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Occupational exposure to pesticides and respiratory health

Ali Mamane, Isabelle Baldi, Jean-François Tessier, Chantal Raherison, Ghislaine Bouvier
European Respiratory Review 2015 24: 306-319; DOI: 10.1183/16000617.00006014
Ali Mamane
1ISPED – Laboratoire Santé Travail Environnement, INSERM U897, Université de Bordeaux, Bordeaux, France
2ISPED – Centre INSERM U897 – Epidémiologie-Biostatistique, Bordeaux, France
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  • For correspondence: ali.mamane@isped.u-bordeaux2.fr
Isabelle Baldi
1ISPED – Laboratoire Santé Travail Environnement, INSERM U897, Université de Bordeaux, Bordeaux, France
2ISPED – Centre INSERM U897 – Epidémiologie-Biostatistique, Bordeaux, France
3Service de Médecine du Travail, CHU de Bordeaux, Bordeaux, France
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Jean-François Tessier
2ISPED – Centre INSERM U897 – Epidémiologie-Biostatistique, Bordeaux, France
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Chantal Raherison
1ISPED – Laboratoire Santé Travail Environnement, INSERM U897, Université de Bordeaux, Bordeaux, France
2ISPED – Centre INSERM U897 – Epidémiologie-Biostatistique, Bordeaux, France
4Service des Maladies Respiratoires, CHU de Bordeaux, Bordeaux, France
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Ghislaine Bouvier
1ISPED – Laboratoire Santé Travail Environnement, INSERM U897, Université de Bordeaux, Bordeaux, France
2ISPED – Centre INSERM U897 – Epidémiologie-Biostatistique, Bordeaux, France
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    FIGURE 1

    Flow chart for the identification and selection of included articles.

