Agriculture-related injuries in the parkland region of Manitoba.
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OBJECTIVE: To review a series of farm injuries in the parkland region of Manitoba, compare the collected data to similar studies, and provide a baseline for deriving effective preventive measures for the local community. DESIGN: Retrospective case study involving review of hospital charts. SETTING: The population studied was derived from the catchment area for Dauphin General Hospital, a referral centre servicing an agricultural region of 57,000 people. PATIENTS: Seventy-two patients were admitted to hospital between January 1981 and December 1991 after being injured by agricultural machines, farm animals, herbicides or other chemicals, and fertilizers. Four fatalities were identified through a review of local medical examiner records, for a total of 76 cases. MAIN OUTCOME MEASURES: The following data were abstracted for each case: sex, age, time and date of injury, cause, type of injury, and body part involved. RESULTS: Most cases involved men, between the ages of 20 and 69, during the afternoon and early evening with a seasonal peak in late summer. More than 60% of injuries were caused by agricultural machinery, followed by animal-related injuries (25%). Grain augers were the most common type of machine causing injury (35%). All patients younger than 9 years were female, and 75% of their injuries involved farm animals. A decreasing annual frequency of farm injuries was noted over the 11-year period. Fewer accidents involving farm machinery appear most responsible for this trend. CONCLUSIONS: Many agriculture-related injuries occur in the parkland region of Manitoba. The type and pattern of injuries observed resembles those documented in other studies. With effective education and preventive measures, most injuries and fatalities could be prevented. Physicians are obliged to encourage and support educational programs in their communities and to review safety practices with patients. (+info)
DDE and shortened duration of lactation in a northern Mexican town.
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OBJECTIVES: Worldwide declines in the duration of lactation are cause for public health concern. Higher levels of dichlorodiphenyl dichloroethene (DDE) have been associated with shorter durations of lactation in the United States. This study examined whether this relationship would hold in an agricultural town in northern Mexico. METHODS: Two hundred twenty-nine women were followed every 2 months from childbirth until weaning or until the child reached 18 months of age. DDE was measured in breast milk samples taken at birth, and women were followed to see how long they lactated. RESULTS: Median duration was 7.5 months in the lowest DDE group and 3 months in the highest. The effect was confined to those who had lactated previously, and it persisted after statistical adjustment for other factors. These results are not due to overtly sick children being weaned earlier. Previous lactation lowers DDE levels, which produces an artifactual association, but simulations using best estimates show that an effect as large as that found here would arise through this mechanism only 6% of the time. CONCLUSIONS: DDE may affect women's ability to lactate. This exposure may be contributing to lactation failure throughout the world. (+info)
Time to pregnancy and occupational exposure to pesticides in fruit growers in The Netherlands.
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OBJECTIVES: Although pesticides are regularly used in agriculture, relatively little is known about possible adverse health effects, especially reproductive effects, due to occupational exposure. This explorative study investigates the relation between exposure of the fruit grower to pesticides and fecundability (probability of pregnancy) in a population of fruit growers. METHODS: The analysis is based on self reported data and includes 91 pregnancies during 1978-1990 of 43 couples. Cox' proportional hazards model was used to analyse time to pregnancy after correction for gravidity and consultation with a physician for fertility problems. RESULTS AND CONCLUSIONS: Application of pesticides solely by the owner was associated with a long time to pregnancy, resulting in a fecundability ratio of 0.46 (95% confidence interval (95% CI) 0.28-0.77). Similarly a low spraying velocity (< or = 1.5 hectares/h) resulted in a fecundability ratio of 0.47 (95% CI 0.29-0.76) and is associated with the use of older spraying techniques and tractors without a cabin. These factors were assumed to cause high exposure, which was confirmed by exposure measurements in the field. The effect of high exposure was mainly apparent if the couple had intended to become pregnant in the period from March-November (fecundability ratio 0.42, 95% CI 0.20-0.92). This is the period in which pesticides are applied. Out of the spraying season the effect of a high exposure was absent (fecundability ratio 0.82, 95% CI 0.33-2.02). In the high exposure group 28% of the pregnancies had been preceded by consulting a physician because of fertility problems, compared with 8% in the low exposure group. These findings indicate that an adverse effect of exposure to pesticides on fecundability is likely. (+info)
Non-Hodgkin's lymphoma and agricultural practices in the prairie provinces of Canada.
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OBJECTIVES: The aim of this study was to provide an update of a cohort study (1971-1985) that previously reported a significant trend in the risk of non-Hodgkin's lymphoma among male Saskatchewan farm operators according to fuel-oil expenditures and herbicide spraying for farms less than 1000 acres (2570 hectares) by including two additional Canadian prairie provinces, two additional years of follow-up, and data from the 1981 Census of Agriculture. METHODS: Information on farmers from 1971 records of the Census of Agriculture was linked to 1971 records of the Census of Population, to 1981 records of the Census of Agriculture, and to death records. Poisson regression was used to estimate risks according to herbicide spraying and fuel and oil expenditures. RESULTS: The addition of a further two years of follow-up resulted in lower risk estimates associated with herbicide spraying for Saskatchewan. No excess risk was observed between herbicide spraying and non-Hodgkin's lymphoma for Alberta or Manitoba in the 1971 data. However, a significantly increased risk of non-Hodgkin's lymphoma according to acres sprayed with herbicides was observed for the three provinces combined when the herbicide spraying data from the 1981 Census of Agriculture was used [> or = 380 acres (> or = 939 hectares) sprayed, rate ratio 2.11, 95% confidence interval 1.1-3.9]. CONCLUSIONS: Although the current results are not entirely consistent with the original Saskatchewan analysis, they support the overall finding of an association between herbicides and risk of fatal non-Hodgkins lymphoma. Prospective cohort studies are needed to overcome the limitations of existing epidemiologic studies. (+info)
Peer discussions of cancer among Hispanic migrant farm workers.
