Economic burden of illness from pesticide poisonings in highland Ecuador.

Active surveillance of acute pesticide poisonings in a potato-growing region of highland Ecuador during 1991-1992 uncovered a rate of 171/100,000, due predominantly to occupational exposures to organophosphate and carbamate pesticides. Occupational exposure among agricultural workers was the most common reason for poisoning (32 male workers and 1 female worker, out of a total of 50 cases). Of these 33 cases, 28 of them reported pesticide application as the work task just prior to poisoning, with over 80% citing the use of World Health Organization Hazard Category I pesticides. The suicide rate of 17.1/100,000 and the overall mortality rate of 20.5/100,000 that we found are among the highest reported anywhere in the world. At the exchange rates prevailing at that time, median costs associated with these poisonings were estimated as follows: public and social security health care direct costs of US$ 9.85/case; private health costs of US$ 8.33/case; and lost-time indirect costs of US$ 8.33/agricultural worker. Each one of those costs was over five times the daily agricultural wage, which was then about US$ 1.50. Further costing of pesticide poisonings should be carried out in other settings to provide appropriate information for decisions about pesticide use. In addition, integrated pest management should be further evaluated as an appropriate technology to reduce the economic burden of illness from pesticide poisonings in developing countries.     

Estimating underreported pesticide poisonings in Nicaragua

We undertook to estimate the degree of underreporting to a regional pesticide poisoning registry, and to estimate the true incidence of poisoning in an agricultural region of Nicaragua. We surveyed 633 workers at 25 of 33 agricultural cooperatives and any nearby private farms in a area geographically convenient to the regional health headquarters with a short structured interview about pesticide poisonings. Eighty-three percent of workers described current use of pesticides. Twenty-five percent described a pesticide poisoning in the preceding 12 months, and almost one-half (48%) described having been made ill by pesticides at some point in time. Sixty-nine (11%) described a poisoning in the preceding month, 23 of whom had received medical attention. The names of the medically treated were sought in the Regional Pesticide Poisoning Registry for the survey year of 1988. Only 8 of the 23 subjects were found reported to the registry when a total of 1,143 human pesticide poisonings were reported in the entire region. Using 65% as an estimate of underreporting to the registry, we calculate that 3,300 (95% Cl 2100–7500) poisonings had received treatment in the region in 1988, of whom more than 2,100 remained unreported. Based on the ratio of total poisonings (treated and untreated) to registry-reported poisonings among our survey respondents, we estimate that 6,700 (95% Cl 4100–18000) systemic poisonings, occurred in 1988 in the region. Underreporting of pesticide poisonings disguises the enormity of the problem in developing countries. Even in a region with a strong emphasis on illness reporting for targeted conditions, underreporting is substantial. This method for estimating underreporting is easily applied and provides a rough estimate of registry underreporting and actual incidence for conditions identifiable by a community-applied questionnaire. © 1996 Wiley-Liss, Inc.     

Acute pesticide illnesses associated with off-target pesticide drift from agricultural applications: 11 States, 1998-2006

Background: Pesticides are widely used in agriculture, and off-target pesticide drift exposes workers and the public to harmful chemicals.Objective: We estimated the incidence of acute illnesses from pesticide drift from outdoor agricultural applications and characterized drift exposure and illnesses.Methods: Data were obtained from the National Institute for Occupational Safety and Health’s Sentinel Event Notification System for Occupational Risks–Pesticides program and the California Department of Pesticide Regulation. Drift included off-target movement of pesticide spray, volatiles, and contaminated dust. Acute illness cases were characterized by demographics, pesticide and application variables, health effects, and contributing factors.Results: From 1998 through 2006, we identified 2,945 cases associated with agricultural pesticide drift from 11 states. Our findings indicate that 47% were exposed at work, 92% experienced low-severity illness, and 14% were children (< 15 years). The annual incidence ranged from 1.39 to 5.32 per million persons over the 9-year period. The overall incidence (in million person-years) was 114.3 for agricultural workers, 0.79 for other workers, 1.56 for nonoccupational cases, and 42.2 for residents in five agriculture-intensive counties in California. Soil applications with fumigants were responsible for the largest percentage (45%) of cases. Aerial applications accounted for 24% of cases. Common factors contributing to drift cases included weather conditions, improper seal of the fumigation site, and applicator carelessness near nontarget areas.Conclusions: Agricultural workers and residents in agricultural regions had the highest rate of pesticide poisoning from drift exposure, and soil fumigations were a major hazard, causing large drift incidents. Our findings highlight areas where interventions to reduce off-target drift could be focused.     

