Abstract
Studies suggest that acute pesticide poisonings (APP) may be linked with long-term neurological effects. To examine long-term neurological and psychological distress symptoms associated with having experienced an APP, we conducted a cross-sectional study of 300 conventional and organic smallholder farmers from Zarcero County, Costa Rica, May–August 2016. We collected self-reported data on sociodemographic characteristics, occupational history, pesticide exposure, APPs, neurological and psychological distress symptoms (using the Brief Symptom Inventory (BSI)). Adjusted logistic regression models were fit. A total of 14% of the farmers (98% male) reported experiencing at least one APP during their lifetime. Self-reported APP was associated with neurological symptoms during the 12 months prior to interview (e.g., fainting (Odds Ratio: 7.48, 95% Confidence Interval: 1.83, 30.74), shaking hands (3.50; 1.60, 7.60), numbness/tingling in hands or feet (3.23; 1.66, 6.32), insomnia (2.53; 1.34, 4.79), accelerated heartrate (2.42; 1.03, 5.47), dizziness (2.38; 1.19, 4.72), increased irritability/anger (2.37; 1.23, 4.55), low energy (2.33; 1.23, 4.46), and difficulty concentrating (2.01; 1.05, 3.85)). Farmers who reported an APP in the ten years prior to interview experienced increased odds of abnormal BSI scores for hostility (4.51; 1.16, 17.70) and paranoid ideation (3.76; 0.99, 18.18). Having experienced an APP may be associated with long-term neurological and psychological distress symptoms.
Highlights
Of the 72 acute pesticide poisonings (APP) reported, 36% (n = 26) were confirmed by a doctor, 76% (n = 55) occurred to farmers working in conventional farms at the time of interview, and 82% (n = 59) were able to be approximated by the farmer to a year
We found that farmers who applied/handled synthetic pesticides at the time of the interview reported a similar frequency of symptoms compared to non-applicators (Figure 1, two-way analysis of variance (ANOVA) results F = 1.74, p = 0.19), suggesting that acute exposure to pesticides is unlikely to account for the difference in symptoms between those who had experienced an APP and those who had not
These results were similar to those of previous studies investigating associations between APPs and neurological symptoms [15,16,26,27]. These neurological symptoms are unlikely to be related to pesticide exposure at the time of the interview, as the sensitivity analysis showed that farmers who apply/handled pesticides at the time of the interview reported a similar frequency of symptoms to those who did not
Summary
Occupational exposure to pesticides is ubiquitous among farmers worldwide [1] and its adverse effects on human health are a well-documented threat [2,3]. The burden of pesticides on health is high in low- and middle-income countries (LMICs), due in part to pesticide applicators with less education, limited access to personal protective equipment [4,5], larger agricultural populations, and fewer or less enforced regulations around pesticide use [2,6,7]. It is estimated that 99% of deaths from acute pesticide poisonings (APPs) occur in LMICs, despite the fact that these countries only use 20% of the.
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