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Contamination of rural surface and ground water

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Article in Environmental Health · April 2003

DOI: 10.1186/1476-069X-2-1 · Source: PubMed

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Journal of Environmental Science and Health Part B (2009) 44, 271–277
Copyright
C Taylor & Francis Group, LLC

ISSN: 0360-1234 (Print); 1532-4109 (Online)

DOI: 10.1080/03601230902728351

Pesticide exposure and blood endosulfan levels after first

season spray amongst farm workers in the Western Cape,
South Africa

MOHAMED AQIEL DALVIE1 , ALGERNON AFRICA1 , ABDULLAH SOLOMONS2 , LESLIE LONDON1 ,

DERK BROUWER3 , and HANS KROMHOUT4
1
Occupational and Environmental Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences,
University of Cape Town, Cape Town, South Africa
2
Cape Peninsula University of Technology, Bellville, Cape Town, South Africa
3
TNO Quality of Life, Zeist, Netherlands
4
Occupational and Environmental Health Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands

The study investigated serum endosulfan changes resulting from occupational exposure to the pesticide on farms. Eight applicators
and 17 non-applicators were tested (serum endosulfan, anthropometry, short exposure questionnaire) before and after the first day
of seasonal spraying. Task-based job exposure matrix (JEM) estimates were calculated. Mean baseline serum endosulfan (530 ±
0.05 µg/L) was high. Increases in post-spraying endosulfan levels (IPSE) were higher in applicators (mean = 60 ± 90 µg/L) than
in non-applicators (mean = 3.5 × 10−6 ± 90.0 µg/L) adjusting for age (β = 54.0, p = 0.162, R2 = 0.22). There was a weak positive
relationship between IPSE and JEM estimates. IPSE occurred in applicators and non-applicators and were higher in applicators. The
validity of the JEM weightings and characterization of other routes of pesticide exposure require further investigation.
Keywords: Pesticide exposure; bio-monitoring; endosulfan; job exposure matrix; spraying, mixing; drift; occupational; environmental.

