Depressive symptoms and suicide attempts among farmers exposed to pesticides.

Pesticides safeguard crop health but may diminish cholinesterase activity in farmers, potentially leading to psychiatric disorders like depression and suicide attempts. This study, with 453 participants (225 pesticide-exposed farmers, 228 non-farmers) in Almería, Spain, aimed to investigate the presence of depressive symptoms and suicide attempts, the decrease acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity, and their relationship with pesticide exposure in farmers. Depressive symptoms were evaluated using the Spanish adaptation of the Beck Depression Inventory, and blood samples were analyzed for AChE and BChE activity. Farmers showed significantly increased risk of moderate/severe depression and suicide attempts compared to non-farmers (OR = 2.18; p = 0.001), with highest risks observed among mancozeb users (OR = 2.76; p = 0.001 for depression) and malathion users (OR = 3.50; p = 0.001 for suicide attempts). Findings emphasize elevated depression and suicide risks among pesticide-exposed farmers, particularly associated with chlorpyrifos, mancozeb, and malathion exposure.

State-trait anxiety levels and vital signs of pregnant women following intervention with virtual reality during the nonstress test: A randomized controlled trial.

BACKGROUND: Pregnant women often experience anxiety due to pregnancy, negatively impacting their and their fetus' health. Non-pharmacological interventions, such as virtual reality (VR), could reduce anxiety levels, potentially impacting non-stress tests or the physiological responses of the pregnant woman and the fetus. METHODS: A randomized clinical trial conducted between February and December 2022 involved 286 term pregnant women. They were divided into a VR intervention group (146 women) and a control group (140 women). The intervention consisted of 20 min of 3D glasses with images and sounds during a third-trimester nonstress test. Anxiety was measured using the Spielberg State-Trait Anxiety Inventory (STAI), alongside physiological parameters. RESULTS: The VR group exhibited lower anxiety levels compared to controls (STAI score: Rosenthal's r: -0.54, p = 0.01; state anxiety: Rosenthal's r: -0.40, p = 0.001; trait anxiety: Rosenthal's r: -0.41, p = 0.001). Within the VR group, there was a significant reduction in trait anxiety (Rosenthal's r, 1.27; p < 0.001) and total anxiety (Rosenthal's r, 1.63; p < 0.001) post-intervention, along with decreased systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001), and maternal heart rate (p = 0.02). LIMITATIONS: Future research could explore additional pregnancy-related variables, such as postpartum anxiety. CONCLUSIONS: The results confirm that the use of VR is beneficial for pregnant women and their fetuses, as it decreases anxiety levels, and improves physiological parameters such as blood pressure and maternal heart rate during the nonstress test. VR is a technique that is easy to integrate into the healthcare system due to its non-invasive and non-pharmacological nature.

Indicators of occupational pesticide exposure are associated with psychiatric symptoms.

In southeastern Spain, intensive and highly productive agriculture under plastic also poses a risk to human health, as evidenced by reports on acute pesticide poisoning and its effects on mental health. However, knowledge of chronic exposures and their relationship to psychiatric disorders is still limited. This study analyzed the relationship between occupational exposure to pesticides and psychiatric disorders in farmers from Almería. A cross-sectional study was conducted amongst a coastal population in Almería, where over 32,800 ha of land are dedicated to intensive agriculture in plastic greenhouses. A total of 409 people participated in the study: 203 farmers and 206 control subjects. The highest risk of psychiatric disorders was observed in farmers living in areas of high exposure to pesticides, working in greenhouses (intensive agriculture), without protective goggles and without wearing masks. This study supports previous evidence of an elevated risk of psychiatric disorders among farm workers exposed to pesticides.

Occupational exposure to pesticides as a potential risk factor for epilepsy.

Epilepsy is a chronic neurological disorder in which brain activity becomes abnormal, causing seizures. In a previous study we found that environmental exposure to pesticides was associated with a greater risk of epilepsy. The present study examined possible occupational risk factors that may contribute to the occurrence of epilepsy in farmers and pesticide applicators (sprayers). A case-referent study was conducted on 19,704 individuals over a 17-year study period (2000-2016). Epilepsy cases (n = 5091) were collected from Hospital records and referents (non-epilepsy cases, n = 14.613) from the Centre for Prevention of Occupational Risks, both from Almería (South-Eastern Spain). A significant increased risk of having epilepsy was found in farmers working in intensive agriculture (high-yield greenhouse crops) compared to extensive agriculture (open-air crops). The risk was greater for farmers residing in rural areas with high pesticide use (intensive farming crops in plastic greenhouses) and for those not wearing protective gloves. As for sprayers, the greatest risk of epilepsy was observed in those not wearing face mask, and in those living in areas with high pesticide use (greenhouse intensive agriculture). Overall, this study supports previous findings on the association between epilepsy and pesticide exposure in the general population, and extends the risk to farmers occupationally exposed to pesticides, mainly those engaged in intensive agriculture.

