Parkinsonism Signs and Symptoms in Agricultural Pesticide Handlers in Washington State.

OBJECTIVES: Examine associations between pesticide exposure and signs or symptoms of parkinsonism. METHODS: Prior to the 2014 pesticide spray season, the authors examined 38 active pesticide handlers aged 35 to 65 (median: 43.5) who participated in the State of Washington's cholinesterase monitoring program in the Yakima Valley, where cholinesterase-inhibiting insecticides are applied in fruit orchards. A movement disorder specialist assessed the workers using the Unified Parkinson's Disease Rating Scale (UPDRS) motor subscore 3 (UPDRS3). Participants also self-reported work and medical histories, including the UPDRS activities of daily living subscore 2 (UPDRS2). The authors explored the relation between these scores and lifetime occupational pesticide exposure while accounting for age. RESULTS: All participants were Hispanic men born in Mexico who had worked in agriculture for 4 to 43 years (median: 21 years, including 11 years applying pesticides, mostly in the United States). Ten participants (26%) reported difficulty with one or more UPDRS2 activities of daily living (maximum = 2), and nine (24%) had a UPDRS3 >0 (maximum = 10). The most common symptom and sign, respectively, were excess saliva (n = 6) and action tremor (n = 5). UPDRS2 and UPDRS3 scores were unrelated to the number of years applying pesticides, but UPDRS3, especially action tremor, was positively associated with living on or by a farm. CONCLUSIONS: Symptoms and signs of parkinsonism were absent to mild in this small sample of active workers who apply cholinesterase-inhibiting insecticides in Washington State, USA. Future studies should be larger and examine older, retired workers with greater cumulative exposure to agricultural pesticides at work and home, including other types of agricultural pesticides.

Hazards faced by informal recyclers in the squatter communities of Asunción, Paraguay.

BACKGROUND: Informal recycling is widespread in developing countries and involves the collection, sorting, and selling of recyclable materials. Workers are exposed to hazards including the risk of cuts and musculoskeletal injury, infection, exposure to medical waste, and respiratory conditions like bronchitis, pneumonia, and sinusitis and often use insufficient personal protective equipment. OBJECTIVE: Assess the occupational and environmental health hazards faced by informal recyclers working at a landfill in Asunción, Paraguay. METHODS: We surveyed 102 informal recyclers and 12 formal recyclers about occupational health, workplace safety, general health, and household economics. Personal air samples were used to assess respirable dust and nobel metal exposure on 18 workers. RESULTS: Exposures to hazards such as syringes, medical waste, and broken glass as well as risk factors such as eating food found in the trash, lack of personal protective equipment (PPE), and inadequate sanitation were frequent among informal recyclers. Minors under 18 years of age constituted 13% of the workforce and experienced equal or greater exposure to these hazards. Formal recyclers had better access to water, sanitation, PPE, and experienced fewer cuts, injuries, and illnesses than formal recyclers. Informal recyclers were exposed to respirable dust that were considerably higher than they would have been exposed to at home or doing other work in their neighborhood. CONCLUSIONS: Better regulation of sharps and medical waste and the provision of adequate sanitation and personal protective equipment would address the most pressing occupational health issues in this high risk group.

Personal exposure to PM(2.5) and urinary hydroxy-PAH levels in bus drivers exposed to traffic exhaust, in Trujillo, Peru.

Public transport vehicle drivers, especially in highly polluted or trafficked areas, are exposed to high levels of air pollutants. In this study, we assessed the influence of traffic on levels of hydroxy polycyclic aromatic hydrocarbons (OH-PAHs) in commercial bus drivers in Trujillo, Peru, by measuring the within-shift changes in the urinary whole weight and creatinine-corrected concentrations of the PAH metabolites. We measured personal PM(2.5) as a proxy of exposure to traffic emission. Urine samples were collected daily from two bus drivers and three minivan drivers in Trujillo, pre-, mid-, post-work shift and on days when the drivers were off work (total n = 144). Ten OH-PAH metabolites were measured in the urine samples. Drivers were also monitored for exposure to PM(2.5) (n = 41). Daily work shift (mean = 13.1 ± 1.3 hr) integrated PM(2.5) was measured in the breathing zones of the drivers for an average of 10.5 days per driver. The differences across shift in OH-PAH concentrations were not statistically significant except for urinary 2-hydroxyfluorene (2-FLU) (p = 0.04) and 4-hydroxyphenanthrene (4-PHE) (p = 0.01) and creatinine-corrected 4-hydroxyphenanthrene (p = 0.01). Correlation between pairs of hydroxy-PAHs (ρ = 0.50 to 0.93) were highest for mid-shift samples. Concentrations of PM(2.5) (geometric mean = 64 µg/m(3); 95% confidence limits = 52 µg/m(3), 78 µg/m(3)) is similar to those measured in many other studies of traffic exposure. There was significant change across work shift for concentrations of only two of the OH-PAHs (2-FLU and 4-PHE). Results indicate that the drivers may have had limited time for clearance of PAH exposure from the body between work shifts. Comparisons of the concentrations of creatinine-corrected hydroxy-PAH to those reported in other studies indicate that exposure of public transport drivers to PAH could be similar. By following the subjects over multiple days, this study gives an indication of appropriate exposure situations for the use of hydroxy-PAHs and will be beneficial in designing future occupational studies of PAH exposure.

Urinary methoxyphenol biomarkers and woodsmoke exposure: comparisons in rural Guatemala with personal CO and kitchen CO, levoglucosan, and PM2.5.

Urinary methoxyphenols have been proposed as biomarkers for woodsmoke exposure, but few field studies have been undertaken. We evaluated these biomarkers for assessing the exposure to woodsmoke of householders in rural Guatemala. The study population was a subset (10 female cooks, 2 female non-cooks, and 8 male non-cooks ranging in age from 7 to 60) drawn from those participating in a longterm randomized intervention trial (RESPIRE) in the highlands. All households rely solely on woodburning for cooking and home heating. Approximately half of the homes in the trial used open woodfires in the home, while the intervention group used cookstoves, called "planchas, "that vent most of the woodsmoke outdoors through a chimney. Corrected for creatinine levels, 16 of the 19 methoxyphenols measured were lower in the urine of cooks using the plancha; and 11 of the 19 compounds were lower in the urine of non-cooks from homes using the plancha. Furthermore, the 4 low-molecular-weight syringyl methoxyphenols (syringol, methysyringol, ethylsyringol, propylsyringol) were each moderately correlated (r2 = 0.71,0.64, 0.68, 0.53 respectively, with all p < 0.05) with personal exposure measurements determined by carbon monoxide (CO) passive diffusion tubes, but not with CO in exhaled breath. 48-Hour kitchen area measurements of PM2.5 mass, PM2.5 levoglucosan, and CO were highly correlated (>0.89) with each other and moderately correlated (0.54-0.78) with personal CO measurements. Although based on relatively few measurements, this study demonstrates that the urinary concentrations of specific methoxyphenols may be effective biomarkers of short-term exposures to inhaled woodsmoke in field conditions.