Exposure to pesticides and agricultural workers’ health: what does literature reveal?

Abstract Introduction: the association between pesticides and health effects has been investigated in several different contexts. Objective: to gather relevant scientific evidence regarding health effects associated to occupational exposure to pesticides. Methods: literature review of studies published between 2000 and 2017 on PubMed, Embase and LILACS. We adopted the following eligibility criteria: a) observational studies; b) population of agricultural workers; c) occupational exposure to pesticides; d) health effects defined as outcome; e) statistical comparison between exposed and non-exposed subjects; f) English, Portuguese or Spanish language. Results: of 59 papers selected, 33 were cross-sectional studies, 22 cohort studies and 4 case-control studies. Discussion: the studies indicated that rural workers presented higher risk for some chronic diseases (cancer, mental, neurological, endocrine, kidney, hearing, respiratory and autoimmune), subclinical effects (genetic damages and biochemical changes) and clinical signs and symptoms of acute pesticide poisoning. We also identified study limitations concerning design and sampling, assessment of exposure and outcome. Conclusion: the evidences suggest the need to complement health evaluation of workers exposed to pesticides using effect biomarkers of genotoxicity and cytotoxicity in order to promote and expand surveillance of pesticides exposure and chronic intoxications, as well as their prevention.