22
Aug
Toxic Pesticides Increase Rates of Chronic Kidney Disease in Agricultural Communities
(Beyond Pesticides, August 22, 2024) A screening and analysis of 36 pesticides finds traces of these chemicals in patients with “unexplained chronic kidney disease†from agricultural communities in the Indian province of Uttar Pradesh. Researchers conducting this study, published in the Journal of Toxicology and Environmental Health Sciences, identify organophosphates, organochlorines, and pyrethroids as the main culprits, building on years of existing research pointing to adverse health impacts originating from bioaccumulation of pesticides after acute and chronic exposure.
Chronic kidney disease (CKD) is a condition that afflicts one in ten adults internationally, based on a peer-reviewed analysis from The Lancet. The Centers for Disease Control and Prevention (CDC) estimate that one in seven U.S. adults (or roughly 35.5 million people) have CKD, with as many as nine in ten adults with the disease undiagnosed, based on 2023 data. The correlation between high rates of CKD and multigenerational use of and reliance on pesticides for food production, lawn care, and general land management reinforces the calls of advocates, farmers, and health professionals to adopt a new approach rooted in organic principles.
Methodology
This study was conducted by a group of researchers from the Department of Chemistry at Babu Banarasi Das University and the Biochemistry and Nephrology Departments at Dr. Ram Manohar Lohia Institute of Medical Sciences in Uttar Pradesh, India. As a prospective case-control study (enrolling study participants before symptoms occur), researchers declared no conflict of interest and followed both internal ethics guidelines and the World Medical Association (WMA) Declaration of Helsinki, the latter of which is a statement of ethical principles established in 1964 to guide human-centered medical research.
With the goal of identifying potential exposure pathways for patients with chronic kidney disease of unknown origin (CKDu), researchers enlisted patients from two health centers in Uttar Pradesh. This province is notable given that the majority of the population (approximately 237 million residents as of 2020) work in agriculture as their primary occupation, which means that roughly 23.7 million people are projected to have chronic kidney disease. Patients that had “episodes of acute kidney injury or any need for renal replacement therapy were excluded from the study.†The control group for this case-control population study consisted of participants from family members, spouses, or any others accompanying the selected patient. Further screening for geographical and age variation, as well as the exclusion of patients who met the CKDu criteria but had confounding health variables that would have disrupted the study, led to the final number of one hundred cases and one hundred corresponding control participants. See the methods section for further details.
Findings
Out of 150 commonly used pesticides, researchers identified 36 pesticides—15 organophosphates, eight organochlorines, and 13 pyrethroids—in the bloodstream of both groups of study participants. “The findings of the study indicate widespread exposure to pesticides among individuals in agricultural areas, with residues detected in both CKDu patients and controls,†as the authors report on the importance of further research to identify more links between CKDu patients and their accompanying control participants. Of the 36 pesticides, malathion, parathion, carbophenothion, azinphosmethyl, chloroneb, HCB, beta HCH, pp’-DDE (DDT metabolite), phenylphenol, transfluthrin, flucythrinate-1, and flucythrinate-2 were all found to be “significantly elevated†among CKD patients compared to the control group. The researchers emphasize “that CKD is associated with greater serum and lower urinary levels of several pesticides…indicating accumulation of various commonly used pesticides in CKD†because it suggests that afflicted patients discharge pesticides less efficiently, which in turn can exacerbate kidney damage and lead to spiraling health impacts.
Existing Research
This study builds on numerous reports that demonstrate the adverse health effects of pesticides on kidney health among various at-risk subpopulations, including women, pregnant women, and agricultural workers, as well as broader populations in various geographical contexts.
For example, a 2022 study published in International Journal of Environmental Research and Public Health found that acute kidney failure is the leading cause of death for agricultural workers in Brazil, based on mortality data from 1980 to 2014, with younger women in rural areas in southern regions of the nation at the highest levels of risk. Rates are also increasing in urban areas of Brazil in the target regions, but not as much as their rural counterparts – a trend consistent across high-, middle-, and low-income nations. A 2023 study in PLOS One corroborates the elevated risk of CKD and CKDu in female agricultural workers in Iran. Female agricultural workers in indoor settings face disproportionate risks, including among women who exhibit zero additional underlying health conditions such as diabetes mellitus and hypertension. More specifically, women face 2.6 times the prevalence of CKD than participating male subjects in this report.
A four-year investigation published in 2012, led by Channa Jayasumana, PhD and Sarath Guanatilake, MD from the Department of Medicine at Rajarata University in partnership with the World Health Organization, identifies pesticides and fertilizers (including cadmium and arsenic-based pesticides, as well as glyphosate) as dominating factors leading to CKD in agricultural communities across Sri Lanka. The two researchers won the 2019 Scientific Freedom and Responsibility Award (per the American Association for the Advancement of Science) for this research linking glyphosate-based herbicide use to elevated risk of CKD. A 2022 study published in npj Clean Water built on this investigation, identifying various insecticides (organochlorine insecticides DDT/DDE, propanil, and endosulfan, and the organophosphate diazinon—none of which are permitted for use in the United States or European Union) in well waters located in agricultural regions of the nation. Simply put, researchers attribute the prevalence of chronic kidney disease of unknown origin to rampant pesticide use.
The culmination of decades of scientific studies, data, and analysis points to what advocates would describe as the need to take transformative action for food production and land management systems. See Daily News sections on kidney failure and CKD for more information.
Take Action
Agricultural justice is a keystone example of ongoing environmental justice concerns among farmworker and farming communities within and outside the United States. See the Pesticide-Induced Disease Database entry on kidney function and disease to delve into dozens of peer-reviewed scientific literature on the connections between kidney health and toxic pesticide exposure. See the Gateway on Pesticide Hazards and Safe Pest Management sections on malathion, parathion, and other toxic pesticides in this study to find additional information and resources on their adverse health effects. For more information on moving beyond toxic pesticides in your local park or playing fields, see the Parks for a Sustainable Future program.
All unattributed positions and opinions in this piece are those of Beyond Pesticides.
