Figures
- FIGURE 1
Flow chart for the identification and selection of included articles.
Tables
- TABLE 1
Effects of pesticides on the respiratory health of agricultural workers
First author [ref.] Country Summary of method Statistically significant main findings Population Pesticide exposure Health outcomes Respiratory diseases: asthma and bronchitis Senthilselvan [25] Canada 1939 farmers Organophosphate, organochlorine, carbamate insecticides Self-reported respiratory symptoms Increased asthma with carbamate insecticide use Kang [26] USA 1499 Vietnam veterans/ 1428 non-Vietnam veterans Sprayed herbicides (Agent Orange) Self-reported; chronic medical condition diagnosed by a doctor Increased chronic bronchitis and asthma, elevated among Vietnam veterans who sprayed herbicides versus non-Vietnam veterans Bener [27] United Arab Emirates 98 farmers/98 controls Pesticides (not specified) Lifelong respiratory symptoms Increased chronic cough and asthma in farmers versus controls Salameh [28] Lebanon 245 asthma cases/ 262 controls Pesticides (not specified) Confirmation of asthma by lung specialist Increased asthma with any exposure to pesticides Salameh [29] Lebanon 110 chronic bronchitis cases/262 controls Pesticides (not specified) Confirmation of chronic bronchitis by lung specialist Increased chronic bronchitis according to increase in intensity and/or duration of different levels of exposure to pesticides Respiratory symptoms Zuskin [30] Croatia 167 exposed/81 unexposed workers Pesticides (not specified) Lifelong respiratory symptoms Increased chronic cough, dyspnoea and chest tightness in exposed females versus controls (p<0.01) Zuskin [31] Croatia 174 exposed/115 unexposed workers Pesticides (not specified) Pulmonary function measures (spirometry) Increased chronic cough and chronic phlegm (p<0.05) in workers employed for >10 years Castro-Gutiérrez [32] Nicaragua 134 paraquat exposed/ 152 unexposed workers Paraquat Respiratory symptoms during the last 24 months Increased episodic wheezing accompanied by shortness of breath among the more intensely exposed workers Wilkins [33] USA 1793 farmers Pesticides (not specified) Respiratory symptoms during the last 12 months Increased chronic cough with lifetime tractor operations Sprince [34] USA 385 farmers Agricultural pesticides (insecticides for crops and livestock, and herbicides) Respiratory symptoms Increased ever-wheezy chest due to applying pesticides to livestock Beseler [35] USA 761 farm operators and spouses Agricultural pesticides (not specified) History of respiratory disorders and symptoms Increased wheeze with pesticide poisoning in current smokers Masley [36] Canada 511 males, 499 females and 393 children Pesticides and fertilisers Respiratory symptoms during life Increase in one or more respiratory symptoms (cough, phlegm, wheeze or shortness of breath) with pesticide exposure Schenker [37] Costa Rica 219 farm workers/110 controls Paraquat Respiratory symptoms Increased shortness of breath with wheeze with each unit increase in the total cumulative paraquat index Fieten [38] Costa Rica 69 exposed/58 unexposed workers Terbufos, chlorpyrifos, paraquat Respiratory symptoms during past year Increased wheeze with exposure to the organophosphate insecticides chlorpyrifos and terbufos in nonsmokers Faria [39] Brazil 1379 farmers Organophosphates, pyrethroids and dithiocarbamates Self-reported asthma and chronic respiratory diseases Increased asthma symptoms and chronic respiratory disease symptoms with pesticide poisoning Ejigu [40] Ethiopia 82 farm workers/47 controls Agricultural pesticides (not specified) Lifelong respiratory symptoms Increased prevalence of respiratory symptoms, including cough, phlegm and wheeze in farm workers versus controls (p<0.05) Pathak [41] India 108 pesticide sprayers/ 30 controls Agricultural pesticides Respiratory symptoms Increased respiratory symptoms with tractor-mounted sprayers compared to controls Ngowi [42] Tanzania 133 coffee farm workers Agricultural pesticides: fungicides, insecticides and herbicides Respiratory symptoms during spraying and nonspraying seasons No significant association Jones [43] USA 100 pilots (aerial spraying of pesticides)/100 controls Agricultural pesticides Respiratory symptoms No significant association Abu Sham'a [44] Palestine 250 farmers Agricultural pesticides not specified Respiratory symptoms during the last 12 months No significant association Respiratory function Mekonnen [45] Ethiopia 102 