Introduction calculated from crop sector specific yearly agrichemical use

Pesticides are used extensively in South African agricul-
ture and their use may pose significant health risks to farm
workers.[1−5] There is therefore a need for conducting epi-
demiological studies investigating the health effects of pes-
ticides in South African agriculture. In order to conduct the
epidemiological studies, careful characterization of chemi-
cal exposures is important in the absence of environmental
measurements and biological monitoring data.
A previous study developed a job exposure matrix to
quantitatively estimate the occupational pesticide exposure
of farm workers in the Western Cape South Africa and
this JEM has subsequently been applied in epidemiologi-
cal studies investigating the health effects of pesticides in
this region.[6] The JEM calculates occupational pesticide
exposure by the product of the weighting for farming type,
Address correspondence to Mohamed Aqiel Dalvie, Occupa-
tional and Environmental Health Research Unit, School of Public
Health and Family Medicine, Faculty of Health Sciences, Univer-
sity of Cape Town, Anzio Road, Observatory, 7925, Cape Town,
South Africa; E-mail: aqiel@cormack.uct.ac.za
Received August 2, 2008.
patterns derived from audit data, weighting for job task and
number of exposure days. Several exposure variables can be
used as independent exposure variables and which are not
incorporated in the JEM. These include current and past
use of personal protective equipment, current knowledge
and attitude score, past poisoning with pesticides, domestic
use of agrichemicals or containers, current water sources,
and potential lifetime residential exposure.
The job weightings (Table 1), which represents pesticide
exposure associated with a particular job activity, were de-
veloped in consultation with experts in industry and indus-
trial hygiene personnel in the previous study and validated
by consulting key informants in industry using the Delphi
technique.[6] Estimates of relative exposure are expressed as
percentages on a scale based on a typically high exposure
activity, such as driving a tractor with a mist blower having
a relative exposure of 100. The JEM is thus able to take into
account reported direct exposures (application, mixing) as
well as indirect exposures (such as field contacts, presumed
spray drift, and other routes). However, the precision of
the JEM is critically dependent of the weighting chosen
and previous research has pointed to the need to validate
these weightings using biomarker analyses.[6]
272
Table 1. Weighting used in the job exposure matrix (JEM’s) ap-
plied in this study.
Job tasks JEM 1∗
Tractor spraying with mist blower 70
Tractor driver of handsprayer configuration 50
Mixing of pesticides (separate from spraying)
Mixes indoors 100
Mixes but outdoors 80
Handspray from back of tractor 70
Back spray 70
Maintenance of equipment (separate from spraying) 20
Thinning work in orchards 10
Shaping work in vineyards 5 thoroughly dried for 15 minutes under vacuum. Pesticides
Blood and urinary bio-monitoring of pesticides mea-
sures the internal dose of pesticides in humans and reflects
absorption resulting from short-term pesticide exposure.[7]
We aimed to determine in the current study the impact
of occupational exposures on blood endosulfan levels and
comparing JEM based exposure estimates to changes in
blood endosulfan levels during first-season exposure of
Western Cape farm workers to endosulfan, a pesticide com-
monly used and frequently detected in environmental me-
dia in the region.[8,9]
Materials and methods
We conducted a cross-sectional study comparing post first-
seasonal spraying increase in serum endosulfan levels to
occupational exposures amongst farm residents (n = 25)
on a farm in the Hex River Valley, an agriculturally inten-
sive grape –farming area in the Western Cape, South Africa.
Participants were selected with the assistance of farm man-
agement. The testing period was 24 hours (baseline mea-
surements were taken on the day before, and post-spraying
measurements on the day of first seasonal application of
endosulfan) as serum endosulfan levels decay rapidly fol-
lowing exposure. The estimated elimination half-lives of en-
dosulfan metabolites range between approximately 1 and 7
days in adult humans and animals.[10]
A short questionnaire with sections on tasks details, use
of protective equipment and environmental pesticide expo-
sures during the period of testing and abbreviated sections
on medical history and lifestyle factors were administered
to all participants. JEM estimates were calculated as the
sum of all task scores (task hours × JEM weight) using the
weighting allocations developed by London and Myers[6]
(Table 1).
A qualified nurse collected 10 mL baseline and post-
spraying blood samples from each participant. A bio-
technician centrifuged the blood samples in the field and
the serum was stored on dry-ice until transported to the
Dalvie et al.
analytical laboratory at the Cape Peninsula University of
Technology.
Endosulfan was measured according the methods devel-
oped by Guardino et al.[11] Serum samples were homoge-
nized followed by extraction using Bond Elute Extraction
Cartridges (C18, 10 mL LRC, 500 mg sorbent mass). The
column was conditioned with 2 volumes (10 mL) of ethyl ac-
etate, and 1 volume each of methanol and deionized water.
High-pressure chromatography grade solvents were used.
A 250 mL amount of filtered sample was column aspirated
at 20–25 mL per minute under vacuum. The column was
then washed with one volume (10 mL) deionized water and
were eluted into a borosilicate glass vial with 2 × 10 mL
ethyl acetate which was then left to evaporate at room tem-
perature. Hexane measuring 1 mL was added to dissolve
the residue, for GC analysis. All the chemicals and reagents
used in the extraction and cleanup of endosulfan residues
were checked for any pesticide contamination. Glassware
used was free from residue contamination. Standards were
prepared from analytical standards (> 98% purity). A Var-
ian 3300 GC with an electron capture detector (ECD) was
used for identification and quantification of extracted sam-
ples. The limit of quantitation (LOQ) was 0.2 µg/L.
Weight and height measurements were taken in field and
body mass index calculated for each participant.
We analyzed increases in post-spraying serum endosul-
fan levels both as a continuous and as a dichotomous (cut-
off = 0) variable. Variables representing occupational expo-
sure included applicant/non-applicant status, JEM score
and JEM score dichotomized at the median and catego-
rized based on quintiles. Univariate, bivariate and multi-
variate analyses, using multiple linear and multiple logistic
regression analysis, were performed for relevant variables.
Residuals were normally distributed, the variances were
homogenous and no variables were collinear for multiple
linear regression models.
We tested multiple linear and logistic regression models
for the form of the linear predictor and for the adequacy
of the link function. For multiple linear regression anal-
ysis, collinearity was identified if r > 0.9 or a variance
inflation factor > 10, and the effect of outliers/influential
points, identified by DFBETAs > 1, Cook’s D > 0.5 or Stu-
dent residuals > 2.5 while outliers and influential points for
multiple logistic regression analysis were identified if stan-
dardized residuals were > 2 or < −2 or if leverage patterns
were far from the average covariate pattern. There were no
outliers and influential points.
In multivariate modelling, increase in post-spraying en-
dosulfan serum levels was treated as the dependant variable
and occupational exposure as the independent variable ad-
justing for age. Age was the only variable yielding an asso-
ciation with endosulfan levels at a p-value < 0.1 in bivariate
analysis. We conducted statistical analysis using Stata 8.[12]
The study was approved by the University of Cape
Town’s Ethics Committee and by the University of
Blood endosulfan levels among farm workers 273

