Occupational risk factors for work-related disorders in greenhouse workers

Aim This study reviews the evidence on the association between working in greenhouses and the occurrence of muscelosckeletal, reproductive and respiratory disorders, dermal effects, cancer and neurobehavioral effects. Subjects and methods PUBMED, MEDLINE and EBSCO literature bases were searched to identify epidemiological studies conducted over 1996–2006 that focused on the health outcomes of greenhouse workers. Three exclusion criteria were used to limit the selection to studies with quantitative assessment of the association between work-related risk factors and health disorders: lack of data on work-related risk factors, lack of a suitable risk estimate for work-related risk factors or of sufficient information that allowed calculation of a risk estimate and serious methodological concerns in relation to the purpose of this review (strong selection bias, very low response rate, recall bias). Results The analysis indicates that greenhouse exposure is associated with an increased risk of respiratory disorders, sensitization to allergens and skin reactions. Exposure to dust, bacteria, allergens, fungi and gases may cause or exacerbate asthma, asthma-like syndrome, mucous membrane irritation, chronic bronchitis and dermatitis. The results of the review showed that male workers employed in greenhouse horticulture for more than 10 years had a decreased median sperm concentration. The data on the effect of working in greenhouses on the time to pregnancy are unequivocal, but most of them indicate a relationship between a decreased fecundability ratio and greenhouse work, this referring mostly to pesticide exposure. There are also some indications that greenhouse work may contribute to musculoskeletal and neurobehavioral disorders, but only a few epidemiological studies have corroborated these findings. Some studies present evidence for the carcinogenicity of the pesticides used in greenhouses. Conclusion The results of this literature review imply a necessity to increase an awareness of the possible adverse health effects among greenhouse workers occupationally exposed to pesticides, biological agents or other factors of their specific work environment. On behalf of the DIRERAF partners: 1. Department of Hygiene and Epidemiology, Medical School University of Athens a. Associate Professor Athena Linos M.D., M.P.H., F.A.C.E b. Mr. Christos Chatzis M.D. c. Mr. Dimitrios Zikos RN d. Dimitrios Kouimintzis M.D. e. Euagelia Hronopoulou M.D. 2. Institute of Preventive Medicine, Environmental and Occupational Health a. Ioanna Kotsioni BA, MSc b. Eirini Papageorgiou BA, MSc 3. Nofer Institute of Occupational Medicine, Lodz 4. International Centre for Pesticides and Health Risk Prevention 5. Institut Municipal d’Investigacio Medical 6. Erasmus University, Rotterdam 7. Dresden University of Technology 8. Charles University of Prague 9. Finnish Institute of Occupational Health 10. Medical University of Sofia 11. Institute of Rural Health, Bratislava Review J. Jurewicz, D. Kouimintzis, A. Burdorf, W. Hanke, C. Chatzis, A. Linos