Ankara Medical Journal (Sep 2020)

Pesticide Exposure and Chronic Kidney Disease Among Agricultural Workers

  • Nezaket Özpolat Çakar,
  • Dilek Kutsal,
  • Sibel Kiran

DOI
https://doi.org/10.5505/amj.2020.37029
Journal volume & issue
Vol. 20, no. 3
pp. 761 – 772

Abstract

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Pesticides are chemicals that are widely used in many areas of life, especially in agriculture. There is always a risk of toxicity if agricultural workers do not have sufficient knowledge and experience about the use of pesticides and preventive measures are inadequate. In the literature, there are references to acute toxic effects of pesticides as well as their chronic effects, such as cancer, diabetes, high blood pressure, cardiovascular diseases, and neurological disorders. In addition to these chronic effects, early-onset and rapidly developing chronic kidney disease has been reported in agricultural workers over the past two decades, which progresses to end-stage renal disease. The renal biopsies that have been performed on these patients showed chronic tubulointerstitial changes. This disease, observed in agricultural workers, is either referred to as 'Chronic Kidney Disease of unknown cause (CKDu)' or "Mesoamerican nephropathy," in reference to the region where it was first identified. It is argued that heat stress and pesticides play an active role in its etiology. From this point of view, countries with high pesticide use that are affected by climate change are referred to as "countries in the risk group". The use of pesticides is increasing in Turkey, which is also adversely affected by climate change caused by global warming. Greenhouse workers in particular are more exposed to heat stress and pesticides, since they work in a closed environment. Therefore, preventive measures and awareness are particularly important in these regions, as the disease progresses without symptoms.

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