NC STATE UNIVERSITY Understanding the Agricultural Health Study Prepared by Julia F. Storm, MSPH...
prev
next
of 51
NC STATE UNIVERSITY Understanding the Agricultural Health Study Prepared by Julia F. Storm, MSPH North Carolina Cooperative Extension North Carolina State
Text of NC STATE UNIVERSITY Understanding the Agricultural Health Study Prepared by Julia F. Storm, MSPH...
Slide 1
NC STATE UNIVERSITY Understanding the Agricultural Health Study Prepared by Julia F. Storm, MSPH North Carolina Cooperative Extension North Carolina State University Department of Environmental & Molecular Toxicology
Slide 2
NC STATE UNIVERSITY Understanding the Agricultural Health Study Part 1: Overview Long-term health study certified pesticide applicators and farm families Iowa and North Carolina Overview Who - Where What- Why When- How
Slide 3
NC STATE UNIVERSITY An Important Note NO Agricultural Health Study participants are depicted in photos Agricultural Health Study Confidential Secure Ethical
Slide 4
NC STATE UNIVERSITY Disease? What Exposures are associated with
Slide 5
NC STATE UNIVERSITY Agricultural Health Study Scientists National Cancer Institute National Institute of Environmental Health Sciences US Environmental Protection Agency University of Iowa College of Public Health Battelle Centers for Public Health Research and Evaluation (North Carolina) National Institute for Occupational Safety and Health
Slide 6
NC STATE UNIVERSITY Agricultural Health Study Participants Certified pesticide applicators and farmers spouses (89,658) North Carolina: Farmers (20,518) Spouses (10,576) Iowa: Farmers (31,877) Spouses (21,771) Commercial applicators (4,916)
Slide 7
NC STATE UNIVERSITY Participants Reflect Agriculture of Iowa... Farmers: white males Farm Size: 75% > 500 acres Crops/Livestock Corn, Soybeans Hogs Commercial applicators Younger than farmers Landscape, highway weed control, agricultural
Slide 8
NC STATE UNIVERSITY... and North Carolina Farmers Mostly male 3% African-American Farm Size: 55%
Slide 9
NC STATE UNIVERSITY Agricultural Health Study Female Participants 3% of Pesticide Applicators are women Farm wives: Active in farm work (51%) Mixed or applied pesticides (40%)
Slide 10
NC STATE UNIVERSITY Previous Studies of Agriculture and Health Health Pluses: Live longer Lower heart disease death rate Lower death rate due to some cancers: Lung Esophagus Bladder Colon Health Problems: Higher risk of injury Risk of lung disease (not lung cancer) Skin conditions Higher rates of certain cancers Other: immune, nervous, reproductive system
Slide 11
NC STATE UNIVERSITY Questions 1 2 3 4 5 6 Scientists Navigate a Maze of Information 7 Answers More Questions
Slide 12
NC STATE UNIVERSITY 1 - Enroll volunteers into the study During 1993-1997 Applicators At pesticide safety training classes Spouses of farmers At home
Slide 13
NC STATE UNIVERSITY Farm work related Environmental 2 Survey participants
Slide 14
NC STATE UNIVERSITY Lifestyle Medical history 2 Survey participants
Slide 15
NC STATE UNIVERSITY Develop exposure formula Test formula in real world Measure pesticide exposure on 100 farms 3 Estimate pesticide exposure
Slide 16
NC STATE UNIVERSITY 4 Collect a genetic sample Rinse and spit Mouthwash rinses cells from mouth Cells contain DNA Sample used in laboratory studies
Slide 17
NC STATE UNIVERSITY 5 Collect health data from databases Cancer registries Iowa North Carolina Death certificate State National
Slide 18
NC STATE UNIVERSITY 6 Analyze the information Users of Pesticide X Non-users of Pesticide X Different disease risk? Have disease No disease Exposures different? Applicators Spouses General Population Cancer rates different?
