| 1. |
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| 2. |
- Blanco, Luis E., et al.
(författare)
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The determinants of dermal exposure ranking method (DERM) : A pesticide exposure assessment approach for developing countries
- 2008
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Ingår i: Annals of Occupational Hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 52:6, s. 535-544
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Tidskriftsartikel (refereegranskat)abstract
- A new method for assessment of dermal exposure to pesticides in subsistence farmers by use of determinants of dermal exposure is described. The method, called the determinants of dermal exposure ranking method (DERM), is a combination of checklists and expert rating assessment. Thus, determinants are listed in a form, which is used to check their presence and to assess them using a simple algorithm based on two factors, the type of transport process (T value) and the area of body surface exposed (A value). In addition, the type of clothing worn during applications is included as a protection factor. We applied the DERM to real pesticide applications, characterizing dermal exposure and comparing DERM estimates with earlier developed semiquantitative visual scores based on fluorescent tracer, the total visual score (TVS) and contaminated body area (CBA). DERM showed a very good level of agreement with both the TVS (r = 0.69, P = 0.000) and the CBA (r = 0.67, P = 0.000). DERM allowed identification of the determinants that had the highest effect on exposure and the farmers with the highest exposure. In conclusion, DERM provided information on the determinants responsible for dermal exposure in a group of subsistence farmers. This can be useful to design monitoring and preventive programs, define priorities for intervention and prioritize and select most adequate measurement strategies. DERM promises to be a low-cost easy-to-use method to assess dermal exposure to pesticides in developing country conditions.
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| 3. |
- Crowe, Jennifer, et al.
(författare)
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A pilot field evaluation on heat stress in sugarcane workers in Costa Rica : what to do next?
- 2009
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Ingår i: Global Health Action. - : Co-action publishing. - 1654-9716 .- 1654-9880. ; 2, s. 71-80
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Climate change is producing major impacts including increasing temperatures in tropical countries, like Costa Rica, where the sugarcane industry employs thousands of workers who are exposed to extreme heat.OBJECTIVES: This article outlines a pilot qualitative evaluation of working conditions and heat in the sugarcane industry.DESIGN: A literature review, direct observations and exploratory interviews with workers were conducted to reach a preliminary understanding of the dimensions of heat-related health issues in the sugarcane industry, as a basis for the design of future studies.RESULTS: The industry employs temporary workers from Nicaragua and Costa Rica as well as year-round employees. Temporary employees work 12-hour shifts during the harvest and processing ('zafra') season. In many cases, sugarcane field workers are required to carry their own water and often have no access to shade. Sugar mill workers are exposed to different levels of heat stress depending upon their job tasks, with the most intense heat and workload experienced by the oven ('caldera') cleaners.CONCLUSIONS: Research is needed to achieve better understanding of the multiple factors driving and interacting with heat exposures in the sugarcane industry in order to improve the health and safety of workers while maintaining worker productivity.
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| 4. |
- Crowe, Jennifer, 1976-
(författare)
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Heat exposure and health outcomes in Costa Rican sugarcane harvesters
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background The remarkably efficient mechanisms of the human body to maintain its core temperature of 37°C can be inadequate when harsh climatic conditions and excessive muscle movement lead to heat stress, dehydration and potential heat illness, ranging from minor symptoms such as fatigue to a potentially fatal heat stroke. Agricultural workers in the tropics are at high risk, which is expected to increase with climate change. Sugarcane harvesting in Costa Rica is largely done by cutting the cane with a machete, by temporary, sub-contracted workers who are often migrants and living in poverty. Sugarcane harvesters are known to be affected by an epidemic of chronic kidney disease of non-traditional origin, currently hypothesized to be related to working conditions.Objectives This work aimed to better understand and document sugarcane harvester exposure to heat and the health consequences of working under such conditions. Specific objectives were to 1) Document working conditions and heat in the Costa Rican sugarcane industry (Paper I); 2) Quantify heat stress exposures faced by sugarcane harvesters in Costa Rica (Paper II); and 3) Quantify the occurrence of heat stress symptoms and abnormal urinary parameters in sugarcane workers in Costa Rica (Papers III and IV).Methods This study took place over three harvests following a pilot assessment prior to the first harvest. Methods included direct observation, semi-structured interviews with 24 individuals and a participatory workshop with 8 harvesters about heat-related perceptions, exposures and coping strategies during the harvest and non-harvest season (Pilot). Researchers accompanied workers in the field during all three harvests, measured wet bulb globe temperature (WBGT) and conducted direct observation. Heat exposure assessment was conducted by calculating metabolic load, WBGT and corresponding limit values based on international guidelines (NTP and OSHA) (Harvest 1). Self-reported symptom data were collected using orally-administered questionnaires from 106 sugarcane harvesters and 63 non-harvesters