Journal of Preventive Medicine and Public Health

Original Articles

Relationship Between Pesticide Exposure Factors and Health Symptoms Among Chili Farmers in Northeast Thailand: Ratchadaporn Pengpan, Kulthida Y. Kopolrat, Sribud Srichaijaroonpong, Nutta Taneepanichskul, Patiwat Yasaka, Ratanee Kammoolkon; J Prev Med Public Health. 2024;57(1):73-82. Published online December 20, 2023; DOI: https://doi.org/10.3961/jpmph.23.353

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Objectives
The unsafe use of pesticides in agriculture represents a major hazard to human health. This study was conducted to investigate the association between pesticide exposure and health symptoms among chili farmers in northeast Thailand.
Methods
This cross-sectional analytic study included 141 chili farmers in Sakon Nakhon Province, in northeast Thailand. Data regarding health symptoms were gathered using a self-report questionnaire. A medical technician tested blood cholinesterase activity using an erythrocyte method, and an occupational medicine specialist at Ramathibodi Hospital in Bangkok, Thailand reviewed the results. Associations between personal characteristics, pesticide exposure factors, and health symptoms were analyzed using multiple logistic regression.
Results
Of the 141 chili farmers studied, 66.7% experienced pesticide poisoning, as indicated by below-normal cholinesterase levels. Fatigue was the most frequently reported symptom associated with pesticide exposure, affecting 37.6% of participants. This was followed by nausea and vomiting (31.9%), dizziness (14.9%), and dry throat (14.9%). Multivariate logistic regression analysis revealed that several factors were significantly associated with adverse symptoms: amount of work experience, volume of pesticides used, use of chemical pesticides, use of leaking containers during spraying, direct pesticide exposure while working, contact with pesticide-soaked clothing, consumption of food and drinks in the fields, and blood cholinesterase level indicating risk.
Conclusions
This study suggests potential health risks for chili farmers stemming from exposure to and contamination by pesticides used in agricultural practices. To mitigate these risks, it is essential to supply personal protective equipment and to implement educational programs aimed at improving protective behaviors among farmers.

Summary

Key Message
This study aimed to demonstrate the impact of pesticide exposure on health symptoms. In a cross-sectional study, the effects of pesticide exposure on acetylcholinesterase erythrocyte activity in blood during agricultural practices were examined as potential health risks for chili farmers. It is crucial to provide personal protective equipment and to implement educational initiatives targeted at encouraging farmers to adopt more protective behaviors to reduce these risks.

Citations

Citations to this article as recorded by

Emerging diseases: trend research and omics-based analysis reveals mechanisms of endophytes modulate Chilli plant resilience
Wiwiek Harsonowati, Evy Latifah, Arinal Haq Izzawati Nurrahma, Jati Purwani, Rashid Iqbal, Javid Ahmad Parray, Ashish D. Patel
Symbiosis.2024;[Epub] CrossRef
An Analysis of Occupational Hazards Based on the Physical Ergonomics Dimension to Improve the Occupational Health of Agricultural Workers: The Case in Mayo Valley, Mexico
Víctor Manuel Ramos-García, Josué Aarón López-Leyva, Ana Paola Balderrama-Carmona, Iván Ochoa-Vázquez, Juan José García-Ochoa, Manuel de Jesús Espinoza-Espino
Safety.2024; 10(3): 61. CrossRef

Interaction Between Persistent Organic Pollutants and C-reactive Protein in Estimating Insulin Resistance Among Non-diabetic Adults: Ki-Su Kim, Nam-Soo Hong, David R Jacobs, Duk-Hee Lee; J Prev Med Public Health. 2012;45(2):62-69. Published online March 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.2.62

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Abstract PDF

Objectives

Chronic inflammation is now thought to play a key pathogenetic role in the associations of obesity with insulin resistance and diabetes. Based on our recent findings on persistent organic pollutants (POPs) including the lack of an association between obesity and either insulin resistance or diabetes prevalence among subjects with very low concentrations of POPs, we hypothesized that POP concentrations may be associated with inflammation and modify the associations between inflammation and insulin resistance in non-diabetic subjects.

