Universidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Saúde Pública. São Paulo, SP, Brasil.
Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Saúde Ambiental. São Paulo, SP, Brasil.
Rev Saude Publica. 2020 Dec 14;54:133. doi: 10.11606/s1518-8787.2020054002263. eCollection 2020.
To explore the association of occupational pesticide exposure with acute and mental health symptoms.
Cross-sectional survey carried out with 78 Brazilian family farmers, who were pesticide applicators and helpers conveniently selected. Symptoms and exposure data were collected by interviews, and mental health outcomes by the Self-Reporting Questionnaire. Blood samples were analyzed to assess cholinesterase levels. Exposure indicators and symptoms were compared between applicators and helpers, and Poisson regression was performed to estimate prevalence ratios.
Farmers reported exposure to multiple pesticides from early ages; they worked without safety training, technical support, and full protective equipment, and they had a high prevalence of acute and mental health symptoms (e.g., headache, mucosal irritation, tachycardia, and depressive signs). Applicators had more cholinesterase changes than helpers, but less symptoms. Helpers used less personal protection and had significantly higher prevalence ratio of headache, dyspnea, wheezing, cough, poor digestion, tiredness, and feeling worthless, after adjustment.
Acute and mental health symptoms were observed, both among farmers and helpers. Thus, surveillance actions must be reinforced in Brazil, technical support and safety training improved, focused on applicators and helpers, who are occupationally and environmentally exposed to pesticides. Agricultural practices of these groups with less pesticide use should receive incentive.
探讨职业性农药暴露与急性和心理健康症状的关联。
本研究采用横断面调查,共纳入 78 名巴西家庭农民(包括农药施用者和辅助人员)。通过访谈收集症状和暴露数据,使用自报告问卷评估心理健康结果。采集血样以评估胆碱酯酶水平。比较施用者和辅助人员的暴露指标和症状,并采用 Poisson 回归估计患病率比。
农民报告称从年轻时就开始接触多种农药;他们在缺乏安全培训、技术支持和全套防护设备的情况下工作,且急性和心理健康症状的患病率较高(如头痛、黏膜刺激、心动过速和抑郁迹象)。与辅助人员相比,施用者的胆碱酯酶变化更大,但症状较少。调整后,辅助人员使用的个人防护措施较少,头痛、呼吸困难、喘息、咳嗽、消化不良、疲劳和自我价值感降低的患病率比显著更高。
本研究观察到农民和辅助人员均出现了急性和心理健康症状。因此,必须在巴西加强监测行动,改进技术支持和安全培训,重点关注职业性和环境性接触农药的施用者和辅助人员。应鼓励这些群体采用农药使用量较少的农业实践。