Michigan Internal Review Board and was conducted in Interestingly, although more than three-quarters of the
accordance with the Declaration of Helsinki of the 25th participants lived within 10 meters of the nearest vineyard
World Medical Assembly.[13] Written informed consent was and more than 90% within 20 meters, only one participant
obtained from workers prior to their inclusion in the study reported that he was aware that spray drifts reach his house.
and their confidentiality was preserved. However, since all participants worked during the period of
testing, proximity of residence to spraying was not thought
to be a confounding variable.
Three workers reported in their medical histories health
Results
problems which could potentially affect their biological
pesticide residue levels including two that had been di-
The participants were predominantly male (88%) and few
agnosed with ‘kidney problems’ and another with ‘liver
(16%) had tertiary education (Table 2). Consistent with
problems’. One applicator reported that he had suffered
findings in previous studies in Western Cape farm worker
pesticide poisoning during that year. None of the three
populations, height (mean = 1.67 ± 0.08 m) and weight
women who participated were pregnant, but one woman
(68.24 ± 11.74 kg) measurements were low with the mean
was menstruating at the time the study was conducted.
body mass index (BMI) = 24.7 ± 5.2. Most (76%) were
Of the 25 participants, eight applied pesticides (mixed
current or past smokers and all participants were current
or sprayed pesticides) during the period of testing and 17
(64%) or past drinkers (36%).[14,15]
did not apply pesticides. Of the eight applicators there were
Only one participant reported the use of pesticides at
seven who did mixing (four indoors and three outdoors).
home during the period of testing (Table 2). Nobody re-
There were five tractor sprayers, all of whom also performed
ported eating from the sprayed crops during the period of
mixing (three outdoors and two indoors). There was one
spraying. About a fifth of the participants reported that
hand sprayer who did not do mixing. Of the 17 workers who
they used empty containers for domestic purposes and
did not apply pesticides, three performed thinning, pruning
most participants (80%) brought their contaminated cloth-
or tying-up of shoots, seven performed other tasks in the
ing home after work.
vineyard and seven performed maintenance work near the
vineyard. There were 14 workers in total who reported that
they performed maintenance work including three applica-
Table 2. Demographic, lifestyle and environmental exposure in-
formation of participants. tors, one that performed pruning and three that performed
other work in the vineyard.
Percentage None of the workers performed back-spraying or were
Variable (n = 25) involved in repair of pesticide equipment. There were also
no-one that performed harvesting as the study was not
Sex
conducted during the harvesting period.
Male 22 (88%)
Female 3 (12%) The mean task duration of all the job tasks studied was
Completed tertiary education 4 (16%) longer than 18 minutes with the lowest duration 15 minutes
Pesticides used at home 0 (0%) and the highest 16 hours (Table 3). Indoor mixing and
Pesticides used in the garden 1 (4%) thinning tasks were the shortest in duration followed by
Ate crops from vineyard 0 (0%) outdoor mixing. All other tasks were substantially longer
Took contaminated clothing home 20 (80%) in duration lasting on average more than six hours with a
Spray drifts reaching homes 1 (4%) maximum of 14 hours.
Walked through vineyard while spraying 10 (40%) Only one participant worked for more than four hours
Walk through vineyard after spraying 16 (64%) at a distance greater than 9 meters from the vineyard.
Distance of home to nearest vineyard All applicators reported wearing at least one protective
< 10 meters 19 (76%)
gear item while a small percentage of those that performed
10–20 meters 4 (16%)
> 20 meters 2 (8%) thinning wore protective gear and none of the other workers
Used of empty containers for domestic use 5 (20%) wore any.
Diagnosed with kidney problems 2 (8%) The median JEM score (calculated as the sum of task du-
Diagnosed with liver problems 1 (4%) ration in hours X task weighting) for applicators (n = 8) was
Diagnosed with heart problems 1 (4%) 460 JEM hours and range 50–1170, for non –applicators
Diagnosed with pesticide poisoning 1 (4%) (n = 17) the median was 40 and range 35–75 JEM hours.
Any other medical problems 3 (12%) For all participants the median was 50 JEM hours and
Menstruating women 1 (4%) range 35–1170 JEM hours.
Current or past smokers 19 (76%) All workers had detectable baseline serum endosulfan
Current drinkers 16 (64%) levels (mean = 524.2 ± 49.5 µg/L). The post-spraying en-
Do not drink but drank in the past 9 (36%)
dosulfan levels of more than half (n = 14, 6%) of the workers
Drank alcohol in the last 24 hrs 11 (44%)
increased. The mean post-spraying serum endosulfan level
274 Dalvie et al.
Table 3. Summaries of work activities and protection during the period of testing.

