Occupational exposure to pesticides and health symptoms among family farmers in Brazil

The Environment and Headache: a Narrative Review

PURPOSE OF REVIEW

In this narrative review, we summarize the peer-reviewed literature published between 2017 and 2022 that evaluated ambient environmental risk factors for primary headache disorders, which affect more than half of the population globally. Primary headache disorders include migraine, tension-type headache (TTH), and trigeminal and autonomic cephalalgias (TAC).

RECENT FINDINGS

We identified 17 articles that met the inclusion criteria via PubMed or Google Scholar. Seven studies (41%) relied on data from US populations. The remaining studies were conducted in China, Taiwan, Germany, Ghana, Japan, the Netherlands, South Korea, and Turkey. Air pollution was the most frequently assessed environmental risk factor. Most studies were cross-sectional and focused on all-cause or migraine headaches; one study included TTH, and none included TAC. Short-term exposure to fine particulate matter (PM2.5) was not consistently associated with headache endpoints, but long-term exposure to PM2.5 was associated with migraine headache prevalence and severity across multiple studies. Elevated ambient temperature, changes in weather, oil and gas well exposure, and less natural greenspace, but not noise pollution, were also associated with headache. No studies considered water pollution, metal exposure, ultrafine particulate matter, or wildfire smoke exposure. There is a need for ongoing research focused on headache and the environment. Study designs with the greatest explanatory power may include longitudinal studies that capture the episodic nature of headache and case-crossover analysis, which control for time-invariant individual-level confounders by design. There is also a clear need for research that considers comorbid psychiatric illness and socioeconomic position as powerful modifiers of the effect of the environment on headache.

Occupational risks associated with chronic kidney disease of non-traditional origin (CKDnt) in Brazil: it is time to dig deeper into a neglected problem

In the past decades, an epidemic of chronic kidney disease (CKD) has been associated with environmental and occupational factors (heat stress from high workloads in hot temperatures and exposure to chemicals, such as pesticides and metals), which has been termed CKD of non-traditional origin (CKDnt). This descriptive review aims to present recent evidence about heat stress, pesticides, and metals as possible causes of CKDnt and provide an overview of the related Brazilian regulation, enforcement, and health surveillance strategies. Brazilian workers are commonly exposed to extreme heat conditions and other CKDnt risk factors, including increasing exposure to pesticides and metals. Furthermore, there is a lack of adequate regulation (and enforcement), public policies, and strategies to protect the kidney health of workers, considering the main risk factors. CKDnt is likely to be a significant cause of CKD in Brazil, since CKD's etiology is unknown in many patients and several conditions for its development are present in the country. Further epidemiological studies may be conducted to explore causal associations and estimate the impact of heat, pesticides, and metals on CKDnt in Brazil. Moreover, public policies should prioritize reducing workers´ exposure and promoting their health and safety.

Health-Related Challenges and Programs Among Agriculture Workers: A Narrative Review

Agriculture is one of the most hazardous occupations, with many workers experiencing occupational accidents and ill health. The misuse of toxic substances, often due to inadequate protective measures, raises concerns about both individual and nature safety. However, the strenuous tasks done by the agricultural workers, especially those related to pesticide exposure and some challenges affect the farmer's health and well-being. This review paper used databases like PubMed and Google Scholar to elaborate this. English language studies are included and other languages are excluded. The health system for agricultural labour in India sheds light on the neglected status of agricultural workers and emphasizes the need for health promotion programs. For that, training and interventions are important as crucial elements in reducing pesticide exposure, with a call for the enforcement of existing laws and regulations. Agriculture workers have a proper knowledge and attitude towards the safety and program to overcome the health-related conditions they face. This paper also addresses the practices of personal protective equipment (PPE) and the challenges faced by farmers in adopting adequate safety measures.

The relationship between pesticide exposures and primary headaches in adults: A cross-sectional study based on Rafsanjan cohort study

Objectives

Toxic substances can trigger headaches. The prevalence of pesticide use and headaches was high among the population of Rafsanjan.

