A follow-up study on micronucleus frequency in Spanish agricultural workers exposed to pesticides.

To determine whether occupational exposure to a complex mixture of pesticides results in a significant increase in the level of cytogenetic damage, a follow-up study was planned on 39 greenhouse workers from Almería (southeastern Spain). Taking into account that pesticide exposure can be season-related, two blood samples were taken from each individual at different times: one in a period of high exposure (sample A, spring-summer) and the other in a period of lower exposure (sample B, autumn-winter). Using the cytokinesis block micronucleus technique the frequency of binucleated cells with micronuclei (BNMN) and the cytokinesis blocked proliferation index (CBPI) were determined in peripheral blood lymphocytes. The results obtained indicate that there were no statistically significant differences in BNMN frequencies between the two sampling periods nor between exposed and controls. ANCOVA analysis of repeated measures revealed that the age of the individuals showed a direct relation with BNMN in the first study period. With regard to CBPI, a significant and season-related effect was found.

Cytogenetic biomonitoring of Spanish greenhouse workers exposed to pesticides: micronuclei analysis in peripheral blood lymphocytes and buccal epithelial cells.

In the present study, we evaluate whether or not occupational exposure to a complex mixture of pesticides results in a significant increase of micronuclei (MN) in both peripheral blood lymphocytes and buccal cells. Sixty four greenhouse workers from Almería (Southeastern Spain), together with 50 men from the same area, without indication of exposure to pesticides, that served as controls were used in this investigation. The results obtained indicate that there are no statistically significant differences in the MN frequencies between the two groups. Each donor was assessed for the presence or absence of glutathione S-transferase M1 (GSTM1) and glutathione S-transferase T1 (GSTT1), to look for relationships between the genotypes and the cytogenetic reponses. According to the GSTT1 genotype, there is a difference between both groups only for the cytokinesis-block proliferation index (CBPI). Neither GSTM1 nor smoking habit and age showed any effect in the overall analysis.

[The self-measurement of blood glucose and mean glycemias in patients with diabetes mellitus]. / Automedición de la glucosa sanguínea y media de glucemias en pacientes con diabetes mellitus.

OBJECTIVE: To assess the influence that self-measurement of capillary blood glucose (SMBG) has on glucaemia control in patients with diabetes mellitus. DESIGN: Quasi-experimental before and after study. SETTING: Semi-urban health centre. PATIENTS: All diabetic patients, with at least two years of evolution, who used reactive strips for SMBG in 1996. MEASUREMENTS AND MAIN RESULTS: Mean values of base glucaemia in the SMBG study year were compared with those of the year before in 85 patients, 33 men and 52 women, with average age 62.38. Thirteen were type 1 and 72 type 2 diabetics, with a mean 15.61 years of evolution of the disease. A drop of -11.47 mg/dl (SD 44.32) was observed, which was significant (p < 0.05, CI 95%) in the overall results. In all the subgroups, except those treated with non-pharmacological measures, there were drops, ranging between -2.17 mg/dl and -17.01 mg/dl, which were significant in women, in patients with type 2 diabetes, in those who had received health education and in those treated with non-pharmacological measures plus insulin. CONCLUSIONS: Despite the limitations of this kind of study, our findings point towards a slightly better control of glucaemia levels in diabetic patients after SMBG. It is very doubtful whether it signifies any real improvement in managing the illness.

Clinical and biochemical changes in greenhouse sprayers chronically exposed to pesticides.

1 This study was conducted with the aim of evaluating the impact on health produced by the use of different types of pesticides in greenhouses. It is based on the need to practice and develop biological monitoring techniques to assess exposure and predict health risk in workers occupationally exposed to pesticides. 2 Two groups of greenhouse workers with either high or low exposure to a combination of pesticides was taken in Almería, a Spanish province where cultures under plastic are very extended. 3 One hundred and five sprayers were interviewed to collect information about symptoms and signs related to past exposures. Each pesticide sprayer was examined by a physician, and a blood sample was drawn for plasma and red blood cell cholinesterases, complete blood count, and liver and renal function tests. 4 Exposure of workers to a combination of pesticides resulted in 37% of the workers showing toxic signs and symptoms. The main toxic effect observed were a high incidence of spontaneous abortion, depression, and certain neurologic disorders like headache, tremor and paraesthesia. 5 The major analytical change was a decrease of the mean corpuscular haemoglobin concentration in 38% of the cases. However, no significant decrease in both serum and erythrocyte cholinesterase activities was observed. 6 The sprayers were not usually aware of the potential hazards of pesticides and did not try their best to maintain personal hygiene.

Increased risk of suicide with exposure to pesticides in an intensive agricultural area. A 12-year retrospective study.

Several reports have suggested that exposure to agricultural pesticides (mainly chronic exposure to organophosphates) produces depression, and depression is a major risk factor for suicide. A retrospective epidemiological study of 251 suicide cases was undertaken to explore the possible relationship between the high suicide rates in an intensive agricultural area, and a specific group of population at risk, namely farmers with chronic exposure to pesticides, who are at risk to develop mood disorders (mainly depression). Our data show that the suicide rate in that area is significantly higher than the suicide rates from other geographic areas with very similar socioeconomic and demographic features. In addition, the mortality from suicide in this population (farmers) does differ significantly from that of the rest of the population.

[The construction and validation of a questionnaire on the satisfaction of primary health care users]. / Construcción y validación de una encuesta de satisfacción de usuarios de atención primaria.

The questionnaire was developed after establishing the domains that might be measured with it and selecting 16 items. During June and September 1987 it was administered to 163 patients, selected by quota sampling, who belonged to two health centers and two outpatient clinics from the city of Almería. With the obtained data several parts of the questionnaire were validated: stability, homogeneity, distorting variables and constructed validity. There were significant differences (analysis of variance) between the satisfaction of the users of health centers and outpatient clinics (p = 0.042) (higher satisfaction in health centers). There were not marked differences between the users of both health centers (p = 0.144) and between both outpatient clinics (p = 0.66). The measurement of satisfaction is a valuable instrument for the investigation and administration of health services and a good indicator of the quality of care.