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Exposure to non-arsenic pesticides is associated with lymphoma among farmers in Spain.

OBJECTIVES: To estimate the risk of lymphoma among farmers in Spain. METHODS: This is a multicentre case control study conducted in Spain. Cases were subjects diagnosed with lymphoma according to the World Health Organization (WHO) classification in four hospitals between 1998-2002. Hospital controls were frequency matched to the cases by sex, age, and centre. All subjects were interviewed about jobs ever held in lifetime for at least one year and the exposures in those jobs were recorded. The risk of lymphomas among subjects ever having had a job as a farmer was compared with all other occupations. Farmers were analysed according to the type of farming job performed: crop farming, animal farming, and general farming. Occupational exposure was summarised into 15 main categories: organic dust, radiation, contact with animals, PAH, non-arsenic pesticides (carbamates, organophosphates, chlorinated hydrocarbons, triazines and triazoles, phenoxy herbicides, chlorophenols, dibenzodioxin, and dibenzofuran), arsenic pesticides, contact with meat, contact with children, solvents, asbestos, soldering fumes, organic colourants, polychlorinated biphenyls, ethylene oxide, and hair dyes. RESULTS: Although farmers were not at an increased risk of lymphoma as compared with all other occupations, farmers exposed to non-arsenic pesticides were found to be at increased risk of lymphoma (OR = 1.8, 95% CI 1.1 to 2). This increased risk was observed among farmers working exclusively either as crop farmers or as animal farmers (OR = 2.8, 95% CI 1.3 to 5.8). Risk was highest for exposure to non-arsenic pesticides for over nine years (OR = 2.4, 95% CI 1.2 to 2.8). CONCLUSIONS: Long term exposure to non-arsenic pesticides may induce lymphomagenesis among farmers.

Adult↗

Prevalence of dermatoses and skin sensitisation associated with use of pesticides in fruit farmers of southern Taiwan.

OBJECTIVES: Agricultural workers are known to have occupational skin diseases. The prevalence and pattern of skin diseases are unknown in Taiwanese fruit farmers. The objective of this study is to determine the work exposure, prevalence of skin diseases, and sensitivity to common skin allergens and agricultural chemicals in fruit farmers of southern Taiwan. METHODS: 122 fruit farmers who regularly prepared and sprayed pesticides and a group of 63 printing press workers with no known exposure to pesticides were examined and patch tested with common skin allergens and agricultural chemicals. The farmers were also interviewed for their work habits, use of protective clothing, and exposure to pesticides. RESULTS: Most farmers reported regular use of hat, boots, and mask, but not gloves, raincoat, and goggles. This resulted in frequent skin contact with pesticides especially on the hands and face. About 30% of farmers had hand dermatitis, and more than two thirds had pigmentation and thickening on the hands. Fungal infection of the skin was noted in a quarter of subjects. By patch test, farmers and the printing press workers had a similar rate of sensitivity to common skin allergens. 40% of farmers were sensitive to agricultural chemical allergens, which was about twofold higher than that of the comparison group. Farmers were most frequently sensitive to Captofol, Folpet, and Captan which were associated with dermatitis on the volar aspects of the hands. CONCLUSIONS: Fruit farmers in southern Taiwan had a high prevalence of skin diseases related to use of pesticides, and appropriate protective measures and work practices should be taken to prevent such problems.

Adolescent↗

Occupation related pesticide exposure and cancer of the prostate: a meta-analysis.

AIMS: To summarise recent literature on the risk of prostate cancer in pesticide related occupations, to calculate the meta-rate ratio, and to compare it to data from meta-analyses previously published. METHODS: A meta-analysis of 22 epidemiological studies, published between 1995 and 2001, was conducted in order to pool their rate ratio estimates. Studies were summarised and evaluated for homogeneity and publication bias. RESULTS: The meta-rate ratio estimate, based on 25 estimators of relative risk from 22 studies, was 1.13 (95% CI 1.04 to 1.22). Significant heterogeneity of rate ratios existed among the different studies. Therefore, a stratified analysis was carried out. Major sources of heterogeneity identified were geographic location, study design, and healthy worker effect. Overall, pooled risk estimates for studies derived from Europe were lower than those derived from the USA/Canada. A significant increase in rate ratio was observed for the occupation category of pesticide applicators, whereas no significant increase was observed for farmers. There was no evidence of publication bias. CONCLUSION: This increased meta-rate ratio for prostate cancer in different pesticide related occupations, including farmers, is very similar to three, previously published, meta-rate ratios for prostate cancer in farmers calculated from studies published before 1995. Although the underlying data do not identify pesticide exposure as an independent cause for prostate cancer, the fact that an increased meta-rate ratio is again obtained points to occupational exposure to pesticides as a possible factor. Future epidemiological studies should focus, as far as possible, on reliable methods to estimate actual exposure.