from the same company (Harvest 2). Chi-square test and gamma statistic were used to evaluate differences in self-reported symptoms and trends over heat exposure categories. Finally, liquid consumption during the work shift was documented and urinalysis was conducted pre-and post-shift in 48 sugarcane harvesters on three days; differences were assessed with McNemar´s test on paired proportions (Harvest 3).Results Sugarcane workers in both the harvest and non-harvest seasons are exposed to heat, but particularly during the harvest season. Field workers have to carry their own water to the field and often have no access to shade. Some plantworkers are also exposed to intense heat. The metabolic load of sugarcane harvesting was determined to be 261 W/m2. The corresponding threshold value is 26 ◦C WBGT, above which workers should decrease work load or take breaks to avoid the risk of heat stress. Harvesters in this study were at risk of heat stress as early as 7:15 am on some mornings and by 9:00 am on all mornings. After 9:15 am, OSHA recommendations would require that harvesters only work at full effort 25% of each hour to avoid heat stress. Heat and dehydration symptoms at least once per week were experienced significantly more frequently among harvesters than non-harvesters (p<0.05): headache, tachycardia, fever, nausea, difficulty breathing, dizziness, and dysuria. Percentages of workers reporting heat and dehydration-related symptoms increased over increasing heat exposure categories. Total liquid consumed ranged from 1 to 9 L and differed over days (median 5.0, 4.0 and 3.25 on days 1, 2 and 3 respectively). On these same days, the two principle indicators of dehydration: high USG (≥1.025) and low pH (≤5), changed significantly from pre to post-shift (p=0.000 and p=0.012).Proportions of workers with proteinuria >30 mg/dL, and blood, leucocytes and casts in urine were also significantly different between pre and post-shift samples at the group level, but unlike USG and pH, these alterations were more frequent in the pre-shift sample. 85% of workers presented with proteinuria at least once and 52% had at least one post-shift USG indicative of dehydration.Conclusion Heat exposure is an important occupational health risk for sugarcane workers according to international standards. A large percentage of harvesters experience symptoms consistent with heat exhaustion throughout the harvest season. Pre and post-shift urine samples demonstrate dehydration and other abnormal findings. The results of this study demonstrate an urgent need to improve working conditions for sugarcane harvesters both under current conditions and in adaptation plans for future climate change.
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| 5. |
- Crowe, Jennifer, et al.
(författare)
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Heat exposure in sugarcane harvesters in Costa Rica
- 2013
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Ingår i: American Journal of Industrial Medicine. - : John Wiley & Sons. - 0271-3586 .- 1097-0274. ; 56:10, s. 1157-1164
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Occupational heat stress is a major concern in sugarcane production and has been hypothesized as a causal factor of a chronic kidney disease epidemic in Central America. This study described working conditions of sugarcane harvesters in Costa Rica and quantified their exposure to heat.METHODS: Non-participatory observation and Wet Bulb Globe Temperatures (WBGT) according to Spanish NTP (Technical Prevention Notes) guidelines were utilized to quantify the risk of heat stress. OSHA recommendations were used to identify corresponding exposure limit values.RESULTS: Sugarcane harvesters carried out labor-intensive work with a metabolic load of 261 W/m(2) (6.8 kcal/min), corresponding to a limit value of 26° WBGT which was reached by 7:30 am on most days. After 9:15 am, OSHA recommendations would require that workers only work 25% of each hour to avoid health risks from heat.CONCLUSIONS: Sugarcane harvesters are at risk for heat stress for the majority of the work shift. Immediate action is warranted to reduce such exposures.
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| 6. |
- Crowe, Jennifer, 1976-, et al.
(författare)
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Heat-Related symptoms in sugarcane harvesters
- 2015
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Ingår i: American Journal of Industrial Medicine. - : John Wiley & Sons. - 0271-3586 .- 1097-0274. ; 58:5, s. 541-548
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Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure to heat stress is a documented risk for Central American sugarcane harvesters. However, little is known about heat-related illness in this population.Methods: This study examined the frequency of heat-related health effects among harvesters (n = 106) exposed to occupational heat stress compared to non-harvesters (n = 63). Chi-square test and gamma statistic were used to evaluate differences in self-reported symptoms and trends over heat exposure categories.Results: Heat and dehydration symptoms (headache, tachycardia, muscle cramps, fever, nausea, difficulty breathing, dizziness, swelling of hands/feet, and dysuria) were experienced at least once per week significantly more frequently among harvesters. Percentages of workers reporting heat and dehydration symptoms increased in accordance with increasing heat exposure categories.Conclusions: A large percentage of harvesters are experiencing heat illness throughout the harvest demonstrating an urgent need for improved workplace practices, particularly in light of climate change and the epidemic of chronic kidney disease prevalent in this population.
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| 7. |
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| 8. |
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| 9. |
- García-Trabanino, Ramón, et al.
(författare)
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Heat stress, dehydration, and kidney function in sugarcane cutters in El Salvador - A cross-shift study of workers at risk of Mesoamerican nephropathy.
