Defeitos congênitos e exposição a agrotóxicos no Vale do São Francisco / Congenital defects and exposure to pesticides in São Francisco Valley

OBJETIVO: avaliar a associação entre a exposição dos genitores aos agrotóxicos e nascimentos com defeitos congênitos no Vale do São Francisco, bem como o perfil sociodemográfico e os defeitos encontrados. MÉTODOS: estudo tipo caso-controle, sendo que para cada caso (recém-nascido com defeito congênito), eram dois controles (recém-nascidos saudáveis) nascidos na cidade de Petrolina, no Vale do São Francisco, em 2009. A amostra constou de 42 casos e 84 controles. Os dados formam colhidos com uso de questionário estruturado, adaptado do Estudo Colaborativo Latino-Americano de Malformações Congênitas (ECLAMC), acrescido de questões relacionadas à exposição aos agrotóxicos, análise do prontuário e contato com a pediatra do hospital. Foi realizado o teste do χ2 com nível de significância de 5 por cento para identificar as variáveis com maiores diferenças entre os grupos caso e controle. Em seguida, foi calculado o Odds Ratio (OR) amostral, bem como o OR obtido por análise de regressão logística e, finalmente, realizou-se uma análise de regressão logística multivariada. RESULTADOS: houve maior exposição aos agrotóxicos durante a gestação em neonatos com defeitos congênitos se comparados aos saudáveis. Maior risco foi observado quando pelo menos um dos genitores foi exposto aos agrotóxicos (OR ajustado = 1,3; IC95 por cento = 0,4-3,9). As variáveis sociodemográficas associadas aos defeitos congênitos foram: baixa escolaridade, baixo peso, prematuridade, genitores jovens, doenças crônicas e fatores físicos. Foram encontrados com maior frequência os polimalformados e os defeitos dos sistemas musculoesquelético e nervoso. CONCLUSÃO: o presente estudo, a despeito de não apresentar significância, sugere associação entre a exposição aos agrotóxicos e a ocorrência de defeitos congênitos.

PURPOSE: to evaluate associations between parental exposure to pesticides and births with congenital defects in São Francisco Valley, as well as the demographic profile and the defects found. METHODS: in this case-control study, each case (newborns with congenital defects) had two controls (healthy newborns). The subjects were born in the city of Petrolina, in São Francisco Valley, in 2009. The sample consisted of 42 cases and 84 controls. Data were gathered by a structured questionnaire adapted from Latin-American Collaborative Study of Congenital Malformations (ECLAMC), with the addition of questions related to exposure to pesticides, analysis of the medical records and contact with the hospital's pediatrician. The χ2 test was performed with a significance level of 5 percent to identify the variables with the greatest differences between case and control groups. Odds Ratio (OR) for the sample was calculated, as well as the OR obtained by logistic regression analysis, and finally, multivariate logistic regression analysis was performed. RESULTS: there was a greater exposure to pesticides during pregnancy in infants with congenital defects compared to healthy subjects. Increased risk was observed when at least one parent was exposed to pesticides (adjusted OR = 1.3; 95 percentCI = 0.4 - 3.9). The sociodemographic variables associated with congenital defects were: low school level, low weight, prematurity, young parents, chronic diseases, and physical factors. Multiple malformations and defects of the musculoskeletal and nervous systems were more frequently found. CONCLUSIONS: the present study suggests an association between exposure to pesticides and the occurrence of congenital defects, although the data were not significant.

Consumo de agrotóxicos e distribuição temporal da proporção de nascimentos masculinos no Estado do Paraná, Brasil / Agricultural toxic use and temporal distribution of male birth rate in the state of Paraná, Brazil

