Browsing by Author "Mora, Ana M."

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    Health Effects of Pesticide Exposure in Latin American and the Caribbean Populations: A Scoping Review
    (Public Health Services, US Dept of Health and Human Services, 2022) Zúñiga-Venegas, Liliana A.; Jara, Juan P. Gutiérrez; Hyland, Carly; Cardenas, Andrés; Smith, Anna; Mora, Ana M.; Muñoz-Quezada, María Teresa; Lucero, Boris; Quirós-Alcalá, Lesliam; Butinof, Mariana; Buralli, Rafael; Fernandez, Ricardo A.; Foerster, Claudia; Gouveia, Nelson; Muñoz, María Pía; Ramírez-Santana, Muriel; Tirado, Noemi; Joode, Berna van Wendel; Calaf, Gloria M.; Handal, Alexis J.; Silva, Agnes Soares; Cortés Arancibia, Sandra Isabel; CEDEUS (Chile)
    © 2022, Public Health Services, US Dept of Health and Human Services. All rights reserved.BACKGROUND: Multiple epidemiological studies have shown that exposure to pesticides is associated with adverse health outcomes. However, the literature on pesticide-related health effects in the Latin American and the Caribbean (LAC) region, an area of intensive agricultural and residential pesticide use, is sparse. We conducted a scoping review to describe the current state of research on the health effects of pesticide exposure in LAC populations with the goal of identifying knowledge gaps and research capacity building needs. METHODS: We searched PubMed and SciELO for epidemiological studies on pesticide exposure and human health in LAC populations published between January 2007 and December 2021. We identified 233 publications from 16 countries that met our inclusion criteria and grouped them by health outcome (genotoxicity, neurobehavioral outcomes, placental outcomes and teratogenicity, cancer, thyroid function, reproductive outcomes, birth outcomes and child growth, and others). RESULTS: Most published studies were conducted in Brazil (37%, n = 88) and Mexico (20%, n = 46), were cross-sectional in design (72%, n = 167), and focused on farmworkers (45%, n = 105) or children (21%, n = 48). The most frequently studied health effects included genotoxicity (24%, n = 62) and neurobehavioral outcomes (21%, n = 54), and organophosphate (OP) pesticides were the most frequently examined (26%, n = 81). Forty-seven percent (n = 112) of the studies relied only on indirect pesticide exposure assessment methods. Exposure to OP pesticides, carbamates, or to multiple pesticide classes was consistently associated with markers of genotoxicity and adverse neurobehavioral outcomes, particularly among children and farmworkers. DISCUSSION: Our scoping review provides some evidence that exposure to pesticides may adversely impact the health of LAC populations, but methodological limitations and inconsistencies undermine the strength of the conclusions. It is critical to increase capacity building, integrate research initiatives, and conduct more rigorous epidemiological studies in the region to address these limitations, better inform public health surveillance systems, and maximize the impact of research on public policies.
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    Latin America and the Caribbean Code Against cancer 1st edition: Environment, occupation, and cancer
    (2023) Blanco, Estela; Algranti, Eduardo; Abdon Cifuentes, Luis; Lopez-Carrillo, Lizbeth; Mora, Ana M.; Rodriguez-Guzman, Julietta; Andrea Rodriguez-Villamizar, Laura; Veiga, Lene H. S.; Canelo-Aybar, Carlos; Nieto-Gutierrez, Wendy; Feliu, Ariadna; Espina, Carolina; Ferreccio, Catterina
    Within the framework of the Latin America and Caribbean region (LAC) Code Against Cancer 1st edition, the current work presents recommendations to reduce exposure to environmental and occupational carcinogenic agents relevant for LAC. Using the methodology established by the International Agency for Research on Cancer (IARC) in the World Code Against Cancer Framework and experience from developing the European Code Against Cancer 4th edition, a working group of LAC cancer-prevention experts reviewed the list of Group I IARC carcinogenic agents, identified prevalent environmental and occupational exposures in the region, and proposed evidence-based cancer prevention recommendations suited to the epidemiological, socioeconomic, and cultural conditions of LAC countries. Two sets of recommendations were drafted: those targeting the general public and a second set for policymakers. Outdoor and indoor air pollution, ultra-violet radiation and occupational exposures to silica dust, asbestos, benzene, diesel, and welding fumes were identified as prevalent carcinogens in LAC and as agents that could be reduced or eliminated to prevent cancers. Recommendations for additional risk factors were not included due to insufficient data of their attributable burden in LAC (sunbeds, radon, aflatoxin), or lack of a clear preventive action to be taken by the individual (arsenic in drinking water, medical radiation), or lack of evidence of carcinogenicity effect (bisphenol A, phthalates, and pesticides). A broad consensus was reached on environmental and occupational carcinogenic exposures present throughout the LAC region and on individual-level and public policy-level recommendations to reduce or eliminate these exposures. Key educational content for the dissemination of these recommendations was also developed as part of LAC Code Against Cancer 1st Edition.