Association between pesticide exposure and ischemic heart disease among adults who took part in the Rafsanjan cohort study

Abstract

Background:Cardiovascular disease (CVD) is recognized as a major cause of death worldwide. Sustained exposure to pesticides is a significant factor that can increase morbidity and mortality rates due to CVD. Aims: This study aimed to investigate the effects of pesticide exposure on CVD among adult participants in the Rafsanjan cohort study (RCS). Methods: Data were analyzed from 9,990 adult participants of RCS as a part of the Prospective Epidemiological Research Studies in IRAN. Data on personal habits, lifestyle, demographic characteristics, comorbidity history, physical activity, and pesticide exposure were collected via face-to-face questionnaires. The prevalence of ischemic heart disease (IHD) was assessed based on the medical history questionnaire of the participants. IHD was defined as a cardiac condition (either IHD or heart failure) diagnosed by a physician. Results: The mean age of participants with IHD was significantly higher than that of healthy participants (P < 0.001). Furthermore, the prevalence of IHD was higher in men compared to women (P = 0.003). In addition, the duration of pesticide exposure at home in men was significantly associated with IHD (P = 0.047). None of the other variables demonstrated a significant correlation with the prevalence of IHD. Conclusion: Pesticide exposure may increase the risk of IHD, as indicated by the results of the studied population. Implementing continuous, well-structured educational programs for individuals professionally exposed to pesticides is important. These programs should focus on personal protection and the safe use of pesticides to prevent or decrease the risk of CVDs. Relevance for patients: It is important for farmers, agricultural workers, and those living near agricultural areas to understand the risks that pesticides pose to cardiovascular health.

Keywords

Cardiovascular disease / Cohort study / Ischemic heart disease / Pesticides / Prospective epidemiological research studies in IRAN

Funding

None.

Conflict of interest

The authors have no conflict of interest to declare.

References

[1] Singh BK, Walker A, Morgan JA, Wright DJ. Biodegradation of Chlorpyrifos by Enterobacter Strain B-14 and Its Use in Bioremediation of Contaminated Soils. Appl Environ Microbiol. 2004; 70:4855-63. doi: 10.1128/AEM.70.8.4855-4863.2004

[2] Delfino RT, Ribeiro TS, Figueroa-Villar JD. Organophosphorus Compounds As Chemical Warfare Agents: A Review. J Braz Chem Soc. 2009;20:407-28. doi: 10.1590/S0103-50532009000300003

[3] Navarro S, Vela N, Navarro G. An Overview On the Environmental Behaviour of Pesticide Residues in Soils. Span J Agric Res. 2007;5:357-75.

[4] Sharma A, Kumar V, Shahzad B, Tanveer M, Sidhu GP, Handa N, et al. Worldwide Pesticide Usage and Its Impacts On Ecosystem. SN Appl Sci. 2019;1:1446. doi: 10.1007/s42452-019-1485-1

[5] Zago AM, Faria NM, Fávero JL, Meucci RD, Woskie S, Fassa AG. Pesticide Exposure and Risk of Cardiovascular Disease: A Systematic Review. Glob Public Health. 2020;17:3944-66. doi: 10.1080/17441692.2020.1808693

[6] Anakwue R. Cardiotoxicity of Pesticides: Are Africans At Risk? Cardiovasc Toxicol. 2019;19:95-104. doi: 10.1007/s12012-018-9486-7

[7] Berg ZK, Rodriguez B, Davis J, Katz AR, Cooney RV, Masaki K. Association between Occupational Exposure to Pesticides and Cardiovascular Disease Incidence: The Kuakini Honolulu Heart Program. J Am Heart Assoc. 2019;8:e012569. doi: 10.1161/JAHA.119.012569

[8] Sekhotha M, Monyeki K, Sibuyi M. Exposure to Agrochemicals and Cardiovascular Disease: A Review. Int J Environ Res Public Health. 2016;13:229. doi: 10.3390/ijerph13020229

[9] Adeyemi JA, Ukwenya VO, Arowolo OK, Olise CC. Pesticides-induced Cardiovascular Dysfunctions: Prevalence and Associated Mechanisms. Curr Hypertens Rev. 2021;17:27-34. doi: 10.2174/1573402117666210111102508

[10] Weichenthal S, Villeneuve PJ, Burnett RT, van Donkelaar A, Martin RV, Jones RR, et al. Long-term Exposure to Fine Particulate Matter: Association with Nonaccidental and Cardiovascular Mortality in the Agricultural Health Study Cohort. Environ Health Perspect. 2014; 122:609-15. doi: 10.1289/ehp.1307277