Pesticide application practices in agricultural workers

OBJECTIVE: We describe the sociodemographic characteristics and determinants of pesticide exposure in agricultural workers applying pesticides. METHODS: The workers selected were included in a case-control study carried out in the Autonomous Community of Valencia in Spain. Contact was made by telephone and individuals who had been involved in agricultural work during the relevant period of exposure were interviewed face-to-face to gain information on the following determinants of pesticide exposure: crops and periods worked, mixing of products, treatment equipment, participation in the washing of equipment, use of personal protection during the treatments and knowledge of the risks of pesticide exposure. RESULTS: Eighty-nine workers, aged between 16 and 46 years old, were included. Most of the interviewees had primary education or less. Pesticide treatments were mostly applied on high crops (82%), with manual equipment (61%) and throughout the year (45%). Workers frequently performed tasks involving additional exposure to pesticides (mixing chemicals, 66%, or washing equipment, 60%). Sixty-five percent of the workers used no personal protection or used it defectively. No differences were found in personal protection use according to age, family income or education. Most of the workers (90%) reported knowledge of the health risks of pesticide exposure and 21% of them rated the risk as null. CONCLUSIONS: Workers involved in pesticide application use personal protection measures very defectively. There is a clear need to develop specific prevention programs for these workers. The determinants of pesticide exposure in agricultural workers described in this study should be properly assessed in epidemiological studies of the health effects of pesticides on agricultural workers.     

Pesticide-related Illness and Injuries among Banana Workers in Costa Rica: A Comparison between 1993 and 1996

Abstract

An intervention program considerably decreased systemic poisonings on banana plantations in Costa Rica in the early 1990s. Nevertheless, pesticide safety continues to be controversial .To examine the determinants of acute pesticide related illness on banana plantations, the authors surveyed occupational injuries and illness among banana workers in the Atlantic Region of Costa. Rica that were reported during 1993 and 1996 to the National Insurance Institute. Incidence rates were calculated for categories of pesticides and types of medical problems, for all and subgroups of banana workers. Between 1993 and 1996, an overall 35% decrease in injuries was observed, attributable to a marked decline in topical injuries (3.3 vs 1.9 per 100 workers), whereas systemic poisonings remained the same (0.7 per 100 in both years). The decrease concerned selectively milder skin contlltioris, indicating underreporting of less severe health effects. In both years, paraquat was the pesticide most frequently associated with injuries, mostly skin and eye lesions. Workers at highest risk per unit time of exposure were nematocide applicators, herbicide applicators, and cleaners of packing plants. Despite control measures, further reduction of systemic illness had not been achieved. The decrease of topical injuries may be partly explained by improved work conditions, but possible underreporting hinders interpretation. Pesticide related illness on banana plantations is a persistent problem.     

