Exposure to organophosphate insecticides, inappropriate personal protective equipment use, and cognitive performance among pesticide applicators.

Inappropriate use of personal protective equipment (PPE) among pesticide applicators may increase urinary organophosphate (OP) metabolite levels and subsequently increase risks of cognitive performance. Therefore, this study aims to (1) compare urinary OP metabolite levels and cognitive performance between pre-and post-pesticide application seasons; (2) PPE use and factors associated with PPE use linked to increased urinary OP metabolite levels during pesticide application; and (3) the association between urinary OP metabolite levels and cognitive performance. This longitudinal follow-up study on 79 pesticide applicators was carried out between October 2021 and January 2022. The applicators were interviewed, collected urine samples, and tested for cognitive performance in pre-and post-pesticide application seasons. The results found that the levels of urinary OP metabolites in post-application season were significantly higher than those in pre-application season (p < 0.001). Multiple linear regression analysis found that increased total diethylphosphate (DEP) and total dialkylphosphate (DAP) levels were associated with not wearing gloves while mixing pesticides [beta (ß) ± standard error (SE) = -43.74 ± 18.52, 95% confidence interval (95% CI) = -80.84, -6.64 for total DEP and -50.84 ± 19.26, 95% CI = -89.41, -12.26 for total DAP] and also with not wearing a mask while spraying pesticides (ß ± SE = -31.76 ± 12.24, 95% CI = -56.28, -7.24 for total DEP and -33.20 ± 12.63, 95% CI = -58.49, -7.92 for total DAP) after adjusting for covariates. The scores of Montreal Cognitive Assessment-Thai, Thai Mental State Examination, and Mini-Cognitive test in post-pesticide application were significantly lower than those in pre-pesticide application (p < 0.001). However, no association was found between urinary OP metabolite levels and cognitive decline. Our findings indicate that inappropriate PPE use during pesticide application was the major factor affecting urinary OP metabolite levels among pesticide applicators. Wearing gloves when mixing pesticides and a mask when spraying pesticides were key factors in reducing occupational exposure to OP. Exposure to OP at low levels and for short periods of exposure may not affect cognitive performance significantly. Therefore, long-term exposure and exposure to high levels of OP should be investigated further.

Changes in agricultural context and mental health of farmers in different regions of Thailand during the fifth wave of the COVID-19 pandemic.

BACKGROUND: Thailand's agricultural sector is crucial to the country's development and economy. The COVID-19 pandemic caused negative effects on the agricultural context and the mental health of Thai farmers. This study aimed to compare changes in the agricultural context and mental health among farmers in different regions of Thailand during the fifth wave of the COVID-19 pandemic. We also investigated the determinants associated with the mental health of farmers. METHODS: This cross-sectional study was carried out from December 2021 to January 2022 in Thailand, with 1,676 Thai farmers interviewed. RESULTS: The results found that the Central region found to be the highest impact of increased agrochemical costs (91.0%) and decreased crop yields (92.0%), while the highest in the North and the North-East was found in decreased crop product prices (84.0 and 66.4%). In the context of economic status, the greatest impact in the Central region was found to be in increased household expense (96.3%), while the highest impact in the North, the North-East, and the South was found in decreased household income (91.5, 80.0, and 69.8%, respectively). Regarding mental health, the Central region was found to be the highest prevalence of extremely high stress and severe depression symptoms (18.3 and 23.4%), whereas the South region was found to be the highest prevalence of severe anxiety symptoms (7.4%). Interestingly, the multivariate analysis also found that the agricultural factors associated with mental health were decreased working days, changes in agrochemical type and crop cultivation, decreased crop rotation, increased difficulty in accessing agrochemicals and markets, decreased crop yields, and increased household debt. CONCLUSION: The findings of this study are useful for government and relevant organizations to plan and implement supportive measures and improve mental health services to mitigate both short and long-term impacts of the COVID-19 pandemic suit on the regions. Specific measures and facilities should be tailored toward the target regions.

Determinants of Consumers' Behavior in Reducing Pesticide Residues in Vegetables and Fruits, Northern Thailand.

Pesticide residues in vegetables in northern Thailand exceed the maximum residue limits established by the European Union. Therefore, improved knowledge and behavior in reducing pesticide residues in vegetables and fruits (VF) would reduce the risk of exposure to pesticides. This study aims to investigate the contributing factors of consumers' behavior in reducing pesticide residues in VF. The differences in knowledge, attitude, and behavior in reducing pesticide residues in VF between consumers living in rural and urban communities of Chiang Mai, Thailand were also investigated. The cross-sectional study was carried out during August and October 2021 with 456 participants. Data was collected from participants using a Google form questionnaire. The results indicated that pesticide-free was the top-ranked consideration for VF purchasing. Linear regression analysis found that factors associated with consumers' behavior in reducing pesticide residues in VF were total knowledge scores (Beta (ß) ± standard error (SE.) = 1.15 ± 0.18, 95%CI = 0.79, 1.51), total attitude scores (ß ± SE. = 1.30 ± 0.49, 95%CI = 3.87, 10.40), having co-morbidity (ß ± SE. = 3.2 ± 1.37, 95%CI = 0.52, 5.90), type of VF purchasing (ß ± SE. = 1.98 ± 0.57, 95%CI = 0.85, 3.11), frequency of VF purchasing (ß ± SE. = 3.81 ± 1.18, 95%CI = 1.49, 6.13), price of VF products (ß ± SE. = -2.23 ± 1.13, 95%CI = -4.45, -0.02), and getting information from the broadcasting tower in the village (ß ± SE. = 7.13 ± 1.66, 95%CI = 0.32, 2.27).