Methods

A cross-sectional study was used to collect data from 9991 adults who participated via sampling people aged 35-70 years old of both genders from the Rafsanjan Cohort Study (RCS) in Iran. Demographic characteristics, habits, chronic primary headache (CPH), and episodic primary headache (EPH) were measured.

Results

The prevalence of CPH and EPH were 7.4 % and 29.9 % respectively. The multivariable model showed the odds of EPH increased significantly by the pesticide exposure on farm OR: 1.16 (1.02-1.34), in yard OR: 1.18 (1.01-1.39), duration of pesticide exposure in yard > median OR: 1.35 (1.06-1.73), at home OR: 1.31 (1.17-1.46), duration of pesticide exposure at home ≤ median OR: 1.24 (1.10-1.40) and > median OR: 1.38 (1.22-1.57). Also, pesticide preparation OR: 1.20 (1.03-1.39), duration of exposure in pesticide preparation ≤ median OR: 1.31 (1.09-1.57), and duration of exposure in managed spraying pesticide > median OR: 1.28 (1.04-1.57) increased odds of EPH. These results showed that the odds of CPH increased in participants using pesticides at home OR: 1.22 (1.02-1.48), duration of pesticide exposure at home > median OR: 1.37 (1.11-1.70), and duration of pesticide exposure in pesticide preparation > median OR: 0.47 (0.27-0.82). The odds of EPH increased with more pesticide exposures (18 %) and duration of pesticide exposure (25 %).

Conclusions

As evidenced by the obtained results, there is a relationship between pesticide exposure and headaches.

Acute health symptoms related to perception and practice of pesticides use among farmers from all regions of Thailand

Introduction

Occupational exposure to pesticides may cause acute health effects for farmers and agricultural workers. Therefore, this study aims to investigate the prevalence of poisoning symptoms related pesticide exposure among farmers from all regions of Thailand, as well as factors linked to poisoning symptoms of neurological and neuromuscular systems, the respiratory system, and eye and skin disorders.

Methods

A cross sectional study was conducted in 4,035 farmers who lived in four regions of Thailand. The samples were chosen using stratified random sampling, with 746 for the Central region, 2,065 for the North-East, 586 for the North, and 638 for the South.

Results

The results found that the highest prevalence of poisoning symptoms was found in association with neurological and neuromuscular systems (75%), followed by the respiratory system (60.4%), the eyes (41.2%), and skin (14.8%). The most prevalent symptoms were muscle pain (49%) for neurological and neuromuscular symptoms, burning nose (37.6%) for respiratory symptoms, itchy eyes (26.3%) for eye symptoms, and rashes (14.4%) for skin symptoms. The remarkable findings were that types of pesticide use, task on the farm, types of pesticide sprayers, and perception are the crucial factors affecting all poisoning symptoms.

Discussion

The findings are also beneficial to the Thai government and other relevant organizations for launching measures, campaigns, or interventions to lower modifiable risk factors, resulting in reducing health risks associated with pesticide exposure.

Relationship Between Pesticide Exposure Factors and Health Symptoms Among Chili Farmers in Northeast Thailand

OBJECTIVES

The unsafe use of pesticides in agriculture represents a major hazard to human health. This study was conducted to investigate the association between pesticide exposure and health symptoms among chili farmers in northeast Thailand.

METHODS

This cross-sectional analytic study included 141 chili farmers in Sakon Nakhon Province, in northeast Thailand. Data regarding health symptoms were gathered using a self-report questionnaire. A medical technician tested blood cholinesterase activity using an erythrocyte method, and an occupational medicine specialist at Ramathibodi Hospital in Bangkok, Thailand reviewed the results. Associations between personal characteristics, pesticide exposure factors, and health symptoms were analyzed using multiple logistic regression.