OBJETIVO: Investigar a tendência temporal da proporção de nascimentos masculinos para o Estado do Paraná no período entre 1994 e 2004 e a correlação dessa tendência com o volume de vendas de agrotóxicos no Estado em 1985. MÉTODO: No presente estudo ecológico, foram empregados como fontes de dados o Instituto Brasileiro de Geografia e Estatística (volume de vendas de agrotóxicos) e o banco DATASUS (nascidos vivos segundo o sexo). Foram analisados 308 municípios, divididos em quartis conforme o consumo de agrotóxicos, resultando em quatro estratos contendo 77 municípios cada um, sendo o quarto quartil o de maior consumo. A proporção de nascimentos masculinos foi obtida ano a ano para cada município e, ao final do período (1994 a 2004), um valor mediano foi calculado para cada uma das localidades. Foi realizada uma análise bivariada e calculados os coeficientes de Pearson para cada quartil de municípios. Uma análise exploratória e comparativa dos quartis foi realizada, na qual se calculou o consumo médio per capita para os mesmos. Posteriormente, foram selecionados e analisados individualmente 10 municípios com intensa atividade agropecuária quanto ao perfil agrícola e à tendência da proporção de nascimentos masculinos ao longo do período de estudo. RESULTADOS: Foi observada uma discreta tendência de declínio na proporção de nascidos vivos do sexo masculino para o Estado como um todo. A magnitude desse declínio foi visivelmente maior quando se analisou individualmente o grupo de 10 municípios, cujos valores observados ao final da série mostraram-se muito abaixo daqueles normalmente descritos na literatura (proporção de nascimentos masculinos < 50 por cento). Em relação aos quartis, todos apresentaram correlação negativa, ainda que sem significância estatística. CONCLUSÕES: A tendência de declínio estatisticamente significativa na proporção de nascimentos masculinos em alguns municípios paranaenses sugere que o fenômeno possa ser decorrente...

OBJECTIVE: To determine the trend in male birth rates from 1994-2004 in the state of Paraná, Brazil, and whether a correlation exists between this trend and the state's agricultural toxic sales in 1985. METHOD: This ecological study employed data from the Brazilian Institute for Geography and Statistics (agricultural toxic sales) and the Unified Health System's data-base "DATASUS" (sex ratio at birth). Three hundred and eight (308) municipalities were analyzed, divided into quartiles by pesticide usage. Each of the four resulting quartiles included 77 municipalities, with the fourth quartile representing the highest consumption. The male birth rate was obtained for each year for each municipality. Then the median rate was calculated for the entire period (1994-2004) for each municipality. A bivariate analysis was carried out. Pearson coefficients were calculated for each quartile. An exploratory and comparative analysis of quartiles was performed, and the mean per capita consumption was calculated for each quartile. Ten municipalities with intense agricultural activity were then selected and analyzed individually in terms of their agricultural profile and male birth rate trend during the study period. RESULTS: A discrete decline was observed in the rate of live male births for the entire state. The magnitude of this decline was more evident when the group of 10 municipalities was analyzed: in this group, the rates observed at the end of the study period were much lower than those usually described in the literature (male birth rate < 50 percent). Pearson's correlation was negative for all quartiles, although without statistical significance. CONCLUSIONS: The statistically significant trend towards a decline in male births in some of the Paraná municipalities suggests that this phenomenon may be a result of a high level of environmental exposure to pesticides. Future studies should confirm and measure the impact of environmental pesticide...

Male exposure mediated adverse reproductive outcomes in carbon disulphide exposed rayon workers.

The authors examined 100 carbon disulphide (CS2) exposed male workers who had been employed ten years prior to study were selected for the study. They were virtually obliged to participate in the study by the Medical Labor Inspector and all of them participated voluntary. The aim was to assess the effects of occupational exposure to carbon disulphide concentrations below the threshold limit value (31 mg/m3) on the reproductive functions with special emphasis on miscarriages. Specially, workers history records were build up on number of children, miscarriages and general weakness, mental fatigue etc. It was found that the incidences of number of miscarriages against number of living children correlated well with environmental concentration of CS2. Where the average CS2 levels were 1.695 ppm, the incidences of miscarriages was 5.71% (group 1). Where as in group 2 environmental concentrations were 12.28 ppm and the incidences of miscarriages were 18.91%. It was also found that in the spinning department the exposure exceeds many times the Threshold Limit Values (TL V).

Exposición a pesticidas y toxicidad reproductiva y del desarrollo en humanos: análisis de la evidencia epidemiológica y experimental / Pesticide exposure and reproductive and birth defects: critical analysis of epidemiological and experimental evidence

Several epidemiological studies link pesticide exposure to reproductive and developmental toxicity. However, additional studies have shown little or no evidence to support such relationship. On the other hand, experimental data show that some pesticides may indeed alter the reproductive function or produce birth defects (as evidenced by intrauterine death, in utero growth retardation, visceral and skeletal malformations or functional deficits) in laboratory animals. This review is a critical analysis of the epidemiological and experimental evidence available to date, that links pesticide exposure with induction of reproductive or developmental defects. Factors that must be considered when establishing a cause-effect relationship are also discussed, including the shape of the dose-response curve, exposure to pesticides in chemical mixtures and the influence of genetic background.