Kowit Nambunmee, Tharinya Kawiya, Richard L Neitzel, Prapamon Seeprasert
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引用次数: 1
Abstract
Background: Farming is an important occupation in Thai hill tribe communities, which are often remote, and lack other economic opportunities along with basic educational, health care, and occupational health and safety services. Additionally, these communities have a unique culture and language.
Objectives: The present study was conducted in northern Thailand to evaluate pesticide exposures and associated health impacts among hill tribe farmers, and to compare them to Thai farmers.
Methods: Lahu hill tribe farmers in a mountain community were recruited by public health hospital staff, along with a reference group of lowland Thai farmers. Participants completed a survey on demographic factors and work practices, and blood and urine samples were collected by a trained nurse. Acetylcholinesterase activity (AChE) was quantified to assess pesticide exposure, whereas liver and kidney functions were evaluated using clinical biomarkers.
Results: A large fraction (nearly 50%) of Lahu farmers were illiterate and could not speak Thai. Thai farmers worked fewer hours per week (39.4) than did Lahu farmers. Among Lahu farmers, AChE levels were significantly lower (worse) than those of Thai farmers. However, other health outcomes in these populations were similar. Formal education and language skills were not associated with pesticide exposures or health outcomes. Pesticide spraying was found to be a significant predictor of reduced AChE (OR=8.5, 95% CI 1.1-69.6).
Conclusions: Pesticide exposures are a significant occupational health hazard among Thai hill tribe farmers. Training, potentially delivered by community health volunteers, is needed to communicate safe pesticide work practices to these farmers.
Participant consent: Obtained.
Ethics approval: The study protocol was approved by the Institutional Review Board of Mae Fah Luang University (REH-61080).
Competing interests: The authors declare no competing financial interests.
背景:农业是泰国山地部落社区的一项重要职业，这些社区往往地处偏远，缺乏其他经济机会以及基本的教育、卫生保健和职业卫生与安全服务。此外，这些社区有独特的文化和语言。目的:本研究在泰国北部进行，以评估山地部落农民的农药暴露及其相关的健康影响，并将其与泰国农民进行比较。方法:公共卫生医院的工作人员招募了山区拉胡山部落的农民，同时招募了泰国低地农民作为参考组。参与者完成了一项关于人口因素和工作实践的调查，血液和尿液样本由一名训练有素的护士收集。通过量化乙酰胆碱酯酶活性(AChE)来评估农药暴露程度，同时使用临床生物标志物来评估肝肾功能。结果:大部分(近50%)的拉祜族农民是文盲，不会说泰语。泰国农民每周工作时间(39.4小时)少于拉祜族农民。在拉祜族农民中，乙酰胆碱酯酶水平明显低于(低于)泰国农民。然而，这些人群的其他健康结果是相似的。正规教育和语言技能与农药接触或健康结果无关。发现农药喷洒是乙酰胆碱酯酶降低的重要预测因子(OR=8.5, 95% CI 1.1-69.6)。结论:农药暴露是泰国山地部落农民的重要职业健康危害。需要培训，可能由社区卫生志愿者提供，以便向这些农民宣传安全的农药工作做法。参与者同意:已获取。伦理批准:研究方案已获得美发銮大学机构审查委员会(REH-61080)批准。利益竞争:作者声明没有经济利益竞争。
期刊介绍：
The Journal of Health and Pollution (JH&P) was initiated with funding from the European Union and World Bank and continues to be a Platinum Open Access Journal. There are no publication or viewing charges. That is, there are no charges to readers or authors. Upon peer-review and acceptance, all articles are made available online. The high-ranking editorial board is comprised of active members who participate in JH&P submissions and editorial policies. The Journal of Health and Pollution welcomes manuscripts based on original research as well as findings from re-interpretation and examination of existing data. JH&P focuses on point source pollution, related health impacts, environmental control and remediation technology. JH&P also has an interest in ambient and indoor pollution. Pollutants of particular interest include heavy metals, pesticides, radionuclides, dioxins, polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), air particulates (PM10 and PM2.5), and other severe and persistent toxins. JH&P emphasizes work relating directly to low and middle-income countries, however relevant work relating to high-income countries will be considered on a case-by-case basis.
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