- 2015
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Ingår i: Environmental research. - : Elsevier BV. - 1096-0953 .- 0013-9351. ; 142, s. 746-755
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Tidskriftsartikel (refereegranskat)abstract
- An epidemic of progressive kidney failure afflicts sugarcane workers in Central America. Repeated high-intensity work in hot environments is a possible cause. To assess heat stress, dehydration, biomarkers of renal function and their possible associations. A secondary aim was to evaluate the prevalence of pre-shift renal damage and possible causal factors. Sugarcane cutters (N=189, aged 18–49 years, 168 of them male) from three regions in El Salvador were examined before and after shift. Cross-shift changes in markers of dehydration and renal function were examined and associations with temperature, work time, region, and fluid intake were assessed. Pre-shift glomerular filtration rate was estimated (eGFR) from serum creatinine. The mean work-time was 4 (1.4–11) hours. Mean workday temperature was 34–36 °C before noon, and 39–42 °C at noon. The mean liquid intake during work was 0.8 L per hour. There were statistically significant changes across shift. The mean urine specific gravity, urine osmolality and creatinine increased, and urinary pH decreased. Serum creatinine, uric acid and urea nitrogen increased, while chloride and potassium decreased. Pre-shift serum uric acid levels were remarkably high and pre-shift eGFR was reduced (<60 mL/min) in 23 male workers (14%). The high prevalence of reduced eGFR, and the cross-shift changes are consistent with recurrent dehydration from strenuous work in a hot and humid environment as an important causal factor. The pathophysiology may include decreased renal blood flow, high demands on tubular reabsorption, and increased levels of uric acid.
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| 10. |
- Hansson, Erik, 1987, et al.
(författare)
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Association Between Acute Kidney Injury Hospital Visits and Environmental Heat Stress at a Nicaraguan Sugarcane Plantation
- 2024
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Ingår i: WORKPLACE HEALTH & SAFETY. - 2165-0799 .- 2165-0969.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings.Method: We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a large Nicaraguan sugarcane plantation and modeled the relationship between these using negative binomial regression. A rest-shade-hydration intervention was gradually enhanced during the study period, and efforts were made to increase the referral of workers with suspected AKI to healthcare.Results: Each 1 degrees C WBGT was associated with an 18% (95% confidence interval [CI]: [4, 33%]) higher AKI-CD rate on the same day and a 14% (95% CI [-5, 37%]) higher rate over a week. AKI-CD rates and severity, and time between symptoms onset and diagnosis decreased during the study period, that is, with increasing rest-shade-hydration intervention. Symptoms and biochemical signs of systemic inflammation were common among AKI-CD cases.Discussion: Occupational heat stress, resulting from heavy work in environmental heat, was associated with a higher rate of clinically diagnosed AKI in a population at risk of CKDnt. Promoting rest-shade-hydration may have contributed to reducing AKI rates during the study period. Occupational health and safety personnel have key roles to play in enforcing rest, shade, and hydration practices, referring workers with suspected AKI to healthcare as well as collecting and analyzing the data needed to support workplace heat stress interventions.
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| 11. |
- Hansson, Erik, 1987, et al.
(författare)
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Impact of heat and a rest-shade-hydration intervention program on productivity of piece-paid industrial agricultural workers at risk of chronic kidney disease of nontraditional origin
- 2024
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Ingår i: ANNALS OF WORK EXPOSURES AND HEALTH. - 2398-7308 .- 2398-7316.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Assess the impact of environmental heat and a rest-shade-hydration (RSH) intervention against heat stress on productivity of piece-paid Mesoamerican sugarcane cutters. These workers are at a high risk of chronic kidney disease of non-traditional origin (CKDnt), from the severe heat stress they experience due to heavy work under hot conditions. RSH interventions in these populations improve kidney health outcomes, but their impact on productivity has yet to be examined. Methods: We accessed routine productivity data from seed (SC, N = 749) and burned (BCC, N = 535) sugarcane cutters observed over five harvest seasons with increasing RSH intervention at a large Nicaraguan sugarcane mill. Hourly field-site wet-bulb globe temperature (WBGT) was recorded by mill staff and summarized as a daily mean. Mixed linear regression was used to model daily productivity, adjusting for age (18-29, 30-44, and >45 years), sex, WBGT (<28, 28-29, 29-30, 30-31, and >31( degrees)C) on the same and preceding day, harvest season (2017-18 to 2021-22), month, and acclimatization status (<1, 1-2, and >2 weeks). Results: There was an inverse dose-response relationship between SC productivity and WBGT on the same and preceding days, decreasing by approximately 3%/C-degrees WBGT. Productivity increased during the study period, i.e. coinciding with RSH scale-up, by approximately 19% in SC and 9% in BCC. Conclusion: Agricultural worker productivity was expected lower on hotter days, strengthening the interest in all stakeholders to mitigate increasing global temperatures and their impact. Despite decreasing the total time allocated for work each day, an RSH intervention appears to result in increased productivity and no apparent loss in productivity.
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| 12. |
- Hansson, Erik, et al.
