Varma Anshu, Neupane Dinesh, Ellekilde Bonde Jens Peter, Jørs Erik
Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Denmark; Department of Occupational and Environmental Medicine, Odense University.
Med Lav. 2016 Jul 26;107(4):271-83.
Farmers' risk of pesticide poisoning can be reduced with personal protective equipment but in low-income countries farmers' use of such equipment is limited.
To examine the effectiveness and efficiency of Locally Adapted Personal Protective Equipment to reduce organophosphate exposure among farmers.
In a crossover study, 45 male farmers from Chitwan, Nepal, were randomly allocated to work as usual applying organophosphate pesticides wearing Locally Adapted Personal Protective Equipment or Daily Practice Clothing. For seven days before each experiment, each farmer abstained from using pesticides. Before and after organophosphate application, an interview surveys and blood tests were carried out, and analyzed with paired t-test, frequencies and percentages.
The difference between follow-up mean for acute organophosphate poisoning symptoms in the two groups was 0.13 [95% CI -0.22;0.49] and for plasma cholinesterase (U/ml) -0.03 [95% CI -0.11;0.06]. The difference between follow-up mean minus baseline mean for acute organophosphate poisoning symptoms in the two groups was 0.29 [95% CI -0.26;0.84] and for plasma cholinesterase (U/ml) -0.01 [95% CI --0.08;0.06]. Wearing the Locally Adapted Personal Protective Equipment versus Daily Practice Clothing gave the following results, respectively: comfort 75.6% versus 100%, sense of heat 64.4% versus 31.3%, other problems 44.4% versus 33.3%, likeability 95.6% versus 77.8%.
We cannot support the expectation that our farmers in Chitwan, Nepal working with Locally Adapted Personal Protective Equipment would have fewer acute organophosphate poisoning symptoms, higher plasma cholinesterase (U/mL) and find it more efficient to work with the equipment than farmers working with their Daily Practice Clothing. Based on the farmers' working behavior, compounds used, intensity and exposure duration we conclude that Locally Adapted Personal Protective Equipment does not provide additional protection during usual work practices. However, our Locally Adapted Personal Protective Equipment might offer protection from (certain) accidental overexposure. Trial Registration NCT02137317.
使用个人防护装备可降低农民农药中毒风险，但在低收入国家，农民对这类装备的使用有限。
研究因地制宜的个人防护装备在降低农民有机磷暴露方面的有效性和效率。
在一项交叉研究中，来自尼泊尔奇特旺的45名男性农民被随机分配，分别穿着因地制宜的个人防护装备或日常工作服，像往常一样使用有机磷农药。在每次实验前的七天，每位农民都停止使用农药。在施用有机磷前后，进行访谈调查和血液检测，并采用配对t检验、频率和百分比进行分析。
两组急性有机磷中毒症状随访均值之差为0.13[95%可信区间-0.22；0.49]，血浆胆碱酯酶（U/ml）之差为-0.03[95%可信区间-0.11；0.06]。两组急性有机磷中毒症状随访均值减去基线均值之差为0.29[95%可信区间-0.26；0.84]，血浆胆碱酯酶（U/ml）之差为-0.01[95%可信区间-0.08；0.06]。穿着因地制宜的个人防护装备与日常工作服相比，舒适度分别为75.6%和100%，热感分别为64.4%和31.3%，其他问题分别为44.4%和३३.३%，喜爱度分别为95.6%和77.8%。
我们无法支持这样的预期，即尼泊尔奇特旺使用因地制宜的个人防护装备的农民会比穿着日常工作服的农民出现更少的急性有机磷中毒症状、更高的血浆胆碱酯酶（U/mL），并发现使用该装备工作效率更高。基于农民的工作行为、使用的化合物、强度和暴露持续时间，我们得出结论，在日常工作中，因地制宜的个人防护装备并不能提供额外的保护。然而，我们的因地制宜的个人防护装备可能会提供针对（某些）意外过度暴露的防护。试验注册号：NCT02137317 。
