The Adverse Health Effects of Air Pollution from Sugarcane Burning: A Scoping Review of Observational and Experimental Evidence.

Background: Sugarcane burning is an agricultural practice that is implemented to increase sugar yields. However, sugarcane burning produces air pollutants associated with adverse health outcomes. This review summarizes the current knowledge of the defined exposures and health effects associated with sugarcane burning and identifies research gaps.

Methods: A scoping review was conducted using PubMed, Scopus, and Web-of-Science to identify peer-reviewed literature on health and exposure investigations associated with air pollution from burning sugarcane. Studies were eligible if they included both an air pollution measurement and a health outcome assessment in human workers and surrounding communities or animal studies associated with sugarcane burning.

Results: A total of 24 studies passed our inclusion criteria, including 19 observational and five experimental studies. All observational studies were conducted in Brazil or the United States with the majority focused on respiratory (65%, 15/24), cardiovascular (13% 3/24), and renal (13%, 3/24) health outcomes. The most frequently assessed air pollutants were particulate matter [with aerodynamic diameter $\le 2.5\mu m$ (${\mathrm{PM}}_{2.5}$) and with aerodynamic diameter $\le 10\mu m$ (${\mathrm{PM}}_{10}$)] and total suspended particulates (TSP). Of the observational studies, 42% (8/19) were prospective cohorts, and 58% (11/19) employed an ecological design and applied variable exposure assessment methods. The experimental studies all used rodent models with varied exposure routes and pollutants.

Discussion: This review supports a well-documented link between air pollution from sugarcane burning and adverse health effects in workers and neighboring communities with respiratory, renal, and cardiovascular health effects; however, several knowledge gaps were identified, including the need for expansion of studies geographically, application of more advanced exposure science to characterize and quantify sugarcane emission components, probing of emerging health effects (i.e., kidney disease) and associated biomarkers, and evaluation of vulnerable populations that neighbor sugarcane operations. Furthermore, pairing exposure measurements and health assessments in the same study would increase our knowledge and better inform policies to improve the health of workers and communities impacted by sugarcane burning. https://doi.org/10.1289/EHP14456.