Artículos científicos

URI permanente para esta colecciónhttp://10.0.96.45:4000/handle/11056/14755

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Assessment of Dermal Pesticide Exposure with Fluorescent Tracer: a Modification of a Visual Scoring System for Developing Countries
(Oxford University Press, 2005-08-26) Aragón, Aurora; Blanco, Luis E.; Fúnez, Aura; Ruepert, Clemens; Lidén, Carola; Nise, Gun; Wesseling Hoogervors, Catharina
En 1988, Fenske presentó un método semicuantitativo de evaluación de la exposición dérmica basado en observaciones visuales de imágenes de fluorescencia. Adaptamos el método a las condiciones de trabajo de Nicaragua y evaluamos su desempeño. Treinta y dos agricultores aplicaron clorpirifos y metamidofos marcados con Tinopal CBS-X®. Se observaron los depósitos fluorescentes en la piel con una lámpara UV portátil en una habitación oscura plegable. Modificamos los dos componentes del sistema original: la extensión ponderando el tamaño de las partes del cuerpo expuestas según la superficie corporal total y la intensidad estableciendo criterios para leer las imágenes de fluorescencia. Esto dio como resultado puntajes de segmentos corporales (BSS) para partes corporales específicas, así como dos medidas de resumen, el área corporal contaminada (CBA) como el porcentaje de piel contaminada en relación con la superficie corporal total y el puntaje visual total (TVS) como un puntaje general que combina el alcance y la intensidad de la contaminación. El puntaje de intensidad se evaluó con análisis cuantitativos de residuos químicos. Las manos fueron las contaminadas con mayor frecuencia y la espalda tuvo el BSS más alto. El CBA varió entre 1 y 66% y el TVS entre 0,5 y 270. El agricultor con el TVS más alto obtuvo un puntaje de 60% del máximo posible. Los residuos aumentaron con el aumento de las intensidades de fluorescencia con algunos errores de clasificación. Las imágenes fluorescentes reflejaron las prácticas laborales y los mecanismos de contaminación. En conclusión, el puntaje visual, tal como lo modificamos, proporciona información sobre los segmentos del cuerpo que más contribuyen a la exposición dérmica y el grado de contaminación de la piel durante las aplicaciones de pesticidas. Los patrones de fluorescencia reflejan las vías de exposición. El sistema es de bajo costo y práctico para los países en desarrollo. Se recomiendan mejoras adicionales.
Comparative Analysis of Pesticide Use Determinants Among Smallholder Farmers From Costa Rica and Uganda
(SAGE Publications Inc., 2020-12-14) Staudacher, Philipp; Fuhrimann, Samuel; Farnham, Andrea; Atuhaire, Aggrey; Niwagaba, Charles; Stamm, Christian; Eggen, Rik IL; Winkler, Mirko S; Mora, Ana Maria
Pesticides are used globally in agriculture and pose a threat to the health of farmers, communities, and the environment. Smallholder farmers in lowand middle-income countries have generally a low socio-economic status and educational level. Consequently, they are particularly vulnerable to negative impacts of pesticides on their health, yields, or land. In a Knowledge, Attitude, and Practices study, we compared the pest management practices between a market-oriented farming system in Zarcero County, Costa Rica, and a subsistence-based farming system in Wakiso District, Uganda. We conducted a cross-sectional survey among smallholder farmers from Costa Rica (n = 300) in 2016 and from Uganda (n = 302) in 2017. We enrolled conventional and organic farmers, but also farmers with mixed practices and non-applicators of any pest management strategy. We found that the majority of pesticides used in both case studies are classified as highly hazardous by the World Health Organization. While more than 90% of smallholder farmers from both countries were aware of the negative health effects of pesticide exposure, <11% in Costa Rica and <2% in Uganda reported using personal protective equipment every time they handled or applied pesticides. Hygiene and other safe use practices were not adopted by all farmers (<61%), especially among farmers applying more hazardous pesticides. Conventional farmers from Costa Rica (14%) and Uganda (19%) reported disposing pesticide residuals into rivers. Using a logistic regression we found that organic farmers were more likely to having been trained on safe pesticide use practices. Using a robust regression, we observed that smallholder household income was primarily driven by education and not directly by the use of synthetic pesticides. Our results suggest that negative effects of pesticides can be managed over the whole life cycle, from purchase, via storage and application to residual and waste management by fostering professionalization of farmers. We advise future safe use and handling interventions to consider the pesticide use-related socioeconomic and demographic findings highlighted in this paper
