Effects on respiratory health and exposure to pesticides in the general population
| First author [ref.] | Location | Study design | Summary of method | Results | |||
| Population characteristics | Pesticides of interest | Exposure assessment | Health outcomes | ||||
| Balluz [44] | USA | Cross-sectional | 117 employees of a health centre in Georgia, 94% women, aged: 21–68 years | Malathion, Organochlorines including DDT: stored, handled and used in the fight against mosquitoes | Environmental sampling of pesticides in the building: Malathion (110 µg·g−1); DDT (24 µg·g−1) Measures of 17 chlorinated pesticides in serum and urine of employees (concentrations below 95% limit for the reference range for the US population) | Self-reported occurrence and severity of respiratory illnesses and symptoms | Duration of employment (at least 3 years) significantly associated with bronchitis (OR 4.3, 95% CI 1.7–11.0) and sinusitis (OR 3.7, 95% CI 1.5–8.7) No association between health complaint and pesticide levels in serum and urine |
| Ames [45] | USA | Retrospective study | 39 subjects who were residents living near farms where paraquat was applied and 172 controls living in areas remote from spraying | Paraquat | Living near farms where paraquat was applied (an area of ∼0.5 miles) Self-reported perception of odour during the 2 weeks of study period | Self-reported symptoms during the 2-week study period | Significant increased risk for cough (RR 2.60; p<0.001) and wheezing (RR 3.04; p<0.01, Chi-squared) in the paraquat-exposed group |
| Karpati [46] | USA | Retrospective study after a mosquito eradication programme | 62 827 visits for asthma in the ED of hospitals in New York, study period, mean age: 34 years | Pyrethroid insecticides sprayed in New York City during July–September 2000 to control mosquito vectors of West Nile virus | None | Data obtained from the New York City Health and Hospitals Corporation for ED visits for asthma during pesticide spraying period | No significant association between pesticide spraying days and daily rates of asthma visits (RR 0.92, 95% CI 0.80–1.07) |
| O'Sullivan [47] | USA | Retrospective study after a mosquito eradication programme | 1 318 patients with a diagnosis of asthma in the ED of Lincoln hospital (South Bronx, NY) during 1997, 1998 and 1999 | Malathion (organophosphate insecticide) and andresmethrin (pyrethroid insecticide) sprayed during the mosquito eradication programme in South Bronx in September 1999 | None | Adult and paediatric asthma ED admissions during the 4 days (September 1999) of the mosquito eradication programme | No significant differences in patient ED asthma admissions between spraying and non-spraying days in September 1999 No significant difference between the number of ED asthma admissions in September 1999 compared with 1997 and 1998 |
| Zhang [48] | China | Cross-sectional | 22 528 rural adults, 48.7% men, age ≥15 years | Insecticides | Face-to-face questionnaire to obtain information on regular occupational and environmental exposure to chemicals (insecticides) | Face-to-face questionnaire (IUATLD questionnaire) about respiratory symptoms during the past 12 months | Exposure to insecticides associated with higher prevalence of chronic cough (OR 2.2, 95% CI 1.4–3.3), asthma attack (OR 1.9, 95% CI 1.3–2.9) and wheeze (OR 1.8, 95% CI 1.2–2.6) |
| LeVan [49] | Singapore | Prospctive cohort (Singapore Chinese Health Study, SCHS) | 52 325 subjects, 42.6% men, age: 45–75 years | Vapour exposure including pesticides | None | Follow-up phone questionnaire based on ATS-DLD: respiratory symptoms, self-report of physician-diagnosed adult-onset asthma and respiratory outcomes in general | Occupational pesticide exposure associated with adult-onset asthma (OR 1.69, 95% CI 1.13–2.52) |
DDT: dichlorodiphenyl trichloroethane; RR: relative risk; ED: emergency department; IUATLD: International Union Against Tuberculosis and Lung Disease; ATS-DLD: American Thoracic Society Division of Lung Disease.