Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas
Resumen: Introducción: La exposición ocupacional a plaguicidas se ha correlacionado con alteraciones del sistema nervioso central dando lugar a enfermedades como la enfermedad de Parkinson y las demencias. Este estudio tuvo como objetivo identificar la evidencia existente sobre las alteraciones neur...
- Autores:
-
González Russi, Gyra Alejandra
Gómez Esteban, Natalia
Barrera Barrera , Julián David
- Tipo de recurso:
- https://purl.org/coar/resource_type/c_7a1f
- Fecha de publicación:
- 2025
- Institución:
- Universidad El Bosque
- Repositorio:
- Repositorio U. El Bosque
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unbosque.edu.co:20.500.12495/13931
- Acceso en línea:
- https://hdl.handle.net/20.500.12495/13931
- Palabra clave:
- Plaguicidas
Exposición ocupacional
Enfermedades del sistema nervioso
Enfermedad de Alzheimer
Enfermedad de Parkinson
658.38
Pesticides
Occupational exposure
Diseases of the central nervous system
Alzheimer's disease
Parkinson's disease
- Rights
- License
- Attribution-NonCommercial-ShareAlike 4.0 International
id |
UNBOSQUE2_89f88b690608cb90d77748339caa7481 |
---|---|
oai_identifier_str |
oai:repositorio.unbosque.edu.co:20.500.12495/13931 |
network_acronym_str |
UNBOSQUE2 |
network_name_str |
Repositorio U. El Bosque |
repository_id_str |
|
dc.title.none.fl_str_mv |
Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas |
dc.title.translated.none.fl_str_mv |
Scoping review: neurocognitive disorders in workers exposed to pesticides |
title |
Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas |
spellingShingle |
Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas Plaguicidas Exposición ocupacional Enfermedades del sistema nervioso Enfermedad de Alzheimer Enfermedad de Parkinson 658.38 Pesticides Occupational exposure Diseases of the central nervous system Alzheimer's disease Parkinson's disease |
title_short |
Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas |
title_full |
Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas |
title_fullStr |
Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas |
title_full_unstemmed |
Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas |
title_sort |
Scoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidas |
dc.creator.fl_str_mv |
González Russi, Gyra Alejandra Gómez Esteban, Natalia Barrera Barrera , Julián David |
dc.contributor.advisor.none.fl_str_mv |
López Michelena, Luis Ignacio Giraldo Luna, Clara Margarita |
dc.contributor.author.none.fl_str_mv |
González Russi, Gyra Alejandra Gómez Esteban, Natalia Barrera Barrera , Julián David |
dc.contributor.orcid.none.fl_str_mv |
González Russi, Gyra Alejandra [0009-0003-4623-1357] Gómez Esteban, Natalia [0009-0002-7386-6641] Barrera Barrera, Julián David [0009-0003-3304-638X] |
dc.subject.none.fl_str_mv |
Plaguicidas Exposición ocupacional Enfermedades del sistema nervioso Enfermedad de Alzheimer Enfermedad de Parkinson |
topic |
Plaguicidas Exposición ocupacional Enfermedades del sistema nervioso Enfermedad de Alzheimer Enfermedad de Parkinson 658.38 Pesticides Occupational exposure Diseases of the central nervous system Alzheimer's disease Parkinson's disease |
dc.subject.ddc.none.fl_str_mv |
658.38 |
dc.subject.keywords.none.fl_str_mv |
Pesticides Occupational exposure Diseases of the central nervous system Alzheimer's disease Parkinson's disease |
description |
Resumen: Introducción: La exposición ocupacional a plaguicidas se ha correlacionado con alteraciones del sistema nervioso central dando lugar a enfermedades como la enfermedad de Parkinson y las demencias. Este estudio tuvo como objetivo identificar la evidencia existente sobre las alteraciones neurocognitivas en trabajadores expuestos a plaguicidas. Metodología: Se realizó un scoping review en los motores de búsqueda PubMed, Clinical Key, SpringerLink, Web of Science y Elsevier. Las palabras claves fueron "Pesticides", “Cognitive Dysfunction", "Neurocognitive Disorders", "Neurological Disorders" y “Cognitive Function", y se incluyeron investigaciones publicadas entre 2019 y 2024. Los criterios de inclusión fueron delineados con las características de la población, el concepto y el contexto (PCC): trabajadores expuestos