Mortality and morbidity by work-related pesticide poisoning in Brazil, 2009-2019

Abstract

BACKGROUND AND AIM: Pesticide poisoning is a key public health problem in Brazil, which is one of the worlds’ largest consumer. OBJECTIVE: To analyze the records of work-related pesticide poisoning from the Brazilian official database. METHODS: Pesticide poisoning data from 2009-2019 from the Information System of Notifiable Diseases (SINAN) was gathered, and mortality and morbidity coefficient among agricultural workers calculated for 2018. Notification of suspected and confirmed poisoning cases is mandatory for health services in Brazil through the SINAN system. RESULTS:From 2009-2019, 23,011 work-related pesticide poisoning were notified in SINAN, with an upward trend over the years, soaring from 1,467 cases in 2009 to 2,842 in 2018 (+94%). But pesticide poisoning is vastly underreported in Brazil, and it is estimated that for every notification there is another 50 cases unregistered. There is a considerable regional difference in the sensitivity of health services to identify poisoning cases and register in SINAN, and states with stronger surveillance systems had more cases notified. Most pesticide poisoning cases registered in SINAN occurred among male workers (79%) aged 26-45 years (50%), who worked in agriculture (70%) and had at most elementary educational level (57%). The morbidity coefficient was, respectively, 30 and 24 (x 100.000) among women and men. The highest coefficient was observed among workers aged 14-25 years and 26-35 years, respectively, 270 and 73 x 100.000. Lethality was 0.7%, and mortality coefficient was 0.001 x 100.000 agricultural workers. Considerable incomplete data was observed in SINAN, especially regarding “work relation”, and “final outcome”. CONCLUSIONS:As Brazilian agricultural production and pesticide use steadily grow, it is necessary to strengthen health surveillance and promotion on pesticide exposure and foster farmer’s technical support and training to reduce occupational exposure, health impacts, and burden of disease. KEYWORDS: Pesticides, Chemical exposures, Occupational exposures, Occupational epidemiology, Outcomes, Mortality