Protection (%)∗
Time spent on activities
Activity N (hrs) Mean (Median, Range) G O T M P Any

Mixed and measured pesticides inside 4 0.31 ± 0.13 (0.25, 0.25–0.5) 75 100 50 50 0 100
Mixed and measured pesticides outside 3 1.67 ± 0.57 (2, 0.1–2) 33 67 67 33 0 100
Drove a tractor and sprayed pesticides with a spray 4 9.0 ± 5.03 (8, 0.4–016) 25 50 50 50 50 100
pump
Drove a tractor while others sprayed pesticides 1 7 100 100 100 100 100 100
with hand sprayers
Hand-sprayed from the back of a tractor 1 0.31 ± 0.13 (0.25, 0.25–0.5) 100 100 0 100 100 100
Did thinning, pruning or tying-up shoots or 3 0.31 ± 0.13 (0.25, 0.25–0.5) 0 0 0 0 0 0
branches
Performed other activities in the vineyard or 7 7.14 ± 1.57 (7, 5–10) 0 28.9 0 0 0 0
orchard while spraying was being done
Maintenance work 14 6.07 ± 3.87 (7, 0.1–14)
∗
N = none, G = gloves, O = overall, P = plastic overcoat with hood, T = top boots, M = Mask.

(544.1 ± 82.1) was higher (p > 0.05) than baseline (mean
difference = 19.9 µg/L ± 0.0946).
Age was positively associated (p = 0.05) with post-
spraying endosulfan levels (Table 4) explaining 15% of the
variance.
Anthropometric measurements, gender, smoking and al-
cohol drinking did not have significant effects on post-
spraying endosulfan levels explaining a low percentage of
the variance (Table 4), though this might have been due to
a small sample size especially in the case of gender with
only three women participants. Domestic gardening, use
of containers at home and medical history were not asso-
ciated with increases in serum endosulfan levels. Two of
the three non-applicators (with JEM scores between 40–35

Table 4. The effect of age, sex, anthropometric measures, smoking and drinking on post-spraying endosulfan levels.

