PDF(Pubmed)
Abstract：
BACKGROUND: Acute pesticide poisoning (APP) continues to affect farm workers, especially in low- and middle-income countries (LMIC). The dose-response relationship between exposure and APP is well-researched, but pesticide exposure assessment in a practical environment is difficult to perform, considering various work practices and protections in place. It is well known that inadequate personal protective equipment (PPE) use is a risk factor of APP. However, it is unknown which types of inadequate PPE use, such as face or other types of general protection, are most harmful.
METHODS: This study aimed to identify if inadequate PPE use is an indicator of APP risk following established specifications for meta-analysis of epidemiological studies. Included studies reported an odds ratio (OR) between PPE use to APP in agricultural workers. Data extracted from selected articles included authors, publication year, country of origin, farm type, population size, method of data collection and time frame of reported symptoms, job task, type of PPE and pesticides used, adjustments made in analysis, OR for APP, and 95% confidence intervals (CI). Meta-analysis was performed using a random effects model, where ORs were pooled to assess an overall estimate for poisoning odds.
RESULTS: Our findings suggested that inadequate PPE use was associated with increased odds (OR = 1.57, 95% CI = 1.16-2.12) of having APP. Failure to use general protection and inadequate face protection increased odds of APP by 1.29 times (95% CI = 0.88-1.90) and 1.92 times (95% CI = 1.23-3.00), respectively.
CONCLUSIONS: The meta-analysis results indicate that improper facial protection and general protection are not differently associated with APP odds. Our study concludes that more robust protection against inhalation and dermal contact are critical because any gaps in comprehensive full-body PPE would put workers and exposed populations at APP risk.
METHODS: This study aimed to identify if inadequate PPE use is an indicator of APP risk following established specifications for meta-analysis of epidemiological studies. Included studies reported an odds ratio (OR) between PPE use to APP in agricultural workers. Data extracted from selected articles included authors, publication year, country of origin, farm type, population size, method of data collection and time frame of reported symptoms, job task, type of PPE and pesticides used, adjustments made in analysis, OR for APP, and 95% confidence intervals (CI). Meta-analysis was performed using a random effects model, where ORs were pooled to assess an overall estimate for poisoning odds.
RESULTS: Our findings suggested that inadequate PPE use was associated with increased odds (OR = 1.57, 95% CI = 1.16-2.12) of having APP. Failure to use general protection and inadequate face protection increased odds of APP by 1.29 times (95% CI = 0.88-1.90) and 1.92 times (95% CI = 1.23-3.00), respectively.
CONCLUSIONS: The meta-analysis results indicate that improper facial protection and general protection are not differently associated with APP odds. Our study concludes that more robust protection against inhalation and dermal contact are critical because any gaps in comprehensive full-body PPE would put workers and exposed populations at APP risk.
摘要：
背景：急性农药中毒（APP）继续影响农场工人，特别是在低收入和中等收入国家（LMIC）。暴露和APP之间的剂量反应关系得到了充分的研究，但是在实际环境中进行农药暴露评估是困难的，考虑各种工作实践和保护措施。众所周知，个人防护装备（PPE）使用不足是APP的风险因素。然而,尚不清楚哪种类型的PPE使用不足，例如面部或其他类型的一般保护，是最有害的。
方法：本研究旨在根据建立的流行病学研究荟萃分析规范，确定PPE使用不足是否是APP风险的指标。纳入的研究报告了农业工人中PPE使用与APP之间的比值比（OR）。从选定的文章中提取的数据包括作者，出版年份,原产国,农场类型,人口规模，数据收集方法和报告症状的时间范围，作业任务,使用的PPE和杀虫剂的类型，分析中做出的调整，或者对于APP，和95%置信区间(CI)。使用随机效应模型进行荟萃分析，其中将OR汇总以评估中毒几率的总体估计值.
结果：我们的研究结果表明，PPE使用不足与APP的几率增加相关（OR=1.57，95％CI=1.16-2.12）。未能使用一般保护和面部保护不足会使APP的几率增加1.29倍（95％CI=0.88-1.90）和1.92倍（95％CI=1.23-3.00），分别。
结论：荟萃分析结果表明，不适当的面部保护和一般保护与APP几率没有不同的关联。我们的研究得出的结论是，针对吸入和皮肤接触的更强大的保护是至关重要的，因为全面的全身PPE中的任何差距都会使工人和暴露人群面临APP风险。
方法：本研究旨在根据建立的流行病学研究荟萃分析规范，确定PPE使用不足是否是APP风险的指标。纳入的研究报告了农业工人中PPE使用与APP之间的比值比（OR）。从选定的文章中提取的数据包括作者，出版年份,原产国,农场类型,人口规模，数据收集方法和报告症状的时间范围，作业任务,使用的PPE和杀虫剂的类型，分析中做出的调整，或者对于APP，和95%置信区间(CI)。使用随机效应模型进行荟萃分析，其中将OR汇总以评估中毒几率的总体估计值.
结果：我们的研究结果表明，PPE使用不足与APP的几率增加相关（OR=1.57，95％CI=1.16-2.12）。未能使用一般保护和面部保护不足会使APP的几率增加1.29倍（95％CI=0.88-1.90）和1.92倍（95％CI=1.23-3.00），分别。
结论：荟萃分析结果表明，不适当的面部保护和一般保护与APP几率没有不同的关联。我们的研究得出的结论是，针对吸入和皮肤接触的更强大的保护是至关重要的，因为全面的全身PPE中的任何差距都会使工人和暴露人群面临APP风险。