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Hispanic migrant agricultural workers' exposure to pesticides and other agrichemicals places them at increased risk for a variety of acute and chronic conditions, including cancer. As a socioeconomically disadvantaged group, migrant workers also face many barriers to effective cancer control. In 1992, a series of focus groups was held with 55 Hispanic migrant agricultural workers (22 women, 33 men) in central Wisconsin to gather information on their knowledge and attitudes regarding cancer etiology and treatment, their practices regarding cancer screening and early detection, and their concerns regarding occupational exposure to pesticides. Beliefs that pesticides are toxic and can cause health problems were common among participants. In addition, however, participants reported that they are reluctant to demand occupational protections to which they are entitled because they are afraid of losing their jobs. Study results also suggest that barriers to effective primary and secondary prevention of cancer in this Hispanic migrant agricultural worker population include knowledge and information barriers, cultural barriers, and socioeconomic barriers. A lack of knowledge and information regarding the causes of cancer, its prevention, and its early detection and treatment was evident among participants, which in turn was reflected in strong fatalistic attitudes toward the disease. Cultural barriers included attitudes of embarrassment and shame associated with physical examinations and women's strong discomfort with male clinicians. Socioeconomic barriers to secondary prevention included the cost of obtaining health services, time constraints associated with the need to work and long working days, and a lack of transportation. Efforts to improve cancer screening as well as other preventive health services in the Hispanic migrant agricultural worker population must acknowledge these barriers and address as many of them as possible to be successful. (+info)
Pesticide exposures, cholinesterase depression, and symptoms among North Carolina migrant farmworkers.
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OBJECTIVES: We conducted a clinic-based study of erythrocyte cholinesterase levels, pesticide exposures, and health effects among farmworkers and nonfarmworkers to determine risks for exposure and associated morbidity. METHODS: Two hundred two farmworkers and 42 nonfarmworkers were recruited sequentially at two community health centers. Erythrocyte cholinesterase levels were measured colorimetrically. Questionnaires obtained data on demographics, occupational history, exposures, and symptoms. RESULTS: Cholinesterase levels were significantly lower among farmworkers (30.28 U/g hemoglobin) than among nonfarmworkers (32.3 U/g hemoglobin). Twelve percent of farmworkers, but no nonfarmworkers, had very low levels. Farmworkers applying pesticides also had lower cholinesterase levels. One half of farmworkers reported being sprayed by pesticides and working in fields with an obvious chemical smell. Of reported symptoms, only diarrhea was associated with cholinesterase levels. Reported exposures, however, were strongly associated with symptoms. CONCLUSIONS: Farmworkers reported many pesticide exposures that violate state and federal regulations. Farmworkers had cholinesterase levels significantly lower than those of nonfarmworkers, although only spraying pesticides was associated with very low levels. (+info)
Screening for insecticide overexposure under field conditions: a reevaluation of the tintometric cholinesterase kit.
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A semiquantitative tintometric field kit has been used in the developing world for almost 30 years to measure whole blood cholinesterase levels in persons exposed to organophosphate pesticides. The validity of this screening kit was evaluated among 79 workers heavily exposed to organophosphates by comparison with a reference assay for erythrocyte cholinesterase. Overall correlation between the two methods was good. However, either sensitivity or specificity of the tintometric kit was less than 75% for each of the three tintometric categories commonly used to define the limit of normal. Because baseline erythrocyte cholinesterase levels were not available for this population, the true sensitivity and specificity of the tintometric assay may be even lower. (+info)
An epidemic of pesticide poisoning in Nicaragua: implications for prevention in developing countries.
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OBJECTIVES: The purpose of this study was to demonstrate the usefulness of the Northwestern Nicaraguan Ministry of Health surveillance system for detecting pesticide poisonings. METHODS: Cases were reported to the regional department of epidemiology through daily telephone reports and through monthly consolidated reports from each of the 18 health centers of the National Health Service. Reporting forms were also distributed to the four area hospitals. RESULTS: During June and July 1987, an epidemic of 548 pesticide poisoning was detected in northwestern Nicaragua. Seventy-seven percent of the poisonings were caused by carbofuran or methamidophos. Of the work-related cases (91% of reported poisonings), more than 80% occurred among maize farmers and on small to medium land holdings (fewer than 140 hectares). Nineteen percent of the work-related cases involved children under 16 years of age. CONCLUSIONS: Unsafe working conditions such as manual application of pesticides and the use of backpack sprayers, the introduction of a hazardous powdered formulation of carbofuran highly restricted in the developed world, and agricultural subsidies that encouraged the use of hazardous pesticides all contributed to the epidemic. (+info)