Name: Glenda Blaser Petarli
Type: PhD thesis
Publication date: 06/09/2019

Namesort descending Role
Luciane Bresciani Salaroli Advisor *

Examining board:

Namesort descending Role
Bruno Pereira Nunes External Examiner *
Edson Theodoro dos Santos Neto Internal Examiner *
Eliana Zandonade Co advisor *
Luciane Bresciani Salaroli Advisor *
Maria Carmen Moldes Viana Internal Examiner *
Neice Muller Xavier Faria External Examiner *

Summary: Introduction: Agricultural work often poses potential health hazards for rural
workers, such as increasing exposure to pesticides. The transformations resulting
from the mechanization and modernization of agricultural activities also had an
impact on the physical, psychological and lifestyle aspects of these workers.
Objectives: To assesss occupational exposure to pesticides, risk perception, safety
practices along with factors associated with the use of Personal Protective
Equipment (PPE) by farmerworkers, as well as to determine the prevalence of
multimorbidity, complex multimorbidity and depression in this population.
Methodology: This is a cross-sectional analytical epidemiological study conducted
with 790 farmerworkers in the municipality of Santa Maria de Jetibá/ES. Data
collection took place beyween December 2016 and April 2017. A semi-structured
questionnaire was used to collect sociodemographic data, occupational contact with
pesticides, lifestyle, clinical condition and job satisfaction. Anthropometric,
biochemical and hemodynamic measurements were also undertaken Depressive
episodes were identified through the Mini-International Neuropsychiatric Interview.
Multimorbidity was defined as the presence of two or more chronic diseases in the
same individual and using the complex multimorbidity concept . Results: 106 brands
of pesticides, 45 chemical groups and 77 active ingredients were detected and
glyphosate was identified as the predominant herbicide. Of the farmerworkers with
direct contact with pesticides, approximately 90% reported the use of extremely toxic
products, half did not read the pesticide label[s] , more than one third did not observe
the grace period and 71.4% did not use PPE or misused it. Among the factors
associated with non-use of these equipments are: socioeconomic class (p = 0.002),
low education levels (p = 0.05), lack of technical support (p <0.001) and non-reading
of labels (p <0.001). . The prevalence of multimorbidity was 41.5% (n = 328) and of
complex multimorbidity 16.7% (n = 132). More than 77% of the sample had at least
one chronic disease and arterial hypertension, dyslipidemia and depression were the
most prevalent morbidities. 40 years or older (OR = 3.33; 95% CI = 2.06 - 5.39),
previous diagnosis of pesticide poisoning (OR = 1.89; 95% CI = 1.03 - 3.44),
perimeter high waist (OR = 2.82; 95% CI = 1.98 - 4.02) and poorer self-rated health
(OR = 2.10; 95% CI = 1.52 - 2.91) significantly increased the chances of

multimorbidity. The same associations were found for the diagnosis of complex
multimorbidity. Regarding depression, 16.8% (n = 132) of the farmers presented
symptoms of major depressive episode, 6% (n = 48) current depressive episode and
10.7% (n = 84) recurrent major depressive episode. The risk factors associated with
this condition were: being separated / divorced or widowed (OR = 2.29; 95% CI =
1.12 - 4.70), not owning the land WHERE they work (OR = 1.79; CI95 % = 1.10 - 2.91),
job dissatisfaction (OR = 1.89; 95% CI = 1.11 - 3.23), history of pesticide poisoning
(OR = 2.66; 95% CI = 1.33 - 5.34), negative self-rated health (OR = 3.14; 95% CI =
1.97 - 4.98) and previous depressive episodes (OR = 7.77; 95% CI = 3.35 - 18.04).
Conclusion: Farmerworkers had prolonged occupational exposure to multiple highly
toxic pesticides, and reported unsafe handling practices. A high prevalence of
multimorbidity and depression was identified in these workers. Factors associated
with these conditions are mostly subject to modification and control, such as
excessive occupational exposure to pesticides. Sound public policies are needed to
prevent, control and monitor the health status of this population.

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