pesticide sprayers/ 69 non-sprayers Pesticides on the farms: chlorpyrifos, diazinon and malathion Pulmonary function measurements Decreased lung volumes (reduced FVC and FEV1) in the 15–24-year age group of pesticide sprayers compared to similarly aged non-sprayers Hernández [46] Spain 89 pesticide sprayers/ 25 unexposed farm workers 10 agricultural pesticides Physical examination during the peak spraying season Decreased FEF25–75% with lifelong cumulative exposure to pesticides; decreased lung volumes (restrictive disease) with recent exposure to neonicotinoids Chakraborty [47] India 376 exposed/348 controls Agricultural pesticides Pulmonary function measurements Decreased lung function in exposed workers compared to controls (p<0.001) Cha [48] South Korea 2508 paraquat applicators/374 non-paraquat applicators Paraquat Report of doctor-diagnosed symptoms/diseases: COPD and asthma; pulmonary function measurements Decreased 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.] Country Summary of method Statistically significant main findings Population Pesticide exposure Health outcomes Asthma and wheeze Hoppin [49] USA 20 468 pesticide applicators (farmers) and 16 630 farmers in the AHS 40 specific pesticides Self-reported wheeze Increased wheezing with atrazine, chlorpyrifos and parathion Hoppin [50] USA 17 920 pesticide applicators and 2255 commercial pesticide applicators in the AHS 40 specific pesticides Self-reported wheeze Increased wheeze with five pesticides used in the past year in farmers; increased wheeze with chlorimuron-ethyl, dichlorvos, and phorate in commercial applicators Hoppin [51] USA 2255 commercial pesticide applicators in the AHS 40 specific pesticides Self-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] USA 25 814 female farm workers, including 702 cases of asthma and 25 112 control subjects in the AHS 50 specific pesticides Self-reported doctor-diagnosed asthma after 19 years of age Increased 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] USA 19 704 farmers, including 441 cases of asthma and 19 263 control subjects in the AHS 50 specific pesticides Self-reported doctor-diagnosed asthma after 19 years of age Increased 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] USA 926 adult pesticide applicators with active asthma in the AHS 36 specific pesticides Exacerbation of asthma, self-reported visit to emergency room Increased exacerbation of allergic asthma associated with pendimethalin and aldicarb Beard [55] Australia 1999 outdoor staff working as part of an insecticide application and 1984 outdoor workers not occupationally exposed to insecticides Pesticides: arsenic, DDT and other chemicals Ascertainment of vital status Higher 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] France 15 494 farmers, including 1246 cases of asthma in the AGRICAN study Agricultural pesticides and farming activities Self-reported doctor-diagnosed asthma Increased allergic asthma in participants reporting a history of pesticide poisoning Boers [57] Netherlands, Italy, Finland and Bulgaria 248 workers exposed to pesticides and 231 non-exposed workers from the EUROPIT study Ethylenebisdithiocarbamate and/or other pesticides Self-reported asthma and respiratory symptoms No significant association Chronic bronchitis Hoppin [58] USA 20 908 farmers, including 654 cases of chronic bronchitis in the AHS 50 specific pesticides Self-reported doctor-diagnosed chronic bronchitis after 19 years of age Increased chronic bronchitis with 11 pesticides; heptachlor use had the highest odds ratio (in the adjusted model) Valcin [59] USA 21 541 nonsmoking female spouses of farm workers, including 583 cases of chronic bronchitis in the AHS 50 specific pesticides Self-reported doctor-diagnosed chronic bronchitis after 19 years of age Increased chronic bronchitis with five pesticides in nonsmoking spouses of farmers; paraquat use had the highest odds ratio Tual [60] France 14 441 farmers, including 1207 cases of chronic bronchitis Agricultural pesticides and farming activities Self-reported doctor-diagnosed chronic bronchitis after 20 years of age Increased chronic bronchitis with exposure to pesticide poisoning and pesticide use in potato farmers AHS: Agricultural Health Study; DDT: dichlorodiphenyltrichloroethane; AGRICAN: Agriculture and Cancer.
Supplementary material
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Vol 24 Issue 136
Table of Contents
Occupational exposure to pesticides and respiratory health