Decreased Kidney Function Among Agricultural Workers In El Salvador
(Elsevier, 2012-04) Peraza, Sandra; Wesseling, Catharina; Aragon, Aurora; Leiva, Ricardo; García-Trabanino, Ramón; Torres, Cecilia; Jakobsson, Kristina; Elinder, Carl-Gustaf; Hogstedt, Christer
Background: An epidemic of chronic kidney disease of unknown cause has emerged along the Pacific coast of Central America, particularly in relatively young male sugarcane workers. In El Salvador, we examined residence and occupations at different altitudes as surrogate risk factors for heat stress. Study Design: Cross-sectional population-based survey. Setting & Participants: Populations aged 20-60 years of 5 communities in El Salvador, 256 men and 408 women (participation, 73%): 2 coastal communities with current sugarcane and past cotton production and 3 communities above 500 m with sugarcane, coffee, and service-oriented economies. Predictor: Participant sex, age, residence, occupation, agricultural history by crop and altitude, and traditional risk factors for CKD. Outcomes: Serum creatinine (SCr) level greater than the normal laboratory range for sex, estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2, and proteinuria categorized as low (protein excretion <30-<300 mg/dL) and high grade (<300 mg/dL). Results: Of the men in the coastal communities, 30% had elevated SCr levels and 18% had eGFR <60 mL/min/1.73 m 2 compared with 4% and 1%, respectively, in the communities above 500 m. For agricultural workers, prevalences of elevated SCr levels and eGFR <60 mL/min/1.73 m 2 were highest for coastal sugarcane and cotton plantation workers, but were not increased in sugarcane workers at 500 m or subsistence farmers. Women followed a weaker but similar pattern. Proteinuria was infrequent, of low grade, and not different among communities, occupations, or sexes. The adjusted ORs of decreased kidney function for 10-year increments of coastal sugarcane or cotton plantation work were 3.1 (95% CI, 2.0-5.0) in men and 2.3 (95% CI, 1.4-3.7) in women. Limitations: The cross-sectional nature of the study limits etiologic interpretations. Conclusion: Agricultural work on lowland sugarcane and cotton plantations was associated with decreased kidney function in men and women, possibly related to strenuous work in hot environments with repeated volume depletion.
Environmental Health Threats to Latino Migrant Farmworkers
(Annual Reviews Inc., 2021-01-04) Castillo, Federico; Mora, Ana M.; Kayser, Georgia L.; Vanos, Jennifer; Hyland, Carly; Yang, Audrey R.; Eskenazi, Brenda
Approximately 75% of farmworkers in the United States are Latino migrants, and about 50% of hired farmworkers do not have authorization to work in the United States. Farmworkers face numerous chemical, physical, and biological threats to their health. The adverse effects of these hazards may be amplified among Latino migrant farmworkers, who are concurrently exposed to various psychosocial stressors. Factors such as documentation status, potential lack of authorization to work in the United States, and language and cultural barriers may also prevent Latino migrants from accessing federal aid, legal assistance, and health programs. These environmental, occupational, and social hazards may further exacerbate existing health disparities among US Latinos. This population is also likely to be disproportionately impacted by emerging threats, including climate change and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Latino migrant farmworkers are essential to agriculture in the United States, and actions are needed to protect this vulnerable population.