Linkage of the California Pesticide Use Reporting Database with spatial land use data for exposure assessment

BACKGROUND: The State of California maintains a comprehensive Pesticide Use Reporting Database (CPUR). The California Department of Water Resources (CDWR) maps all crops in agricultural counties in California about once every 5 years. OBJECTIVE: We integrated crop maps with CPUR to more accurately locate where pesticides are applied and evaluated the effects for exposure assessment. METHODS: We mapped 577 residences and used the CPUR and CDWR data to compute two exposure metrics based on putative pesticide use within a 500-m buffer. For the CPUR metric, we assigned pesticide exposure to the residence proportionally for all square-mile Sections that intersected the buffer. For the CDWR metric, we linked CPUR crop-specific pesticide use to crops mapped within the buffer and assigned pesticide exposure. We compared the metrics for six pesticides: simazine, trifluralin (herbicides), dicofol, propargite (insecticides), methyl bromide, and metam sodium (fumigants). RESULTS: For all six pesticides we found good agreement (88-98%) as to whether the pesticide use was predicted. When we restricted the analysis to residences with reported pesticide use in Sections within 500 m, agreement was greatly reduced (35-58%). The CPUR metric estimates of pesticide use within 500 m were significantly higher than the CDWR metric for all six pesticides. CONCLUSIONS: Our findings may have important implications for exposure classification in epidemiologic studies of agricultural pesticide use using CPUR. There is a need to conduct environmental and biological measurements to ascertain which, if any, of these metrics best represent exposure.     

Ocular toxicity from pesticide exposure: A recent review

Toxic effects on eyes result from exposure to pesticides via inhalation, ingestion, dermal contact and ocular exposure. Exposure of unprotected eyes to pesticides results in the absorption in ocular tissue and potential ocular toxicity. Recent literature on the risks of ocular toxicity from pesticide exposure is limited. Ocular toxicity from pesticide exposure, including the dose-response relationship, has been studied in different animal species. Cholinesterase enzymes have been detected in animal ocular tissue, with evidence of organophosphate-induced inhibition. Pathological effects of pesticides have been observed in conjunctiva, cornea, lens, retina and the optic nerve. Pesticide exposure has been associated with retinopathy in agricultural workers and wives of farmers who used pesticides. Saku disease, an optico-autonomic peripheral neuropathy, has been described in Japan in people living in an area where organophosphates were used. Pesticide exposure is also associated with abnormal ocular movements. Progressive toxic ocular effects leading to defective vision are a serious health concern. Agricultural workers are at high risk of exposure to pesticides and associated ocular toxicity. Primary prevention is the appropriate method of protecting eyes from pesticide-related damage. This includes improved eye safety and care in workplaces, and effective pesticide regulation for maintenance of public eye health.     

Pesticide safety behaviors in Latino farmworker family households

BACKGROUND: Studies to assess pesticide exposure of individuals living in agricultural settings suggest that farmworkers create a "take-home" pathway from the fields to the home that increases exposure risk for non-farmworker household members. METHODS: A survey was conducted with 142 Latino women in farmworker family households in North Carolina to identify predictors of adherence to pesticide safety behaviors that may affect take-home exposure risk. Behaviors included changing work clothes before entering the house, storing and washing contaminated work clothes separately from family clothing, and showering upon returning home. RESULTS: The number of farmworkers in the household was negatively associated with adherence to recommended changing, storing, and showering behaviors. Most workers followed recommended laundry procedures for work clothes. CONCLUSIONS: Results support existing evidence for a take-home pathway for pesticide residues in homes with several farmworkers. Pesticide safety education needs to reinforce behaviors that reduce take-home exposure in farmworker households.     

California surveillance for pesticide-related illness and injury: coverage, bias, and limitations

The California Pesticide Illness Surveillance Program (PISP) is a major resource for pesticide illness epidemiology. This work attempts to improve characterization of pesticide illness in California, evaluate case ascertainment of the PISP and identify PISP's limitations and biases for studying the incidence and epidemiology of pesticide-related illness. Abstractors collected standardized information from 1994-1996 PISP files, poison control logs, hospital records, and death certificates. Linkage produced a merged file of all records that documented consideration of pesticide exposure as a cause of ill health. We identified 23 deaths and estimated 1,310 hospitalizations attributable to pesticide exposure, corresponding to 0.024 fatalities and 1.38 hospitalizations (95% confidence interval [CI] = 1.01-1.74) per 100,000 California population person-years. Most intoxications followed domestic exposures and were not reported to the surveillance program, which identified primarily occupational exposures. Excluding groups of five or more, we estimated 16% ascertainment (CI = 0.05-0.27) for non-agricultural occupational cases. Agricultural connections increased the probability of ascertainment to about 50%, cultural and economic barriers notwithstanding. Surveillance records existed for all identified episodes in which five or more people were exposed. California pesticide surveillance data appear complete for mass exposures, and adequate to characterize agricultural and occupational exposures. Work is needed to explore domestic exposures and occurrences beyond the reach of the health care system.     