Methods

Cross-sectional associations among serum POPs, C-reactive protein (CRP), and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated in 748 non-diabetic participants aged ≥20 years. Nineteen types of POPs in 5 subclasses were selected because the POPs were detectable in ≥60% of the participants.

Results

Among the five subclasses of POPs, only organochlorine (OC) pesticides showed positive associations with CRP concentrations, while polychlorinated biphenyls (PCBs) showed inverse associations with CRP concentrations. There were statistically significant interactions between CRP and OC pesticides and between CRP and PCBs, in estimating HOMA-IR (P for interaction <0.01 and <0.01, respectively). CRP was not associated with HOMA-IR among subjects with low concentrations of OC pesticides or PCBs, while CRP was strongly associated with HOMA-IR among subjects with high concentrations of these POPs.

Conclusions

In the current study, OC pesticides were associated with increased levels of CRP, a marker of inflammation, and both OC pesticides and PCBs may also modify the associations between CRP and insulin resistance.

Summary

Citations

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Is Physical Activity an Efficient Strategy to Control the Adverse Effects of Persistent Organic Pollutants in the Context of Obesity? A Narrative Review
Quentin A. Serrano, Sébastien Le Garf, Vincent Martin, Serge S. Colson, Nicolas Chevalier
International Journal of Molecular Sciences.2024; 25(2): 883. CrossRef
The associations between endocrine disrupting chemicals and markers of inflammation and immune responses: A systematic review and meta-analysis
Zhiqin Liu, Yao Lu, Kunxia Zhong, Chenchen Wang, Xi Xu
Ecotoxicology and Environmental Safety.2022; 234: 113382. CrossRef
Endocrine Disruptors and the Induction of Insulin Resistance
Rafael Vanni, Renata Maksoud Bussuan, Renato Luiz Rombaldi, Alberto K. Arbex
Current Diabetes Reviews.2021;[Epub] CrossRef
Influence of polychlorinated biphenyls and organochlorine pesticides on the inflammatory milieu. A systematic review of in vitro, in vivo and epidemiological studies
F.M. Peinado, F. Artacho-Cordón, R. Barrios-Rodríguez, J.P. Arrebola
Environmental Research.2020; 186: 109561. CrossRef
Associations between persistent organic pollutants and metabolic syndrome in morbidly obese individuals
S. Dusanov, J. Ruzzin, H. Kiviranta, T.O. Klemsdal, L. Retterstøl, P. Rantakokko, R. Airaksinen, S. Djurovic, S. Tonstad
Nutrition, Metabolism and Cardiovascular Diseases.2018; 28(7): 735. CrossRef
Health and environmental effects of persistent organic pollutants
Omar M.L. Alharbi, Al Arsh Basheer, Rafat A. Khattab, Imran Ali
Journal of Molecular Liquids.2018; 263: 442. CrossRef
The influence of persistent organic pollutants in the traditional Inuit diet on markers of inflammation
L. K. Schæbel, E. C. Bonefeld-Jørgensen, H. Vestergaard, S. Andersen, Jaymie Meliker
PLOS ONE.2017; 12(5): e0177781. CrossRef
Pesticide Use and Age-Related Macular Degeneration in the Agricultural Health Study
Martha P. Montgomery, Eric Postel, David M. Umbach, Marie Richards, Mary Watson, Aaron Blair, Honglei Chen, Dale P. Sandler, Silke Schmidt, Freya Kamel
Environmental Health Perspectives.2017;[Epub] CrossRef
Hemostatic, inflammatory, and oxidative markers in pesticide user farmers
Fatima Zohra Madani, Merzouk Hafida, Sid Ahmed Merzouk, Bouchra Loukidi, Katia Taouli, Michel Narce
Biomarkers.2016; 21(2): 138. CrossRef
Persistent organic pollutants and biomarkers of diabetes risk in a cohort of Great Lakes sport caught fish consumers
Mary Turyk, Giamila Fantuzzi, Victoria Persky, Sally Freels, Anissa Lambertino, Maria Pini, Davina H. Rhodes, Henry A. Anderson
Environmental Research.2015; 140: 335. CrossRef
Vitamin D-rich marine Inuit diet and markers of inflammation – a population-based survey in Greenland
L. K. Schæbel, E. C. Bonefeld-Jørgensen, P. Laurberg, H. Vestergaard, S. Andersen
Journal of Nutritional Science.2015;[Epub] CrossRef
Persistent Organic Pollutants and Inflammatory Markers in a Cross-Sectional Study of Elderly Swedish People: The PIVUS Cohort
Jitender Kumar, P. Monica Lind, Samira Salihovic, Bert van Bavel, Erik Ingelsson, Lars Lind
Environmental Health Perspectives.2014; 122(9): 977. CrossRef