Exposure to pesticides and health effects on farm owners and workers from conventional and organic agricultural farms in Costa Rica : Protocol for a cross-sectional study
(JMIR Publications, 2019-01-25) Fuhrimann, Samuel; Winkler, Mirko S.; Staudacher, Philipp; Weiss, Frederik T.; Stamm, Christian; Eggen, Rik IL; Lindh,Christian H; Menezes-Filho, José A; Baker, Joseph M; Ramírez-Muñoz, Fernando; Gutiérrez-Vargas, Randall; Mora, Ana M
Background: Pesticide use is increasing in low- and middle-income countries (LMICs) including Costa Rica. This increase poses health risks to farm owners, farm workers, and communities living near agricultural farms. Objective: We aimed to examine the health effects associated with occupational pesticide exposure in farm owners and workers from conventional and organic smallholder farms in Costa Rica. Methods: We conducted a cross-sectional study involving 300 owners and workers from organic and conventional horticultural smallholder farms in Zarcero County, Costa Rica. During the baseline study visit, we administered a structured, tablet-based questionnaire to collect data on sociodemographic characteristics, pesticide exposure, and health conditions (eg, respiratory and allergic outcomes and acute pesticide intoxication symptoms) and administered a neurobehavioral test battery (eg, Finger Tapping Test and Purdue Pegboard); we measured blood pressure, anthropometry (height, weight, and waist circumference), and erythrocytic acetylcholinesterase activity and also collected urine samples. In addition, a functional neuroimaging assessment using near-infrared spectroscopy was conducted with a subset of 50 study participants. During the follow-up study visit (~2-4 weeks after the baseline), we administered participants a short questionnaire on recent pesticide exposure and farming practices and collected hair, toenail, and urine samples. Urine samples will be analyzed for various pesticide metabolites, whereas toenails and hair will be analyzed for manganese (Mn), a biomarker of exposure to Mn-containing fungicides. Self-reported pesticide exposure data will be used to develop exposure intensity scores using an exposure algorithm. Furthermore, exposure-outcome associations will be examined using linear and logistic mixed-effects regression models. Results: Fieldwork for our study was conducted between May 2016 and August 2016. In total, 113 farm owners and 187 workers from 9 organic and 83 conventional horticultural smallholder farms were enrolled. Data analyses are ongoing and expected to be published between 2019 and 2020. Conclusions: This study is one of the first to examine differences in health effects due to pesticide exposure between farm owners and workers from organic and conventional smallholder farms in an LMIC. We expect that this study will provide critical data on farming practices, exposure pathways, and how occupational exposure to pesticides may affect farm owners and workers’ health. Finally, we hope that this study will allow us to identify strategies to reduce pesticide exposure in farm owners and workers and will potentially lay the groundwork for a future longitudinal study of health outcomes in farm owners and workers exposed to pesticides.
Kidney function in rice workers exposed to heat and dehydration in Costa Rica
(MDPI, 2022-04-19) Crowe, Jennifer; Rojas-Valverde, Daniel; Rojas Garbanzo, Marianela; Gutierrez-Vargas, Randall; Ugalde-Ramírez, Jose Alexis; Ledezma Rojas, José Pablo; Cabrera Alpizar, Willian; Salazar Salazar, Minor; Mauricio La Torre, Robinson; Valera-Amador, Lázara; van Wendel de Joode, Berna
The aim of this study was to evaluate heat exposure, dehydration, and kidney function in rice workers over the course of three months, in Guanacaste, Costa Rica. We collected biological and questionnaire data across a three-month-period in male field (n = 27) and other (n = 45) workers from a rice company where chronic kidney disease of unknown origin (CKDu) is endemic. We used stepwise forward regression to determine variables associated with estimated glomerular filtration rate eGFR at enrollment and/or change in eGFR, and Poisson regression to assess associations with incident kidney injury (IKI) over the course of three months. Participants were 20–62 years old (median = 40 in both groups). Dehydration was common (≥37%) in both groups, particularly among other workers at enrollment, but field workers were more exposed to heat and had higher workloads. Low eGFR (<60 mL/min/1.73 m2) was more prevalent in field workers at enrollment (19% vs. 4%) and follow-up (26% vs. 7%). Field workers experienced incident kidney injury (IKI) more frequently than other workers: 26% versus 2%, respectively. Age (β = −0.71, 95%CI: −1.1, −0.4), current position as a field worker (β = −2.75, 95%CI: −6.49, 0.99) and past work in construction (β = 3.8, 95%CI: −0.1, 7.6) were included in the multivariate regression model to explain eGFR at enrollment. The multivariate regression model for decreased in eGFR over three month included current field worker (β = −3.9, 95%CI: −8.2, 0.4), current smoking (β= −6.2, 95%CI: −13.7–1.3), dehydration (USG ≥ 1.025) at both visits (β= −3.19, 95%CI: −7.6, 1.2) and pain medication at follow-up (β= −3.2, 95%CI: −8.2, 1.95). Current fieldwork [IR (incidence rate) = 2.2, 95%CI 1.1, 5.8) and being diabetic (IR = 1.8, 95%CI 0.9, 3.6) were associated with IKI. Low eGFR was common in field workers from a rice company in Guanacaste, and being a field worker was a risk factor for IKI, consistent with the hypothesis that occupational heat exposure is a critical risk factor for CKDu in Mesoamerica.
