High pesticide exposure events among farmers and spouses enrolled in the Agricultural Health Study.
ABSTRACT We completed a nested case-control analysis of factors associated with reporting a high pesticide exposure event (HPEE) by pesticide applicators and spouses during the five years since enrollment in the Agricultural Health Study (AHS). Cases and controls were identified from the 16,415 private pesticide applicators and 14,045 spouses with completed five-year follow-up interviews as of October 2000. Among the applicators, 306 cases with at least one HPEE in the five years since enrollment and 612 controls, randomly selected from those without a reported HPEE, were identified for analysis. Among the spouses, 63 cases were identified and 126 controls were selected. Risk for a new HPEE was increased among applicators reporting at enrollment ever having an HPEE with an odds ratio (OR) of 3.8 (95% CI: 2.7, 5.3). Compared to applicators who applied pesticides fewer than 5 days per year, the ORs ranged from 1.4 (95% CI: 0.9, 2.2) for 6 to 10 days per year to 2.2 (95% CI: 1.4, 3.6) for more than 20 application days per year. The incidence of HPEE among Iowa applicators was much greater (8.8/1000 applicators) than among North Carolina applicators (2.0/1000). Spouses reported fewer HPEEs compared to applicators (2/1000 spouses). Overall, the observed risk factors for new HPEEs among applicators are similar to risk factors observed in previous cross-sectional analyses of HPEE history. Further, only 13% of applicators and 22% of spouses with symptoms resulting from HPEE sought medical care, suggesting that pesticide poisoning surveillance data may seriously underreport the frequency of such events.
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ABSTRACT: This study estimated the level of underreporting of acute pesticide poisonings (APP) in the pesticide surveillance system in Nicaragua in 2000. Data on pesticide exposure and health effects were assessed in a nationally representative cross-sectional survey of 3,169 persons aged 15 years and older. The authors found 1,369 cases of APP in the official register for 2000. Responses to questionnaires revealed 22 cases of APP in which individuals sought medical attention. Most of these cases involved agricultural workers who spray organophosphate pesticides, mostly class I. In 68 percent of cases, the mean out-of-pocket cost for treatment of one APP episode was $41, almost equivalent to one month's salary. Only 1 of the 22 cases (< 5%) in which the individual sought medical attention was reported to the national register. The authors estimate that, nationally, about 30,000 pesticide poisoning cases receiving medical treatment were not reported. Characterization of APP based only on official figures, without considering the underreported cases, leads to a constant inability to interpret and report acute pesticide health effects in a manner useful to policymakers. The pesticide surveillance system must be strengthened to improve registration routines, analysis and interpretation of data, health personnel training, and participation of private providers.International Journal of Health Services 10/2008; 38(4):773-87. DOI:10.2190/HS.38.4.k · 0.99 Impact Factor
- 01/2008: pages 1-238; Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago.
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ABSTRACT: Background Farmwork is one of the most hazardous occupations for men and women. Research suggests sex/gender shapes hazardous workplace exposures and outcomes for farmworkers. This paper reviews the occupational health literature on farmworkers, assessing how gender is treated and interpreted in exposure-outcome studies.Methods The paper evaluates peer-reviewed articles on men and women farmworkers' health published between 2000 and 2012 in PubMed or SCOPUS. Articles were identified and analyzed for approaches toward sampling, data analysis, and use of exposure indicators in relation to sex/gender.Results18% of articles reported on and interpreted sex/gender differences in health outcomes and exposures. Sex/gender dynamics often shaped health outcomes, yet adequate data was not collected on established sex/gender risk factors relating to study outcomes.Conclusion Research can better incorporate sex/gender analysis into design, analytical and interpretive approaches to better explore its mediation of health outcomes in light of emerging calls to mainstream gender research. Am. J. Ind. Med. 9999:1–24, 2014. © 2014 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.American Journal of Industrial Medicine 12/2014; 57(12). DOI:10.1002/ajim.22375 · 1.59 Impact Factor