Increase in post - Number of workers Summary of linear

spraying serum whose post - regression analysis
endosulfan (µg/L) spraying endosulfan P-value, regression
Variable N Median levels increased (%) coefficient, R2

Age 0.05, 3.5, 0.15

<33 13 −2.0 ± 23.0 7 (54%)
>32 12 43.0 ± 30.0 7 (58%)
Sex 0.79, −15.0, 0.003
Female 3 33.0 ± 61.7 2 (66.7)
Male 22 18.0 ± 29.0 12 (54.6)
Weight 0.98, 3.6x10−2 , 0.0
< 13 30.0 ± 30.0 7 (53.9)
> 12 9.0 ± 30.0 7 (58.3%)
Height 0.54, −15.8, 0.02
<1.67 13 28.4 ± 30.0 8 (61.5%)
>1.66 12 10.8 ± 23.0 6 (50%)
BMI 0.89, 0.05, 0.003
< 24.5 12 9.0 ± 24.7 5 (41.7)
> 24.49 13 30.0 ± 28.0 9 (69.2)
Smoking 0.732, −20.0, 0.005
Yes 19 16.0 ± 22.0 11 (58%)
No 6 31.0 ± 16.0 3 (50%)
Drinking 0.43, 31.0, 0.03
Current 9 40.0± 33.0 5 (55.6)
Past 16 9.0 ± 23.0 9 (56.3)
BMI: Body Mass Index
N:
Blood endosulfan levels among farm workers
JEM hours) who reported walking through the vineyard
while spraying occurred had increased post-spraying en-
dosulfan levels (by 40 and 70 µg/L). Three of the 9 non-
applicators (all with JEM hours below 40) who reported
that they walked through the vineyard after spraying but
not during spraying had endosulfan levels that increased
(between 10–150 µg/L).
All workers who did not take contaminated clothing
home (n = 5) were sprayers whose mean post spraying in-
crease in serum endosulfan levels (80 .0 ± 45.0 µg/L) were
higher (p > 0.05) than applicators who took contaminated
clothing home (40.0 ± 60.0 µg/L, n = 20).
The two workers with kidney problems were non-
applicators with low JEM estimates (< 50 JEM hours) of
whom the post-spraying endosulfan levels of one increased
by 0.1 mg/L. The worker with liver problems was an ap-
plicator with a high JEM estimate (430 JEM hours) whose
post-spraying serum endosulfan level did not increase.
The one applicator who reported that he had suffered
pesticide poisoning during that year had both a high JEM
estimate (490 JEM hours) and a post-spraying increase in
serum endosulfan level of 80 µg/L. The woman who was
menstruating was a non-applicator with a low JEM score
(35 JEM hours) who’s post-spraying serum endosulfan level
increased by 15 µg/L.
Based on the above bivariate analysis we included only
age in multivariate analysis. Sensitivity analysis was con-
ducted excluding participants with outlying serum endosul-
fan results due to factors such as kidney or liver disease, the
participant reporting pesticide poisoning, the three non-
applicators who reported walking through the vineyard
during spraying and whose post-spraying endosulfan levels
increased, and the six workers with low JEM scores whose
post-spraying endosulfan levels increased. The menstruat-
ing woman was also excluded.
Increases in post-spraying endosulfan levels were more
common (p > 0.05) amongst applicators (75%) than in
non-applicators (47%) (Table 5) and the increases were
also higher (p > 0.05) both when adjusting and not ad-
justing for age. The post-spraying endosulfan levels of the
workers that performed maintenance work were the high-
Table 5. Increases in post-spraying blood endosulfan levels
amongst the different occupational exposure groups in the study.
Number of workers
whose post-
Median endosulfan spraying endosulfan
Task (Range)(µg/L) levels increased
Applicator 8 80.0 (−60.0–21.0) 6 (75%)
Thinning 3 −80.0 (−130 – −70.0) 0 (0%)
Other work in 7 10.0 (−120.0–15.0) 4 (57%)
vineyard
Maintenance 7 30.0 (−11.0–150.0) 4 (57%)
work
275
Table 6. Crude and adjusted associations between occupational
exposure indices and post-spraying increase in serum endosulfan
levels using multiple linear regression analysis (N = 25).
Dependent variable: Post-spraying increase in serum
endosulfan levels (µg/L)
Dependent variables β± SD P-Value R2
Applicator (Yes, No)
Crude 63.0 ± 39.0 0.120 0.10
Adjusted for age 54.0 ± 38.0 0.162 0.22
JEM score
(JEM hours)
Crude 1.93 × 10−2 ± 6.7 × 10−2 0.776 0.004
Adjusted for age 2.6 × 10−2 ± 6.3 × 10−2 0.685 0.15
JEM: Job exposure matric.
est amongst the non-applicators, followed closely by those
that performed tasks other than thinning in the vineyard.
The post-spraying endosulfan levels of the three workers
that performed thinning did not increase (Table 5).
JEM score was positively related to post-spraying endo-
sulfan levels although the strength of the relationship was
weak (Table 6). The results did not differ substantially when
