职业医学与健康事务

抽象的

An Evaluation of Occupational Exposures to Pesticides in Brazil

Danieli Bendetti, Jodel Alves, Fernanda Rabaioli Da Silva, Juliana Da Silva

All over the world, pesticides are frequently used in large quantities. Even though these substances are potentially toxic and may affect the human health, depending on the degree of exposure, contamination, and toxicity, they are nevertheless constantly released into the environment. Currently, predominantly organophosphorus (OP) and carbamate (CBM) pesticides, which are considered neurotoxic due to their potential to inhibit cholinesterase (ChE) activity, are used frequently in developing countries. Accordingly, many intoxication symptoms regarding these chemicals are diagnosed via the ChE analysis and its degree of inhibition. This is therefore the method of choice for biomonitoring exposed individuals, and has been described in the evaluation of thirteen Brazilian studies, which we retrieved from different online databases and present in this review. However, conflicting results on the effects on ChE as a result of repeated and prolonged exposure to low doses still prevail, mainly because farmers are usually exposed to mixtures of pesticides simultaneously. Reviews based exclusively on the laboratory analyses of ChE activity render the clinical interpretation difficult, as it is not a very sensitive method and does not efficiently address the reality of chronic intoxications in the absence of clinical signs. Many diseases among farmers are related to genetic damage, which includes carcinogenic and neurotoxic processes, reproductive and developmental defects, hormonal changes, as well as immune and neurodegenerative diseases. In this article, we therefore discuss the use of different biomarkers for the occupational evaluation, as clinical interpretations still require improvement and widely available laboratory tests still remain unattainable, especially with respect to individual conditions arising from mild to moderate exposures, which might have no immediate, but can have significant detrimental long-term health effects on the health of exposed individuals.