Pesticide exposure and health effects in Latin American and the Caribbean populations: A systematic review.

Abstract

Background: Growing evidence suggests that exposure to pesticides may be associated with adverse health effects in different population groups, including farmworkers, pregnant women, and children. However, data on the current state of research on this topic in the Latin American and the Caribbean (LAC) region are scarce. We examined the available epidemiological literature on the health effects of pesticide exposure in LAC populations, with the goal of identifying knowledge gaps and capacity building needs. Methods: We searched PubMed and SciELO for epidemiological studies on environmental and/or occupational pesticide exposure and human health in LAC populations published between January 2007 and March 2019. Ultimately, 137 papers from 13 countries were selected and grouped by health outcome (genotoxicity and oxidative stress, neurotoxicity, placental effects and teratogenicity, cancer, endocrine disruption, reproductive health, and others). Results: Most papers (87%) reported associations of pesticide exposure with at least one of the health outcomes. The most frequently studied health effects included genotoxic and oxidative damage (26%), neurotoxicity (19%), and endocrine disruption (10%). Most published studies were conducted in Brazil (40%) and Mexico (23%), were primarily cross-sectional in design (75%), and examined farmworkers (42%) and children (22%). About half of the published studies used direct methods to assess exposure (e.g., exposure biomarkers; 47%) and were rated as high or intermediate-high quality (44%). Conclusion: Despite the small number of published studies and their limitations, our review suggests that pesticides are associated with adverse health outcomes among occupationally and/or environmentally exposed populations. Additional research would allow a better understanding of the potential health effects of pesticides in LAC populations and would help to identify effective intervention. An integration of research initiatives that bridge multiple disciplines and the establishment a regional network of researchers would also help address existing knowledge gaps and capacity building needs.