Environmental and Health Risks of Pesticide Use in Ethiopia.

BACKGROUND: There are frequent reports of unsafe pesticide use in many parts of Africa. Ethiopia is the second most populous nation in Africa with around 80% of the population still depending on agriculture which intensively uses pesticides. A number of studies have examined pesticide-related health and environmental risks in Ethiopia. However, most of these studies have been small in scale and it is therefore challenging to get a general overview of the extent of health risks and level of environmental contamination in the country. OBJECTIVES: The aim of the present study was to synthesize and summarize contemporary knowledge on pesticide-related risks and relevant gaps in Ethiopia. METHODS: An electronic database search and gathering of grey literature were done to collect information on the risks of pesticide use in Ethiopia. The electronic search was conducted using MEDLINE (via PubMed) without any publication date or language specifications. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) checklist was used as guide in the creation of this review. DISCUSSION: A synthesis of the reviewed studies showed evidence of health risks due to occupational pesticide exposure, surface water pollution with pesticides that could cause chronic health risks to the public, evidence of pesticide contamination of the environment (e.g., soil organisms, fish, bee colonies and wildlife) and local as well as international consumer risks due to pesticide residues in food items. In addition, there have been frequent reports of health and environmental hazards in association with cut-flower farms. There is also evidence of direct use of DDT (dichlorodiphenyltrichloroethane) on food crops and detection of DDT residues in surface water, soil and human breast milk. Those reported risks might be due to lack of knowledge among farm workers, negligence of farm owners, absence of post-registration monitoring systems and poor implementation of both national and international regulations in Ethiopia due to poor institutional capacity. CONCLUSIONS: The health and environmental risks of inappropriate use of pesticides requires action by all concerned bodies. Improved institutional arrangements for enforcement of regulations, awareness and further intervention studies could lessen the high risks of pesticide misuse. COMPETING INTERESTS: The authors declare no competing financial interests.

Gender differences in respiratory health outcomes among farming cohorts around the globe: findings from the AGRICOH consortium.

Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spouses from six continents.Methods: Cohorts collected data between 1992 and 2016 and ranged in size from 200 to >128,000 individuals; 44% of participants were female. Farming practices varied from subsistence farming to large-scale industrial agriculture. All cohorts provided respiratory outcome information for their cohort based on their study definitions. The majority of outcomes were based on self-report using standard respiratory questionnaires; the greatest variability in assessment methods was associated with chronic obstructive pulmonary disease (COPD).Results: For all three respiratory symptoms (cough, phlegm, and wheeze), the median prevalence in men was higher than in women, with the greatest difference for phlegm (17% vs. 10%). For asthma, women had a higher prevalence (7.8% vs 6.5%), with the difference associated with allergic asthma. The relative proportion of allergic asthma varied among cohorts. In two of eight cohorts for women and two of seven cohorts for men, allergic asthma was more common than non-allergic asthma.Conclusions: These findings indicate that respiratory outcomes are common among farmers around the world despite differences in agricultural production. As women in the general population are at higher risk of asthma, exploring gender differences in occupational studies is critical for a deeper understanding of respiratory disease among agricultural workers.

Neurobehavioural symptoms and acute pesticide poisoning: a cross-sectional study among male pesticide applicators selected from three commercial farming systems in Ethiopia.

OBJECTIVE: To estimate prevalence of acute pesticide poisoning (APP) and its association with neurobehavioural symptoms in Ethiopian pesticide applicators. METHODS: We performed a cross-sectional survey among 256 pesticide applicators from small-scale irrigated farms, a large-scale open farm and large-scale greenhouses. APP was ascertained using a modified WHO case definition, and neurobehavioural symptoms were collected with a standardised questionnaire (Q16). Exposure to pesticides was estimated using detailed exposure algorithms specifically developed for Ethiopian farms. Multiple logistic regression models were used to estimate risk of APP and its association with neurobehavioural symptoms. RESULTS: Overall APP prevalence was 16%. Working as an applicator in greenhouses was strongly associated with APP (OR 3.00, 95% CI 1.38 to 6.54). Estimated annual pesticide exposure was also associated with APP (OR 1.14, 95% CI 1.00 to 1.20). Longer duration of employment appeared to be negatively associated with APP. Having had an APP was strongly associated with reporting more neurobehavioural symptoms (OR 2.15, 95% CI 1.01 to 4.58) independent of cumulative pesticide exposure. Cumulative exposure to pesticides appeared to be associated with neurobehavioural symptoms among applicators without and with APP. CONCLUSIONS: We showed a substantial prevalence of APP that differed between farming systems and was strongly associated with neurobehavioural symptoms. Intensity of exposure was also clearly associated with these symptoms. Reduction and control of occupational exposure to pesticides is urgently needed in Ethiopia.

Occupational pesticide exposure and respiratory health: a large-scale cross-sectional study in three commercial farming systems in Ethiopia.

