Academic journal article Environmental Health Perspectives

Studying Health Outcomes in Farmworker Populations Exposed to Pesticides

Academic journal article Environmental Health Perspectives

Studying Health Outcomes in Farmworker Populations Exposed to Pesticides

Article excerpt

A major goal of studying farmworkers is to better understand how their work environment, including exposure to pesticides, affects their health. Although a number of health conditions have been associated with pesticide exposure, clear linkages have yet to be made between exposure and health effects except in cases of acute pesticide exposure. In this article, we review the most common health end points that have been studied and describe the epidemiologic challenges encountered in studying these health effects of pesticides among farmworkers, including the difficulties in accessing the population and challenges associated with obtaining health end point data. The assessment of neurobehavioral health effects serves as one of the most common and best examples of an approach used to study health outcomes in farmworkers and other populations exposed to pesticides. We review the current limitations in neurobehavioral assessment and strategies to improve these analytical methods. Emerging techniques to improve our assessment of health effects associated with pesticide exposure are reviewed. These techniques, which in most cases have not been applied to farmworker populations, hold promise in our ability to study and understand the relationship between pesticide exposure and a variety of health effects in this population. Key words: biomarkers, cancer, epidemiology, health outcomes, immigrants, neurobehavioral, neuropathy, pesticides. Environ Health Perspect 114:953-960 (2006). doi:10.1289/ehp.8526 available via http://dx.doi.org/ [Online 16 February 2006]

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The major goal of studying farmworkers is to better understand how their work environment, including exposure to pesticides, affects their health. Our understanding of the health effects associated with pesticide exposures is formed by contributions from toxicology, physiology, pharmacology, epidemiology, sociological studies, and the emerging area of "omics." The purpose of this article is to examine the issues related to studying health effects associated with chronic low-dose exposure to pesticides particularly in the farmworker population. We present a brief overview of the range of health outcomes that have been associated with pesticide exposure. Then the basic tools of epidemiology and surveillance are discussed in the context of the farmworker population. The limitations and information gaps for conducting this research are described. We present neurobehavioral health effects as one of the best examples of an approach used to study health outcomes in farmworkers and the methodologic challenges of conducting these assessments in field investigations. We conclude with a discussion of emerging techniques that have the potential to improve our ability to study and understand the relationship between pesticide exposure and a variety of health effects in this population.

Health Effects Associated with Pesticide Exposure

Organophosphate pesticides have gained popularity worldwide in preference to organochlorines, which are persistent and more damaging to the environment (Jaga and Dharmani 2003). Organophosphates are associated with well-known acute health problems such as nausea, dizziness, vomiting, headaches, abdominal pain, and skin and eye problems (Ecobichon 1996). Some studies have also indicated that pesticide exposure is associated with chronic health problems or health symptoms such as respiratory problems, memory disorders, dermatologic conditions, cancer, depression, neurologic deficits, miscarriages, and birth defects (Arcury et al. 2003; Cordes and Rea 1988; Daniels et al. 1997; Das et al. 2001; Engel et al. 2000; Eskenazi et al. 1999; Firestone et al. 2005; Garcia et al. 2003; Moses 1989; O'Malley 1997; Schwartz et al. 1986; Stallones and Beseler 2002; Strong et al. 2004; Van Maele-Fabry 2003). Daniels et al. (1997) provided a comprehensive review of the epidemiologic studies of links between pesticide exposure and cancer in children, but these studies were not with farmworker children, who may experience disproportionate risk of exposure and who may be very underrepresented in cancer registries. …

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