Pesticide exposure beliefs among Latino farmworkers in North Carolina's Christmas tree industry

BACKGROUND: Pesticide exposure is a major preventable occupational hazard for farmworkers. This study examined the beliefs of Latino farmworkers in North Carolina's Christmas tree industry regarding pesticide exposure. METHODS: In-depth interviews were conducted with 20 Mexican male seasonal farmworkers. Participants discussed beliefs about agricultural chemicals, routes of exposure, and health effects of these chemicals. They also discussed their knowledge and use of pesticide safety practices and safety training received. RESULTS: Most farmworkers knew that pesticides could be harmful, though workers varied in their levels of knowledge regarding routes of exposure, specific health effects of pesticides, and ways to avoid and reduce exposure. Workers varied considerably in the amount of safety training received and use of safety practices. Perceived lack of control and health beliefs were salient factors that decreased workers' use of safety practices. CONCLUSIONS: This study adds to the growing body of research which documents the health beliefs of Latino farmworkers in the U.S. relative to pesticides and pesticide safety. This literature is beginning to show convergence on several points (e.g., farmworker knowledge of acute vs. long-term illness resulting from pesticide exposure), as well as regional variation in pesticide safety beliefs. This study substantiates the need for pesticide safety education to address issues of control as well as beliefs.     

Wash Day Blues: Secondhand Exposure to Agricultural Chemicals

The issue of personal cleanliness for farm workers exposed to pesticides is a significant health problem. One area that requires more attention centers on the issues of handling and laundering of clothing suspected of being contaminated by pesticides. This exploratory research focused on the handling and laundering behaviors of California farm workers with pesticide contaminated clothing. Of particular interest was the phenomenon of "secondhand" exposure that may result from improper handling and unsafe laundering practices.
Members of farm worker families (N=109) were interviewed at two California health clinics that serve a large portion of low income farm worker families. The sample was divided into three groups based on exposure to pesticides: direct exposure, indirect exposure, nonexposed. The findings revealed the least safe handling and laundering behaviors were reported by the group most at risk from first hand exposure (i.e., handlers, loaders, applicators). Also, secondhand exposure to pesticides appears to be related to storage and laundering practices reported by those who are directly or indirectly exposed to pesticides.
The findings revealed the actual laundering practices of farm workers and their knowledge of what constitutes unsafe laundering behavior, including "secondhand" contamination. This information can help to identify realistic safe laundering practices for farm worker families who come in contact with pesticides in the field or at home.     

A Conference on the Aging Farm Community: Using Current Health and Safety Status to Map Future Action

Abstract

The California Pesticide Illness Surveillance Program (PISP) is a major resource for pesticide illness epidemiology. This work attempts to improve characterization of pesticide illness in California, evaluate case ascertainment of the PISP and identify PISP's limitations and biases for studying the incidence and epidemiology of pesticide-related illness. Abstractors collected standardized information from 1994–1996 PISP files, poison control logs, hospital records, and death certificates. Linkage produced a merged file of all records that documented consideration of pesticide exposure as a cause of ill health. We identified 23 deaths and estimated 1,310 hospitalizations attributable to pesticide exposure, corresponding to 0.024 fatalities and 1.38 hospitalizations (95% confidence interval [CI] = 1.01–1.74) per 100,000 California population person-years. Most intoxications followed domestic exposures and were not reported to the surveillance program, which identified primarily occupational exposures. Excluding groups of five or more, we estimated 16% ascertainment (CI = 0.05–0.27) for non-agricultural occupational cases. Agricultural connections increased the probability of ascertainment to about 50%, cultural and economic barriers notwithstanding. Surveillance records existed for all identified episodes in which five or more people were exposed. California pesticide surveillance data appear complete for mass exposures, and adequate to characterize agricultural and occupational exposures. Work is needed to explore domestic exposures and occurrences beyond the reach of the health care system.     

