Rationale In the last decade, due to expansion of greenhouses and irrigated farms, the use of pesticides in Ethiopia has increased 6–13-fold leading to potential health risks.
Objective To investigate if occupational exposure to pesticides is associated with respiratory health effects in farmers and farm workers from commercial farming systems.
Methods We performed two cross-sectional surveys comprising different farming systems. In the first survey we studied respiratory symptoms among 1104 subjects of which 601 were occupationally exposed to pesticides (ie, 256 pesticide applicators, 345 re-entry workers) and 503 unexposed individuals. The second survey, carried out 2 years later in the same farming regions, additionally included lung function measurement and comprised a total of 387 study subjects of which 206 were occupationally exposed to pesticides (142 applicators and 64 re-entry workers) and 180 unexposed individuals.
Results We observed increased risks for chronic cough and shortness of breath (OR=3.15, 95% CI 1.56 to 6.36 and OR=6.67, 95% CI 2.60 to 17.58) among the exposed subjects as compared with unexposed individuals in the first survey. These results were corroborated in the second survey where we also observed reductions in FEV1 (140 mL), forced expiratory flow 25%–75% (550 mL/s) and risk of FEV1/FVC ratio <0.8 (OR=4.31, 95% CI 2.11 to 8.81) among pesticide exposed workers.
Conclusions These findings indicate an increased risk of adverse respiratory health among workers exposed to pesticides. As those effects occurred in young workers (mean age 27 years) and within a relative short duration of exposure (4 years) implementation of stringent occupational health measures are warranted.
- Occupational Lung Disease
- Respiratory Measurement
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Contributors Conception and design: BN, HK, RV and YM. Collection of the data: BN and YM. Analysis and interpretation: BN, HK and RV. All authors participated in drafting and finally approving the manuscript.
Funding This study was supported by the Pesticide Risk Reduction Programme (PRRP) Ethiopia. PRRP was a comprehensive programme for pesticide registration and management started in 2010 and lasted till 2015. The following donors funded the programme: Ministry of Agriculture and Rural Development of Ethiopia by making available sufficient qualified personnel to execute the activities, the government of the Netherlands, represented by the Ministry of Development Cooperation, Food and Agriculture Organization of the United Nations and the Strategic Approach to International Chemicals Management, a policy framework to promote chemical safety around the world. The sponsors have no involvement in the study design; in the collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication.
Competing interests None.
Ethics approval The study was approved by the Institutional Review Board of the College of Natural Sciences Addis Ababa University, Ethiopia.
Provenance and peer review Not commissioned; externally peer reviewed.