RESULTS

Of the 141 chili farmers studied, 66.7% experienced pesticide poisoning, as indicated by below-normal cholinesterase levels. Fatigue was the most frequently reported symptom associated with pesticide exposure, affecting 37.6% of participants. This was followed by nausea and vomiting (31.9%), dizziness (14.9%), and dry throat (14.9%). Multivariate logistic regression analysis revealed that several factors were significantly associated with adverse symptoms: amount of work experience, volume of pesticides used, use of chemical pesticides, use of leaking containers during spraying, direct pesticide exposure while working, contact with pesticide-soaked clothing, consumption of food and drinks in the fields, and blood cholinesterase level indicating risk.

CONCLUSIONS

This study suggests potential health risks for chili farmers stemming from exposure to and contamination by pesticides used in agricultural practices. To mitigate these risks, it is essential to supply personal protective equipment and to implement educational programs aimed at improving protective behaviors among farmers.

Occupational exposure to pesticides and symptoms of depression in agricultural workers. A systematic review

BACKGROUND

The use of pesticides can result in harm to both the environment and human health. There is a growing concern in the field of occupational health about the impact on the mental health of agricultural workers.

OBJECTIVES

The objective of this review was to systematize scientific evidence from the last ten years on the impact of occupational exposure to pesticides on the development of depression symptoms in agricultural workers.

METHODS

We conducted a comprehensive search in the PubMed and Scopus databases from 2011 to September 2022. Our search included studies in English, Spanish, and Portuguese that examined the association between occupational exposure to pesticides and symptoms of depression in agricultural workers, following the guidelines recommended by the PRISMA statement and the PECO strategy (Population, Exposure, Comparison, and Outcomes).

RESULTS

Among the 27 articles reviewed, 78% of them indicated a link between exposure to pesticides and the incidence of depression symptoms. The pesticides most frequently reported in the studies were organophosphates (17 studies), herbicides (12 studies), and pyrethroids (11 studies). The majority of the studies were rated as having intermediate to intermediate-high quality, with the use of standardized measures to assess both exposure and effect.

CONCLUSION

The updated evidence presented in our review indicates a clear association between pesticide exposure and the development of depressive symptoms. However, more high-quality longitudinal studies are necessary to control for sociocultural variables and utilize pesticide-specific biomarkers and biomarkers of depression. Given the increased use of these chemicals and the health risks associated with depression, it is crucial to implement more stringent measures to monitor the mental health of agricultural workers regularly exposed to pesticides and to enhance surveillance of companies that apply these chemicals.

Occupational safety and health in the agricultural sector: a bibliographic review

In the labor context the agricultural sector has been a little neglected in terms of the implementation of policies and standards that allow maintaining low accident rates, and in the last year strategies have been established to improve this situation. The aim of this study was to conduct a bibliometric analysis of the scientific literature on the methodologies used to plan, verify, and maintain occupational safety and health in the agricultural sector. The methodology focused on the search for information in the Scopus and Web of Science databases through a search equation, and then through inclusion and exclusion criteria to evaluate the selected articles. It was found that the country with most studies on occupational safety and health was the United States, and that methodologies such as social participation, videos, and team learning are among the most successful processes. The year of publication with the largest amount of research published was 2021, the survey approach appears in 82% of the articles, the use of technology as a means of dissemination of improvement actions was evidenced, and the most innovative processes included: use of religion, checklists, fear, threats, and work organization processes.

Self-rated health status and associated factors in rural workers

BACKGROUND

Self-rated health status can be considered a good predictor of morbidity and mortality and has been used due to its easy assessment and applicability. The instrument is efficient for understanding sociodemographic, environmental and clinical conditions that may be related to the self-rated health status. Thus, this study aims to analyze the self-assessment of health status in rural workers and its association with socioeconomic characteristics, lifestyle, clinical condition and work characteristics.