Farm worker illness following exposure to carbofuran and other pesticides--Fresno County California, 1998

In California, suspected pesticide-related illnesses and suspected work-related illnesses and injuries are reportable conditions. On July 31, 1998, the Occupational Health Branch of the California Department of Health Services (CDHS) received a report from the California Department of Pesticide Regulation (CDPR) of a pesticide exposure incident in Fresno County involving 34 farm workers. CDHS investigated this incident by reviewing medical records of the 34 workers and interviewing 29. The findings indicated that the workers became ill after early reentry into a cotton field that had been sprayed with a cholinesterase-inhibiting carbamate pesticides     

Pesticides in Lebanon: a knowledge, attitude, and practice study

Pesticides, despite their known toxicity, are widely used in developing countries. Evaluating the pattern of their use would be interesting to assess the appropriateness of adequate intervention. Using a standardized questionnaire, a knowledge, attitude, and practice study was performed in two Lebanese regions, in which a group of agricultural workers was compared to workers of the general population and a third group of pesticide distributors. Agricultural workers were exposed to pesticides during cropping, mixing, loading, and application (100%). They had low pesticide knowledge scales compared to pesticide distributors and to the general population workers (P<10(-7)). The preventive measures they took were low, and the lower their knowledge was, the lower were the preventive measures applied (P<10(-3)). Pesticide safety education is necessary in order to induce protective behavior among agricultural workers. The general population may also benefit from increasing their awareness regarding pesticides.     

武汉市2006-2016年农药中毒流行病学分析

目的 调查武汉市农药中毒流行特征并分析其中可能的原因,为进一步防治农药中毒提供思路及策略依据。方法 收集武汉市2006-2016年农药中毒相关数据,采用Prism6软件进行统计分析。结果 2006-2016年全市累计报告病例5 156例,包括生产性和非生产性,分别占39.43%和60.57%。中毒种类以杀虫剂为主,占65.83%,杀虫剂种类以有机磷类为主,占71.57%。农药中毒女性占50.60%,男性占49.40%,性别分布比较,差异有统计学意义（χ²=4.709,P<0.001）;年龄以40~岁年龄段为主,占24.26%;农药中毒以夏季7、8月份为主,占33.86%。中毒病例集中在远城区,占86.87%。生产性农药中毒年发生率整体呈降低态势,尤其是最近三年趋于平缓;非生产性农药中毒发病率呈波浪形波动变化,但波动范围较小。结论 武汉市农药中毒多发生在远城区,有机磷杀虫剂是主要中毒农药种类,中年女性服非生产性农药中毒是防控重点,应尽快采取有效的措施预防、减少农药中毒的发生。     

Patterns of pesticide use and their determinants among wives of farmer pesticide applicators in the Agricultural Health Study

Pesticide exposure among farmers' wives is poorly characterized. Using questionnaire data from a cohort study of licensed pesticide applicators and their spouses, we investigated patterns of pesticide use among farmers' wives (n = 31,173). Wives reported a wide range of pesticide use: 36% never used pesticides during their lifetimes, whereas the heaviest pesticide users (10%) reported lifetime use of 3 or more agricultural pesticides plus commonly used residential pesticides. We identified 5 ordinal pesticide-use categories and studied factors associated with each category through polytomous logistic regression. Engaging in field work and household hygiene practices that could increase exposure were associated with pesticide use, and associations appeared to strengthen with increasing pesticide use category. Farm women reporting the heaviest pesticide use could exacerbate their exposure by engaging in practices that could increase pesticide contact.     

