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拉美和加勒比地区人群接触农药的健康影响:范围综述。

Health Effects of Pesticide Exposure in Latin American and the Caribbean Populations: A Scoping Review.

机构信息

Centro de Investigaciones de Estudios Avanzados del Maule, Universidad Católica del Maule, Talca, Chile.

Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, Berkeley, California, USA.

出版信息

Environ Health Perspect. 2022 Sep;130(9):96002. doi: 10.1289/EHP9934. Epub 2022 Sep 29.

Abstract

BACKGROUND

Multiple epidemiological studies have shown that exposure to pesticides is associated with adverse health outcomes. However, the literature on pesticide-related health effects in the Latin American and the Caribbean (LAC) region, an area of intensive agricultural and residential pesticide use, is sparse. We conducted a scoping review to describe the current state of research on the health effects of pesticide exposure in LAC populations with the goal of identifying knowledge gaps and research capacity building needs.

METHODS

We searched PubMed and SciELO for epidemiological studies on pesticide exposure and human health in LAC populations published between January 2007 and December 2021. We identified 233 publications from 16 countries that met our inclusion criteria and grouped them by health outcome (genotoxicity, neurobehavioral outcomes, placental outcomes and teratogenicity, cancer, thyroid function, reproductive outcomes, birth outcomes and child growth, and others).

RESULTS

Most published studies were conducted in Brazil (37%, ) and Mexico (20%, ), were cross-sectional in design (72%, ), and focused on farmworkers (45%, ) or children (21%, ). The most frequently studied health effects included genotoxicity (24%, ) and neurobehavioral outcomes (21%, ), and organophosphate (OP) pesticides were the most frequently examined (26%, ). Forty-seven percent () of the studies relied only on indirect pesticide exposure assessment methods. Exposure to OP pesticides, carbamates, or to multiple pesticide classes was consistently associated with markers of genotoxicity and adverse neurobehavioral outcomes, particularly among children and farmworkers.

DISCUSSION

Our scoping review provides some evidence that exposure to pesticides may adversely impact the health of LAC populations, but methodological limitations and inconsistencies undermine the strength of the conclusions. It is critical to increase capacity building, integrate research initiatives, and conduct more rigorous epidemiological studies in the region to address these limitations, better inform public health surveillance systems, and maximize the impact of research on public policies. https://doi.org/10.1289/EHP9934.

摘要

背景

多项流行病学研究表明,接触农药与健康不良后果有关。然而,在拉丁美洲和加勒比地区(LAC),一个农业和住宅农药使用密集的地区,有关农药相关健康影响的文献很少。我们进行了范围界定审查,以描述目前关于 LAC 人群中农药暴露对健康影响的研究状况,目的是确定知识差距和研究能力建设需求。

方法

我们在 PubMed 和 SciELO 中搜索了 2007 年 1 月至 2021 年 12 月期间发表的关于 LAC 人群中农药暴露与人类健康的流行病学研究。我们从 16 个国家确定了符合纳入标准的 233 篇出版物,并按健康结果(遗传毒性、神经行为结果、胎盘结果和致畸性、癌症、甲状腺功能、生殖结果、出生结果和儿童生长以及其他)进行分组。

结果

大多数已发表的研究是在巴西(37%,)和墨西哥(20%,)进行的,设计为横断面研究(72%,),主要针对农场工人(45%,)或儿童(21%,)。研究最多的健康影响包括遗传毒性(24%,)和神经行为结果(21%,),最常检查的是有机磷(OP)农药(26%,)。47%()的研究仅依赖于间接的农药暴露评估方法。接触 OP 农药、氨基甲酸酯或多种农药类别与遗传毒性和不良神经行为结果的标志物始终相关,尤其是在儿童和农场工人中。

讨论

我们的范围界定审查提供了一些证据,表明接触农药可能对 LAC 人群的健康产生不利影响,但方法学上的限制和不一致性削弱了结论的力度。在该地区增加能力建设、整合研究计划以及开展更严格的流行病学研究至关重要,以解决这些限制,更好地为公共卫生监测系统提供信息,并最大限度地发挥研究对公共政策的影响。https://doi.org/10.1289/EHP9934.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34c9/9521041/bfbfbf31e588/ehp9934_f1.jpg

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