Agricultural Workers' Diseases↗

Integrative assessment of multiple pesticides as risk factors for non-Hodgkin's lymphoma among men.

BACKGROUND: An increased rate of non-Hodgkin's lymphoma (NHL) has been repeatedly observed among farmers, but identification of specific exposures that explain this observation has proven difficult. METHODS: During the 1980s, the National Cancer Institute conducted three case-control studies of NHL in the midwestern United States. These pooled data were used to examine pesticide exposures in farming as risk factors for NHL in men. The large sample size (n = 3417) allowed analysis of 47 pesticides simultaneously, controlling for potential confounding by other pesticides in the model, and adjusting the estimates based on a prespecified variance to make them more stable. RESULTS: Reported use of several individual pesticides was associated with increased NHL incidence, including organophosphate insecticides coumaphos, diazinon, and fonofos, insecticides chlordane, dieldrin, and copper acetoarsenite, and herbicides atrazine, glyphosate, and sodium chlorate. A subanalysis of these "potentially carcinogenic" pesticides suggested a positive trend of risk with exposure to increasing numbers. CONCLUSION: Consideration of multiple exposures is important in accurately estimating specific effects and in evaluating realistic exposure scenarios.

Adult↗

Health effects of chronic pesticide exposure: cancer and neurotoxicity.

Pesticides are widely used in agricultural and other settings, resulting in continuing human exposure. Epidemiologic studies indicate that, despite premarket animal testing, current exposures are associated with risks to human health. In this review, we describe the routes of pesticide exposures occurring today, and summarize and evaluate the epidemiologic studies of pesticide-related carcinogenicity and neurotoxicity in adults. Better understanding of the patterns of exposure, the underlying variability within the human population, and the links between the animal toxicology data and human health effects will improve the evaluation of the risks to human health posed by pesticides. Improving epidemiology studies and integrating this information with toxicology data will allow the human health risks of pesticide exposure to be more accurately judged by public health policy makers.

Environmental Exposure↗

Association between Parkinson's disease and exposure to pesticides in southwestern France.

A case-control study was performed in southwestern France in order to assess the relationship between pesticide exposure and Parkinson's disease (PD) in the elderly. During the period from 1997 to 1999, 84 cases were recruited together with 252 population-based controls. Experts in occupational health reviewed job codes and provided pesticide exposure levels, making it possible to calculate cumulated exposure lifelong for individuals. Environmental pesticide exposure was considered in relation to the place of residence. A positive association was found with occupational pesticide exposure (odds ratio = 2.2, 95% confidence interval 1.1-4.3) in conditional logistic multiple regression analysis taking into account age, sex, educational level and smoking; however, no clear dose relationship was found. Our results support the hypothesis of an association between occupational pesticide exposure and PD and point to the need to investigate the role of fungicides, for which toxicological hypotheses exist.

Aged↗

Pesticide-related incidents treated in Finnish hospitals--a review of cases registered over a 5-year period.

Pesticide-related incidents are uncommon in Finland. They comprised 0.11% of all hospitalizations due to poisoning in 1987-88. A search of the nationwide Hospital Discharge Register revealed 78 pesticide-related incidents in a 5-year period. Some 30 different agents were involved, the most frequent being organophosphate and MCPA. Only 36 cases (46%) were judged to be unequivocal or probable pesticide poisonings; 26 (33%) were probably other illnesses because of no or minimal exposure and of the children admitted for follow-up, nine (12%) had potentially marked exposure, but no poisoning developed owing to vigorous early treatment which limited absorption, and seven (9%) cases remained undetermined. According to our analysis, the management of patients with (suspected) pesticide poisoning at hospitals could be further improved if the following procedures were emphasised: decontamination of the skin when appropriate, systematic early estimation of the likely dose involved, analytical verification of pesticide absorption whenever feasible, and consistent collaboration with a toxicological advisory service.

Adolescent↗

Deaths from pesticide poisoning in England and Wales 1990-1991.