(författare)
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Workload and cross-harvest kidney injury in a Nicaraguan sugarcane worker cohort
- 2019
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Ingår i: Occupational and environmental medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 76:11, s. 818-826
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the association between workload and kidney injury in a fieldworker cohort with different levels of physically demanding work over a sugarcane harvest, and to assess whether the existing heat prevention efforts at a leading occupational safety and health programme are sufficient to mitigate kidney injury. METHODS: Biological and questionnaire data were collected before (n=545) and at the end (n=427) of harvest among field support staff (low workload), drip irrigation workers (moderate), seed cutters (high) and burned sugarcane cutters (very high). Dropouts were contacted (87%) and reported the reason for leaving work. Cross-harvest incident kidney injury (IKI) was defined as serum creatinine increase ≥0.30 mg/dL or ≥1.5 times the baseline value, or among dropouts reporting kidney injury leading to leaving work. RESULTS: Mean cross-harvest estimated glomerular filtration rate change was significantly associated with workload, increasing from 0 mL/min/1.73 m2 in the low-moderate category to -5 mL/min/1.73 m2 in the high and -9 mL/min/1.73 m2 in the very high workload group. A similar pattern occurred with IKI, where low-moderate workload had 2% compared with 27% in the very high workload category. A healthy worker selection effect was detected, with 32% of dropouts reporting kidney injury. Fever and C reactive protein elevation were associated with kidney injury. CONCLUSIONS: Workers considered to have the highest workload had more cross-harvest kidney damage than workers with less workload. Work practices preventing heat stress should be strengthened and their role in preventing kidney damage examined further. Future occupational studies on chronic kidney disease of unknown aetiology should account for a healthy worker effect by pursuing those lost to follow-up.
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| 13. |
- Marcotte, Erin L., et al.
(författare)
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Caesarean delivery and risk of childhood leukaemia : a pooled analysis from the Childhood Leukemia International Consortium (CLIC)
- 2016
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Ingår i: The Lancet Haematology. - 2352-3026. ; 3:4, s. E176-E185
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Tidskriftsartikel (refereegranskat)abstract
- Background Results from case-control studies have shown an increased risk of acute lymphoblastic leukaemia (ALL) in young children born by caesarean delivery, and prelabour caesarean delivery in particular; however, an association of method of delivery with childhood leukaemia subtypes has yet to be established. We therefore did a pooled analysis of data to investigate the association between childhood leukaemia and caesarean delivery. Methods We pooled data from 13 case-control studies from the Childhood Leukemia International Consortium done in nine countries (Canada, Costa Rica, Egypt, France, Germany, Greece, Italy, New Zealand, and the USA) for births from 1970-2013. We analysed caesarean delivery overall and by indications that probably resulted in prelabour caesarean delivery or emergency caesarean delivery. We used multivariable logistic regression models, adjusted for child's birthweight, sex, age, ethnic origin, parental education, maternal age, and study, to estimate odds ratios (ORs) and 95% CIs for the risk of ALL and acute myeloid leukaemia (AML) in children aged 0-14 years at diagnosis. Findings The studies provided data for 8780 ALL cases, 1332 AML cases, and 23 459 controls, of which the birth delivery method was known for 8655 (99%) ALL cases, 1292 (97%) AML cases, and 23 351 (> 99%) controls. Indications for caesarean delivery were available in four studies (there were caesarean deliveries for 1061 of 4313 ALL cases, 138 of 664 AML cases, and 1401 of 5884 controls). The OR for all indications of caesarean delivery and ALL was 1.06 (95% CI 0.99-1.13), and was significant for prelabour caesarean delivery and ALL (1.23 [1.04-1.47]; p= 0.018). Emergency caesarean delivery was not associated with ALL (OR 1.02 [95% CI 0.81-1.30]). AML was not associated with caesarean delivery (all indications OR 0.99 [95% CI 0.84-1.17]; prelabour caesarean delivery 0.83 [0.54-1.26]; and emergency caesarean delivery 1.05 [0.63-1.77]). Interpretation Our results suggest an increased risk of childhood ALL after prelabour caesarean delivery. If this association is causal, maladaptive immune activation due to an absence of stress response before birth in children born by prelabour caesarean delivery could be considered as a potential mechanism.
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| 14. |
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| 15. |
- Monge, Patricia, et al.
(författare)
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Parental occupational exposure to pesticides and the risk of childhood leukemia in Costa Rica
- 2007
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 33:4, s. 293-303
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Parental exposure to pesticides and the risk of leukemia in offspring were examined in a population-based case-control study in Costa Rica. METHODS: All cases of childhood leukemia (N=334), in 1995-2000, were identified at the Cancer Registry and the Children's Hospital. Population controls (N=579) were drawn from the National Birth Registry. Interviews of parents were conducted using conventional and icon-based calendar forms. An exposure model was constructed for 25 pesticides in five time periods. RESULTS: Mothers' exposures to any pesticides during the year before conception and during the first and second trimesters were associated with the risk [odds ratio (OR) 2.4, 95% confidence interval (95% CI) 1.0-5.9; OR 22, 95% CI 2.8-171.5; OR 4.5, 95% CI 1.4-14.7, respectively] and during anytime (OR 2.2, 95% CI 1.0-4.8). An association was found for fathers' exposures to any pesticides during the second trimester (OR 1.5, 95% CI 1.0-2.3). An increased risk with respect to organophosphates was found for mothers during the first trimester (OR 3.5, 95% CI 1.0-12.2) and for fathers during the year before conception and the first trimester (OR 1.5, 95% CI 1.0-2.2 and OR 1.6, 95% CI 1.0-2.6, respectively), and benzimidazoles during the first, second, and third trimesters of pregnancy (OR 2.2, 95% CI 1.0-4.4; OR 2.2, 95% CI 1.0-5.0; OR 2.2, 95% CI 1.0-5.2, respectively). There was a suggestion of an exposure-response gradient for fathers as regards picloram, benomyl, and paraquat. Age at diagnosis was positively associated with fathers' exposures and inversely associated with mothers' exposures. CONCLUSIONS: The results suggest that parental exposure to certain pesticides may increase the risk of leukemia in offspring.
