Occupational risk factors among Iranian farmworkers: a review of the available evidence

Abstract

INTRODUCTIONFarming is one of the most important components of the economy in most countries. It exerts major effects on both public health and food safety. The agricultural workforce, consisting of over 1.1 billion individuals, is the largest workforce in the world. Moreover, the health of farmworkers has an important role in food provision [1]. Farming is known as a high-risk job in both developed and developing countries [1,2]. In addition to exposure to physical, chemical, and biological risk factors, work-related injuries and accidents can also threaten the health of farmworkers [3][4][5].Agriculture plays an important economic role in the lives of people in many countries, including Iran [6]. In 2015, more than 18.0% of employees (approximately 4 million people) in Iran worked in the farming sector [7]. According to previous studies, occupational hazards such as musculoskeletal disorders [8] and injuries [9], pesticide poisoning, skin cancer, and infectious diseases threaten the health of Iranian farmworkers [10][11][12]. Unfortunately, there is no comprehensive occupational health monitoring system for farming-related diseases and injuries in Iran. Based on the available health indices, in 2010, only 32.0% of Iranian farmworkers were registered with the health system. Of these, 18.7% were covered by health care services and regular screening tests [13].However, despite the magnitude of agricultural areas and the agricultural workforce in Iran, limited epidemiologic research has Farming is one of the most important components of most economies. No comprehensive picture exists of the health status of Iranian farmers and the work-related hazards that affect them. We aimed to determine the gaps in the current knowledge regarding the occupational health of Iranian farmworkers. Electronic databases including Medline, Web of Science, Scopus, and Embase, as well as national databases including the Scientific Information Database, MagIran, and Barakat Knowledge System, were searched for articles published through March 2017. All epidemiologic studies regarding the occupational health of farmworkers in Iran were reviewed, regardless of their design, language, time of publication, and location. Of the 86 retrieved articles, 39 studies were ultimately analyzed. Most studies were conducted in Fars, Kerman, and Mazandaran provinces. According to the results of this review, chemical, physical, and biological hazards, along with work-related injuries, may be the main factors threatening the health of farmworkers. The unsafe use of pesticides was related to male infertility, eye and digestive complications, pesticide poisoning, pesticide absorption, hematological changes, non-Hodgkin lymphoma, and multiple myeloma. Chemical hazards (e.g., the unsafe use of pesticides), physical hazards, injuries, and biological hazards (e.g., work-related infectious diseases) threaten the health of Iranian farmworkers. Moreover, farmworkers lack adequate knowledge about the occupational hazards they face and the relevant risk factors.

Health problems in agricultural workers occupationally exposed to pesticides

“… 5 , 6 , 10 A study performed in Ethiopia found that 42% of agricultural workers had never used PPE. 40 Ghafari et al 3 reported that 68% of rural workers in Iran did not use any form of PPE during pesticide application, while Zhang et al 38 , in China, reported that only 13.4% of farmers used PPE when handling pesticides. The attention to correct PPE use, which includes removing clothing immediately after use and washing the hands and face after handling pesticides, are as important as the equipment itself.…”

“…In female agricultural workers, studies showed an increase in the incidence of ovarian and pancreatic cancer, acute myeloid leukemia and breast cancer. 3 , 21 The prevalence of breast cancer among the wives of agricultural workers who used pesticides on their farms was also studied, but no differences were observed between women who handled the pesticides and those who did not, nothing a similar breast cancer risk in both participant groups. The highest risk of breast cancer was observed in premenopausal women and those who used organophosphate pesticides.…”

“…Agriculture plays an important role in the economy of most countries and in the lives of local populations, since it provides stable jobs and a steady income to many families. 3 Yet agricultural workers are also exposed to several health hazards as a result of their professional activities, including ultraviolet radiation; exhaust toxicity; inhalation of organic dust from spores and minerals when handling feed; exposure to microorganisms such as viruses, bacteria and infectious parasites, and their toxic products; as well as pesticides, which are among the greatest potential hazards to the health of agricultural workers. 3 , 4 …”

Epidemiology of Multiple Myeloma

“…Agriculture plays an important economic role in both developed and developing countries. There is a growing body of evidence about the association between farming and the risk of MM [83][84][85]. Despite methodological issues in some studies, the exposure to potential or confirmed carcinogens such as herbicides and pesticides commonly used by agricultural workers have been pointed out as key determinants of the cancer risk observed in agricultural populations.…”

Development of a Training Manual for Reducing Use of Pesticides by Para Rubber Farmers at Bueng Khan Province, Thailand

“…In recent years, there have been pressing public health and food safety and environmental condition concerns related to pesticide residues (Gesesew, Woldemichael, Massa, & Mwanri, 2016;Bhusnure, Dongare, Gholve, & Giram, 2018). Farmers are the largest groups of workforce in the world consisting of over 1.1 billion individuals (Ghafari, Cheragh, & Irani, 2017). They are particularly at high risk of pesticide poisoning due to high risk from occupation exposure.…”