Pesticide Exposure and Risk of Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

Rheumatoid arthritis (RA) is a disease that affects people all over the world and can be caused by a variety of factors. Exposure to pesticides is one of the risk factors for the development of RA. However, the evidence of exposure to pesticides linked with the development of RA is still controversial. This study aimed to investigate the association between exposure to pesticides and RA by a systematic review of relevant literature and a meta-analysis. Full-text articles published in PubMed, Web of Science, Scopus, and Google Scholar between 1956 and 2021 were reviewed and evaluated. A total of eight studies were eligible for inclusion (two cohort studies, four case-control studies, and two cross-sectional studies). The adjusted odds ratio for pesticide exposure on RA was 1.20 for insecticides (95% CI = 1.12-1.28), 0.98 for herbicides (95% CI = 0.89-1.08), 1.04 for fungicides (95% CI = 0.86-1.27), and 1.15 in for non-specific pesticides (95% CI = 1.09-1.21). There is some evidence to suggest that exposure to insecticides (especially fonofos, carbaryl, and guanidines) contributes to an increased risk of RA. However, the evidence is limited because of a small number of studies. Therefore, further epidemiological studies are needed to substantiate this conclusion.

Efficiency of Gum Rosin-Coated Personal Protective Clothing to Protect against Chlorpyrifos Exposure in Applicators.

An ideal theoretical model for personal protective clothing (PPC) is to protect wearers from external workplace hazards while meeting certain ergonomic requirements. This study aims to compare the efficiency of different personal protective clothing in its protection against chlorpyrifos, including gum rosin-coated PPC, commercial PPC (Tychem® coverall), and everyday clothing, during application under field conditions. Perception of discomfort and physiological effects after wearing PPC were also investigated. Thirty-one applicators were invited and consented to participate in the study. The study established that the median percentage of chlorpyrifos protection efficiency was 90.7% for commercial PPC, 89.2% for gum rosin-coated PPC, and 76.5% for everyday PPC. When the protection efficiency was compared among the different types of PPC, the percentage protection efficiency of gum rosin-coated PPC was not significantly different from that of commercial PPC. The percentage protection efficiencies of commercial PPC and gum rosin-coated PPC were significantly higher than that of everyday PPC. The major characteristics of gum rosin-coated PPC were water-repellency, breathability, low cost, and ease of manufacture. Therefore, this study suggests that gum rosin-coated PPC is a reasonable alternative PPC for farmers, particularly in low and middle-low-income countries and tropical climates, to protect against pesticides while providing acceptable comfort.

Insecticide Exposure and Risk of Asthmatic Symptoms: A Systematic Review and Meta-Analysis.

The incidence of respiratory disease is increasing. In relation to this, in addition to infection, factors associated with working with chemical insecticides are a cause for concern. Some of the chemicals involved have been shown to affect the respiratory system, and consequentially workers are at increased risk of conditions such as asthma. However, medical opinion around this area is still controversial; therefore, the objective of this study is to investigate the association between exposure to insecticides and asthma by means of a systematic review of the relevant literature. Relevant literature was identified, and a systematic review was conducted to investigate the association between exposure to insecticides and asthma. A total of five studies (three cross sectional and two cohort) including 45,435 subjects were identified as relevant. The summary odds ratios related to the impact of exposure to specific insecticides on asthma were organophosphates 1.31 (95%CI = 1.17-1.48, I2 = 27%, p = 0.172), carbamates 1.44 (95%CI 1.08-1.92, I2 = 56.7%, p = 0.031) and organochlorines 1.31 (95%CI 1.19-1.64, I2 = 37.3%, p = 0.131). Farmers exposed to certain insecticides may have an increased risk of asthma and asthmatic symptoms, but further research on that issue is urgently needed.

Physical Frailty and Fall Risk in Community-Dwelling Older Adults: A Cross-Sectional Study.