JEM score was dichotomized at the median or categorized
based on quartiles.
Sensitivity analysis, alternatively including and exclud-
ing workers with outlying endosulfan levels gave the same
findings. Logistic regression analysis using dichotomized
increase in post-spraying serum endosulfan levels (in-
creased vs. did not increase) as the dependent variable and
the same independent variables above, produced similar
results.
Discussion
The baseline serum endosulfan levels amongst all the par-
ticipants in the study was high (mean = 524.2 ± 49.5 µg/L)
in comparison to those found in other settings.[16−19] This
is indicative that rural residents in these farming areas are
exposed to endosulfan present in the environment as this
was the first time that endosulfan was sprayed in the year on
the farm studied. Previous studies in rural Western Cape
have detected endosulfan in water and soil.[8−9] Another
interesting finding was that there was an increase in post-
spraying serum endosulfan levels amongst both applicators
(75%) and non-applicators (>50%).
An important consideration in determining the relation-
ship between occupational exposure and blood endosul-
fan levels is to evaluate to what extent individual varia-
tion in absorption of endosulfan amongst workers would
affect the comparability in their serum endosulfan levels
after spraying. The fact that age was the only significant
confounder in predicting post-spraying increases in serum
276
endosulfan levels out of a wide range of variables (BMI,
height, weight, sex, smoking, alcohol consumption, med-
ical problems, pesticide poisoning and environmental pes-
ticide exposures) was an advantage in this study for com-
paring post-spraying increases in serum endosulfan levels
amongst workers. In view of the above, it is feasible to com-
pare post-spraying increases in serum endosulfan levels to
indices of occupational exposure. It should, however, be
noted that both serum endosulfan levels and occupational
indices do not reflect the metabolism and distribution of
endosulfan.[7]
The positive association of application status (applica-
tor versus non-applicator) with increases in post-spraying
serum endosulfan levels (explaining 10% of the variance)
demonstrated that this occupational exposure variable re-
flected a difference in endosulfan absorption. The statis-
tical non-significance of the relationship could have been
due to a low sample size. A limitation of the study was
the fact that application status could not be further cate-
gorized as applicators were predominantly tractor sprayers
who also did mixing. The increase in post-spraying serum
endosulfan levels amongst many non-applicators was prob-
ably due to the fact that they were all in-field workers, but
demonstrates that pesticide spray mist does impact the en-
dosulfan levels of workers near the spraying area. The rea-
son why the increase in post-spraying endosulfan levels of
the workers performing maintenance work was the highest
amongst the non-applicators could be due to direct contact
with contaminated surfaces and low usage of protective
gear amongst these workers. Amongst the non-applicators,
it was surprising that there was no increase in the post-
spraying serum endosulfan levels of the three workers who
only performed thinning but this could be due to the higher
usage of protective gear of these workers compared to the
other non-applicators and the fact that re-entry exposure
was not measured in the study. Another limitation in the
study was that workers performing tasks out of the field
was not evaluated.
JEM score (product of JEM task weighting and task
duration) had a positive but weak association with post-
spraying increases in serum endosulfan levels explaining a
low percentage of the variance.[6] This could have been due
to a too-low sample size for this relationship and also the
lack of exposure contrast amongst the workers. The sen-
sitivity of the analytical methods in measuring endosulfan
was unlikely a problem as serum endosulfan levels in this
study were high compared to a previous study and were
measured in parts per billion.[18]
The lack of an increase in post-spray endosulfan levels
of those workers who performed only thinning (Table 5)
was probably due to the fact that re-entry exposure was not
applicable in this study.
It is interesting that nobody reported domestic use of