METHODS

This is a cross-sectional study carried out with 787 male and female rural reporting agriculture as their main source of income in the municipality of Santa Maria de Jetibá. A simple and direct question was used "In general, compared to people your age, how do you rate your own state of health?" to see how rural workers rate their current health status. The independent variables analyzed were socioeconomic, clinical, health and work conditions. The magnitude of the associations was evaluated by means of hierarchical logistic regression.

RESULTS

It was found that 42.1% of rural workers self-rated their health status as regular or poor. Belonging to socioeconomic classes C (OR = 1.937; 95% CI = 1.009-3.720) or D/E (OR = 2.280; 95% CI = 1.178-4.415), being overweight (or having excess weight) (OR = 1.477; 95% CI = 1.086-2.008), multimorbidity (OR = 1.715; 95% CI = 1.201-2.447) and complex multimorbidity (OR = 1.738; 95% CI = 1.097-2.751) were risk factors for worse self-rated health.

CONCLUSION

It was concluded that chronic diseases, socioeconomic status and overweight are risk factors for negative self-rated health. The identification of these determinants through self-rated status can support the planning of actions aimed at improving the health of the rural population.

TRIAL REGISTRATION

This study was approved by the Research Ethics Committee of the Health Sciences Center of the Federal University of Espírito Santo (Protocol No. 2091172; CAAE No. 52839116.3.0000.5060). All research participants gave their informed consent.

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.

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

BACKGROUND

Multiple epidemiological studies have shown that exposure to pesticides is associated with adverse health outcomes. However, the literature on pesticide-related health effects in the Latin American and the Caribbean (LAC) region, an area of intensive agricultural and residential pesticide use, is sparse. We conducted a scoping review to describe the current state of research on the health effects of pesticide exposure in LAC populations with the goal of identifying knowledge gaps and research capacity building needs.

METHODS

We searched PubMed and SciELO for epidemiological studies on pesticide exposure and human health in LAC populations published between January 2007 and December 2021. We identified 233 publications from 16 countries that met our inclusion criteria and grouped them by health outcome (genotoxicity, neurobehavioral outcomes, placental outcomes and teratogenicity, cancer, thyroid function, reproductive outcomes, birth outcomes and child growth, and others).

RESULTS

Most published studies were conducted in Brazil (37%, n = 88 ) and Mexico (20%, n = 46 ), were cross-sectional in design (72%, n = 167 ), and focused on farmworkers (45%, n = 105 ) or children (21%, n = 48 ). The most frequently studied health effects included genotoxicity (24%, n = 62 ) and neurobehavioral outcomes (21%, n = 54 ), and organophosphate (OP) pesticides were the most frequently examined (26%, n = 81 ). Forty-seven percent (n = 112 ) of the studies relied only on indirect pesticide exposure assessment methods. Exposure to OP pesticides, carbamates, or to multiple pesticide classes was consistently associated with markers of genotoxicity and adverse neurobehavioral outcomes, particularly among children and farmworkers.

DISCUSSION

Our scoping review provides some evidence that exposure to pesticides may adversely impact the health of LAC populations, but methodological limitations and inconsistencies undermine the strength of the conclusions. It is critical to increase capacity building, integrate research initiatives, and conduct more rigorous epidemiological studies in the region to address these limitations, better inform public health surveillance systems, and maximize the impact of research on public policies. https://doi.org/10.1289/EHP9934.

Potential Effects on Mental Health Status Associated with Occupational Exposure to Pesticides among Thai Farmers