1. Data on deaths from pesticide poisoning occurring in England and Wales in 1990 and 1991 have been collated. Pesticides were responsible for 44 of 3978 deaths from poisoning (excluding carbon monoxide and other gases) over this period. 2. At least 66% of all pesticide fatalities were due to suicide and overall there was a predominance of males (male:female ratio 2.4:1). Eighty per cent of deaths occurred in those more than 44 years old and no child under 10 years old died, although almost 50% of suspected pesticide poisoning incidents involve this age group. 3. Herbicides were responsible for 35 of the 44 deaths; seven were caused by insecticides, one by a molluscicide and one by an unspecified agent. The herbicide, paraquat, was responsible for 33 of 44 deaths (75%) and, although fewer fatalities have occurred from this cause in recent years, paraquat remains the most common cause of fatal pesticide poisoning in England and Wales.

Adolescent↗

Hepatic injury and disturbed amino acid metabolism in mice following prolonged exposure to organophosphorus pesticides.

Chronic occupational exposure to organophosphorus and carbamate-type pesticides significantly inhibits acetylcholinesterase activity and causes morbidity. This study on mice was designed to evaluate their amino profile and to identify signs of hepatic dysfunction following their chronic exposure to mixtures of organophosphorus pesticides. Laboratory mice were exposed to a formulated mixture of the six organophosphorus pesticides (Dimethoate, Chlorpyrifos, Profenofos, Pirimiphos methyl, Triazophos and Dimethoate) most commonly used in agriculture in this region of the Middle East. Doses (10% of LD50 of the mixture) were given once a week by gavage in corn oil for 7 weeks; the control group was given only corn oil. At the end of the exposure period, mice were culled and blood samples were collected to determine erythrocyte acetylcholinesterase activity, biochemical markers of liver function and concentrations of serum amino acids. Erythrocyte acetylcholinesterase activity and total serum proteins decreased significantly in the exposed group. Serum concentrations of alanine aminotransferase and aspartate aminotransferase, alanine, glutamic acid, glycine, isoleucine, leucine, methionine, ornithine, proline, serine, threonine and valine were significantly increased in the exposed mice, while serum levels of cystine were decreased significantly. There were also non-significant increases in serum alkaline phosphatase, gama-glutamyl transpeptidase and some of the other amino acids. Chronic exposure to mixtures of organophosphorus pesticides is associated with decreased acetylcholinesterase activity, hepatic dysfunction and disturbance of amino acids profile. Biochemical indices of hepatocellular injury and disturbed amino acid metabolism may be of value as markers of chronic exposure to such pesticides.

Acetylcholinesterase↗

Pesticide-related illness and injuries among banana workers in Costa Rica: a comparison between 1993 and 1996.

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 conditions, 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.

Accidents, Occupational↗

The tragedy of Tauccamarca: a human rights perspective on the pesticide poisoning deaths of 4 children in the Peruvian Andes.

The pesticide poisoning deaths of 24 children in an isolated Peruvian village make a compelling case that corporate accountability for pesticide poisonings in the developing south should be examined from a human rights perspective. Highly toxic pesticides cannot be used safely under prevailing socioeconomic conditions. The industry asserts that the deaths of these children were accidental, blaming misuse. Tragedies such as these poisonings are not accidents, but foreseeable, and therefore preventable. Sales of highly toxic pesticides that cause repeated and predictable poisonings violate the fundamental human rights to life, health, and security of person. The Tauccamarca tragedy is a clear example of the urgency of applying a precautionary, human rights approach to pesticide issues in the developing south.

Chemical Industry↗

Acute pesticide poisoning among female and male cotton growers in India.

A season-long assessment of acute pesticide poisoning among farmers was conducted in three villages in India. Fifty female cotton growers reported the adverse effects experienced after exposures to pesticides by themselves and by their male relatives (n=47). The study documented the serious consequences of pesticide use for the health of farmers, particularly women field helpers. Typically female tasks such as mixing concentrated chemicals and refilling spraying tanks were as hazardous as direct pesticide application. Of 323 reported events, 83.6% were associated with signs and symptoms of mild to severe poisoning, and 10% of the pesticide application sessions were associated with three or more neurotoxic/systemic signs and symptoms typical of poisoning by organophosphates, which were used in 47% of the applications. Although in 6% of the spray sessions the workers' neurotoxic effects were extremely serious, none sought medical care. Low-income marginal farmers were more often subjected to severe poisoning than were landlords.

Acute Disease↗

Ames, pesticides, and cancer revisited.

