Republic of Korea, in 2005, and embellished with examples of surveillance, research, and intervention activities conducted in the United States and elsewhere, this article provides guidance to promote and protect the health of Korean agricultural workers. This information can also guide other countries to reduce agricultural hazards.

Children's environmental health in agricultural settings

Children residing in rural settings may encounter environmental hazards derived from agricultural production activities. Health consequences of organic dusts, farm chemicals including pesticides, machinery noise, excess sun exposure, and zoonotic infectious agents have been clearly described among farm-working adults. The author reviews the related evidence base on child health with a life-stage perspective on their differential exposure and vulnerabilities. Methemoglobinemia among infants consuming nitrate-contaminated well water, neurodevelopmental health impacts associated with early life exposure to organophosphate pesticides, and diarrheal disease due to zoonotic infectious agents are well-described pediatric concerns. There is suggestive but more limited evidence for respiratory health consequences from air contaminants associated with confined animal feeding operations and hearing deficits for children exposed to machinery-related noise. Many contaminants of concern for children in these environments remain largely understudied-diesel exhaust, biomass burning, solvents, veterinary antibiotics, and silica-containing particulate matter. Overall, the state of knowledge and programmatic activities on agriculturally derived environmental contaminants and child health is immature and much less complete than for working adults. This overview provides a context for research, policy, and programmatic needs.

Work safety climate, musculoskeletal discomfort, working while injured, and depression among migrant farmworkers in North Carolina

OBJECTIVES

This analysis described Latino migrant farmworkers' work safety climate and its association with musculoskeletal discomfort, working while injured or ill, and depressive symptoms.

METHODS

Data were from a cross-sectional survey of 300 farmworkers conducted in North Carolina in 2009. Generalized estimating equations models were used to investigate the association of work safety climate with health and safety outcomes.

RESULTS

Farmworkers perceived their work safety climate to be poor. About 40% had elevated musculoskeletal discomfort, 5.0% had worked at least 1 day while injured or ill, and 27.9% had elevated depressive symptoms. The odds of elevated musculoskeletal discomfort were 12% lower and the odds of working while injured or ill were 15% lower with each 1-unit increase in the work safety climate. Work safety climate was not associated with depressive symptoms.

CONCLUSIONS

Work safety climate was important for agricultural workers. Poor work safety climate was associated with health outcomes (musculoskeletal discomfort) and safety (working while injured or ill). Interventions to improve work safety climate in agriculture are needed, with these interventions being directed to employers and workers.

Biomonitoring of rural workers exposed to a complex mixture of pesticides in the municipalities of Tianguá and Ubajara (Ceará state, Brazil): genotoxic and cytogenetic studies

In recent years, the use of pesticides in agriculture has been steadily increasing, and associations between exposure to agricultural chemicals and DNA damage and cancer have been reported. Brazil is one of the world leaders in pesticide use; however, studies that evaluate the impact of pesticide exposure on cancer incidence and mortality are very scarce in the Brazilian population. The alkaline comet assay and the chromosome aberration (CA) test were used to evaluate primary DNA damage in the peripheral blood lymphocytes of workers exposed to a complex mixture of pesticides in two small rural communities in the municipalities of Tianguá and Ubajara, located in the western part of Ceará State (Northeast Brazil), which are among the largest agricultural areas of the state. The comet assay showed that the damage index and damage frequency observed in the exposed groups were significantly higher in relation to the controls (P < 0.05). On the other hand, no differences were detected regarding structural and numerical CAs in the communities evaluated. Additionally, the observed levels of DNA strand breaks and frequencies of CAs, stratified for exposure time, were not statistically different for individuals of either rural community. Our results suggest that the damages caused by pesticides in our study area were not great enough to induce permanent mutations or to interfere with mitotic apparatus formation; minimal pesticide damages could have undergone cellular repair, explaining the absence of structural and numerical CAs.

Using surveillance data to promote occupational health and safety policies and practice at the state level: a case study

BACKGROUND

Following the investigation of a birth defects cluster involving migrant farmworkers employed in North Carolina and Florida, it became clear that greater efforts were needed to protect agricultural workers from pesticide exposure.

METHODS

Documentation is drawn from peer-reviewed published articles, government reports and news accounts.

RESULTS

The birth defects cluster was identified and investigated by state and federal pesticide poisoning surveillance system staff. Following the investigation, efforts were initiated to highlight pesticides as an important public health issue needing more attention. A series of subsequent events led to the creation and passage of important legislation recently enacted in North Carolina. The legislation resulted in funding to promote various activities to prevent harm from pesticides including strengthening surveillance, improving the quality of pesticide compliance inspections, and increasing and improving pesticide safety training. The legislation also broadened the coverage of anti-retaliation rules to include agricultural workers, and increased recordkeeping requirements pertaining to pesticide applications.

CONCLUSION

The important and positive impacts that can occur through surveillance activities are highlighted. As such, it is important to continue to support and improve occupational illness and injury surveillance programs.

Exposure to sodium metam during zebrafish somitogenesis results in early transcriptional indicators of the ensuing neuronal and muscular dysfunction

Exposures to sodium metam (NaM) within the developmental period of somitogenesis (10- to 18-h postfertilization [hpf]) results in easily detectable distortions of the notochord by 24 hpf in the developing zebrafish. We hypothesized that NaM-induced transcriptional changes during somitogenesis would reveal the major molecular targets in the zebrafish embryo. Embryos were exposed to NaM beginning at 4 hpf (1000 cells) and total RNA was isolated from embryos at the 3 somite (11 hpf), 10 somite (14 hpf), 18 somite (18 hpf), and larval (24 hpf) stages of development. Using the Affymetrix zebrafish gene array we observed relatively few mRNAs differentially regulated at least twofold at each time point (11 hpf, 101 genes; 14 hpf, 151; 18 hpf, 154; 24 hpf, 33). The transcriptional profiles reveal neurodevelopment and myogenesis as the two primary targets of NaM developmental exposure. Quantitative PCR of several muscle and neuronal genes confirmed the array response. We also followed the structural development of the peripheral nervous system under NaM exposure using antibodies against neuronal structural proteins. Although there was no change in the onset of antibody staining, profound alterations became apparent during the period in which the notochord becomes distorted (> 18 hpf). Motor neuron development observed with the Tg(NBT:MAPT-GFP)zc1 transgenic zebrafish and a primary motor neuron specific antibody showed similar timing in the structural alterations observed in these cell types. Further study of the interactions of dithiocarbamates with the regulatory elements of fast muscle development and neurodevelopment is warranted.