Mortalidade de trabalhadores agrícolas por câncer de próstata e a exposição a agrotóxicos no estado do Paraná

Abstract

Agricultural workers are directly and indirectly exposed to pesticides, which generates a significant burden to their health, due to the intrinsic toxicity of these substances and the ability to promote the development of hormone-dependent cancers, including prostate cancer. Since the 2000s, there has been an increasing number of Brazilian studies evaluating the negative externalities of pesticides on workers' health; however, there is still a lack of studies on prostate cancer. Therefore, this thesis aimed to analyze the mortality of agricultural workers from prostate cancer in the state of Paraná between 2003 and 2020 and its relationship with exposure to pesticides. This is an ecological and exploratory study. Data were obtained from the Mortality Information System (SIM), the Annual Report of Social Information (RAIS), the Monitoring System of Trade and Use of Pesticides in the State of Paraná, and the Municipal Agricultural Production of the Brazilian Institute of Geography and Statistics (IBGE). We calculated the mortality rates and trends of agricultural workers for prostate cancer (per 100,000 inhabitants) and their odds ratios for death. Correlations between death rate and some agricultural variables were analyzed by Moran's Index and by a spatial linear regression model. The analyses showed a significant decreasing trend (p=0.043) of the prostate cancer mortality rate for agricultural workers. Despite the downward trend, this population is considered vulnerable, since the mortality rates of rural workers were higher than those of other occupations throughout the period of analysis. Moreover, high odds ratios of mortality for the neoplasm studied are verified in this group, reaching a risk 12.19 times higher (95%CI 10.07 - 14.76) in 2008, when compared to other workers. Between 2013 and 2020, there was an increase of 12.70% in the consumption of pesticides in Paraná. The planted area grew only 3.34%, i.e., there was an increase in the amount of pesticides used per hectare, from 8.87 kg/ha in 2013 to 9.82 kg/ha in 2020. It is noteworthy that the active ingredients of pesticides most used in Paraná crops were glyphosate and paraquat, products that have biological plausibility for the occurrence of cancer. Furthermore, the spatial regression model showed a significant association (p<0.010) between the prostate cancer mortality rate and the rate of pesticide consumption. It is concluded that the population of rural workers is at a higher risk of death from prostate cancer. The existence of a relationship between exposure to pesticides and the development of this neoplasm cannot be ruled out. These data are expected to assist in the development of public policies and actions to reduce mortality from prostate cancer in this population, and to promote strategies to control the use of pesticides, contributing to the achievement of goal 3 "health and well-being" of the Sustainable Development Goals.