Manoj Kumar Pathak

Adverse health effects of pesticides in agrarian populations of developing countries.

Developing countries use only 20% of the worlds agrochemicals, yet they suffer 99% of deaths from pesticide poisoning. Pesticide poisoning is a significant problem in developing countries primarily because of unsafe pesticide application and handling practices. Safety is further exacerbated by the illiteracy and poverty that prevails in most farming communities of developing countries. Pesticides classified as being extremely or highly hazardous by FAO and WHO, including those banned by other countries, continue to be used in developing countries. Many farmers in developing countries continue to be exposed to pesticides from either storing them in or near their residences, or from inadequate or unsafe application or handling practices. Farming populations exposed to pesticides suffer from several health problems, primarily neurological abnormalities, respiratory ailments, and reproductive, endocrinological, and dermal problems. In developing countries, the scientific literature (including the Indian Institute of Toxicology Research, India) have taken the initiative to monitor health problems resulting from pesticide exposure in agrarian communities. The welfare fund for agricultural laborers could institute a special program for pesticide applicators in developing countries. The primary need, currently, in such countries is creation and implementation of sound national policies to effectively articulate appropriate guidelines for managing farm pest control activities. Such policies should be aimed at both limiting pesticide exposure and usage, but doing so without damaging the yields of food production. If such steps are taken, it is fully expected that the incidence of adverse health consequences for agrarian populations from pesticide toxicity will decrease, and the health of farmers improve.

Adverse respiratory health and hematological alterations among agricultural workers occupationally exposed to organophosphate pesticides: a cross-sectional study in North India.

Background Non-protective work practices followed by farm workers during spraying of pesticides lead to occupational exposure among them. Objective This study is designed to explore the respiratory health and hematological profile of agricultural workers occupationally exposed to OP pesticides. Materials and Methods A cross sectional study was undertaken among 166 pesticide sprayers working in mango orchards of Lucknow district in North India compared with 77 controls to assess the respiratory illness, lung functions, cholinesterase levels and hematological profile. A questionnaire based survey and clinical examination for respiratory health were conducted among study subjects. Lung function test was conducted among study subjects by using spirometer. Cholinesterase level as biomarker of OP pesticides and hematological profile of study subjects were investigated in the laboratory by following the standard protocols. Results Overall respiratory morbidity observed among exposed subjects was 36.75%. Symptoms for respiratory illness like dry cough, productive cough, wheezing, irritation of throat and blood stained sputum were found to be significantly more (p<0.05) among pesticide sprayers than controls. Lung function parameters viz. PEFR, FEV1, %PEFR predicted, %FEV1 predicted and FEV1/FVC were found to be significantly decreased (p<0.05) among pesticide sprayers as compared to controls. Exposure wise distribution of respiratory illness and lung functions among pesticide sprayers show that the exposure duration significantly elevates (p<0.05) the respiratory problems and significantly decreases (p<0.001) lung functions among pesticide sprayers. Activities of acetylcholinesterase and butyrylcholinesterase were found to be significantly depleted (p<0.001) among pesticide sprayers as compared to controls which show the exposure of OP pesticides among them. The hematological profile viz. RBC, WBC, monocytes, neutrophils, MCV, MCH, MCHC and platelet count were significantly altered (p<0.001) in pesticide sprayers than controls. Conclusion This study shows that the unsafe occupational exposure of OP pesticides causes respiratory illness, decreased lung functions and hematological alterations among pesticide sprayers.

Cholinesterase levels and morbidity in pesticide sprayers in North India

BACKGROUND Pesticide sprayers in North India use different application methods for different crops. AIMS To compare cholinesterase activity and symptoms in knapsack and tractor-mounted pesticide sprayers. METHODS Blood cholinesterase activity and symptoms were recorded for 42 knapsack and 66 tractor-mounted sprayers attending a health camp in North India in 2009 and for 30 controls. RESULTS One hundred and eight of 197 (55%) eligible sprayers consented to participate. Mean acetylcholinesterase (AChE) and butyrylcholinesterase activity was 33 and 60% lower, respectively, in knapsack sprayers than in controls (P < 0.001) and 56 and 62% lower, respectively, in tractor-mounted sprayers than in controls (P < 0.001). AChE depletion was greater in tractor-mounted sprayers than in knapsack sprayers (P < 0.001). In knapsack sprayers compared to controls, odds ratios (OR) were significantly raised for musculoskeletal symptoms (OR 3.9, 95% CI 1.03-18) but not for other symptoms. In tractor-mounted sprayers compared to controls, ORs were significantly raised for neurological (OR 7, 95% CI 2-23), ocular (OR 8.7, 95% CI 2.7-32), respiratory (OR 5.14, 95% CI 1-29), cardiovascular (OR 7.5, 95% CI 2-42), gastrointestinal (OR 5.43, 95% CI 2-18) and musculoskeletal (OR 6.12, 95% CI 2-26) symptoms but not for dermal symptoms (OR 1.93, 95% CI 0.3-20). CONCLUSIONS The risk of cholinesterase inhibition and symptoms is greater in tractor-mounted than in knapsack pesticide sprayers and in both groups compared to controls. Occupational exposure in pesticide sprayers in North India needs better control, perhaps through redesign of spraying equipment.