a plaguicidas, desarrollo de alteraciones neurocognitivas y exposición ocupacional a plaguicidas. Resultados: La revisión incluyó 20 artículos, destacando la asociación entre exposición ocupacional a plaguicidas y el desarrollo de enfermedades neurocognitivas como EA, EP y deterioro cognitivo. Varios plaguicidas tienen asociaciones estadísticamente significativas con las alteraciones neurocognitivas; además, existen varios factores de riesgo como el tiempo de exposición, frecuencia de aplicación y el uso insuficiente de EPP. La inhibición de enzimas como la AChE y la BChE se relaciona con déficits neurocognitivos. Conclusiones: La exposición ocupacional a plaguicidas se relaciona con el desarrollo de alteraciones neurocognitivas, principalmente la EP y la EA, además de afectar funciones cognitivas esenciales como la memoria y la atención. Se han identificado varios plaguicidas específicos que aumentan el riesgo de patologías neurocognitivas (clorpirifos, β-hexaclorociclohexano, diclorodifenildicloroetileno, paraquat, rotenona, diquat, 2,4,5-T y trifluralina). Sin embargo, todos los grupos de plaguicidas se han relacionado con la aparición de alteraciones neurocognitivas. |
publishDate |
2025 |
dc.date.accessioned.none.fl_str_mv |
2025-02-12T13:05:09Z |
dc.date.available.none.fl_str_mv |
2025-02-12T13:05:09Z |
dc.date.issued.none.fl_str_mv |
2025-01 |
dc.type.coar.fl_str_mv |
http://purl.org/coar/resource_type/c_7a1f |
dc.type.local.none.fl_str_mv |
Tesis/Trabajo de grado - Monografía - Especialización |
dc.type.coar.none.fl_str_mv |
https://purl.org/coar/resource_type/c_7a1f |
dc.type.driver.none.fl_str_mv |
info:eu-repo/semantics/bachelorThesis |
dc.type.coarversion.none.fl_str_mv |
https://purl.org/coar/version/c_ab4af688f83e57aa |
format |
https://purl.org/coar/resource_type/c_7a1f |
dc.identifier.uri.none.fl_str_mv |
https://hdl.handle.net/20.500.12495/13931 |
dc.identifier.instname.spa.fl_str_mv |
instname:Universidad El Bosque |
dc.identifier.reponame.spa.fl_str_mv |
reponame:Repositorio Institucional Universidad El Bosque |
dc.identifier.repourl.none.fl_str_mv |
repourl:https://repositorio.unbosque.edu.co |
url |
https://hdl.handle.net/20.500.12495/13931 |
identifier_str_mv |
instname:Universidad El Bosque reponame:Repositorio Institucional Universidad El Bosque repourl:https://repositorio.unbosque.edu.co |
dc.language.iso.fl_str_mv |
spa |
language |
spa |
dc.relation.references.none.fl_str_mv |
1. Departamento Administrativo Nacional de Estadística. 3er Censo Nacional Agropecuario [Internet]. Bogotá; 2015 Jul [cited 2024 Oct 22]. Available from: https://www.dane.gov.co/files/CensoAgropecuario/entrega-definitiva/Boletin1-Uso-del-suelo/1-Boletin.pdf. 2. Richardson JR, Fitsanakis V, Westerink RHS, Kanthasamy AG. Neurotoxicity of pesticides. Vol. 138, Acta Neuropathologica; 2019. p. 343–62. 3. Ministerio de Ambiente y Desarrollo Sostenible. Lo que todos debemos saber sobre Contaminantes Orgánicos Persistentes [Internet]. Bogotá; 2017 [cited 2024 Oct 22]. Available from: https://quimicos.minambiente.gov.co/wp-content/uploads/2021/05/Cartilla_Conociendo_los_COP_2017.pdf 4. Gallo Ó, Hawkins D, Luna-García J, Torres-Tovar M. Trabajo decente y saludable en la agroindustria en América Latina. Revisión sistemática resumida. Revista Facultad Nacional de Salud Pública. 2019 May 31;37(2). DOI: https://doi.org/10.17533/udea.rfnsp.v37n2a03 5. Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editors. Harrison's Principles of Internal Medicine. 21st ed. New York: McGraw-Hill Education; 2022. 6. Weinberg MS, Holiman JJ. Neurocognitive Disorders. In: Ferri’s Clinical Advisor. 2022. p. 1059-1061. 7. Aloizou AM, Siokas V, Vogiatzi C, Peristeri E, Docea AO, Petrakis D, et al. Pesticides, cognitive functions and dementia: A review. Toxicology Letters. 2020 Jun 15;326:31–51. 8. Flores-Gutierrez CA, Torres-Sanchez ED, Reyes-Uribe E, Torres-Jasso JH, Reyna-Villela MZ, Rojas-Bravo D, et al. The Association between Pesticide Exposure and the Development of Fronto-Temporal Dementia-Cum-Dissociative Disorders: A Review. Vol. 13, Brain Sciences; 2023. 9. Hayden KM, Norton MC, Darcey D, Østbye T, Zandi PP, Breitner JCS, et al. Occupational exposure to pesticides increases the risk of incident AD. Neurology [Internet]. 