INTRODUCTION: Frailty is a condition in older adults with decreased physical and cognitive performance that can affect health outcomes associated with fracture, disability, and falls. The aim of this study was to compare fall risk with different physical frailty statuses and investigate factors associated with fall risk in community-dwelling older adults. METHODS: The population studied included 367 older adults (mean age = 73.2 years ± 7.0; 237 females (64.6%) and 130 males (35.4%)) who live in Chiang Mai, Thailand. This study was of cross-sectional design. Fried's phenotype was used to screen the physical frailty status. The physiological profile assessment (PPA) was used to screen for fall risk. One-way ANOVA analysis was used to compare the fall risk between the different levels of frailty status. Linear regression analysis was used to assess the association between frailty status and fall risk. RESULTS: The prevalence of the frailty group was 8.7% and that of the prefrailty group was 76.8%. The three statuses of frailty identified were found to have different levels of risk of falling. The frailty group had a higher fall risk than the nonfrailty group and the prefrailty group. In addition, the nonfrailty group had a lower fall risk than the prefrailty group. CONCLUSION: The frailty group had the highest fall risk in this cohort of older adults living in a community-dwelling facility. Therefore, it is important to assess the frailty status among older adults as it can be a predictor for fall risk. This assessment will therefore lead to a reduction in the rate of disability and death in the community.

Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial.

Effective interventions for indicated fall prevention are necessary for older adults with frailty. We aimed to determine the effectiveness of a Multi-system Physical Exercise (MPE) for fall prevention and Health-Related Quality of Life (HRQOL) in pre-frail older adults. This randomized control trial with allocation concealment included 72 adults aged 65 and above, identified as pre-frailty and with mild and moderate fall risk scores measured by the Physiological Profile Assessment (PPA). Randomly, using block randomization, participants were divided into two groups: an MPE group (n = 36) and a control group (n = 36). The intervention consisted mainly of proprioception, muscle strengthening, reaction time, and balance training and was carried out three days per week for 12 weeks. The primary outcome was fall risk assessed using PPA at 12 weeks post-baseline and at a 24 week follow-up. Significant differences were found in the improvement in fall risk, proprioception, muscle strength, reaction time and postural sway, and fear of fall scores in the MPE group compared with controls at week 12 and 24. In addition, HRQOL had increased significantly in the MPE group in comparison to controls. The MPE program significantly increased muscle strength and improved proprioception, reaction time, and postural sway leading to fall risk reduction in older adults with pre-frailty. Therefore, the MPE program is recommended for used in day-to-day primary care practice in the pre-frail population.

Combined Black Rice Germ, Bran Supplement and Exercise Intervention Modulate Aging Biomarkers and Improve Physical Performance and Lower-Body Muscle Strength Parameters in Aging Population.

Aging is a time-dependent functional decline in muscle mass and strength, which is reflected in poor physical performances, hormonal imbalance, and development of chronic low-grade inflammation. This study aimed to assess the effectiveness of black rice germ, bran supplement, and exercise program either alone or in combination for 24 weeks on the aging biomarkers (C-reactive protein, Interleukin-6, Insulin-like growth factor-1, and CD4:CD8 T cell ratio) physical performance, muscle strength parameters (walking speed, sit-to-stand time, grip strength) among Thai aging population. A total of 120 healthy volunteers aged 65-74 years were assigned to the exercise group (EX), black rice germ, and bran supplement (BR) group or the combination of BR and EX group (BR + EX). Over the course of the 24-week intervention, compared with baseline data (T0), the combined BR + EX intervention significantly decreased the inflammatory biomarkers (C-reactive protein and interleukin-6 levels, both p < 0.05 vs. T0) and significantly increased the insulin-like growth factor-1 levels (p < 0.001 vs. T0). Significant improvement in physical performance and muscle strength were also observed in the combined BR + EX group (decrease in sit-to-stand time and gait speed over the 24-week intervention, both p < 0.05 vs. T0, and trend toward grip strength improvement at p = 0.088 vs. T0). Overall, our results indicated a synergistic effect towards the combined intervention with the sustainable improvement in physical performances, lower-body muscle strength, and the modulation of both inflammatory and endocrine biomarkers. This study could encourage older adults to change their lifestyles to improve healthy aging and longevity.

A longitudinal follow-up study of oxidative stress and DNA damage among farmers exposed to pesticide mixtures.

Exposure to pesticides may have increased risk of oxidative stress and genetic damage and hence of development of chronic diseases. The aim of this longitudinal follow-up study is to compare oxidative stress and DNA damage between the pre- and post-pesticide application seasons among 56 male farmers. The study also investigated the factors associated with changes in oxidative stress, DNA damage, and health symptoms during the pesticide application season. The eligibility criteria for the subjects were men aged between 25 and 55 years, applied pesticide mixtures during May and June 2018, and healthy without current illness. Ten milliliters of venous blood samples was collected twice from each subject in the pre- and post-pesticide application seasons for determination of superoxide dismutase (SOD), 8-hydroxy-2'-deoxyguanosine (8-OHdG), comet tail length, and comet tail moment. The remarkable findings included a statistically significant increase in SOD activity during the pesticide application season (P < 0.001). However, there were no statistical differences in 8-OHdG, comet tail length, and comet tail moment. When we analyzed the factors associated with changes in SOD activity during the pesticide application season by using linear regression analysis, working hours on the farm (B ± SE. = 0.790 ± 0.341, P = 0.025) and planting activities (B ± SE. = 1.217 ± 0.504, P = 0.020) were associated with increase in SOD activity. Therefore, increase in SOD may be a consequence of oxidative damage induced by pesticide exposure and this marker may be used as an early warning for pesticide-induced acute and chronic toxicities.