Pesticide exposure in Chile and population health: urgency for decision making

Abstract

Background: In the last 25 years, Chile has had an expanding role as an agro-export country in the global economy, with efficient rates of productivity in the region, large areas with monocultures and the intensive application of agrochemicals. This form of agriculture has also lacked efficient regulations and surveillance, so it is difficult to estimate the real magnitude of the exposed population and its acute and chronic effects on health. Objective: to compile the epidemiological evidence on health effects associated with pesticide exposure and to promote a public discussion on pesticides used in Chile. Methods: in this review, epidemiological studies made in Chile were identified from Scielo and Pubmed databases according to PRISMA criteria. No restrictions by year were used. Results: 13 studies estimated exposure to pesticides and health effects; the other 6 studies only estimated exposure or susceptibility. Of the total number of articles, 50% included farmers, 25% children, and 25% women of childbearing age. The greatest effects being the neurotoxic (54%), genotoxic (31%) and reproductive (15%). Based on the highest quality published studies (n=5), significant associations were established between cognitive impairment (e.g., verbal comprehension, visual and auditive memory, and processing speed) and exposure in farmers and children; DNA damage levels were higher in farmers than controls. Conclusions: The evidence collected shows exposure to pesticides in the general and occupational Chilean populations. Despite several limitations observed in some studies, the evidence collected until now allow shows the urgency to protect the health of both the occupational and general population and especially children through stricter control of the sale and use of pesticides, with comprehensive surveillance systems in environmental health and educational actions in the context of vulnerable communities. It is a priority to strictly restrict the use of pesticides already prohibited in developed countries.