Severe Acute Illness in a Toddler Exposed to Multiple Agricultural Pesticides and an Insect Repellent

ABSTRACT

Acute severe pesticide-related illness among farm worker children is rarely reported. The authors report a toddler with acute onset of apnea, cyanosis, somnolence, hypotonia, tachycardia, and miosis who required hospitalization. Health care providers suspected pesticide poisoning, but were unable to determine the causal agent. Investigation by a public health program documented four pesticide exposures that occurred within one-half hour of acute illness. This case illustrates the importance of a thorough environmental/occupational exposure history and obtaining biological samples. It also documents the need to strengthen the Worker Protection Standard for agricultural workers and the importance of reporting and investigating pesticide-related illness.     

Residential proximity to agricultural pesticide use and incidence of breast cancer in the California Teachers Study cohort

We examined the association between residential proximity to agricultural pesticide use and breast cancer incidence among members of the California Teachers Study cohort, a large study of professional school employees with extensive information on breast cancer risk factors, followed for cancer incidence since 1995. We identified 1552 invasive breast cancer cases, diagnosed between 1996 and 1999, among 114,835 cohort members. We used California Pesticide Use Reporting data to select pesticides for analysis based on use volume, carcinogenic potential, and exposure potential; a Geographic Information System was used to estimate pesticide applications within a half-mile radius of subjects' residences. We applied Cox proportional hazard models to estimate hazard rate ratios (HR) for selected pesticides, adjusting for age, race, and socioeconomic status. We saw no association between residential proximity to recent agricultural pesticide use and invasive breast cancer incidence. HR estimates for the highest compared to the lowest exposure categories for groups of agents were as follows: probable or likely carcinogens (1.07, 95% confidence interval (CI): 0.86-1.32), possible or suggestive carcinogens (1.06, 95% CI: 0.87-1.29), mammary carcinogens (1.15, 95% CI: 0.90-1.48), and endocrine disruptors (1.03, 95% CI: 0.86-1.25). HR estimates for other groups and individual pesticides did not differ from unity, nor was there a trend for any groupings of or individual pesticides examined. Stratifying by menopausal status or family history of breast cancer did not substantially affect our results. Our analyses suggest that breast cancer incidence is not elevated in areas of recent, high agricultural pesticide use in California.     

Acute pesticide poisoning in the U.S. retail industry, 1998-2004

OBJECTIVE: This study was conducted to describe the national magnitude and characteristics of acute pesticide poisoning among workers and customers in retail establishments. METHODS: Analyses included retail employees 15-64 years of age and customers with acute pesticide poisoning identified from the Sentinel Event Notification System for Occupational Risks-Pesticides (SENSOR-Pesticides) and California Department of Pesticide Regulation from 1998 to 2004. Pesticide poisoning incidence rates and incidence rate ratios (IRR) were calculated. RESULTS: A total of 325 cases of acute pesticide poisoning were identified. Of these cases, 287 (88%) were retail employees and 38 (12%) were customers. Overall, retail employees had a significantly lower acute pesticide poisoning incidence rate compared with non-agricultural, non-retail employees (IRR=0.53; 95% confidence interval 0.47, 0.59). However, significantly elevated pesticide poisoning incidence rates were observed for four retail occupations (janitors, stock handlers/baggers, bakery/deli clerks, and shipping/receiving handlers). In addition, workers employed in two retail industry sectors (farm supply stores and hardware stores) had significantly elevated acute pesticide poisoning incidence rates. Incidence rates among the retail employees demonstrated a quadratic trend, monotonically decreasing from 1998 to 2000 and monotonically increasing from 2000 to 2003. The rates appear to have leveled off in 2003 and 2004. CONCLUSIONS: Preventive measures to decrease acute pesticide poisoning incidence in the retail sector include adoption of unbreakable and tear-resistant container requirements, increased utilization of integrated pest management strategies, and advisement to store managers, employees, and customers about poisoning prevention.