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| 16. |
- Pearce, Neil E, et al.
(författare)
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IARC Monographs : 40 Years of Evaluating Carcinogenic Hazards to Humans
- 2015
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Ingår i: Journal of Environmental Health Perspectives. - : Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 123:6, s. 507-514
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Recently the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also the approach used to perform these evaluations. Some critics have claimed that IARC Working Groups' failures to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans.OBJECTIVES: The authors of this paper are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We have examined here criticisms of the IARC classification process to determine the validity of these concerns. We review the history of IARC evaluations and describe how the IARC evaluations are performed.DISCUSSION: We conclude that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various discipline and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed.CONCLUSIONS: The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.
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| 17. |
- Peraza, Sandra, et al.
(författare)
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Decreased Kidney Function Among Agricultural Workers in El Salvador
- 2012
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Ingår i: American Journal of Kidney Diseases. - : Elsevier BV. - 1523-6838 .- 0272-6386. ; 59:4, s. 531-540
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Tidskriftsartikel (refereegranskat)abstract
- Background: An epidemic of chronic kidney disease of unknown cause has emerged along the Pacific coast of Central America, particularly in relatively young male sugarcane workers. In El Salvador, we examined residence and occupations at different altitudes as surrogate risk factors for heat stress. Study Design: Cross-sectional population-based survey. Setting & Participants: Populations aged 20-60 years of 5 communities in El Salvador, 256 men and 408 women (participation, 73%): 2 coastal communities with current sugarcane and past cotton production and 3 communities above 500 m with sugarcane, coffee, and service-oriented economies. Predictor: Participant sex, age, residence, occupation, agricultural history by crop and altitude, and traditional risk factors for CKD. Outcomes: Serum creatinine (SCr) level greater than the normal laboratory range for sex, estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2), and proteinuria categorized as low (protein excretion >= 30-<300 mg/dL) and high grade (>= 300 mg/dL). Results: Of the men in the coastal communities, 30% had elevated SCr levels and 18% had eGFR <60 mL/min/1.73 m(2) compared with 4% and 1%, respectively, in the communities above 500 m. For agricultural workers, prevalences of elevated SCr levels and eGFR <60 mL/min/1.73 m(2) were highest for coastal sugarcane and cotton plantation workers, but were not increased in sugarcane workers at 500 m or subsistence farmers. Women followed a weaker but similar pattern. Proteinuria was infrequent, of low grade, and not different among communities, occupations, or sexes. The adjusted ORs of decreased kidney function for 10-year increments of coastal sugarcane or cotton plantation work were 3.1 (95% CI, 2.0-5.0) in men and 2.3 (95% CI, 1.4-3.7) in women. Limitations: The cross-sectional nature of the study limits etiologic interpretations. Conclusion: Agricultural work on lowland sugarcane and cotton plantations was associated with decreased kidney function in men and women, possibly related to strenuous work in hot environments with repeated volume depletion. Am J Kidney Dis. 59(4): 531-540. (C) 2012 by the National Kidney Foundation, Inc.
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| 18. |
- Rodriguez, Teresa, et al.
(författare)
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Assessment of long-term and recent pesticide exposure among rural school children in Nicaragua
- 2012
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 69:2, s. 119-125
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Tidskriftsartikel (refereegranskat)abstract
- Objective This study assessed pesticide exposure of children in rural Nicaragua in relation to parental pesticide use, from around conception to current school age, as part of an epidemiological evaluation of neurodevelopment effects. Methods We included 132 children whose parents were subsistence farmers or plantation workers, or had an agricultural history. As proxies for children's long-term exposures, we constructed cumulative parental pesticide-specific use indices for periods before and after the child's birth from data obtained using an icon-calendar-based questionnaire, of application hours (h) for plantation workers and subsistence farmers, and of kilograms of active ingredients (ai) only for subsistence farmers. Pesticide residues of TCPY, 3-PBA and 2,4-D were analysed in children's urine as indicators for current exposures. Results Life-time indices were highest for the organophosphates chlorpyrifos (median 114 h (min 2; max 1584), 19.2 kg ai (min 0.37; max 548)) and methamidophos (84 h (6; 1964), 12.2 kg ai (0.30; 780)). The P50 values of children's urinary residues were 3.7 mu g/g creatinine for TCPY, 2.8 for 3-PBA and 0.9 for 2,4-D; TCPY values are comparable with those in other countries, but 3-PBA and 2,4-D are considerably higher. The maximum levels for all three pesticides are the highest reported for children. Residues increased on days after application, but most high residue levels were unrelated to parental pesticide applications. Conclusion Urinary pesticide residues reveal high environmental exposure among children in rural Nicaragua. The quantitative parental pesticide use indices as proxies for children's exposures during different periods may be useful for the evaluation of developmental health effects.