Occupational Exposure to Pesticides as a Risk Factor for Sleep Disorders.

Inadequate sleep has been linked to a variety of impairments in bodily functions, including endocrine, metabolic, higher cortical function, and neurological disorders. For this reason, the aim of this study was to analyze the link between occupational pesticide exposure and sleep health among farmers in Almeria. A cross-sectional study was conducted among a population living on the coast of Almeria (southeastern Spain), where about 33,321 hectares of land are used for intensive agriculture in plastic greenhouses. A total of 380 individuals participated in the study: 189 greenhouse workers and 191 control subjects. The participants were contacted during their annual scheduled occupational health survey. Data on sleep disturbances were collected using the Spanish version of the Oviedo Sleep Questionnaire. Agricultural workers were found to be at a significantly higher risk of insomnia, especially among those who did not wear protective gloves (OR = 3.12; 95% C.I. = 1.93-3.85; p = 0.04) or masks (OR = 2.43; 95% C.I. = 1.19-4.96; p = 0.01). The highest risk of insomnia related to pesticide applicators was observed in those who did not wear a mask (OR = 4.19; 95% C.I. = 1.30-13.50; p = 0.01) or goggles (OR = 4.61; 95% C.I. = 1.38-10.40; p = 0.01). This study supports previous findings indicating an increased risk of sleep disorder in agricultural workers exposed to pesticides at work.

Effect of Virtual Reality and Music Therapy on the Physiologic Parameters of Pregnant Women and Fetuses and on Anxiety Levels: A Randomized Controlled Trial.

INTRODUCTION: Anxiety negatively affects pregnant women and their fetuses. It can cause misleading test readings in electronic fetal monitoring, affect the duration of the first stage of labor, and influence certain aspects related to childbirth. This study aimed to evaluate the effects of virtual reality and music therapy on anxiety levels, maternal and fetal physiologic parameters, and labor and birth outcomes. METHODS: A total of 343 full-term pregnant women participated in a randomized controlled trial and were divided into 3 parallel groups: music therapy intervention (n = 104), virtual reality intervention (n = 124), and control (n = 115). The interventions were delivered during a nonstress test in the third trimester and during labor. Data were collected from April 2017 to May 2018. Measures included the Spielberger State-Trait Anxiety Inventory, maternal blood pressure, maternal and fetal heart rates, and labor and birth outcomes. The study was registered in the Australian New Zealand Clinical Trial Registry (ACTRN12621001647820). RESULTS: Women in the music therapy and virtual reality groups had lower levels of anxiety after a nonstress test (P < .001), and the women were more likely to have a reactive nonstress test (P < .001) compared with the control group. After the nonstress test and intervention were complete, the music therapy and virtual reality groups had significant decreases in systolic blood pressure (P < .001), diastolic blood pressure (P < .001), and maternal heart rate (P = .003) compared with the control group. Furthermore, fetuses in the control group were more likely to experience nonreassuring fetal heart rate tracings compared with the music therapy and virtual reality groups, respectively (P = .004). DISCUSSION: Our findings support the use of music and virtual reality during nonstress tests and labor as nonpharmacologic interventions to reduce anxiety, improve maternal and fetal physiologic parameters, and improve labor and birth outcomes. This research should be replicated in diverse perinatal settings.

Environmental exposure to pesticides and risk of thyroid diseases.

Occupational and environmental exposure to pesticides has been associated with thyroid dysfunction, particularly changes in circulating thyroid hormone levels (T3, T4) and thyroid stimulating hormone (TSH). This study assessed the association between environmental exposure to pesticides and the risk of developing thyroid diseases. A population-based case-control study was carried out among Spanish populations living in areas categorized as of high or low pesticide use according to agronomic criteria, which were used as surrogates for environmental exposure to pesticides. The study population consisted of 79.431 individuals diagnosed with goiter, thyrotoxicosis, hypothyroidism, and thyroiditis (according to the International Classification of Diseases, Ninth Revision) and 1.484.257 controls matched for age, sex and area of residence. Data were collected from computerized hospital records for the period 1998 to 2015. Prevalence rates and risk of having thyroid diseases were significantly higher in areas with higher pesticide use, with a 49% greater risk for hypothyroidism, 45% for thyrotoxicosis, 20% for thyroiditis and 5% for goiter. Overall, this study indicates an association between increased environmental exposure to pesticides as a result of a greater agricultural use and diseases of the thyroid gland, thus supporting and extending previous evidence. This study also provides support to the methodology proposed for real-life risk simulation, thus contributing to a better understanding of the real life threat posed by exposure to multiple pesticides from different sources.