pesticides during the period of testing but this would un-
likely have influenced the results as endosulfan is not an
active ingredient contained in household pesticides.
Dalvie et al.
It should be noted that the JEM applied for the 24 hour
testing period in this study differed in some respects to
the one used in epidemiological studies measuring long-
term exposure to pesticides. Firstly, task duration in this
study was measured more precisely in hours rather than in
days. Secondly, amongst in-field non-applicators, this study
measured endosulfan absorption resulting from spray-drift
and did not measure exposure during re-entry into the field.
An important finding in this study which has implica-
tions for the application of the JEM in future epidemiolog-
ical studies was that walking through the vineyard during
and after spraying impacted on serum endosulfan levels.
This exposure needs proper characterization. The results
also showed that age should be considered as a potential
confounder for future studies when applying the JEM in
future epidemiological studies.
Another important assumption to consider with regard
to the application of the JEM in determining occupational
exposure is that one set of task weightings is used for all
pesticides although the absorption co-efficients for differ-
ent pesticides might differ considerably. The JEM exposure
calculations therefore assume that the variation in pesti-
cide absorption across job tasks to be fairly constant for all
pesticides.
The low predictability of anthropometric measurements,
sex, smoking and alcohol drinking of post-spraying in-
creases in endosulfan (Table 5) was due to a low sample
size especially in the case of sex with only three women
participants.
There were a few anecdotal findings which may warrant
further attention. The increase in the post-spraying endo-
sulfan by 0.15 mg/L in the woman non-applicator with a
low JEM score (70 JEM hours) who was menstruating was
an interesting finding. Additionally the possible impact of
history of kidney and/or liver problems on post-spraying
serum endosulfan needs further investigation. The impact
of personal protective equipment on post-spraying serum
endosulfan levels could not be determined in this study as
the usage was similar amongst applicators.
Conclusions
The baseline serum endosulfan levels of all the participating
farm workers were high. This indicates that farm workers
as well as farm residents in this intensive farming area and
also other intensive farming areas in the Western Cape
are exposed to endosulfan present in the environment. The
study also demonstrated that endosulfan spraying not only
increase serum levels of applicators, but also those of non-
applicators probably due to exposure to spray drift. There
were no out-of –field farm residents included in the study,
but it is possible that spray drift could also impact the serum
levels of these residents. A study investigating the health
effects of endosulfan on farm residents in the Western Cape
is therefore warranted.
Blood endosulfan levels among farm workers
There was a positive association between application
status (applicator versus non-applicator) with increases
in post-spraying serum endosulfan levels of workers. The
study results, however, did not provide much information
regarding the validity of the JEM weightings mainly due
to a too-small sample size and a lack of exposure contrast.
A larger study including a breakdown of more applicators,
non-applicators not working in the field and also measure-
ment of the impact of re-entry exposure for those workers
performing thinning tasks is recommended.
The study also showed that exposure from walking
through the vineyard during and after spraying might be
an important route of exposure to pesticides and that age
is an important confounder. Additionally, factors such as
menstruation and history of kidney and/or liver problems
need further characterization.
Acknowledgments
The National Research Foundation (SA), the University of
Cape Town’s Faculty of Health Sciences Research Commit-
tee and the NIH and The University of Michigan/US Na-
tional Institutes of Health/Forgarty International Centre-
Southern African Programme in Environmental and Occu-
pational Health are thanked for their financial support.
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