Pesticide exposure and adverse health effects associated with farm work in Northern Thailand

Abstract

<jats:title>Article Summary</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>To assess pesticide exposure and understand the resultant health effects of agricultural workers in Northern Thailand.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Cross-sectional study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>The entirety of this study was completed in Chiang Rai, Thailand, at Mae Fah Luang University, Chiang Rai Prachanukroh hospital, the village leader’s home, and the community center.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>97 men between the ages of 22-76 years of age; 70 were conventional farmwokers and 27 did not report any prior farm or pesticide spraying.</jats:p></jats:sec><jats:sec><jats:title>Primary Outcome Measures</jats:title><jats:p>We quantified exposure to pesticides including chlorpyrifos, methomyl, and metalaxyl, by air sampling and liquid chromatography/mass spectrometry. We estimated differences in self-reported health outcomes, complete blood counts, cholinesterase activity, and serum/urine calcium and creatinine concentrations at baseline between farmworkers and comparison workers, and after pesticide spraying in farmworkers only.</jats:p></jats:sec><jats:sec><jats:title>Secondary Outcome Measures</jats:title><jats:p>We quantified</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>None of the farmworkers wore standardized PPE for the concentrated chemicals they were working with. Methomyl, ethyl chlorpyrifos, and metalaxyl were detected air samples in varying amounts. When it came to reporting confidence in the ability to handle personal problems, only 43% of farmworkers reported feeling confident; which reflects higher stress levels in comparison to 78% of comparison workers (p = 0.028). Farmworkers also had significantly lower monocyte counts (p=0.01), serum calcium (p=0.01), red blood count (p=0.01), white blood cell count (p=0.04), and butyrylcholinesterase activity (p&lt;0.0001), relative to comparison workers. After adjusting for BMI, age, and smoking, methomyl air concentrations were associated with a decrease in farmworker acetylcholinesterase activity (beta= −0.327, p =0.016).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Farmworkers’ blood analytes, acetylcholinesterase, and self-reported symptoms differed from comparison workers. Improving PPE use presents a likely route for preventive intervention in this population.</jats:p><jats:p>Strengths and Limitations: <jats:list list-type="bullet"><jats:list-item><jats:p>The US Occupational Safety and Health Administration (OSHA) generally recommends testing for baseline cholinesterase levels after not working with organophosphates for at least 30 days(1). However, this was not capable for our study, and baseline cholinesterase measurements may not actually represent a true baseline measurement due to their overlapping work schedules</jats:p></jats:list-item><jats:list-item><jats:p>This pilot study did not take multiple baseline measurements, and the one baseline that was taken was likely taken before the OSHA recommended guideline of 30 days since pesticide use.</jats:p></jats:list-item><jats:list-item><jats:p>Our study also focused on workplace sampling at a time when the specific farm of interest was expected to be spraying chlorpyrifos, therefore the study results show an over-representation of chlorpyrifos.</jats:p></jats:list-item><jats:list-item><jats:p>This is the first study of its type that took a mixed-methods approach using survey, biomarker, and workplace observation data to analyze farmworker pesticide health effects in comparison to other workers in Northern Thailand.</jats:p></jats:list-item><jats:list-item><jats:p>This pilot study is one of the larger studies on farmworker chemical exposures in Thailand. These data can inform the methods for future global occupational health research on farmworkers.</jats:p></jats:list-item><jats:list-item><jats:p>This study is very generalizable to farmworkers in LMIC and Thailand.</jats:p></jats:list-item></jats:list></jats:p></jats:sec>