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  • TABLE 1

    Effects of pesticides on the respiratory health of agricultural workers

    First author [ref.]CountrySummary of methodStatistically significant main findings
    PopulationPesticide exposureHealth outcomes
    Respiratory diseases: asthma and bronchitis
     Senthilselvan [25]Canada1939 farmersOrganophosphate, organochlorine, carbamate insecticidesSelf-reported respiratory symptomsIncreased asthma with carbamate insecticide use
     Kang [26]USA1499 Vietnam veterans/ 1428 non-Vietnam veteransSprayed herbicides (Agent Orange)Self-reported; chronic medical condition diagnosed by a doctorIncreased chronic bronchitis and asthma, elevated among Vietnam veterans who sprayed herbicides versus non-Vietnam veterans
     Bener [27]United Arab Emirates98 farmers/98 controlsPesticides (not specified)Lifelong respiratory symptomsIncreased chronic cough and asthma in farmers versus controls
     Salameh [28]Lebanon245 asthma cases/ 262 controlsPesticides (not specified)Confirmation of asthma by lung specialistIncreased asthma with any exposure to pesticides
     Salameh [29]Lebanon110 chronic bronchitis cases/262 controlsPesticides (not specified)Confirmation of chronic bronchitis by lung specialistIncreased chronic bronchitis according to increase in intensity and/or duration of different levels of exposure to pesticides
    Respiratory symptoms
     Zuskin [30]Croatia167 exposed/81 unexposed workersPesticides (not specified)Lifelong respiratory symptomsIncreased chronic cough, dyspnoea and chest tightness in exposed females versus controls (p<0.01)
     Zuskin [31]Croatia174 exposed/115 unexposed workersPesticides (not specified)Pulmonary function measures (spirometry)Increased chronic cough and chronic phlegm (p<0.05) in workers employed for >10 years
     Castro-Gutiérrez [32]Nicaragua134 paraquat exposed/ 152 unexposed workersParaquatRespiratory symptoms during the last 24 monthsIncreased episodic wheezing accompanied by shortness of breath among the more intensely exposed workers
     Wilkins [33]USA1793 farmersPesticides (not specified)Respiratory symptoms during the last 12 monthsIncreased chronic cough with lifetime tractor operations
     Sprince [34]USA385 farmersAgricultural pesticides (insecticides for crops and livestock, and herbicides)Respiratory symptomsIncreased ever-wheezy chest due to applying pesticides to livestock
     Beseler [35]USA761 farm operators and spousesAgricultural pesticides (not specified)History of respiratory disorders and symptomsIncreased wheeze with pesticide poisoning in current smokers
     Masley [36]Canada511 males, 499 females and 393 childrenPesticides and fertilisersRespiratory symptoms during lifeIncrease in one or more respiratory symptoms (cough, phlegm, wheeze or shortness of breath) with pesticide exposure
     Schenker [37]Costa Rica219 farm workers/110 controlsParaquatRespiratory symptomsIncreased shortness of breath with wheeze with each unit increase in the total cumulative paraquat index
     Fieten [38]Costa Rica69 exposed/58 unexposed workersTerbufos, chlorpyrifos, paraquatRespiratory symptoms during past yearIncreased wheeze with exposure to the organophosphate insecticides chlorpyrifos and terbufos in nonsmokers
     Faria [39]Brazil1379 farmersOrganophosphates, pyrethroids and dithiocarbamatesSelf-reported asthma and chronic respiratory diseasesIncreased asthma symptoms and chronic respiratory disease symptoms with pesticide poisoning
     Ejigu [40]Ethiopia82 farm workers/47 controlsAgricultural pesticides (not specified)Lifelong respiratory symptomsIncreased prevalence of respiratory symptoms, including cough, phlegm and wheeze in farm workers versus controls (p<0.05)
     Pathak [41]India108 pesticide sprayers/ 30 controlsAgricultural pesticidesRespiratory symptomsIncreased respiratory symptoms with tractor-mounted sprayers compared to controls
     Ngowi [42]Tanzania133 coffee farm workersAgricultural pesticides: fungicides, insecticides and herbicidesRespiratory symptoms during spraying and nonspraying seasonsNo significant association
     Jones [43]USA100 pilots (aerial spraying of pesticides)/100 controlsAgricultural pesticidesRespiratory symptomsNo significant association
     Abu Sham'a [44]Palestine250 farmersAgricultural pesticides not specifiedRespiratory symptoms during the last 12 monthsNo significant association
    Respiratory function
     Mekonnen [45]Ethiopia102 pesticide sprayers/ 69 non-sprayersPesticides on the farms: chlorpyrifos, diazinon and malathionPulmonary function measurementsDecreased lung volumes (reduced FVC and FEV1) in the 15–24-year age group of pesticide sprayers compared to similarly aged non-sprayers
     Hernández [46]Spain89 pesticide sprayers/ 25 unexposed farm workers10 agricultural pesticidesPhysical examination during the peak spraying seasonDecreased FEF25–75% with lifelong cumulative exposure to pesticides; decreased lung volumes (restrictive disease) with recent exposure to neonicotinoids
     Chakraborty [47]India376 exposed/348 controlsAgricultural pesticidesPulmonary function measurementsDecreased lung function in exposed workers compared to controls (p<0.001)
     Cha [48]South Korea2508 paraquat applicators/374 non-paraquat applicatorsParaquatReport of doctor-diagnosed symptoms/diseases: COPD and asthma; pulmonary function measurementsDecreased restrictive ventilatory defect with paraquat application
    • All the studies were cross-sectional except those of Salameh and co-workers [28, 29], which were case–control studies. FVC: forced vital capacity; FEV1: forced expiratory volume in 1 s; FEF25–75%: forced expiratory flow at 25–75% of FVC; COPD: chronic obstructive pulmonary disease.