[11] Tuangratananon T, Wangmo S, Widanapathirana N, Pongutta S, Viriyathorn S, Patcharanarumol W, et al. Implementation of National Action Plans On Noncommunicable Diseases, Bhutan, Cambodia, Indonesia, Philippines, Sri Lanka, Thailand and Viet Nam. Bull World Health Organ. 2019; 97:129-41. doi: 10.2471/BLT.18.220483

[12] Wahab A, Hod R, Ismail NH, Omar N. The Effect of Pesticide Exposure On Cardiovascular System: A Systematic Review. Int J Community Med Public Health. 2016;3:1-10. doi: 10.18203/2394-6040.ijcmph20151542

[13] Mehryar S, Sliuzas R, Sharifi A, Van Maarseveen MF. The Water Crisis and Socio-ecological Development Profile of Rafsanjan Township, Iran. WIT Trans Ecol Environ. 2015;199:271-85. doi: 10.2495/RAV150231

[14] Poustchi H, Eghtesad S, Kamangar F, Etemadi A, Keshtkar AA, Hekmatdoost A, et al. Prospective Epidemiological Research Studies in Iran (The PERSIAN Cohort Study): Rationale, Objectives, and Design. Am J Epidemiol. 2018;187:647-55. doi: 10.1093/aje/kwx314

[15] Hakimi H, Ahmadi J, Vakilian A, Jamalizadeh A, Kamyab Z, Mehran M, et al. The Profile of Rafsanjan Cohort Study. Eur J Epidemiol. 2021;36:243-52. doi: 10.1007/s10654-020-00668-7

[16] Khalili P, Ayoobi F, Mohamadi M, Jamalizadeh A, La Vecchia C, Esmaeili-Nadimi A. Effect of Opium Consumption On Cardiovascular Diseases-A Cross-sectional Study Based On Data of Rafsanjan Cohort Study. BMC Cardiovasc Disord. 2021;21:2.doi: 10.1186/s12872-020-01788-4

[17] Kazemi M, Bazyar M, Naghizadeh MM, Dehghan A, Rahimabadi MS, Chijan MR, et al. Lipid Profile Dysregulation in Opium Users Based on Fasa PERSIAN Cohort Study Results. Sci Rep. 2021;11:12058. doi: 10.1038/s41598-021-91533-4

[18] Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, et al. Behavioral Counseling Interventions to Promote A Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in adults with Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement. JAMA. 2020; 324:2069-75. doi: 10.1001/jama.2020.21749

[19] Linde K, Wright CY, Du Plessis JL. Subjective and Objective Skin Colour of a Farmworker Group in the Limpopo Province, South Africa. Skin Res Technol. 2020; 26:923-31. doi: 10.1111/srt.12895

[20] Sandoval-Insausti H, Chiu YH, Wang YX, Hart JE, Bhupathiraju SN, Mínguez-Alarcón L, et al. Intake of Fruits and Vegetables According to Pesticide Residue Status in Relation to All-cause and Disease-specific Mortality: Results from Three Prospective Cohort Studies. Environ Int. 2022;159:107024. doi: 10.1016/j.envint.2021.107024

[21] Chen Y, Graziano JH, Parvez F, Liu M, Slavkovich V, Kalra T, et al. Arsenic Exposure from Drinking Water and Mortality from Cardiovascular Disease in Bangladesh: Prospective Cohort Study. BMJ. 2011;342:d2431. doi: 10.1136/bmj.d2431

[22] Rojas-Rueda D, Morales-Zamora E, Alsufyani WA, Herbst CH, AlBalawi SM, Alsukait R, et al. Environmental Risk Factors and Health: An Umbrella Review of Meta-analyses. Int J Environ Res Public Health. 2021;18:704. doi: 10.3390/ijerph18020704

[23] Dayton SB, Sandler DP, Blair A, Alavanja M, Freeman LE, Hoppin JA. Pesticide Use and Myocardial Infarction Incidence among Farm Women in the Agricultural Health Study. J Occup Environ Med. 2010; 52:693-7. doi: 10.1097/JOM.0b013e3181e66d25

[24] Zaller JG, Brühl CA. Non-target Effects of Pesticides On Organisms Inhabiting Agroecosystems. Front Environ Sci. 2019;7:75. doi: 10.3389/fenvs.2019.00075

[25] London L, Nell V, Thompson M, Myers J. Health Status among Farm Workers in the Western Cape--collateral Evidence from A Study of Occupational Hazards. S Afr Med J. 1998;88:1096-101.

