Small-Scale Farming, Pesticide Exposure, and Respiratory Health: A Cross-Sectional Study in Bolivia

Abstract

This study analyzed the relationship between pesticide exposure with respiratory symptoms and lung function among small-scale farm workers in rural communities of Sucre, Bolivia. A cross-sectional study was conducted including 277 farmers and 214 non-farmers ≥ 16 years. Pesticide exposure and respiratory symptoms were assessed by questionnaire, and lung function was assessed by spirometry. Logistic regression models were used to estimate odds ratios and 95% confidence intervals for associations between pesticide exposure and respiratory symptoms, while multiple linear regression was employed to estimate associations with lung function. The adjusted regression models indicated a positive association between pesticide exposure and chronic cough or phlegm (aOR 1.22; 95% CI 1.0 to 1.5), chest tightness (1.14; 1.0 to 1.3), and nasal allergies (1.21; 1.0 to 1.4). Also, pesticide exposure showed a slight positive association with FVC (β = 0.04; 95% CI = 0.01 to 0.07). Agricultural work (vs. non-agricultural work) showed a dual effect; on the one hand, it showed a negative association with lung function (FEV1/FVC (%): −1.57; 95% CI = −3.25 to −0.11); on the other hand, it seemed to be a protective factor for nasal allergies (aOR 0.31; 95% CI 0.1–0.8). Our study suggests an association between pesticide exposure and respiratory symptoms and farm work with lung function parameters. The results underscore the need to enhance programs that regulate and train farmers on the use of pesticides, thereby reducing health effects on workers and agricultural and neighboring communities.