English Abstract

Reliability of Self-Reported Information by Farmers on Pesticide Use.: Yo Han Lee, Eun Shil Cha, Eun Kyeong Moon, Kyoung Ae Kong, Sang Baek Koh, Yun Keun Lee, Won Jin Lee; J Prev Med Public Health. 2010;43(6):535-542.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.535

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Abstract PDF

OBJECTIVES
Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. METHODS: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009 a self-administrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. RESULTS: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. CONCLUSIONS: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.

Summary

Citations

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Evaluation of two-year recall of self-reported pesticide exposure among Ugandan smallholder farmers
William Mueller, Aggrey Atuhaire, Ruth Mubeezi, Iris van den Brenk, Hans Kromhout, Ioannis Basinas, Kate Jones, Andrew Povey, Martie van Tongeren, Anne-Helen Harding, Karen S. Galea, Samuel Fuhrimann
International Journal of Hygiene and Environmental Health.2022; 240: 113911. CrossRef
Recall of exposure in UK farmers and pesticide applicators: trends with follow-up time
William Mueller, Kate Jones, Hani Mohamed, Neil Bennett, Anne-Helen Harding, Gillian Frost, Andrew Povey, Ioannis Basinas, Hans Kromhout, Martie van Tongeren, Samuel Fuhrimann, Karen S Galea
Annals of Work Exposures and Health.2022; 66(6): 754. CrossRef
Increased risk of atherosclerosis associated with pesticide exposure in rural areas in Korea
Sungjin Park, Jung Ran Choi, Sung-Kyung Kim, Solam Lee, Kyungsuk Lee, Jang-Young Kim, Sung-Soo Oh, Sang-Baek Koh, Paula Boaventura
PLOS ONE.2020; 15(5): e0232531. CrossRef
Exposure to pesticides and the prevalence of diabetes in a rural population in Korea
Sungjin Park, Sung-Kyung Kim, Jae-Yeop Kim, Kyungsuk Lee, Jung Ran Choi, Sei-Jin Chang, Choon Hee Chung, Kyu-Sang Park, Sung-Soo Oh, Sang-Baek Koh
NeuroToxicology.2019; 70: 12. CrossRef
Reliability of self‐reported questionnaire on occupational radiation practices among diagnostic radiologic technologists
Moon Jung Kim, Eun Shil Cha, Yousun Ko, Byung Chul Chun, Won Jin Lee
American Journal of Industrial Medicine.2017; 60(4): 377. CrossRef
Comparison of Questionnaire Items Used to Evaluate the Level of Occupational and Environmental Exposure in Questionnaires for Epidemiological Studies
Jiyeon Lim, Hyung-Suk Yoon, Mansuk Park, Young Seoub Hong, Jong-Koo Lee, Se-Eun Oh, Daehee Kang, Kyoung-Mu Lee
Korean Journal of Environmental Health Sciences.2016; 42(2): 71. CrossRef
Symptom Prevalence and Work-related Risk Factors of Acute Pesticide Poisoning among Korean Farmers in Gyeong-gi Province
Hyang Seok Lee, Ji Hoon Lee, Soo Yong Roh, Ho Gil Kim, Kyung Jun Lee, Sun Ju Nam-gung, Soon Chan Kwon, Soo Jin Lee
Journal of agricultural medicine and community health.2015; 40(4): 228. CrossRef
A Pilot Study for Pesticide Poisoning Symptoms and Information on Pesticide Use among Farmers
Hyun-Joong Kim, Eun-Shil Cha, Eun-Kyeong Moon, You-Sun Ko, Jae-Young Kim, Mi-Hye Jeong, Won-Jin Lee
Korean Journal of Environmental Health Sciences.2011; 37(1): 22. CrossRef
Pesticide Exposure and Health
Won-Jin Lee
Korean Journal of Environmental Health Sciences.2011; 37(2): 81. CrossRef

