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American Journal of Epidemiology Advance Access originally published online on April 16, 2009
American Journal of Epidemiology 2009 169(12):1500-1506; doi:10.1093/aje/kwp060
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Pesticide Exposure and Respiratory Health of Indigenous Women in Costa Rica

Karin B. Fieten, Hans Kromhout, Dick Heederik and Berna van Wendel de Joode

Correspondence to Dr. Berna van Wendel de Joode, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Apdo 86-3000, Heredia, Costa Rica (e-mail: bvanwen{at}una.ac.cr).

Received for publication February 26, 2008. Accepted for publication February 18, 2009.

A cross-sectional study was conducted in 2007 to evaluate the relation between pesticide exposure and respiratory health in a population of indigenous women in Costa Rica. Exposed women (n = 69) all worked at plantain plantations. Unexposed women (n = 58) worked at organic banana plantations or other locations without pesticide exposure. Study participants were interviewed using questionnaires to estimate exposure and presence of respiratory symptoms. Spirometry tests were conducted to obtain forced vital capacity and forced expiratory volume in 1 second. Among the exposed, prevalence of wheeze was 20% and of shortness of breath was 36% versus 9% and 26%, respectively, for the unexposed. Prevalence of chronic cough, asthma, and atopic symptoms was similar for exposed and unexposed women. Among nonsmokers (n = 105), reported exposures to the organophosphate insecticides chlorpyrifos (n = 25) and terbufos (n = 38) were strongly associated with wheeze (odd ratio = 6.7, 95% confidence interval: 1.6, 28.0; odds ratio = 5.9, 95% confidence interval: 1.4, 25.6, respectively). For both insecticides, a statistically significant exposure-effect association was found. Multiple organophosphate exposure was common; 81% of exposed women were exposed to both chlorpyrifos and terbufos. Consequently, their effects could not be separated. All findings were based on questionnaire data. No relation between pesticide exposure and ventilatory lung function was found.

Costa Rica; occupational exposure; pesticides; respiratory function tests; signs and symptoms, respiratory

Abbreviations: CI, confidence interval; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; OR, odds ratio


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