SHORT REPORT

Association of allergic rhinitis with pesticide use among grape farmers in Crete, Greece

Leda Chatzi¹, Athanasios Alegakis², Nikolaos Tzanakis³, Nikolaos Siafakas³, Manolis Kogevinas^1,4, Christos Lionis¹

¹ Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
² Biostatistics Laboratory, Faculty of Medicine, University of Crete, Heraklion, Greece
³ Department of Thoracic Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
⁴ Center for Research in Environmental Epidemiology, IMIM, Barcelona, Spain

Correspondence to:
Dr L Chatzi
Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece; lchatzi{at}med.uoc.gr

Objective: To explore the association of allergic rhinitis with the use of pesticides among grape farmers in Crete.

Methods: A cross-sectional study of 120 grape farmers and 100 controls at the Malevisi region in Northern Crete was conducted. The protocol consisted of a questionnaire, skin prick tests for 16 common allergens, measurement of specific IgE antibodies against 8 allergens, and spirometry before and after bronchodilatation.

Results: Grape farmers who used pesticides had higher prevalence rates of allergic rhinitis symptoms (OR, 3.0; 95% CI, 1.4 to 6.2) compared with grape farmers who reported no current use of pesticides, and control subjects. Logistic regression models controlling for age, sex and smoking status showed that 6 of the 12 predefined groups of major pesticides were significantly related to allergic rhinitis symptoms. The highest risks were observed for paraquat and other bipyridyl herbicides (OR, 2.2; 95% CI, 1.0 to 4.8), dithiocarbamate fungicides (OR, 2.5; 95% CI, 1.1 to 5.3) and carbamate insecticides (OR, 3.0; 95% CI, 1.4 to 6.5). A factor analysis of pesticides used identified 3 distinct factors. The most common factor was that of multiple pesticide use that included 9 pesticides and was significantly associated with allergic rhinitis (OR, 1.5; 95% CI, 1.0 to 2.3). ORs were higher when allergic rhinitis was defined using both questionnaire data on symptoms and atopy.

Conclusions: Occupational exposure to multiple agricultural chemicals could be related to allergic rhinitis in grape farmers.

Abbreviations: AR, allergic rhinitis; SPT, skin prick test

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