Original Articles

Pesticides and Cancer Incidence: The Kangwha Cohort Study.: Jae Woong Sull, Sang Wook Yi, Tae Yong Sohn, Sun Ha Jee, Chung Mo Nam, Heechul Ohrr; Korean J Prev Med. 2002;35(1):24-32.

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Abstract PDF: OBJECTIVE
Few studies have examined the relationship between the risk of cancer and exposure to pesticides in Korea or in other East Asian that have until recently used chlorophenoxy herbicides. The aim of this study was to evaluate the relationship between the exposure to pesticides and cancer incidence. METHODS: We conducted a prospective cohort study with a follow-up period of 13 years (1985-1998). The subjects included 2,687 male and 3,589 female Kangwha Island residents, Koreans aged fifty-five or more as of March 1985, who received a personal health interview and completed a health examination survey. A Cox proportional hazards models were used to estimate relative risks (RR). RESULTS: At baseline, the mean age of the study participants in 1985 was 66.4 for males and 67.1 for females. During the 13 years follow-up, a total of 300 incidents of cancer in males and 146 in females developed. In males, the total cancer incidence in the highest group was RR, 1.4 (95% CI=1.0-1.9), p for trend=0.041, for digestive organ cancer incidence in the highest group, RR, 1.5 (95% CI=1.0-2.3), p for trend=0.057, for stomach cancer incidence in the highest group, RR, 1.6 (95% CI=0.9-2.8), p for trend=0.094, for gallbladder cancer incidence in the highest group, RR, 9.1 (95% CI=1.1-77.0), p for trend=0.014 were elevated according to the higher frequency of pesticide use per year. In particular, the risk of gallbladder cancer was very high. Although not significant, the risk of liver cancer was higher than in the non-exposed group (in the highest group, RR, 2.0 (95% CI=0.7-5.9)). In females, although not significant, breast cancer incidence in the highest exposure group was higher than in the non-exposed group (in the highest group, RR, 4.7 (95% CI=0.8-27.9)). CONCLUSIONS: This study demonstrates that Korean farmers who use pesticides, particularly males, have a significantly higher total cancer incidence, particularly from digestive organ cancers such as, stomach, gallbladder, and liver cancer. In particular, the risk of gallbladder cancer was very high.; Summary

Immunotoxicity among Farmers Exposed to Pesticides.: Wonjin Lee, Chae Sung Lim, Kun Sei Lee, Soung Hoon Chang; Korean J Prev Med. 1999;32(3):347-354.