The case for continuing use of existing levels of pesticides in agriculture, espoused by Bruce Ames, is refuted. Ames' contentions that naturally occurring carcinogens are far more widespread than man-made ones, that pesticides prevent cancer by providing fruits and vegetables at lower costs to the poor, and that animal data on high risks with high doses cannot predict low risks from low doses in humans do not address key issues: 1) fruits and vegetables contain mixtures of carcinogens and anti-carcinogens, and selection effects from human exposures to these mixtures go back more than a million years; 2) exposures from bioconcentrations of biopersistent organochlorines in the food chain create particular risks for meat-eaters, who have higher cancer risks than vegetarians; 3) even low doses from ingestion of produce containing pesticide residues can cause tissue injury, which could itself promote cancer; 4) epidemiologic data show rises in cancer incidences in older people in many countries, major differences in cancer risks between countries, and converging trends in risks for populations migrating to certain countries; 5) studies of pesticide-exposed workers consistently show increased rates of cancers and birth defects and cancers in their offspring; 6) epidemiologic studies based on large databases tend to underestimate risks from environmental causes because of exposure misclassification; 7) exposures to many organochlorines may have pervasive effects on endocrine function; 8) crop yields can be increased with less use of pesticides. Studies demonstrating the latter need replication, and should be supported as part of a coherent government agenda to develop alternative farming methods.

Acute Disease↗

Respiratory symptoms in children and exposure to pesticides.

In Lebanon, childhood asthma is an important disease and pesticides are commonly used. The objective of this study was to evaluate whether exposure to pesticides has chronic effects on the respiratory health of Lebanese children. A cross-sectional study was performed on children from a randomly selected sample of Lebanese public schools. Exposure to pesticides was evaluated by a standardised questionnaire and a residential exposure score, and respiratory symptoms were assessed by using the American Thoracic Society standardised questionnaire. A chronic respiratory disease was reported in 407 (12.4%) out of 3,291 children. The baseline difference in mean age was small but statistically significant. Any exposure to pesticides, including residential, para-occupational and domestic, was associated with respiratory disease and chronic respiratory symptoms (chronic phlegm, chronic wheezing, ever wheezing), except for chronic cough. Exposure to pesticides was associated with chronic respiratory symptoms and disease among Lebanese children.

Adolescent↗

Cancer and pesticides: an overview and some results of the Italian multicenter case-control study on hematolymphopoietic malignancies.

Exposure to pesticides is recognized as an important environmental risk factor associated with development of cancer. Epidemiological studies, although sometimes contradictory, have linked phenoxy acid herbicides with non-Hodgkin's lymphoma (NHL) and Soft Tissue Sarcoma (STS); organochlorine insecticides with STS, NHL, and leukemia; organophosphorous compounds with NHL and leukemia; and triazine herbicides with ovarian cancer. Exposure assessment is a crucial point in studying the association between cancer and pesticides. In order to investigate the association between hematolymphopoietic malignancies and occupational exposures, including pesticides, a population-based case-control study was carried out in Italy in 11 areas, 9 of which are agricultural or mixed areas. All newly diagnosed cases of hematolymphopoietic malignancies were collected in a 3-year period (1991-1993). The control group consisted of a random sample of the population residing in each area. The approach to infer exposures in agriculture was based on: the use of an agricultural questionnaire with 24 crop-specific questionnaires; expert agronomists who reviewed the collected information for each subject and translated it into pesticides histories. In total, 1925 cases and 1232 controls were interviewed in the nine agricultural areas. Increased risk was observed for some specific classes of pesticides. Furthermore, a nonstatistically significant increased risk of NHL was observed for subjects who were exposed to phenoxy herbicides not using protective equipment and a significant increased risk for exposure to 2, 4-dichlorophenoxy acetic acid (2,4-D).

Adult↗

Pesticides and adult respiratory outcomes in the agricultural health study.

