RESUMO
The contribution of community-based interventions, including farmer field schools (FFSs) in integrated pest management (IPM), to reducing pesticide exposures and associated neurotoxic burden among small-farm families in Ecuador was assessed in three Andean farming communities in a co-design of targeted action-research. Baseline questionnaire surveys elicited pesticide-related knowledge, practices, and exposure and neurobehavioral assessments were done using an adapted WHO battery. Pesticide applications on plots farmed by FFS versus non-FFS participants were compared. A year later, repeated surveys of participating households (n = 29) and neurobehavioral testing of individuals (n = 63) permitted comparisons of pre- and post-intervention values. The FFS graduates applied pesticides on their plots less frequently (p = 0.171). FFS households had increased pesticide-related knowledge of labels and exposure risk factors (both p < 0.004), better pesticide-handling practices (p < 0.01), and less skin exposure (p < 0.01). Neurobehavioural status had improved, particularly digit span and visuo-spatial function, resulting in overall z-score increases. Thus, community interventions reduced pesticide use, reported skin exposure, and neurotoxic burden among smallholder farm families.
Assuntos
Educação em Saúde , Exposição Ocupacional/prevenção & controle , Praguicidas , Adolescente , Adulto , Agricultura , Participação da Comunidade , Equador , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Desempenho PsicomotorRESUMO
BACKGROUND: Since its founding in 1970, Canada's International Development Research Centre (IDRC) has supported research by concerned Latin American researchers on environments and human health relationships. Framing of such relationships has changed through different periods. METHODS: Participant observation, bibliographic searches, document review, and interviews with key IDRC staff. FINDINGS: From the early years of multiple different projects, IDRC developed more focussed interest in tropical diseases, pesticides, agriculture and human health in the 1980s. The United Nations Conference on Sustainable Development in the early 1990s gave impetus to examination of links between ecosystems and human health or "EcoHealth". Projects in Latin America built on earlier work but extended it in methods (transdisciplinarity, community participation, gendered approach) and scope (broader land use and development paradigm issues tackled). A key IDRC-funded activity in Latin America was "EcoSalud", an Ecuadorian effort, which has worked with farming communities, agricultural researchers, health practitioners and local politicians to advance integrated pest management, better recognize and treat poisonings and improve pesticide-related policies. ONGOING CHALLENGES INCLUDE: mobilizing sufficient resources for the primary prevention focus of EcoHealth activities when primary care infrastructure remains stretched, promoting micro-level change in diverse communities and ecosystems, and addressing power structures at the global level that profoundly affect environmental change.
Assuntos
Saúde Ambiental/organização & administração , Financiamento Governamental/estatística & dados numéricos , Cooperação Internacional , Saúde Pública , Apoio à Pesquisa como Assunto/organização & administração , Agricultura , Canadá , Tomada de Decisões Gerenciais , Países em Desenvolvimento/economia , Ecossistema , Saúde Ambiental/economia , Financiamento Governamental/tendências , Humanos , América Latina , Praguicidas , Apoio à Pesquisa como Assunto/tendênciasRESUMO
Pesticide use in highland Ecuador is concentrated in the high-risk, commercial production of potatoes. Small farm families experience considerable exposure and adverse health consequences. The authors describe a three-pronged strategy to reduce health impacts: 1) a community-based process of education and provision of personal protective equipment to reduce exposure; 2) farmer field schools to increase agro-ecosystem understanding and to reduce pesticide use; and 3) policy interventions to restructure incentives and to reduce availability of highly toxic insecticides. They discuss the challenges faced by each and the ongoing need for integrated interventions both to reduce adverse pesticide health impacts in the developing world and to promote sustainability of agricultural production in highland ecosystems.