Pesticide exposure and cancer among rural workers from Bariri, Sao Paulo State, Brazil.

This article reports an environmental health study on risk identification. It discusses risk factors linked to rural work and pesticide contact in a restricted geographic area and shows the necessity of improving rural workers' health in the central part of Sao Paulo State. The municipality of Bariri, which is the case studied in this research, typifies this agriculturally based region. The study focuses on environmental problems engendered by modern agriculture that may have human-health repercussions such as cancer, as indicated by hard statistical association on an extended cause-effect time scale. For specific cases, the research used a database containing records of Amaral Carvalho Hospital, located in the city of Jau and a highly respected regional reference unit for over 85 years as one of the best in the Brazilian public health system for treating cancer. Statistics for age and gender were analyzed; relative risk was calculated for a group of cases registered from 2000 to 2002, as well as for a randomly selected control group from the same hospital. A map indicating the residences of cases (68) and non-cases (60) was made by geoprocessing techniques. For the period of time and the group studied, the authors concluded that the cancers of the skin and digestive system were the most prevalent. Bariri presented 24 cases representing all cancer types for each group of 10,000 citizens. The study indicated an almost two times higher probability of cancer development among rural workers, with a calculated relative risk between those exposed (agriculture workers) and the non-exposed (other occupations) of 1.6. No patterns of geographical distribution of cancer in that time period were recorded among rural workers of Bariri. However, the higher number of positive occurrences in the southwestern outskirts of the city indicated an area that must be prioritized in distributing environmental health information and conducting preventive education campaigns.