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Abstract PDF: OBJECTIVE
This paper examines the possible toxicity to immune system in farmers chronically exposed to pesticides. METHODS: We compared 43 male farmers exposed to pesticides with 29 male residents who had neither past nor current pesticides exposure. The selected variables for studying immunotoxicity were WBC, CD3, CD4, CD8, CD19, CD56, IgG, IgA, IgM, and IL-2. As part of the baseline questionnaires for the immunotoxicity, subjects were asked about kinds of farming, pesticides exposure and medical history. RESULTS: None of the variables for studying immunotoxicity showed statistically significant difference between the two groups. Although the results were not statistically significant, CD4 and the CD4/CD8 ratio decreased and CD8 increased. These effects showed a dose response change with exposure level. In the exposed group, the values of CD3, CD4, CD4/CD8 and CD19 decreased and those of the CD8 and CD56 increased compared to the non-exposed group. Also there was higher prevalence of self-reported disease in the exposed group compared to the non-exposed group. CONCLUSIONS: Although statistically significant differences in indices of immunotoxicity in farmers exposed to pesticides were not shown, the results suggest that pesticides may decrease immune function. More advanced test methods for immunotoxicity need to be developed and tested in larger population to detect immunotoxic effects of pesticides.; Summary

Risk Assessment on Carcinogenic Pesticides of Vegetables in Korea.: Jae Hong Yoon, Jong Tae Lee, Yong Chung, Dongchun Shin; Korean J Prev Med. 1999;32(2):155-161.

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Abstract PDF: OBJECTIVES
The study was conducted to estimate the carcinogenic risks from the ingestion of some carcinogenic pesticides (CPs) in vegetables sampled at a local agricultural product market in Seoul. METHODS: After applying a hazard identification step, we selected four pesticides, such as DDT, dieldrin, folpet, and heptachlor epoxide, for this risk assessment. Concentrations of each pesticide were measured from randomly sampled vegetables. In order to estimate the human exposure levels, we combined the concentration of pesticides in the vegetables with consumption rate of those vegetables. Three scenarios were hypothesized for human exposure assessment. Scenario I was the most conservative which supposed the undetected CPs would be the detection limit values. Scenario II was assumed that the undetected CPs would be a half of the detection limit values, and finally scenario III merely considered only values greater than the detection limit values. We finally presented the estimated carcinogenic risks on the basis of the traditional risk assessment procedure suggested by U.S. EPA. RESULTS: Pesticides including DDT, dieldrin, folpet and heptachlor epoxide were detected in 9 samples (6%) in the range of 0.0006~0.09ppm. The daily intake levels of carcinogenic pesticides were estimated in the range of 0.0009~0.0079 microgram/day. As we expected, excess cancer risks based on scenario I was also the highest (1.1x10-8~ 5.5x10-5). CONCLUSIONS: We found that the estimated risks from the pesticides we investigated were not serious. We, however, propose that a continuos monitoring is needed to make sure for the protection of public health.; Summary

Assessment of the Naktong river pollution after phenol spillage from the Kumi industrial estates II, Korea.: Doo Hie Kim, Bong Ki Jang, Sung Chul Hong, Hyo Jung Moon, Duck Hee Lee, Hae Ju Oh; Korean J Prev Med. 1993;26(2):268-281.

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Abstract PDF: The aquatic quality of the Naktong river after two of three months in June, 1991 with phenol spillage from a electrical factory in Kumi was investigated. The samples were collected at six sites of the Naktong river basin and Kachang and Kongsan lakes. Phenol was not detected from all water samples. Turbidity was very much increased to the down stream in the Naktong river. The BOD and COD values exceeded the 2nd grade(3 mg/l) of the Korean standard quality of Environmental Water Act at the all sampling sites of the Naktong river. Especially, the value of COD at Kaejin (12.5 mg/l) was poorly classified as to the 5th grade of water class for the environmental quality standards. Organophosphorous pesticides such as parathion, malathion, fenitrothion and diazinon were investigated but not detected. Diazinon was only detected at the Ilson bridge(1.42 ppb), Okkye stream(6.95 ppb), Waekwan bridge(0.32 ppb), Gangjung reservior(0.13 ppb), Kaejin(0.05 ppb). Of the carbamates such as carbanyl, isoprocarb and cabofuran, the carbofuran was detected all sites except tap water, and Kachang and Kongsan lakes. The content of heavy metals such ans Cd, Pb, Zn, Fe, Mn, Hg were not exceeding for drinking water standards at the all sampling region, but only mecury was detected from Okkye stream(0.018ppb) and Kaejin(0.09ppb). In the regions of Kachang and Kongsan lakes, the content of heavy metals were lower than that of reservoir of Naktong river.; Summary