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| 19. |
- Rodriguez, Teresa, 1966-, et al.
(författare)
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Cognitive deficits in organophosphate exposed children of Nicaraguan subsistence farmers
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: This study examined cognitive and behavioral performance among school-age children in Nicaragua in relation with long-term and recent organophosphate exposures.Methods: Long-term organophosphate was assessed in 110 children aged 7-9 through a parental use index of kg of organophosphate during de pregnancy, first year of life and from 1 year old to the present. Recent exposure was determined in a subset of 74 children by urinary 3,5,6-trichloro-2-pyridinol (TCPY) levels. Cognitive function was evaluated with Wechsler Intelligence Scale for Children (WISC IV), total IQ and subtests grouped into indices for perceptual reasoning, verbal comprehension, working memory, and processing speed. Behavior at school was measured with the Conners’ Teacher Rating Scale-Revised:Short (CTRS-R:S). Multivariate linear regression models assessed adjusted associations.Results: For each 10-fold increase in prenatal indices for total OP use, children’s performance on working memory significantly decreased with 3.5 points, and similarly for chlorpyrifos and methamidophos. Prenatal methamidophos use was, in addition, significantly associated with poorer verbal comprehension and decrease in total IQ, a 10-fold use increase decreasing scores with 3.8 and 3.3 points respectively. Urinary TCPY (mg/g of creatinine) also affected, not significantly, working memory with a 3.2 point decrease for each 10-fold increase. This study did not find associations between postnatal organophosphate use indices and cognitive performance, or pre or postnatal use indices with behavior. Conclusion: Prenatal exposure to organophosphates decreased the cognitive abilities in Nicaraguan children, particularly in working memory. Methamidophos was also associated with poor verbal comprehension and total IQ.
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| 20. |
- Rodríguez, Teresa, 1966-
(författare)
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Environmental Pesticide Exposure and Neurobehavioral Effects among Children of Nicaraguan Agricultural Workers
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Children exposed to pesticides are susceptible for neurodevelopmental disruption. Data from developing countries are scarce.Aim: Assessing long-term and recent pesticide exposure in Nicaraguan children in relation to parental pesticide use and examining potential associated neurobehavioral effects.Methods: In the first study, pre- and post-spraying urinary residues of the chlorpyrifos metabolite TCPY and diazinon metabolite IMPY were measured among 7 subsistence farmers and 10 plantation workers, and in one child per worker. In the second study, for 110 children in an agricultural village and 22 in a non-agricultural village, aged 7-9, parental pesticide use was assessed by hours of spraying and kilograms of active ingredients during pre-and-postnatal time windows, as proxies for children’s long term pesticide exposures. Urinary TCPY, 3-PBA (pyrethroid metabolite), and 2,4-D were determined in 211 samples of 74 children of the agricultural village. IQ components and total IQ (WISC-IV) were evaluated in all agricultural village children. Behavior was evaluated with the Conners’ Teacher Rating Scale-Revised: Short. Multivariate linear regression models assessed associations between long-term and recent exposure to organophosphates and pyrethroids and cognitive and behavioral scales.Results: In study 1, post-spraying urinary levels of pesticide metabolites of subsistence farmers and their children were highly correlated (r=0.85), but not those of plantation workers and their children. In study 2, a wide range of exposures was reported by parents for all pesticides and time windows. The median urinary TCPY (3.7 μg/g creatinine), 3-PBA (2.8), and 2,4-D (0.9) were comparable to other studies for TCPY and 3-PBA but high for 2,4-D. Maximum levels were the highest reported for all compounds. Prenatal use of organophosphates affected working memory, and methamidophos also verbal comprehension and total IQ. Urinary TCPY was associated with poorer working memory. Organophosphate exposures were not associated with children’s behavior. Pyrethroid exposure during the first year of life associated with poorer perceptual reasoning and behavior, and urinary 3-PBA with a number of cognitive functions and ADHD in girls but not in boys.Conclusion: Nicaraguan children in poor agricultural areas are highly exposed to pesticides, which is influenced by parental pesticide use in subsistence farms. Organophosphate and pyrethroid exposures adversely affect their neurobehavioral development.
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| 21. |
- Rodriguez, Teresa, 1966-, et al.
