Pesticides, health outcomes and agroecology in Brazil: a scope review

ABSTRACT The present scope review aimed to highlight the profile of Brazilian research that investigates health outcomes caused by exposure to pesticides, seeking to understand the main findings, such as methodology used, type of substance, health outcomes, investigated locations, suggested actions, and dialogue with agroecology. The scoping review methodology was used, following the Prisma-ScR model. Among the 83 articles found in the review, 61 studied farmers and 22 studied other population groups. There was a predominance of primary and quantitative studies, followed by systematic reviews. Of the total, 79 articles found outcomes, with emphasis on hematological and genetic damage, mostly caused by poisoning by more than 1 pesticide. The largest number of studies were carried out in the South, followed by the Southeast, Northeast, Midwest, and North. Only 1 survey suggested the agroecological transition as a solution to the problem. It is concluded that, faced with a scenario of growth in the use of pesticides, it is urgent to have proposals for intersectoral actions and that do not involve only health education or the health sector in isolation, as most articles suggest, requiring articulation between sectors related to agriculture, supply, education, health, and the environment.

摘要 本范围综述旨在梳理巴西关于农药暴露所致健康结局的研究概况，以期明晰该领域的核心研究结果，包括所采用的研究方法、涉毒物质类型、健康结局、研究开展区域、提出的干预措施，以及与农业生态学（agroecology）的相关探讨。本研究采用范围综述方法，遵循Prisma-ScR模型。本次综述共检索到83篇相关文献，其中61篇以农民为研究对象，剩余22篇针对其他人群展开研究。研究类型以原创性定量研究为主，其次为系统综述。其中79篇文献报道了健康结局，以血液学损伤与遗传损伤为主，此类损伤多由接触多种农药引发中毒导致。研究开展数量最多的区域为巴西南部，其次为东南部、东北部、中西部与北部地区。仅有1项研究提出将农业生态学转型作为该问题的解决方案。综上，在农药使用量持续增长的背景下，亟需提出跨部门行动方案——正如多数文献所建议的，此类方案不应仅局限于健康教育或单一卫生部门范畴，而需要统筹农业、供应链、教育、卫生与环境等相关领域的协同联动。