Association between pesticide use and liver injury: A field study in Taiwan.

Abstract

Pesticides are crucial for agricultural development but can be harmful to humans. We conducted a study to investigate the association between pesticide use and liver injury. We recruited participants ≥40 years from a district with two agricultural regions where water caltrops and mangoes are cultivated. A random sample of 200 residents from each region was selected, and prevalence ratios (PR) for abnormal liver tests were compared. A total of 331 individuals participated (participation rate: 82.8%), with 151 from the water caltrop region and 180 from the mango region. Most participants were ≥60 years and predominantly female. Pesticide users had a higher risk of abnormal liver tests [PR 1.74, 95% confidence interval (CI) 1.15-2.62]. Stratified analyses showed higher risks among those with a positive HBsAg test (PR 2.50, 95% CI 1.34-4.64) or a positive anti-HCV Ab test (PR 10.61, 95% CI 6.00-18.77). Multivariable analysis identified a positive HBsAg test [adjusted PR (PR_adj) 3.21, 95% CI 1.38-7.48], a positive anti-HCV Ab test (PR_adj 23.52, 95% CI 11.30-48.96), and upward pesticide spraying (PR_adj 3.39, 95% CI 1.52-7.54) as independent risk factors for abnormal liver tests. Pesticide use was associated with a higher risk of liver injury, particularly among upward sprayers and those with hepatitis B or C infection. The proportion of abnormal liver test cases attributable to upward pesticide spraying in this population might be as large as hepatitis B, supporting the importance of pesticide exposure.