(författare)
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Pyrethroids exposure and neurobehavioral performance in school age children in rural Nicaragua
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: This cross-sectional study explored whether pre or postnatal pyrethroid exposure impaired cognitive performance and behavior in school-aged children from a rural area in Nicaragua.Methods: Pyrethroid exposure was assessed in 110 children age 7-9, attending grade 1-3, with cumulative parental pyrethroid use indices of hours of spraying, during pregnancy, the first year of life, and older than age one. Cypermethrin accounted for most of the pyrethroid use. Cognitive performance of the children was evaluated with 12 sub-tests and total IQ of Wechsler Intelligence Scale for Children (WISC IV), grouped into indices for perceptual reasoning, verbal comprehension, working memory, and processing speed. Behavior at school was measured with the oppositional, cognitive problem/inattention, hyperactivity and ADHD index subscales of the Conners’ Teacher Rating Scale-Revised:Short form (CTRS-R:S). One year later, the pyrethroid metabolite 3-PBA was measured in 211 urine samples from 74 children (median 3.3 µg/g creatinine, max. 547) and the effect of recent exposure on cognitive and behavior was assessed with a shortened battery. Results:Pyrethroid exposure indices during the first year of life significantly decreased performance of perceptual reasoning in children aged 7-9. For each 10-fold increasein hours of pyrethroid application , children’s performance on the Perceptual Reasoning Index decreased on average with 1.1 point. Postnatal exposures, during the first year and after age 1, associated with hyperactivity and attention problem. Urinary 3-PBA levels were negatively associated with a number of cognitive functions and, noteworthy, with increased scores for ADHD in girls but not in boys.Conclusion:Pyrethroid exposure in the first year of life was associated with decreased perceptual reasoning in rural children and with hyperactivity and ADHD predominantly in girls.
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| 22. |
- Rodriguez, Teresa, 1966-, et al.
(författare)
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Pyrethroids exposure and neurobehavioral performance in school age children in rural Nicaragua
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Annan publikation (populärvet., debatt m.m.)abstract
- Objective: This cross-sectional study explored whether pre or postnatal pyrethroid exposure impaired cognitive performance and behavior in school-aged children from a rural area in Nicaragua.Methods: Pyrethroid exposure was assessed in 110 children age 7-9, attending grade 1-3, with cumulative parental pyrethroid use indices of hours of spraying, during pregnancy, the first year of life, and older than age one. Cypermethrin accounted for most of the pyrethroid use. Cognitive performance of the children was evaluated with 12 sub-tests and total IQ of Wechsler Intelligence Scale for Children (WISC IV), grouped into indices for perceptual reasoning, verbal comprehension, working memory, and processing speed. Behavior at school was measured with the oppositional, cognitive problem/inattention, hyperactivity and ADHD index subscales of the Conners’ Teacher Rating Scale-Revised:Short form (CTRS-R:S). One year later, the pyrethroid metabolite 3-PBA was measured in 211 urine samples from 74 children (median 3.3 µg/g creatinine, max. 547) and the effect of recent exposure on cognitive and behavior was assessed with a shortened battery. Results:Pyrethroid exposure indices during the first year of life significantly decreased performance of perceptual reasoning in children aged 7-9. For each 10-fold increasein hours of pyrethroid application , children’s performance on the Perceptual Reasoning Index decreased on average with 1.1 point. Postnatal exposures, during the first year and after age 1, associated with hyperactivity and attention problem. Urinary 3-PBA levels were negatively associated with a number of cognitive functions and, noteworthy, with increased scores for ADHD in girls but not in boys.Conclusion:Pyrethroid exposure in the first year of life was associated with decreased perceptual reasoning in rural children and with hyperactivity and ADHD predominantly in girls.
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| 23. |
- Smpokou, Evangelia Theano, et al.
(författare)
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Environmental exposures in young adults with declining kidney function in a population at risk of Mesoamerican nephropathy
- 2019
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Ingår i: Occupational and environmental medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 76:12, s. 920-926
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Tidskriftsartikel (refereegranskat)abstract
- Objectives There is an epidemic of Mesoamerican nephropathy (MeN) in Central America, where sugarcane production is prominent. Numerous causes are proposed, but to date limited evidence supports any one hypothesis. A nested case-control study using biosamples from a rural, community-based follow-up study of 350 young adults from Northwest Nicaragua at risk of MeN was conducted with the aim of characterising the associations between urinary concentrations of metals, pesticides and mycotoxins from samples collected in the first 6 months and decline in kidney function over 2 years. Methods Urine samples collected at baseline (pre-sugarcane harvest) and the first 6 month follow-up (post-sugarcane harvest) visit were tested. Twelve metals and metalloids (aluminium, total arsenic, cadmium, chromium, cobalt, copper, lead, manganese, mercury, selenium, silicon and strontium) were analysed by inductively coupled plasma-mass spectrometry. Twelve pesticides or their metabolites (2,4-dichlorophenoxyacetic acid, 3-phenoxybenzoic acid, 4-fluoro-3-phenoxybenzoic acid, chloro-3,3,3-trifluoro-1-propen-1-yl-2,2-dimethylcyclopropanecarboxylic acid, cis/trans 3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid, ethylenethiourea, glyphosate, 4-chloro-2-methylphenoxy acetic acid, 3-hydroxy-pyrimetanil, 5-hydroxytiabendazole, hydroxy-tebuconazole and 3,5,6-trichloro-2-pyridinol) and two mycotoxins (ochratoxin A (OTA) and citrinin (CIT)) were analysed by liquid chromatography coupled-mass spectrometry. Differences in the creatinine-corrected urinary concentrations of the measured exposures between outcome groups (participants with stable vs declining kidney function) were examined. Results Elevated levels of aluminium and total arsenic as well as metabolites of several pesticides were detected across the population. No differences were identified between the declining and stable groups in the levels of metals or pesticides tested. OTA and CIT were below the limit of detection. Conclusions The tested metals, metalloids, pesticides and mycotoxins were not associated with loss of kidney function in participants at-risk of MeN.