RATIONALE: In the last decade, due to expansion of greenhouses and irrigated farms, the use of pesticides in Ethiopia has increased 6-13-fold leading to potential health risks. OBJECTIVE: To investigate if occupational exposure to pesticides is associated with respiratory health effects in farmers and farm workers from commercial farming systems. METHODS: We performed two cross-sectional surveys comprising different farming systems. In the first survey we studied respiratory symptoms among 1104 subjects of which 601 were occupationally exposed to pesticides (ie, 256 pesticide applicators, 345 re-entry workers) and 503 unexposed individuals. The second survey, carried out 2 years later in the same farming regions, additionally included lung function measurement and comprised a total of 387 study subjects of which 206 were occupationally exposed to pesticides (142 applicators and 64 re-entry workers) and 180 unexposed individuals. RESULTS: We observed increased risks for chronic cough and shortness of breath (OR=3.15, 95% CI 1.56 to 6.36 and OR=6.67, 95% CI 2.60 to 17.58) among the exposed subjects as compared with unexposed individuals in the first survey. These results were corroborated in the second survey where we also observed reductions in FEV1 (140 mL), forced expiratory flow 25%-75% (550 mL/s) and risk of FEV1/FVC ratio <0.8 (OR=4.31, 95% CI 2.11 to 8.81) among pesticide exposed workers. CONCLUSIONS: These findings indicate an increased risk of adverse respiratory health among workers exposed to pesticides. As those effects occurred in young workers (mean age 27 years) and within a relative short duration of exposure (4 years) implementation of stringent occupational health measures are warranted.

A Method for Semi-quantitative Assessment of Exposure to Pesticides of Applicators and Re-entry Workers: An Application in Three Farming Systems in Ethiopia.

OBJECTIVE: To develop an inexpensive and easily adaptable semi-quantitative exposure assessment method to characterize exposure to pesticide in applicators and re-entry farmers and farm workers in Ethiopia. METHODS: Two specific semi-quantitative exposure algorithms for pesticides applicators and re-entry workers were developed and applied to 601 farm workers employed in 3 distinctly different farming systems [small-scale irrigated, large-scale greenhouses (LSGH), and large-scale open (LSO)] in Ethiopia. The algorithm for applicators was based on exposure-modifying factors including application methods, farm layout (open or closed), pesticide mixing conditions, cleaning of spraying equipment, intensity of pesticide application per day, utilization of personal protective equipment (PPE), personal hygienic behavior, annual frequency of application, and duration of employment at the farm. The algorithm for re-entry work was based on an expert-based re-entry exposure intensity score, utilization of PPE, personal hygienic behavior, annual frequency of re-entry work, and duration of employment at the farm. RESULTS: The algorithms allowed estimation of daily, annual and cumulative lifetime exposure for applicators, and re-entry workers by farming system, by gender, and by age group. For all metrics, highest exposures occurred in LSGH for both applicators and female re-entry workers. For male re-entry workers, highest cumulative exposure occurred in LSO farms. Female re-entry workers appeared to be higher exposed on a daily or annual basis than male re-entry workers, but their cumulative exposures were similar due to the fact that on average males had longer tenure. Factors related to intensity of exposure (like application method and farm layout) were indicated as the main driving factors for estimated potential exposure. Use of personal protection, hygienic behavior, and duration of employment in surveyed farm workers contributed less to the contrast in exposure estimates. CONCLUSIONS: This study indicated that farmers' and farm workers' exposure to pesticides can be inexpensively characterized, ranked, and classified. Our method could be extended to assess exposure to specific active ingredients provided that detailed information on pesticides used is available. The resulting exposure estimates will consequently be used in occupational epidemiology studies in Ethiopia and other similar countries with few resources.

Use of Chemical Pesticides in Ethiopia: A Cross-Sectional Comparative Study on Knowledge, Attitude and Practice of Farmers and Farm Workers in Three Farming Systems.

Chemical pesticides, regardless of their inherent hazard, are used intensively in the fast changing agricultural sector of Ethiopia. We conducted a cross-sectional pesticide Knowledge, Attitude and Practice (KAP) survey among 601 farmers and farm workers (applicators and re-entry workers) in three farming systems [large-scale closed greenhouses (LSGH), large-scale open farms (LSOF), and small-scale irrigated farms (SSIF)]. Main observations were that 85% of workers did not attain any pesticide-related training, 81% were not aware of modern alternatives for chemical pesticides, 10% used a full set of personal protective equipment, and 62% did not usually bath or shower after work. Among applicators pesticide training attendance was highest in LSGH (35%) and was lowest in SSIF (4%). None of the female re-entry farm workers had received pesticide-related training. Personal protective equipment use was twice as high among pesticide applicators as among re-entry workers (13 versus 7%), while none of the small-scale farm workers used personal protection equipment. Stockpiling and burial of empty pesticide containers and discarding empty pesticide containers in farming fields were reported in both LSOF and by 75% of the farm workers in SSIF. Considerable increment in chemical pesticide usage intensity, illegitimate usages of DDT and Endosulfan on food crops and direct import of pesticides without the formal Ethiopian registration process were also indicated. These results point out a general lack of training and knowledge regarding the safe use of pesticides in all farming systems but especially among small-scale farmers. This in combination with the increase in chemical pesticide usage in the past decade likely results in occupational and environmental health risks. Improved KAP that account for institutional difference among various farming systems and enforcement of regulatory measures including the available occupational and environmental proclamations in Ethiopia are urgently needed.