Consumer risk perception towards pesticide-stained tomatoes in Uganda.

BACKGROUND: Tomatoes are consumed daily. Unfortunately, abuse of pesticide application by vegetable growers in Uganda increases risks of pesticide residue exposure among consumers, as they may be above Maximum Residue Limits (European Union Maximum Residue Limits used as a standard in Uganda). This study aimed to determine consumer attitudes and risk perceptions towards pesticide-stained tomatoes in Uganda to support interventions that could be used to reduce pesticide residue exposures in food. METHODS: A mixed methods cross-sectional study sampled 468 household consumers in four regions of Uganda, selecting one district (interventional project area) per region. In each district, about 60 household members were randomly selected from a total of three Sub Counties and interviewed. In addition, 9 tomato handlers (three tomato farmers, three tomato retailers, and three tomato wholesalers) participated in Focus Group Discussions (FGDs) per district. Collected data were entered into MS-Excel 13 and exported into Stata version 14.0 for cleaning and analysis at a 5% level of significance and 95% Confidence Intervals (CI). The proportion of risk perceptions and attitudes were computed and presented as percentages, while factors associated with risk perception were determined using Fisher exact test. Qualitative data collected under a traditional theory were analyzed using thematic content analysis. RESULTS: More than half, 54.2% (253/468), of the respondents were females, mean age was 37 years (SD = 13.13, ranging from 18 to 88 years). Half of the respondents, 50.9% (238/467), were farmers by occupation, and 40.3% (188/468) had completed upper primary education. Only 5.0% (20/396) of consumers reported a high-risk perception towards tomatoes stained with pesticide residues, the rest, 95.0% (376/396), were buying pesticide-stained tomatoes despite their awareness of the possible health effects. The main reason for buying the pesticide-stained tomatoes was that a majority, 59.0% (230/390), lacked an alternative to stained tomatoes like organically grown tomatoes. However, consumers generally had a negative attitude towards pesticide-stained tomatoes, with 67.0% (313/468) of the consumers disagreeing with the statement that tomatoes sold on the market are safe. Consumer risk perception was significantly associated with their awareness about residues in the tomatoes; where the proportion of consumers who were aware of the risk of pesticide-stained tomatoes was 42.8 times more likely not to buy stained tomatoes compared to the proportion of those who were not aware. OR, 42.8 (95% CI: 10.76-170.28). However, after Fisher-Exact tests analysis, level of education P(0.975), gender P(0.581), and age group P(0.680) were not associated with consumer risk perception (95% CI and 5% level of significance). CONCLUSION: Although the consumers had a negative attitude towards the pesticide-stained tomatoes, their risk perception towards them ranked low, with most consumers buying tomatoes stained with pesticide residues due to a lack of an alternative. Ministry of Agriculture extension service efforts should promote and emphasize community to start household-based organic kitchen gardens as the efforts for the establishment of a national pesticide residue monitoring center awaits.

Precision and accuracy of FEV1 measurements from the Vitalograph copd-6 mini-spirometer in a healthy Ugandan population.

OBJECTIVE: Evaluate the accuracy and precision of the copd-6 mini-spirometer for FEV1 in a rural Ugandan population. METHODS: In a cross-sectional study, 171 smallholder farmers performed spirometry with copd-6, and a diagnostic-quality spirometer. RESULTS AND DISCUSSION: The copd-6 underestimated FEV1 at low flows and overestimated FEV1 at high flows. Across all participants, the device slightly overestimated FEV1 by 0.04 [0.02; 0.06] L. Calibration data showed similar patterns. CONCLUSION: The copd-6 could be considered as an affordable tool for research on lung function impairment in resource-constrained settings. However, further validation in a study population with obstructive lung disease is needed.

Organophosphate and carbamate insecticide exposure is related to lung function change among smallholder farmers: a prospective study.

INTRODUCTION AND AIM: Exposure to some insecticides may cause airway obstruction, but existing evidence is limited by cross-sectional designs and inadequate confounder control. We investigated the relation between organophosphate and carbamate insecticides and pulmonary function in a prospective study accounting for important confounders. METHODS: In a cohort of 364 smallholder farmers in Uganda (69% women), participants underwent pre-bronchodilator spirometry at baseline (September/October 2018) and at two follow-up visits (November/December 2018 and January/February 2019). Exposure to carbamate and organophosphate insecticides was assessed using haemoglobin-adjusted erythrocyte acetylcholinesterase (AChE/Hb). Less than 3% of participants were lost to follow-up. We calculated Z-scores for FEV1, FVC and FEV1/FVC using the Global Lung Function Initiative equations. Data were analysed in linear mixed and fixed effect models accounting for family relationships and repeated measures of exposure and outcome. RESULTS: Low AChE/Hb was significantly associated with low FEV1 Z-score in both unadjusted and adjusted analyses. Compared with individuals with AChE/Hb 25.90 U/g (50th percentile, reference), those with lower AChE/Hb 24.50 U/g (35th percentile) had mean FEV1 Z-score 0.045 (0.003 to 0.087) lower, and persons with higher AChE/Hb 27.30 U/g (65th percentile) had a mean FEV1 Z-score 0.043 (-0.002 to 0.087) higher compared with the reference. Similar, but numerically smaller and statistically non-significant effects were seen for Z-scores of FVC and FEV1/FVC. CONCLUSION: Exposure to organophosphate and carbamate insecticides may lead to lung function decline. Our results add to the growing evidence of health effects in relation to exposure to organophosphate and carbamate insecticides, underlining the importance of minimising exposure.

Exposure to cholinesterase inhibiting insecticides and blood glucose level in a population of Ugandan smallholder farmers.

OBJECTIVES: The risk of diabetes mellitus may be elevated among persons exposed to some pesticides, including cholinesterase-inhibiting insecticides (organophosphates and carbamates). The objective of this study was to investigate how acetylcholinesterase activity was associated with mean blood glucose levels among smallholder farmers in Uganda. METHODS: We conducted a short-term follow-up study among 364 smallholder farmers in Uganda. Participants were examined three times from September 2018 to February 2019. At each visit, we measured glycosylated haemoglobin A (HbA1c) as a measure of long-term average blood glucose levels. Exposure to organophosphate and carbamate insecticides was quantified using erythrocyte acetylcholinesterase normalised by haemoglobin (AChE/Hb). For a subgroup of participants, fasting plasma glucose (FPG) was also available. We analysed HbA1c and FPG versus AChE/Hb in linear mixed and fixed effect models adjusting for age, sex, physical activity level, and consumption of fruits and vegetables, alcohol and tobacco. RESULTS: Contrary to our hypothesis, our mixed effect models showed significant correlation between low AChE/Hb and low HbA1c. Adjusted mean HbA1c was 0.74 (95% CI 0.17 to 1.31) mmol/mol lower for subjects with AChE/Hb=24.3 U/g (35th percentile) compared with subjects with AChE/Hb=25.8 U/g (50th percentile). Similar results were demonstrated for FPG. Fixed effect models showed less clear correlations for between-phase changes in AChE/Hb and HbA1c. CONCLUSIONS: Our results do not clearly support a causal link between exposure to cholinesterase-inhibiting insecticides and elevated blood glucose levels (expressed as HbA1c and FPG), but results should be interpreted with caution due to the risk of reverse causality.