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| 24. |
- Torres, Cecilia, et al.
(författare)
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Decreased Kidney Function of Unknown Cause in Nicaragua : A Community-Based Survey
- 2010
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Ingår i: American Journal of Kidney Diseases. - : Elsevier BV. - 0272-6386 .- 1523-6838. ; 55:3, s. 485-496
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Tidskriftsartikel (refereegranskat)abstract
- Background: End-stage kidney disease overwhelms health services in Central America. We determined prevalences of decreased kidney function in distinct populations in the most affected region of Nicaragua. Study Design: Cross-sectional survey. Setting & Participants: Total populations aged 20-60 years of 5 villages in Northwest Nicaragua: mining/subsistence farming (elevation, 100-300 m above sea level), banana/sugarcane (100-300 m), fishing (0-100 m), services (0-100 m), and coffee (200-675 m); 479 men and 617 women (83% response). Predictor or Factor: Village; participant sex, age, and occupation; conventional chronic kidney disease risk factors. Outcomes: Serum creatinine (SCr) values greater than laboratory reference range for sex, estimated glomerular filtration rate <60 mL/min/1.73 m(2), proteinuria stratified in the low (dipstick protein excretion, 30-300 mg/dL) and high (>300 mg/dL) range. Results: Prevalences of abnormal SCr levels: 18% (of all men) and 5% (of all women); in the mining/subsistence farming village, 26% and 7%; banana/sugarcane, 22% and 6%; fishing, 13% and 4%; services, 0% and 1%; and coffee, 7% and 0%. Prevalences of estimated glomerular filtration rate <60 mL/min/1.73 m2: 14% (of all men) and 3% (of all women); in the listed villages, 19% and 5%, 17% and 4%, 10% and 2%, 0% and 0%, and 7% and 0%, respectively. Proteinuria, predominantly in the low range, affected 14% and 11% of all men and women without marked differences between villages. By occupation, abnormal SCr levels occurred in 31% and 24% of male and female agricultural workers at 100-300 m above sea level, but not at higher altitudes, and also was high in male artisans (43%), construction workers (15%), and miners (14%). In logistic regression models, for the banana/sugarcane and mining/subsistence farming villages, high blood pressure and age were significant predictors of abnormal SCr levels in men, and for mining/subsistence farming, age in women. Limitations: Causality is not addressed. Conclusions: In some Nicaraguan villages and population segments, men in particular show a high prevalence of decreased kidney function of unknown origin, possibly environmental or occupational.
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| 25. |
- van Wendel de Joode, Berna, et al.
(författare)
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Aerial Application of Mancozeb and Urinary Ethylene Thiourea (ETU) Concentrations among Pregnant Women in Costa Rica: The Infants' Environmental Health Study (ISA).
- 2014
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Ingår i: Environmental Health Perspectives. - : Environmental Health Perspectives. - 1552-9924 .- 0091-6765. ; 122:12, s. 1321-1328
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mancozeb and its main metabolite ethylene thiourea (ETU) may alter thyroid function; thyroid hormones are essential for fetal brain development. In Costa Rica, mancozeb is aerially sprayed at large-scale banana plantations on a weekly basis. Objectives: (1) evaluate urinary ETU concentrations in pregnant women living nearby large-scale banana plantations; (2) compare their estimated daily intake (EDI) with established Reference Doses (RfDs); and (3) identify factors that predict their urinary ETU concentrations. Methods: We enrolled 451 pregnant women from Matina County, Costa Rica, with large-scale banana production. We visited 445 women up to three times during pregnancy to obtain urine samples (n = 872) and information on factors that possibly influence exposure. We determined urinary ETU concentrations using liquid chromatography mass spectrometry (LCMS). Results: Pregnant women's median urinary ETU concentrations were more than five times higher than reported for other general populations. Seventy-two percent of the women had EDIs above the RfD. Women who lived closest (1st quartile, < 48 meters) to banana plantations on average had a 45% (95% CI: 23, 72%) higher urinary ETU compared with women who lived farthest away (4th quartile, ≥ 565 meter). Compared with the other women, ETU was also higher in women who washed agricultural work clothes on day before sampling (11%; 95% CI; 4.9, 17%), worked in agriculture during pregnancy (19%; 95% CI: 9.3, 29), and immigrant women (6.2%; 95% CI: 1.0, 13%). Conclusions: The pregnant women's urinary ETU concentrations are of concern, and the principal source of exposure is likely to be aerial spraying of mancozeb. The factors predicting ETU provide insight into possibilities for exposure reduction.
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