A1943 Acute pesticide poisoning among Brazilian tobacco farmers, according to pesticide related symptoms and medical evaluation

Wednesday, March 21, 2012: 16:20
Bacalar 3 (Cancun Center)
Neice M X Faria, Occupational Health Surveillance, Health Department Of Bento Gonçalves, Bento Gonçalves, Brazil
Anaclaudia G Fassa, Social Medicine Department, Federal University of Pelotas, Pelotas, Brazil
Rodrigo D Meucci, PPG Epidemiology, Federal University of Pelotas, Pelotas, Brazil
Nadia S Fiori, PPG Epidemiology, Federal University of Pelotas, Pelotas, Brazil
Vanessa I Miranda, Social Medicine Department, Federal University of Pelotas, Pelotas, Brazil
Maria Laura V Carret, Social Medicine Department, Federal University of Pelotas, Pelotas, Brazil
Introduction
Introduction: Brazil is the largest pesticide consumer and the second largest tobacco producer in the world but there is little information about pesticide poisonings among tobacco growers. This study aimed to evaluate acute pesticide poisoning, validating a symptom questionnaire in the tobacco growing area in South Brazil.

Methods
Methods: A cross-sectional study was conducted among 493 tobacco growing farmers, who applied pesticides. A questionnaire of 25 symptoms that appeared or worsened within 48 hours after pesticide use was tested (as per classification tool proposed by WHO). The farmers underwent a detailed medical evaluation, including serum cholinesterase - BChE (during low and high pesticide exposure). The BChE was evaluated in the group who had used organophosphate (OP) in the last 10 days. The agreement between symptom questionnaire and medical evaluation was assessed by Kappa test.

Results
Results: Among evaluated farmers, 78% were male, mean age of 38.8 (sd = 12.02) and had worked with pesticides on average 17.6 years (sd = 10.8). Most of them (81.1%) had applied pesticides in the last 10 days. The most frequent chemical types were sulfentrazone, clomazone, neonicotinoids, organophosphates, dithiocarbamates and glyphosate.
Among farmers, 51 (10.7%) reported two or more symptoms after pesticide spraying. The most common symptoms were headache (7.3%), eye irritation (6.7%), dizziness (4.7%) and irritability (4.0%). The medical evaluation identified 59 (12%) possible cases of poisoning. Agreement between the two methods by the Kappa test was 0.42 (p <0.001) with some differences in the criteria. The serum cholinesterase was not related to pesticide poisoning by any methods.

Discussion
Discussion: The frequency of acute pesticide poisoning using a symptom questionnaire found a result close to that obtained in the assessment by trained physicians, consistent with previous studies in South Brazil. Both methods confirm that preventing pesticide poisoning is a priority of public health in Brazil.

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