  • TABLE 2

    Respiratory health of agricultural workers: longitudinal studies

    First author [ref.]CountrySummary of methodStatistically significant main findings
    PopulationPesticide exposureHealth outcomes
    Asthma and wheeze
     Hoppin [49]USA20 468 pesticide applicators (farmers) and 16 630 farmers in the AHS40 specific pesticidesSelf-reported wheezeIncreased wheezing with atrazine, chlorpyrifos and parathion
     Hoppin [50]USA17 920 pesticide applicators and 2255 commercial pesticide applicators in the AHS40 specific pesticidesSelf-reported wheezeIncreased wheeze with five pesticides used in the past year in farmers; increased wheeze with chlorimuron-ethyl, dichlorvos, and phorate in commercial applicators
     Hoppin [51]USA2255 commercial pesticide applicators in the AHS40 specific pesticidesSelf-reported wheeze, asthma (self-reported doctor-diagnosed)Increased wheeze with eight herbicides; highest odds ratio was for application of chlorpyrifos for >40 days per year
     Hoppin [52]USA25 814 female farm workers, including 702 cases of asthma and 25 112 control subjects in the AHS50 specific pesticidesSelf-reported doctor-diagnosed asthma after 19 years of ageIncreased atopic asthma with seven insecticides, two herbicides and one fungicide; parathion use had the highest odds ratio (2.88); increased non-atopic asthma only with permethrin use on crops
     Hoppin [53]USA19 704 farmers, including 441 cases of asthma and 19 263 control subjects in the AHS50 specific pesticidesSelf-reported doctor-diagnosed asthma after 19 years of ageIncreased allergic asthma with ever-use of 12 pesticides and nonallergic asthma with four pesticides; for allergic asthma, the strongest association was with coumaphos (odds ratio 2.34), and for nonallergic asthma with DDT
     Henneberger [54]USA926 adult pesticide applicators with active asthma in the AHS36 specific pesticidesExacerbation of asthma, self-reported visit to emergency roomIncreased exacerbation of allergic asthma associated with pendimethalin and aldicarb
     Beard [55]Australia1999 outdoor staff working as part of an insecticide application and 1984 outdoor workers not occupationally exposed to insecticidesPesticides: arsenic, DDT and other chemicalsAscertainment of vital statusHigher asthma mortality for applicators compared with the general Australian population; increased asthma mortality in subjects working with modern chemicals compared to other subjects
     Baldi [56]France15 494 farmers, including 1246 cases of asthma in the AGRICAN studyAgricultural pesticides and farming activitiesSelf-reported doctor-diagnosed asthmaIncreased allergic asthma in participants reporting a history of pesticide poisoning
     Boers [57]Netherlands, Italy, Finland and Bulgaria248 workers exposed to pesticides and 231 non-exposed workers from the EUROPIT studyEthylenebisdithiocarbamate and/or other pesticidesSelf-reported asthma and respiratory symptomsNo significant association
    Chronic bronchitis
     Hoppin [58]USA20 908 farmers, including 654 cases of chronic bronchitis in the AHS50 specific pesticidesSelf-reported doctor-diagnosed chronic bronchitis after 19 years of ageIncreased chronic bronchitis with 11 pesticides; heptachlor use had the highest odds ratio (in the adjusted model)
     Valcin [59]USA21 541 nonsmoking female spouses of farm workers, including 583 cases of chronic bronchitis in the AHS50 specific pesticidesSelf-reported doctor-diagnosed chronic bronchitis after 19 years of ageIncreased chronic bronchitis with five pesticides in nonsmoking spouses of farmers; paraquat use had the highest odds ratio
     Tual [60]France14 441 farmers, including 1207 cases of chronic bronchitisAgricultural pesticides and farming activitiesSelf-reported doctor-diagnosed chronic bronchitis after 20 years of ageIncreased chronic bronchitis with exposure to pesticide poisoning and pesticide use in potato farmers
    • AHS: Agricultural Health Study; DDT: dichlorodiphenyltrichloroethane; AGRICAN: Agriculture and Cancer.

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Occupational exposure to pesticides and respiratory health
Ali Mamane, Isabelle Baldi, Jean-François Tessier, Chantal Raherison, Ghislaine Bouvier
European Respiratory Review Jun 2015, 24 (136) 306-319; DOI: 10.1183/16000617.00006014

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Occupational exposure to pesticides and respiratory health
Ali Mamane, Isabelle Baldi, Jean-François Tessier, Chantal Raherison, Ghislaine Bouvier
European Respiratory Review Jun 2015, 24 (136) 306-319; DOI: 10.1183/16000617.00006014
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