Residential Proximity to Agricultural Fields and Neurological and Mental Health Outcomes in Rural Adults in Matlab, Bangladesh.

Pesticide exposure is an important rural public health concern that is linked to a spectrum of health outcomes in farmers. However, little is known about these effects on residents living in close proximity to agricultural fields and who are not involved in regular farming. This paper compared the effects of residential proximity to farming lands on a number of neurological and mental health outcomes in adults. A cross-sectional study was performed on 57 adults involved in farming only occasionally in rural Matlab in Bangladesh. A health and demographic surveillance system (HDSS) and geocoding were used to define proximity to the agricultural field. Neurological health was measured using the trail making test, vibrotactile threshold measurement, and dominant ulnar nerve conduction velocity (NCV) amplitude. An adapted Center for Epidemiological Studies Depression scale (CES-D) questionnaire was used to evaluate mental health. Results indicated that respondents living near agricultural fields had significantly higher vibrotactile threshold in big toes (p < 0.004) and needed a longer time to complete the trail making test (p < 0.004) than those living far from fields after accounting for the covariates. Results of this pilot study suggest further investigations to establish the impact of pesticide exposure among occasional and non-farmers on neurological health outcomes.

A disease burden analysis of garment factory workers in Bangladesh: proposal for annual health screening.

Background: To characterize the health status of selected garment and textile factory workers in Bangladesh using a workplace mobile health clinic. Methods: A retrospective review of de-identified worker health information was performed using 1906 medical records. Results: The mean age of the workers was 27.9±7.3 y, with 60.3% (1150/1906) female and 39.7% (756/1906) male workers. The most common medical conditions identified were anemia (19.0%; 362/1906), elevated BP (EBP) (11.9%; 226/1906) and elevated fasting blood glucose (FBG) (8.0%; 151/1906). Among the workers who had EBP, 86.3% (195/226) were previously undiagnosed, while out of the workers with elevated FBG, 72.8% (110/151) were newly diagnosed. Men were more likely than women to have EBP (OR 3.5, 95% CI [2.12-5.56], p<0.001), a family history of diabetes (OR 3.6, 95% CI [2.1-5.9], p<0.001) and no formal education (OR 4.9, 95% CI [3.6-6.7], p<0.001). Conclusions: Despite the relatively young mean age, significant percentages of workers were identified as having undiagnosed chronic health conditions, including EBP and elevated FBG, that require urgent medical attention and health education. The findings suggest that provision for annual health screening, either by mobile on-site clinics or by training the existing in-house paramedics, will help improve health of the factory workers.