Slide 19
NC STATE UNIVERSITY 7 Update Information Repeat Steps 2: Survey participants 5: Collect health database info 6: Analyze information Answers More Questions 2 5 6
Slide 20
NC STATE UNIVERSITY Study Timeline 19931997Recruit & survey participants 19982003Field test exposure estimates; Collect genetic sample 20042008Assess disease rates & risk factors 20092013Evaluate disease mechanisms
Slide 21
NC STATE UNIVERSITY High Pesticide Exposure Events Pesticides of Interest Estimating Exposure to Applicators Measuring Pesticide Exposure Understanding the Agricultural Health Study Part 2: Pesticide Exposure
Slide 22
NC STATE UNIVERSITY High Pesticide Exposure Events (HPEE) 14% of applicators reported HPEE Risk factors Repair application equipment Delay in changing/washing Characteristics Mix pesticide/family wash Believe farming is highly risky Farm in financial stress
Slide 23
NC STATE UNIVERSITY Medical Visits for Pesticide Exposure 7% of applicators 3,733 medical visits Risk Factors: Use insecticides and fumigants vs. herbicides Mix pesticides more than 50% of the time Repair own equipment
Slide 24
NC STATE UNIVERSITY African-American Farmers Reported Less pesticide use, fewer high exposure application methods More PPE use (except chemically- resistant gloves) Fewer health symptoms
Slide 25
NC STATE UNIVERSITY Pesticides of Interest First survey: 50 crop/livestock pesticides 40 Current-Use Pesticides 16 insecticides, 16 herbicides, 6 fungicides, 2 fumigants 10 Historical-Use Pesticides Follow-up surveys: all pesticides used in previous season
Slide 26
NC STATE UNIVERSITY Top 11 Pesticides Used 1993-97 North Carolina Iowa PESTICIDETYPEPESTICIDETYPE GlyphosateH2,4-DH 2,4 DHGlyphosateH AtrazineHImazethapyrH ChlorpyrifosIAtrazineH Methyl bromideFUMDicambaH CarbarylIMetolachlorH HTrifluralinH ChlorothalonilFGChlorpyrifosI MetalaxylFGCyanazineH AlachlorHTerbufosI MalathionIAlachlorH
Slide 27
NC STATE UNIVERSITY Estimating Pesticide Exposure: A New Approach Lifetime Applicator Pesticide Exposure =Pesticide application days/year X Years of pesticide use NoneLowMediumHigh X Average Work-Day Exposure Score X Average Work-Day Exposure Score
Slide 28
NC STATE UNIVERSITY Average Work-Day Exposure Score (0 to 20) = Mix(0,3,9) + Apply (1 to 9) (1 to 9) + Repair (0,2) (0,2) X PPE (0.1 to 1)
Slide 29
NC STATE UNIVERSITY Iowa Example: 2,4-D Exposure Farmer Bill grows 1000 acres corn Applies 2,4-D to control weeds after plant emergence using boom sprayer
Slide 30
NC STATE UNIVERSITY Iowa Example: Bills 2,4-D Average Work-Day Exposure FORMULAVALUE WHAT BILL DOES Mix 9 Mixes > 50% of time Apply + 3 Uses boom on tractor Repair + 2 Repairs in field = 14 PPE X.4 Wears chemically resistant gloves, goggles Score5.6
Slide 31
NC STATE UNIVERSITY North Carolina Example: Chlorpyrifos Exposure Farmer Fred grows 300 acres peanuts Applies granular chlorpyrifos for southern corn rootworm
Slide 32
NC STATE UNIVERSITY NC Example: Freds Chlorpyrifos Average Work-Day Exposure FORMULAVALUE WHAT FRED DOES Mix 9 Mixes > 50% of time Apply + 1 Applies granular formulation Repair + 2 Repairs in field =12 PPE X.6 Wears chemically- resistant gloves Score7.2
Slide 33
NC STATE UNIVERSITY Iowa and NC Examples: Lifetime Exposure Iowa Corn Farmer Bills Lifetime 2,4-D Exposure =5.6 X 10 days/year X 15 years =840 NC Peanut Farmer Freds Lifetime Chlorpyrifos Exposure =7.2 X 3 days/year X 10 years = 216
Slide 34
NC STATE UNIVERSITY 2,4-D Exposure in the AHS Average Work-Day NC:7.6 Farmers:6.5 IA:6.0 Bill5.6 Commercial:5.1 Lifetime Commercial:1692 NC: 1249 IA:1116 Farmers:1096 Bill 840
Slide 35
NC STATE UNIVERSITY Testing the Formula by Measuring Pesticide Exposure 100 farms; 8 field situations 2,4-D and chlorpyrifos Before, during, after application Personal air (applicator) Dermal patch (applicator) Urine (applicator, spouse, children) Formula estimate matches measurements
Slide 36
NC STATE UNIVERSITY Use of PPE Good News/Bad News Chemically-resistant glove use doubled from 1980s to 1990s in NC 21% vs. 46% PPE use greater in Iowa, except respirators Never use PPE 4% (Iowa) 18% (NC)
Slide 37
NC STATE UNIVERSITY Understanding the Agricultural Health Study Part 3: Health Findings Cancers Nervous system Respiratory system Reproductive health
Slide 38
NC STATE UNIVERSITY Cancer Incidence Compared to General Population Overall cancer rate lower Rates for 18 of 20 cancers lower Applicators Spouses General Population Applicators: Prostate cancer higher Spouses: Skin melanomas higher
Slide 39
NC STATE UNIVERSITY Childhood Cancer: Interpret with Caution Children of Iowa Farmer Applicators Slightly increased rates of All childhood cancers All lymphomas Children of Iowa Applicators General Population of Children in Iowa
Slide 40
NC STATE UNIVERSITY Pesticides and Prostate Cancer Prostate cancer associated with Methyl bromide Chlorinated pesticides (in men over 50) 5 pesticides and men with a family history of prostate cancer
Slide 41
NC STATE UNIVERSITY Pesticides and Other Cancers Breast cancer in farmers wives NO clear association with 50 pesticides Lung cancer in applicators Possible association with metolachlo