Health risks of employees working in pesticide retail shops: An exploratory study

Background: Shop keepers dealing with pesticides are exposed to multiple pesticides that include organophosphates, organochlorines, carbamates, pyrethroids. Hence an exploratory health study was conducted on shopkeepers selling pesticides in urban areas of Lucknow and Barabanki District, Uttar Pradesh, India. Materials and Methods: Detailed information regarding socio-economic status, family history, personal habits and work practices were recorded for 20 subjects and controls by the investigator on a pre-tested questionnaire. Clinical examination including neurological studies of the shopkeepers and control subjects was done. Results: The study revealed significant slowing of motor nerve conduction velocity and low peak expiratory flow rate among shopkeepers as compared to control subjects. Prevalence of significantly higher gastro-intestinal problems was also observed among exposed subjects. Neurological, ocular, cardiovascular and musculo-skeletal symptoms were also found to be higher among shopkeepers. This was not statistically significant. Significantly higher relative risk for sickness related to systems viz., cardio-vasular, genito-urinary, respiratory, nervous and dermal was observed among exposed subjects compared to controls. Conclusions: These findings provide a prima facie evidence of clinical manifestations because of multiple exposures to pesticides and poor safety culture at work place.

Visual disturbances with cholinesterase depletion due to exposure of agricultural pesticides among farm workers

In this study, risk assessment for visual disturbances among farm workers spraying agricultural pesticides in farms have been assessed. A cross-sectional study for the assessment of visual disturbances was undertaken using questionnaire survey and clinical examination among agricultural workers exposed to pesticides. Two hundred and thirty nine pesticide sprayers participated in the study. The study was compared to 110 controls not occupationally exposed to pesticides with similar socio-economic status. The prevalence of ocular morbidity was found to be 40% among pesticide sprayers which was significantly higher (p < 0.01) as compared to controls. The symptoms among morbid subjects were found to be blurred vision, lacrimation, pain in eyes, red swollen eyes, and irritation of eyes. Exposure wise assessment of ocular symptoms among pesticide sprayers illustrates that exposure time elevates the ocular problems among sprayers. The cholinesterase activity was found to be significantly depleted (p < 0.01) among pesticide sprayers as compared to controls which show the exposure of organophosphate pesticides among them. The visual disturbances observed among pesticide sprayers clearly exhibit that eyes get exposed by pesticides during spraying operations in agriculture and eventually get affected leading to ocular illness.

Hematological and biochemical alterations in sprayers occupationally exposed to mixture of pesticides at a mango plantation in Lucknow, India

The aim of this study was to examine the hematological and cholinesterase (ChE) activity levels of pesticide sprayers employed in mango plantations at Lucknow. Fifty-two sprayers from mango plantations who regularly spray mixtures of pesticides including organochlorines (OC), organophosphates (OP), and carbamates were included as exposed group. Twenty residents living close to mango plantations, but not involved in pesticide spraying were taken as controls. Pesticide residues for OC were analyzed in blood by gas chromatography with electron capture detector. There was a significant decrease in acetylcholinesterase and butyrylcholinesterase activities in pesticide sprayers (n = 52) relative to the control group (n = 20). A significant difference in the frequency distribution of hematological variations in red blood cell, white blood cell, monocytes, neutrophils, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and platelet count was observed. Residues of OC pesticides including α-hexachlorocyclohexane (HCH) and total HCH were found to be significantly higher in the blood of sprayers compared to controls. Hematological variations were quantitatively more frequent among the sprayers with 5 years of pesticide exposure compared to the controls and to subjects with less than 5 years of exposure group. Hematological abnormalities in sprayers were correlated with pesticide exposure as evidenced by lower ChE activity as well as the presence of OC pesticides in blood. The poorly controlled use of pesticides in the plantation appeared to have produced sub-clinical intoxication in the sprayers and indicated the need for training and implementation of proper, safer hygiene practices.

Fast agitated directly suspended droplet microextraction technique for the rapid analysis of eighteen organophosphorus pesticides in human blood

A new sample preparation technique named as fast agitated directly suspended droplet microextraction (FA-DSDME) was proposed as an improved version of directly suspended droplet microextraction (DSDME) for the extraction and pre-concentration of wide-range organophosphorus pesticides (OPPs) from human blood prior to liquid chromatography tandem mass spectrometric (LC-MS/MS) analysis. In this method, instead of protecting the unwanted rupturing of extraction droplet (organic solvent), it was deliberately splintered into fine droplets by providing automated high-speed agitation to the biphasic extraction system (extraction solvent and sample solution). Fine organic droplets were then recollected into one, not by using a centrifuge machine but just by giving a very slow stirring to the bottom of the extraction system. The present method has surmounted the problem of prolonged extraction time associated with old DSDME. Under optimum extraction conditions, the method showed good sensitivity with low detection limits ranging from 0.0009 to 0.122μgL(-1). Mean recoveries were achieved in the range of 86-109% at three levels of spiking concentration (low, middle and high) from linearity range of individual analyte. Intra-day and inter-day precisions were ≤4.68 and ≤9.57 (%RSD) respectively. Enrichment factor (EF) for each analyte varied from 30 to 132 which prove the ability of this technique to pre-concentrate the extracted analytes up to a good extent. The sample matrices have shown an insignificant influence on methods sensitivity. The proposed method may find immense use in epidemiological, toxicological, regulatory and forensic laboratories.