Pesticide-related mental health issues in Thailand, an upper-middle-income country, are not well known. This study aimed to investigate the association between the history of occupational exposure to pesticides and the mental health of Thai farmers. A cross-sectional study was carried out in the areas around Chiang Mai, a large city in Northern Thailand, between June 2020 and January 2021. A total of 6974 farmers from six districts were interviewed to determine whether they regularly experienced symptoms related to mental health by the Self-Reporting Questionnaire (SRQ-20) as well as their lifetime history of agricultural pesticide exposure from 31 active ingredients and five functional categories: insecticides, herbicides, fungicides, rodenticides, and molluscicides. The cut-off of 6 was used to evaluate probable mental disorder. Most of the farmers under investigation were men (53.8%), with a mean age of 55.2 (11.7) years, and were involved mainly in the planting of rice, fruit, and vegetables. About 86.7% reported having used pesticides on their crops at some point in their lives-mostly glyphosate, paraquat, 2,4-D, methomyl, and carbofuran. All functional groups, as well as pesticide classes like organochlorines, organophosphates, and carbamates, were significantly associated with a higher risk of probable mental disorder based on exposure duration, frequency, personal protective equipment usage, and hygienic behavior. In a model with multiple pesticides, there was an association between mental disorder and exposure to endosulfan (AOR = 2.27, 95%CI = 1.26-4.08) and methyl parathion (AOR = 2.26, 95%CI = 1.26-4.06). Having previously reported pesticide poisoning symptoms was related to mental disorder (AOR = 7.97, 95%CI = 5.16-12.31), the findings provided evidence of pesticide exposure posing a risk to farmers' mental health, particularly long-term and high-intensity exposure.

Dietary patterns, breakfast consumption, meals with family and associations with common mental disorders in adolescents: a school-based cross-sectional study

Background

Adolescence is a period of transition and vulnerabilities, in which mental illnesses can develop more easily. The objective of this work is to analyze the association of dietary patterns, breakfast consumption, and the practice of having meals accompanied by the family with the presence of Common Mental Disorders in Brazilian adolescents.

Methods

This is a cross-sectional study which analyzed data from 71,553 Brazilian adolescents aged 12–17 years, from the Study of Cardiovascular Risk in Adolescents (Portuguese acronym, “ERICA”). Principal Component Analysis was performed to identify dietary patterns, and Logistic Regression Models were performed to identify the associations between Common Mental Disorders, dietary patterns, and eating practices that are breakfast consumption and practice of having meals accompanied by family.

Results

Two patterns were found, a Healthy Dietary Pattern and an Unhealthy Dietary Pattern. Adolescents classified in the second (OR: 0.79; 95% CI 0.70—0.89) or third (OR: 0.86; 95% CI 0.77—0.96) tercile of the Healthy Dietary Pattern had a lower chance of having Common Mental Disorders. Eating breakfast sometimes (OR: 0.71; 95% CI 0.61—0.83) or almost every day/every day (OR: 0.54; 95% CI 0.47—0.62), and the practice of having the main meals with the family sometimes (OR: 0.69; 95% CI 0.57—0.84) or almost every day/every day (OR: 0.50; 95% CI 0.44–0.58), decreased the chance for Common Mental Disorders.

Conclusion

This study observed that healthy dietary patterns are associated with better mental health in adolescents, thus should be encouraged and promoted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13367-7.

Effect of socioeconomic status on the physical and mental health of the elderly: the mediating effect of social participation

BACKGROUND

Previous studies have demonstrated the effect of socioeconomic status on the health status of the elderly. Nevertheless, the specific dimensions of the effect and the mechanism await further investigation. In this study, socioeconomic status was divided into three dimensions and we used social participation as the mediation variable to investigate the specific path of effect.

METHODS

Using the 2018 Waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset, a total of 10,197 effective samples of the elderly over 65 years old were screened out. Socioeconomic status included income, education level, and main occupation before retirement. The physical health and mental health of the elderly was measured by the Instrumental Activities of Daily Living Scale and the Minimum Mental State Examination, respectively. The social participation of the elderly was the mediation variable, including group exercise, organized social activities and interacting with friends. Omnibus mediation effect analysis was adopted to examine the mediation effect and mediation analysis was completed using the SPSS PROCESS program.