[26] Stiernström E-L, Holmberg S, Thelin A, Svärdsudd K. A Prospective Study of Morbidity and Mortality Rates among Farmers and Rural and Urban Nonfarmers. J Clin Epidemiol. 2001;54:121-6. doi: 10.1016/s0895-4356(00)00287-0

[27] Allon N, Rabinovitz I, Manistersky E, Weissman BA, Grauer E. Acute and Long-lasting Cardiac Changes Following A Single Whole-body Exposure to Sarin Vapor in Rats. Toxicol Sci. 2005;87:385-90. doi: 10.1093/toxsci/kfi263

[28] Gress S, Lemoine S, Séralini GE, Puddu PE. Glyphosate-based Herbicides Potently Affect Cardiovascular System in Mammals: Review of the Literature. Cardiovasc Toxicol. 2015; 15:117-26. doi: 10.1007/s12012-014-9282-y

[29] Jackson E, Shoemaker R, Larian N, Cassis L. Adipose Tissue As A Site of Toxin Accumulation. Compr Physiol. 2017; 7:1085-135. doi: 10.1002/cphy.c160038

[30] Steenland K, Dick RB, Howell RJ, Chrislip DW, Hines CJ, Reid TM, et al. Neurologic Function among Termiticide Applicators Exposed to Chlorpyrifos. Environ Health Perspect. 2000; 108:293-300. doi: 10.1289/ehp.00108293

[31] Arnal N, Cristalli DO, de Alaniz MJ, Marra CA. Clinical Utility of Copper, Ceruloplasmin, and Metallothionein Plasma Determinations in Human Neurodegenerative Patients and their First-degree Relatives. Brain Res. 2010; 1319:118-30. doi: 10.1016/j.brainres.2009.11.085

[32] Arenas de Larriva AP, Limia-Pérez L, Alcalá-Díaz JF, Alonso A, López-Miranda J, Delgado-Lista J. Ceruloplasmin and Coronary Heart Disease-A Systematic Review. Nutrients. 2020;12:3219. doi: 10.3390/nu12103219

[33] Lozano-Paniagua D, Gómez-Martín A, Gil F, Parrón T, Alarcón R, Requena M, et al. Activity and Determinants of Cholinesterases and Paraoxonase-1 in Blood of Workers Exposed to Non-cholinesterase Inhibiting Pesticides. Chem Biol Interact. 2016; 259:160-7. doi: 10.1016/j.cbi.2016.04.008

[34] Mahrooz A, Mackness M, Bagheri A, Ghaffari-Cherati M, Masoumi P. The Epigenetic Regulation of Paraoxonase 1 (PON1) As An Important Enzyme in HDL Function: The Missing Link between Environmental and Genetic Regulation. Clin Biochem. 2019; 73:1-10. doi: 10.1016/j.clinbiochem.2019.07.010

[35] Wang CH, Hsiao CK, Chen CL, Hsu LI, Chiou HY, Chen SY, et al. A Review of the Epidemiologic Literature On the Role of Environmental Arsenic Exposure and Cardiovascular Diseases. Toxicol Appl Pharmacol. 2007; 222:315-26. doi: 10.1016/j.taap.2006.12.022

[36] Velmurugan G, Swaminathan K, Mohanraj S, Dhivakar M, Veerasekar G, Alexander T, et al. Association of Co-accumulation of Arsenic and Organophosphate Insecticides with Diabetes and Atherosclerosis in A Rural Agricultural Community: KMCH-NNCD-I Study. Acta Diabetol. 2020;57:1159-68. doi: 10.1007/s00592-020-01516-6

[37] Aminov Z, Haase RF, Pavuk M, Carpenter DO. Analysis of the Effects of Exposure to Polychlorinated Biphenyls and Chlorinated Pesticides on Serum Lipid Levels in Residents of Anniston, Alabama. Environ Health. 2013;12:108. doi: 10.1186/1476-069X-12-108

[38] Morselli E, Santos RS, Criollo A, Nelson MD, Palmer BF, Clegg DJ. The Effects of Oestrogens and their Receptors on Cardiometabolic Health. Nat Rev Endocrinol. 2017; 13:352-64. doi: 10.1038/nrendo.2017.12

[39] Wafa T, Nadia K, Amel N, Ikbal C, Insaf T, Asma K, et al. Oxidative Stress, Hematological and Biochemical Alterations in Farmers Exposed to Pesticides. J Environ Sci Health B. 2013;48:1058-69. doi: 10.1080/03601234.2013.824285

[40] Zhang B, Li XL, Zhao CR, Pan CL, Zhang Z. Interleukin-6 As A Predictor of the Risk of Cardiovascular Disease: A Meta-analysis of Prospective Epidemiological Studies. Immunol Invest. 2018;47:689-99. doi: 10.1080/08820139.2018.1480034