Particulate matter in ambient air and its association with alterations in lung functions and respiratory health problems among outdoor exercisers in National Capital Region, India

Regular exercise improves physiological processes and yields positive health outcomes. However, it is relatively less known that exposure to air pollution during outdoor exercises may actually exacerbate several health problems. The present cross–sectional study was undertaken to assess the particulate matter (PM) in the ambient air and its association with lung functions, pulse rate and respiratory problems among 378 outdoor exercisers in the National Capital Region (NCR), India. Lung functions were measured using a Spirometer (PIKO–1, PIKO–6) and respiratory problems were recorded through a questionnaire–based survey. Concentrations of particulate matter smaller than 2.5 and 1 microns were monitored at 10 locations across the study area using an online automated ambient air monitoring instrument–HAZ–DUST (EPAM–5000). Decline in Forced Expiratory Volume in 1 sec–FEV1 (p<0.001) and Peak Expiratory Flow Rate–PEFR (p<0.001) was observed among the outdoor exercisers compared to the Indian reference values. Ambient air monitoring showed higher PM2.5 concentrations at all the study locations compared to the recommended permissible levels for residential areas in India. Risk of FEV1 (%) predicted cases with <80% showed an increase from 2.32% to 8.69% among the exercisers with respect to PM1 concentration from lower to higher limit at the study locations. Similarly, PEFR showed an increased risk of predicted cases <80% from 0.78% to 2.91% among outside exercisers for lower to higher limit of PM1 concentration. Cases with FEV1 predicted <80% increased from 2.56% to 13.98% and for PEFR from 0.96% to 5.24% among outdoor exercisers for the corresponding lower to higher limits of PM2.5 concentrations. The study demonstrates that outdoor exercisers in locations with high PM concentrations are at a risk of lung function impairment. These impairments are due to deposition of PM in the smaller and larger airways.

Nerve conduction studies in sprayers occupationally exposed to mixture of pesticides in a mango plantation at Lucknow, North India

In this study, nerve conduction, organochlorine (OC) pesticide residues in blood and cholinesterase activity levels of pesticide sprayers employed in mango plantations at Lucknow, North India, were determined. Fifty-two sprayers from mango plantations who regularly spray mixture of pesticides like organophosphates (OP), OCs, and carbamates were considered as exposed group. Eighteen subjects with similar socio-economic status of exposed group, who do not handle pesticides, were selected as controls. Questionnaire-based interviews related to personal and occupational histories of the study subjects were carried out. Sprayers did not use any personal protective equipment during pesticide handling. The blood-pesticide analyses of sprayers show higher mean values of hexachlorohexane (HCH), γ-HCH, δ-HCH, total HCH, op-DDT compared with the controls. Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activites were significantly reduced among sprayers. Risk of motor nerve conduction deficits was observed in sprayers with low AChE activity. Negative correlation of motor and sensory nerve conduction deficits was observed with the duration of exposure and age among sprayers. The study demonstrated that the prolonged exposure to mixture of pesticides, ergonomic factors, decline in cholinesterase activity may lead to nerve conduction dysfunction. The findings suggest the need for controlled use of pesticides in the plantation and indicated the need for training and implementation of hygiene practices like proper usage of personal protective equipments.

Mathematically derived body volume and risk of musculoskeletal pain among housewives in North India.

Background Global Burden of Disease Study 2010 demonstrates the impact of musculoskeletal diseases as the second greatest cause of disability globally in all regions of the world. The study was conducted to determine the role of mathematically derived body volume (BV), body volume index (BVI), body mass index (BMI), body surface area (BSA) and body fat % (BF %) on musculoskeletal pain (MSP) among housewives in National Capital Region (NCR). Methods A cross sectional study was undertaken among 495 housewives from Gurgaon and New Okhla Industrial Development Area (NOIDA) in National Capital Region (NCR), New Delhi, India. The study includes questionnaire survey, clinical examination and body composition monitoring among housewives. Results A significantly higher BMI, BVI, BV and BSA were observed in subjects with MSP as compared to those who had no MSP. This was also true for subjects with pain in knee for BMI category for overweight. Subjects with pain in limbs had significantly high BMI and BVI as compared to subjects with no MSP. A significant positive correlation of age with BMI, BVI, BV and BSA was observed among subjects having no MSP denoting a direct relationship of age and these body factors. Conclusions The prevalence of MSP among housewives is associated with increasing age, BMI and BVI. This can possibly be used for formulating a strategy for prevention of MSP.