title: Occupational exposure to pesticides, nicotine and minor psychiatric disorders among tobacco farmers in southern Brazil.
abstract: BACKGROUND
  Exposure to pesticides has been associated with psychiatric problems among farm workers, although there is still controversy as to chemical types, intensity and forms of exposure that represent risk factors for neuropsychological problems. Furthermore, tobacco workers are exposed to dermal absorption of nicotine, although its effect on mental health has not yet been studied.
  
  
  OBJECTIVE
  To identify the prevalence of minor psychiatric disorders (MPD) among tobacco farmers and associated factors, paying special attention to pesticide and nicotine exposure.
  
  
  METHODS
  This is a cross-sectional study with a representative sample of tobacco growers, characterizing economic indicators of the farms, socio-demographic factors, lifestyle habits and occupational exposures. Multivariate analysis was performed using a hierarchical Poisson regression model.
  
  
  RESULTS
  A total of 2400 tobacco farmers were assessed and MPD prevalence was 12%. MPD was higher among women (PR 1.4), workers aged 40 or over, tenants/employees (PR 1.8) and those who reported having difficulty in paying debts (PR 2.0). Low socioeconomic status was inversely associated with MPD prevalence. Tasks involving dermal exposure to pesticides showed risk varying between 35% and 71%, whereas tobacco growers on farms using organophosphates had 50% more risk of MPD than those not exposed to this kind of pesticide. The number of pesticide poisoning and green tobacco sickness episodes showed linear association with MPD.
  
  
  CONCLUSIONS
  The study reinforces the evidence of the association between pesticide poisoning and mental health disorders. It also points to increased risk of MPD from low socioeconomic status, dermal pesticide exposure as well as from exposure to organophosphates. Furthermore, the study reveals intense nicotine exposure as a risk for tobacco farmers' mental health.
authors.affiliation: Postgraduate Program in Epidemiology, Social Medicine Department, Pelotas Federal University, RS, Brazil. Electronic address: neice@clinicagianisella.com.br.
authors.forename: Neice Muller Xavier
authors.initials: NM
authors.lastname: Faria
authors.affiliation: Postgraduate Program in Epidemiology, Social Medicine Department, Pelotas Federal University, RS, Brazil.
authors.forename: Anaclaudia Gastal
authors.initials: AG
authors.lastname: Fassa
authors.affiliation: Postgraduate Program in Epidemiology, Social Medicine Department, Pelotas Federal University, RS, Brazil.
authors.forename: Rodrigo Dalke
authors.initials: RD
authors.lastname: Meucci
authors.affiliation: Postgraduate Program in Epidemiology, Social Medicine Department, Pelotas Federal University, RS, Brazil.
authors.forename: Nadia Spada
authors.initials: NS
authors.lastname: Fiori
authors.affiliation: Postgraduate Program in Epidemiology, Social Medicine Department, Pelotas Federal University, RS, Brazil.
authors.forename: Vanessa Iribarrem
authors.initials: VI
authors.lastname: Miranda
mesh_terms: D000293:Adolescent; D000328:Adult; D000382:Agricultural Workers' Diseases / Q000139:chemically induced / Q000453:epidemiology*; D000383:Agriculture; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced / Q000453:epidemiology*; D008875:Middle Aged; D009538:Nicotine / Q000506:poisoning*; D016273:Occupational Exposure / Q000009:adverse effects*; D010575:Pesticides / Q000506:poisoning*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014026:Nicotiana; D055815:Young Adult
chemical_list: D010575:Pesticides; D009538:Nicotine
keywords: Farm workers; Mental disorders; Nicotine; Occupational; Pesticide