title: Occupational pesticide exposure and adverse health effects at the clinical, hematological and biochemical level.
abstract: OBJECTIVE
  Although epidemiological studies have investigated associations between occupational pesticide exposures and different adverse health outcomes, they have rarely assessed individuals at two time-points of a same crop season with different pesticide use.
  
  
  METHODS
  Clinical symptoms, physical examination signs, hematological and clinical chemistry parameters were measured in 189 intensive agriculture workers and 91 healthy control subjects from Almeria coastline (Southeastern Spain) to evaluate potential effects of pesticide exposure.
  
  
  RESULTS
  Greenhouse workers showed an increased risk of ocular and skin signs relative to controls at the period of high pesticide exposure (OR: 4.80 and 2.87, respectively); however, no differences were observed for clinical symptoms. A greater risk for ECG changes (OR: 3.35) and altered spirometry (OR: 5.02) was found at the period of low exposure. Erythrocyte acetylcholinesterase was significantly decreased in greenhouse workers relative to controls in both periods. Assessment of hematological parameters revealed increased counts of erythrocytes, leukocytes, platelets and hemoglobin in greenhouse workers relative to controls, and also in the period of high versus low pesticide exposure. Changes in clinical chemistry parameters included decreased levels of glucose, creatinine, total cholesterol, triglyceride and alkaline phosphatase in greenhouse workers relative to controls; however, these parameters were raised in the period of high versus low pesticide exposure.
  
  
  CONCLUSIONS
  These findings suggest that chronic occupational exposure to pesticides of lower toxicity than former compounds under integrated production systems elicit mild toxic effects, particularly targeting the skin and eyes, as well as subtle subclinical (biochemical) changes of unknown long-term consequences.
authors.affiliation: Primary Care Health Center, Health District Jaen Northeast, Jaen, Spain.
authors.forename: Carmen R
authors.initials: CR
authors.lastname: García-García
authors.affiliation: Council of Health at Almeria Province, Almeria, Spain; Department of Neuroscience and Health Sciences, University of Almeria, Almeria, Spain.
authors.forename: Tesifón
authors.initials: T
authors.lastname: Parrón
authors.affiliation: Department of Neuroscience and Health Sciences, University of Almeria, Almeria, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Requena
authors.affiliation: Department of Neuroscience and Health Sciences, University of Almeria, Almeria, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Alarcón
authors.affiliation: Department of Forensic Sciences and Toxicology, Medical School, University of Crete, Heraklion, Greece.
authors.forename: Aristidis M
authors.initials: AM
authors.lastname: Tsatsakis
authors.affiliation: Department of Legal Medicine and Toxicology, University of Granada School of Medicine, Granada, Spain. Electronic address: ajerez@ugr.es.
authors.forename: Antonio F
authors.initials: AF
authors.lastname: Hernández
mesh_terms: D000110:Acetylcholinesterase / Q000378:metabolism; D000328:Adult; D000382:Agricultural Workers' Diseases / Q000097:blood / Q000139:chemically induced* / Q000201:enzymology; D000383:Agriculture / Q000379:methods; D001772:Blood Cell Count; D005128:Eye Diseases / Q000097:blood / Q000139:chemically induced* / Q000201:enzymology; D000067565:Farmers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D010575:Pesticides / Q000009:adverse effects*; D012871:Skin Diseases / Q000097:blood / Q000139:chemically induced* / Q000201:enzymology; D013030:Spain / Q000453:epidemiology
chemical_list: D010575:Pesticides; D000110:Acetylcholinesterase
keywords: Cholinesterase; Chronic toxicity; Occupational health; Pesticides; Serum enzymes