RESULTS

First, the results showed that when the income gap between the elderly reached a certain level, there was a significant difference in health status. Significant differences existed in health status amongst with different education levels. There was no sufficient evidence to show that occupation has a significant effect on the physical health. But when the dependent variable was mental health, the effect was significant. Second, group exercise mediated 64.11% (a_ib = 0.24, 95% CI [0.17,0.3]) and up to 20.44% (a_ib = 0.12, 95% CI [0.07,0.17]) of the disparity in physical and mental health due to income gap, respectively. And it could mediate the effect up to 56.30% (a_ib = 0.62, 95% CI [0.52,0.73]) and 17.87% (a_ib = 0.50, 95% CI [0.4,0.61]) of education on physical and mental health status, respectively. The proportion of relative mediation effect of occupation was up to 28.74% (a_ib = 0.19, 95% CI [0.13,0.25]) on mental health. Interacting with friends mediated only on the path that the education affected the health status of the elderly. The proportion was up to 33.72% (a_ib = 0.29, 95% CI [0.16,0.44]). The relative mediation effect of organized social activities on the health gap caused by income or education level gap was significant at some levels. The proportion was up to 21.20% (a_ib = 0.33, 95% CI [0.26,0.4]).

CONCLUSION

The SES of the elderly including relatively large income gap, different education levels and occupational categories could indeed have a significant effect on health status of the elderly, and the reason why this effect existed could be partly explained by the mediation effect of social participation. Policymakers should pay more attention to the social participation of the elderly.

Impact of Pesticides on Human Health in the Last Six Years in Brazil

Every year, Brazil intensifies its activity in agriculture and, as a result, it has become one of the biggest consumers of pesticides in the world. The high rate of these substances raises environmental and human health concerns. Therefore, we collected papers from PubMed, Scopus, Scielo, and Web of Science databases, from 2015 to 2021. After a blind selection using the software Rayyan QCRI by two authors, 51 studies were included. Researchers from the South and the Southeast Brazilian regions contributed to most publications, from areas that concentrate agricultural commodity complexes. Among the pesticides described in the studies, insecticides, herbicides, and fungicides were the most frequent. The articles reported multiple toxic effects, particularly in rural workers. The results obtained can be used to direct policies to reduce the use of pesticides, and to protect the health of the population.

Metal exposure and oxidative stress biomarkers in a Brazilian agricultural community

We examined the association between exposure to metals, metalloids, and oxidative stress biomarkers among rural community residents in Brazil. Multiple linear regression was used to evaluate associations between serum metal and metalloid concentrations and blood oxidative stress biomarkers, adjusting for sex, age, education, smoking, and alcohol use. After adjustment for covariates, glutathione peroxidase activity (GPx) was inversely and significantly associated with an increase in serum arsenic (As) levels. Positive and significant associations were seen between elevated glutathione reductase (GR) activity and serum cadmium (Cd), barium (Ba), and lead (Pb) concentrations. In addition, we observed a significant increase in malondialdehyde (MDA) levels in association with an increase in Ba levels. These findings suggest that toxic metals and metalloids such as As, Ba, Cd, and Pb alter antioxidant enzyme activities. In addition, Ba seems to promote lipid peroxidation.

Factors Associated with Suicidal Behavior in Farmers: A Systematic Review

This review aimed to investigate the factors associated with suicidal behavior in farmers in the scientific literature. Two researchers participated independently in searching databases, specifically PubMed/MEDLINE, LILACS, Web of Science, Scopus, PsycINFO, and SciELO. Only observational studies were included. The quality of the selected studies was assessed with a critical assessment checklist for cross-sectional analytical and case-control studies, prepared by the Joanna Briggs Institute. Data related to the publication were collected (author and year; city/country); methodological design; sample/population (gender; average age), outcome, measuring instrument and factors associated with suicidal behavior. A total of 14 studies were included in the systematic review, and factors associated with farmers' behavior in mental health (depression), seasonal impacts (drought), and work exposures (herbicides and insecticides) were identified. However, heterogeneity was found in terms of the method, measurement of suicidal behavior, and associated factors, which indicates the need for further studies.