Pesticide Exposure and Neurological Effects in Children of Nicaraguan Agricultural Workers, With an Ecosystem Approach
(Wolters Kluwer Health, Inc., 2007-09) Rodríguez, T; van Wendel de Joode, Berna; Soto, A; Rojas, M; Wesseling, Catharina
Las familias de trabajadores agrícolas en Nicaragua suelen tener mayor contacto con plaguicidas en el entorno general debido a que viven cerca de los campos tratados con plaguicidas. Los niños suelen jugar y trabajar en o cerca de los campos tratados. Un estudio previo reportó TCPY en aplicadores y sus hijos (LOD 146.82 μg/L y LOD 125.13 μg/L, respectivamente). Además, los niveles urinarios de los metabolitos generales de los piretroides, PBA, cis-DCCA, trans-DCCA y DBCA, superan los niveles de referencia publicados en niños. El objetivo principal de este estudio es determinar el contexto económico y social de la exposición infantil a plaguicidas y sus efectos neurológicos.
Reliability of a Visual Scoring System with Fluorescent Tracers to Assess Dermal Pesticide Exposure
(Oxford University Press, 2004-09-20) Aragon, Aurora; Blanco, Luis; Lopéz, Lylliam; Lidén, Carola; Nise, Gun; Wesseling Hoogervors, Catharina
We modified Fenske's semi-quantitative ‘visual scoring system’ of fluorescent tracer deposited on the skin of pesticide applicators and evaluated its reproducibility in the Nicaraguan setting. The body surface of 33 farmers, divided into 31 segments, was videotaped in the field after spraying with a pesticide solution containing a fluorescent tracer. A portable UV lamp was used for illumination in a foldaway dark room. The videos of five farmers were randomly selected. The scoring was based on a matrix with extension of fluorescent patterns (scale 0–5) on the ordinate and intensity (scale 0–5) on the abscissa, with the product of these two ranks as the final score for each body segment (0–25). Five medical students rated and evaluated the quality of 155 video images having undergone 4 h of training. Cronbach alpha coefficients and two-way random effects intraclass correlation coefficients (ICC) with absolute agreement were computed to assess inter-rater reliability. Consistency was high (Cronbach alpha = 0.96), but the scores differed substantially between raters. The overall ICC was satisfactory [0.75; 95% confidence interval (CI) = 0.62–0.83], but it was lower for intensity (0.54; 95% CI = 0.40–0.66) and higher for extension (0.80; 95% CI = 0.71–0.86). ICCs were lowest for images with low scores and evaluated as low quality, and highest for images with high scores and high quality. Inter-rater reliability coefficients indicate repeatability of the scoring system. However, field conditions for recording fluorescence should be improved to achieve higher quality images, and training should emphasize a better mechanism for the reading of body areas with low contamination.
