Long-Term Neurological and Psychological Distress Symptoms among Smallholder Farmers in Costa Rica with a History of Acute Pesticide Poisoning

Abstract

Studies suggest that acute pesticide poisonings (APP) may be linked with long-term neurological effects. To examine long-term neurological and psychological distress symptoms associated with having experienced an APP, we conducted a cross-sectional study of 300 conventional and organic smallholder farmers from Zarcero County, Costa Rica, May–August 2016. We collected self-reported data on sociodemographic characteristics, occupational history, pesticide exposure, APPs, neurological and psychological distress symptoms (using the Brief Symptom Inventory (BSI)). Adjusted logistic regression models were fit. A total of 14% of the farmers (98% male) reported experiencing at least one APP during their lifetime. Self-reported APP was associated with neurological symptoms during the 12 months prior to interview (e.g., fainting (Odds Ratio: 7.48, 95% Confidence Interval: 1.83, 30.74), shaking hands (3.50; 1.60, 7.60), numbness/tingling in hands or feet (3.23; 1.66, 6.32), insomnia (2.53; 1.34, 4.79), accelerated heartrate (2.42; 1.03, 5.47), dizziness (2.38; 1.19, 4.72), increased irritability/anger (2.37; 1.23, 4.55), low energy (2.33; 1.23, 4.46), and difficulty concentrating (2.01; 1.05, 3.85)). Farmers who reported an APP in the ten years prior to interview experienced increased odds of abnormal BSI scores for hostility (4.51; 1.16, 17.70) and paranoid ideation (3.76; 0.99, 18.18). Having experienced an APP may be associated with long-term neurological and psychological distress symptoms.

Differences in Knowledge, Awareness, Practice, and Health Symptoms in Farmers Who Applied Organophosphates and Pyrethroids on Farms

“…Concerning neurological symptoms, the farmers who applied OP had a significantly higher prevalence of fatigue and paresthesia than those who applied PY (OR = 10.62 and 6.76, respectively). These findings were consistent with the study by Farnham (18) that reported an association between pesticide poisonings and neurological symptoms such as paresthesia or tingling in hands or feet (OR = 3.23), dizziness (OR = 2.38), low energy (OR = 2.33), and tremor of the hands (OR = 3.50) (18). Long-term dermal exposure to OP may cause chronic adverse health effects such as paresthesia and organophosphateinduced delayed polyneuropathy (OPIDP) (56,57).…”

“…In the case of neurobehavioral symptoms, farmers who applied OP had significantly poorer concentration, short term memory, and insomnia than those who applied PY (OR = 13.84, 3.75, and 8.99, respectively). These findings support previous studies that found that organophosphate poisoning in workers had more psychological and affective problems, difficulty concentrating (OR = 2.07), trouble remembering things (OR = 2.54), and insomnia (OR = 2.53) (18,60,61). As a consequence of AChE inhibition, OP exposure causes brain hyperactivity and acetylcholine accumulation (62).…”

“…In several human studies, pesticides have been shown to be related to chronic adverse effects on the immune, neurological, respiratory, endocrine, and reproductive systems (7,(10)(11)(12)(13)(14)(15)(16). Symptoms indicating neurobehavioral, motor, and sensory dysfunction, have been reviewed in some symptom prevalence studies (11,(17)(18)(19).…”

Occupational and environmental pesticide exposure and associated health risks among pesticide applicators and non-applicator residents in rural Ethiopia

“…This may be due to the “healthy worker effect” ( 66 ), or to other confounding factors that have not been assessed in this study. Similar findings which also support the present observation were reported from Costa Rica where the loss of appetite, paleness, stomach pain and nausea were more frequently observed in farmers who never experienced health effects than in those who experienced at least one following pesticide application ( 68 ).…”

Occupational Exposure to Pesticides as a Risk Factor for Sleep Disorders

“…In previous studies, several researchers found that environmental exposure to pesticides was associated with a greater prevalence rate and a higher risk of having neurological disorders [ 15 , 16 , 17 ]. However, little is known about the effects of pesticide exposure on sleep.…”