Effects of Multiple Exposures to Pesticides on Plasma Cholinesterase Activity and p-nitrophenol Excretion in Rats.: Bong Suk Cha, Jung Gyun Park, Jong Ku Park, Sei Jin Chang; Korean J Prev Med. 1992;25(2):180-188.

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Abstract PDF: The effects of multiple exposures to pesticides on plasma cholinesterase(ChE) activities and urinary p-nitrophenol excretion were evaluated in rats. Rats were received single dose i.p. with LD50/100(mg/kg) of organophosphorous(OP), organophosphorous-organochroline(OP-OC), organophosphorous-carbamate(OP-CAB), organophosphorous-organoarsenate(OP-OA) pesticides for 4 consecutive days. In repeated administration of pesticides, plasma ChE activities were decreased, but urinary p-nitrophenol were increased after the first injection and then decreased gradually. The recovery rates of ChE activities and p-nitrophenol excretion at 48 hours after the fourth infection were delayed in comparison with the baseline value of 24 hours before the first injection. Statistical significances were found between OP and other groups except OP-OA group after the second injection in plasma ChE activities, but in urinary p-nitrophenol excretion there was statistical significance only between OP and OP-CAB.; Summary

A cohort study on the relationship between pesticide use and mortality, and cancer mortality.: Hee Chul Oh, Chung Mo Nam, Sun Hee Lee; Korean J Prev Med. 1991;24(3):390-399.

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Abstract PDF: The purpose of this study is to examine the relationship between pesticide use and mortality, and cancer mortality which are recognized as health hazards of pesticides. Data were analyzed from a cohort of 6,066 people aged fifty-five or over and who have been residing in the main island of Kangwha county. Death certificates, computerized citizenship registers searches, and household interview survey lead to get more than ninety-seven percents follow-up rate for the first five year observation period. Important findings are as follows: 1. Age specific mortality rates of pesticide users are significantly lower than those of pesticides nonusers. The SMR of male is 0.80, and 0.58 for females respectively probably due to healthy worker effects. But, age specific cancer mortality rates are significantly higher than those of pesticide nonusers (SMR=1.59) in males. this finding is not observed in females (SMR=0.85), however. 2. Logistic regression analyses showed that self-reported health status, drinking, and smoking histories in male are significantly associated with total mortality rate. The histories of pesticide use are also calculated to be highly associated with cancer mortality as in univariate analyses in males. In female, self-reported health status, age of first delivery are found to be significantly related to total mortality rate. Only drinking history is calculated to be associated with cancer mortalities in females. Data from further observation of 'Kangwha cohort' and indepth analyses of these are highly expected.; Summary

An Estimation of Carbamate Pesticide Exposure in a Rural Area: A pilot study using personal sampler and gas chromatography.: Byung Hae Kim, Yong Sik Kim, Jin Su Choi; Korean J Prev Med. 1990;23(2):201-206.

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Abstract PDF: The exposures to carbamate pesticides (BPMC specifically) of agricultural workers were estimated by collecting pesticide in air by personal sampler and by analyzing with gas chromatography. Data revealed that the highest BPMC concentration in the aspirated air was 7.7 mg/m3. Concentrations were generally higher in the group whose spray conditions were controlled than the group uncontrolled. Actual concentrations were relatively lower than the values predicted theoretically. These findings suggest that personal sampler be useful in the estimation of pesticide exposure.; Summary

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