Respiratory, allergy and eye problems in bagasse-exposed sugar cane workers in Costa Rica
(BMJ Journals, 2012-01-22) Gascon, Mireia; Kromhout, Hans; Heederik, Dick; Eduard, Wijnand; van Wendel de Joode, Berna
Aims To evaluate bagasse (sugar cane fibres) and microbiological exposure among sugar cane refinery workers in Costa Rica and its relationships with respiratory, allergy and eye problems. Methods Ventilatory lung function and total serum IgE were measured in 104 sugar cane workers in five departments at one refinery before the harvesting season, and repeated for 77 of the workers at the end of the season. Information on the prevalence of respiratory and other symptoms was collected with a standardised questionnaire. During the harvesting season, inhalable dust, endotoxin and mould levels were measured among 74 randomly selected sugar cane workers across departments. Results During the harvesting season, dust levels were relatively high in some departments, while endotoxin and mould levels were around background levels. Workers' ventilatory lung function differed between departments before, but not during the harvesting season or between seasons. During the harvesting season, the prevalence of wheeze and eye problems almost doubled in workers exposed to bagasse and other types of dust, whereas shortness of breath and rhinitis increased only in bagasse-exposed workers. Reporting wheeze and shortness of breath was positively associated with the number of years working at the refinery, suggesting a long-term health effect. Conclusion In this refinery, the differences in workers' ventilatory lung function before the harvesting season are unlikely to be explained by bagasse exposure. However, the increase in reported symptoms (wheeze, shortness of breath, eye problems and rhinitis) over the season is likely due to irritation by dust, in particular bagasse, rather than microbiological agents.
The Determinants of Dermal Exposure Ranking Method (DERM): A Pesticide Exposure Assessment Approach for Developing Countries
(Oxford University Press, 2008-07-07) Blanco, Luis E.; Aragón, Aurora; Lundberg, Ingvar; Wesseling Hoogervors, Catharina; Nise, Gun
Anewmethod for assessment of dermal exposure to pesticides in subsistence farmers by use of determinants of dermal exposure is described. The method, called the determinants of dermal exposureranking method(DERM),isacombinationofchecklists andexpert ratingassessment. Thus, determinants are listed in a form, which is used to check their presence and to assess them using a simple algorithm based on two factors, the type of transport process (T value) and the area of body surface exposed (Avalue). In addition, the type of clothing worn during applications is included as a protection factor. We applied the DERM to real pesticide applications, characterizing dermal exposure and comparing DERM estimates with earlier developed semiquantitative visual scores based on fluorescent tracer, the total visual score (TVS) and contaminated body area (CBA). DERM showed avery good level of agreement with both the TVS (r 5 0.69; P 5 0.000) and the CBA (r 5 0.67; P 5 0.000). DERM allowed identification of the determinants that had the highest effect on exposure and the farmers with the highest exposure. In conclusion, DERM provided information on the determinants responsible for dermal exposure in a group of subsistence farmers. This can be useful to design monitoring and preventive programs, define priorities for intervention and prioritize and select most adequate measurementstrategies. DERM promises to be a low-cost easy-to-use method to assess dermal exposure to pesticides in developing country conditions.
Unintentional Fatal Paraquat Poisonings Among Agricultural Workers in Costa Rica: Report of 15 Cases
(Wiley-Liss, Inc., 1998-12-06) Wesseling, Catharina; Hogstedt, Christer; Picado, Anabelle; Johansson, Leif
Este estudio analiza las circunstancias de exposición de 15 intoxicaciones ocupacionales fatales por paraquat. Para evaluar el peligro potencial de la absorción dérmica y la cantidad necesaria para producir un desenlace fatal en caso de ingesta oral, revisamos los registros médicos y los protocolos de autopsia y entrevistamos a los familiares. Cinco muertes se debieron a la ingestión de un trago de concentrado de paraquat y cinco a la ingesta de una cantidad menor; tres casos se asociaron con exposición dérmica y en dos, no hubo evidencia de exposición oral o dérmica. Varios casos se referían a aerosoles de paraquat diluidos. Los hallazgos clínicos y patomorfológicos, incluida una evaluación "ciega" de portaobjetos de pulmón, fueron consistentes con intoxicación por paraquat en todos los casos. Se identificaron dificultades para establecer el diagnóstico y reconocer la exposición, así como la clasificación de los envenenamientos no intencionales como suicidios en la autopsia. Los hallazgos sugieren que el paraquat puede causar intoxicaciones mortales por ingestión de pequeñas cantidades, por absorción dérmica de paraquat diluido y posiblemente por inhalación. Se justifican estudios más concluyentes.

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