In the 1700s, Bernardino Ramazzini was among the first to describe respiratory disease among agricultural workers. Since then, farmers continue to have higher rates of respiratory illnesses, even as changes occur in occupational and environmental exposures on farms. While grain and animal exposures have been well studied for their role in agricultural lung diseases, pesticide exposures have not. Using the Agricultural Health Study, a prospective cohort study of approximately 89,000 licensed pesticide applicators and their spouses in Iowa and North Carolina, we are currently assessing the association of pesticides with respiratory outcomes, including wheeze, adult asthma, farmer's lung, and chronic bronchitis. At enrollment (1993-1997), 19% of farmers and 22% of commercial pesticide applicators reported wheeze in the previous year. Using logistic regression models adjusted for age, state, smoking status, and body mass index, we evaluated the association of 40 individual pesticides with wheeze within these two groups separately. In both groups, we observed strong evidence of an association of organophosphates with wheeze. For farmers, the organophosphates chlorpyrifos, malathion, and parathion were positively associated with wheeze; for the commercial applicators, the organophosphates chlorpyrifos, dichlorvos, and phorate were positively associated with wheeze. Chlorpyrifos was strongly associated with wheeze in a dose-dependent manner in both groups; use of chlorpyrifos for at least 20 days per year had an odds ratio of 1.48 (95% confidence interval [CI] = 1.00-2.19) for farmers and 1.96 (95% CI = 1.05-3.66) for commercial applicators. Our wheeze results are consistent with recent animal models that support a role for organophosphates and respiratory outcomes.

Adult↗

[Utilization of school lunch dietary data to estimate theoretical maximum daily intake (TMDI) of selected pesticide residues].

OBJECTIVES: The theoretical maximum intake values of pesticides by body weight (TMI) were estimated for school children and the differences in district and age-group were compared. Furthermore TMI values for children (7-11 years old) were calculated from Japanese National Nutrition Survey (NNS) data. Our TMI values for school children were compared with those from NNS data and evaluated to assess whether our values were appropriate for use in the calculation of theoretical maximum of daily intake (TMDI) of the pesticides. METHODS: The TMI values of pesticides for children were estimated using the intake amounts of agricultural products calculated from school lunch data in three elementary school districts (in Hyogo, Tokyo and Yamagata prefectures) and the survey of data from meals at home. Furthermore, TMI values for children (7-11 years old) were estimated from NNS data relating to agricultural products intake. Target pesticides for TMI calculations were chlorpyrifos, cyhalothrin, fenbutatin oxide, malathion, meltribuzin, oxamyl, permethrin and vamidothion. RESULTS: TMI of malathion from school lunch data corresponded to 58% of ADI and was too large for exposure from one meal in comparison to other pesticides (8-24%). Our estimations of TMI of chlorpyrifos, cyhalothrin, oxamyl and vamidothion in the school lunches were smaller than those from the NNS data. However TMI of malathion calculated from the school lunch data was larger than that from the NNS data. TMI of fenbutatin oxide, meltribuzin and permethrin from the school lunch data were similar to those from the NNS data. CONCLUSIONS: The TMI values for children in three districts depended upon the agricultural products used in school lunches. Even though the survey methods differed between the NNS's and our data, the TMI values closely corresponded. We concluded that the school lunch data might compensate for the lack of NNS data in order to estimate more appropriate TMDI for children's ingestion of agricultural products.

Child↗

Community exposures to airborne agricultural pesticides in California: ranking of inhalation risks.

We assessed inhalation risks to California communities from airborne agricultural pesticides by probability distribution analysis using ambient air data provided by the California Air Resources Board and the California Department of Pesticide Regulation. The pesticides evaluated include chloropicrin, chlorothalonil, chlorpyrifos, S,S,S-tributyl phosphorotrithioate, diazinon, 1,3-dichloropropene, dichlorvos (naled breakdown product), endosulfan, eptam, methidathion, methyl bromide, methyl isothiocyanate (MITC; metam sodium breakdown product), molinate, propargite, and simazine. Risks were estimated for the median and 75th and 95th percentiles of probability (50, 25, and 5% of the exposed populations). Exposure estimates greater than or equal to noncancer reference values occurred for 50% of the exposed populations (adults and children) for MITC subchronic and chronic exposures, methyl bromide subchronic exposures (year 2000 monitoring), and 1,3-dichloropropene subchronic exposures (1990 monitoring). Short-term chlorpyrifos exposure estimates exceeded the acute reference value for 50% of children (not adults) in the exposed population. Noncancer risks were uniformly higher for children due to a proportionately greater inhalation rate-to-body weight ratio compared to adults and other factors. Target health effects of potential concern for these exposures include neurologic effects (methyl bromide and chlorpyrifos) and respiratory effects (1,3-dichloropropene and MITC). The lowest noncancer risks occurred for simazine and chlorothalonil. Lifetime cancer risks of one-in-a-million or greater were estimated for 50% of the exposed population for 1,3-dichloropropene (1990 monitoring) and 25% of the exposed populations for methidathion and molinate. Pesticide vapor pressure was found to be a better predictor of inhalation risk compared to other methods of ranking pesticides as potential toxic air contaminants.

Adolescent↗