2010 May 11 [cited 2024 Nov 16];74(19):1524–30. Available from: https://www.neurology.org/doi/10.1212/WNL.0b013e3181dd4423. 10. Steenland K, Wesseling C, Román N, Quirós I, Juncos JL. Occupational pesticide exposure and screening tests for neurodegenerative disease among an elderly population in Costa Rica. Environmental Research. 2013 Jan;120:96–101. 11. Baldi I, Lebailly P, Mohammed-Brahim B, Letenneur L, Dartigues JF, Brochard P. Neurodegenerative diseases and exposure to pesticides in the elderly. American Journal of Epidemiology. 2003 Mar 1;157(5):409–14. 12. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Vol. 169, Annals of Internal Medicine. American College of Physicians; 2018. p. 467–73. 13. Schneider Medeiros M, P. Reddy S, P. Socal M, Schumacher-Schuh AF, Mello Rieder CR. Occupational pesticide exposure and the risk of death in patients with Parkinson’s disease: An observational study in southern Brazil. Environmental Health: A Global Access Science Source. 2020 Jun 17;19(1). DOI:10.1186/s12940-020-00624-8 14. Silvestre GCSB, Ferreira MJM, Figueiredo Sue EFMR, Silva CAL, Siqueira HH, Silva AMC. Parkinson disease and occupational and environmental exposure to pesticides in a region of intense agribusiness activity in Brazil: a case-control study. Journal of Occupational and Environmental Medicine. 2020 Dec 1;62(12):e732–7. DOI: 10.1097/JOM.0000000000002043 15. Perrin L, Spinosi J, Chaperon L, Kab S, Moisan F, Ebaz A. Pesticides expenditures by farming type and incidence of Parkinson disease in farmers: A French nationwide study. Environ Res [Internet]. 2021 Jun [cited 2024 Nov 16];197:111161. DOI: 10.1016/j.envres.2021.111161 16. Sturm ET, Castro C, Mendez-Colmenares A, Duffy J, Burzynska AAZ, Stallones L, et al. Risk Factors for Brain Health in Agricultural Work: A Systematic Review. Int J Environ Res Public Health [Internet]. 2022 Mar 13;19(6). Available from: http://www.ncbi.nlm.nih.gov/pubmed/35329061. DOI:10.3390/ijerph19063373 17. Brown EG, Goldman SM, Coffey CS, Siderowf A, Simuni T, Meng C, et al. Occupational Pesticide Exposure in Parkinson’s Disease Related to GBA and LRRK2 Variants. Journal of Intelligent and Fuzzy Systems. 2024 Jun 4;14(4):737–46 DOI: 10.3233/JPD-240015 18. de Graaf L, Boulanger M, Bureau M, Bouvier G, Meryet-Figuiere M, Tual S, et al. Occupational pesticide exposure, cancer and chronic neurological disorders: A systematic review of epidemiological studies in greenspace workers. Environ Res [Internet]. 2022 Jan 1 [cited 2024 Nov 16];203:111822. DOI10.1016/j.envres.2021.111822 19. Shrestha S, Parks CG, Umbach DM, Richards-Barber M, Hofmann JN, Chen H, et al. Pesticide use and incident Parkinson’s disease in a cohort of farmers and their spouses. Environmental Research. 2020 Dec 1;191. DOI: 10.1016/j.envres.2020.110186 20. Arab A, Mostafalou S. Neurotoxicity of pesticides in the context of CNS chronic diseases. Vol. 32, International Journal of Environmental Health Research; 2022. p. 2718–55. DOI: 10.1080/09603123.2021.1987396 21. Lini RS, Scanferla DTP, de Oliveira NG, Aguera RG, Santos T da S, Teixeira JJV, et al. Fungicides as a risk factor for the development of neurological diseases and disorders in humans: a systematic review. Vol. 54, Critical Reviews in Toxicology; 2024. p. 35–54. DOI: 10.1080/10408444.2024.2303481 22. Wongta A, Hongsibsong S, Xu ZL, Chantara S, Pattarawarapan M, Sapbamrer R, et al. The Relationship of Organophosphate Pesticide Exposure and Cognitive Decline Among Residents of an Agricultural Area in Northern Thailand. Journal of Health Research. 2023;37(6):372–9. DOI: 10.56808/2586-940X.1035 23. Rosales-Rimache J, Machado-Pereyra P, Bendezu-Quispe G. Relationship between Butyrylcholinesterase Activity and Cognitive Ability in Workers Exposed to Chlorpyrifos. Safety. 2023 Mar 1;9(1). DOI: 10.3390/safety9010012 24. Medehouenou TCM, Ayotte P, Carmichael PH, Kröger E, Verreault R, Lindsay J, et al. Exposure to polychlorinated biphenyls and organochlorine pesticides and risk of dementia, Alzheimer’s disease and cognitive decline in an older population: A prospective analysis from the Canadian Study of Health and Aging. Environmental Health: A Global Access Science Source. 2019 Jun 14;18(1). https://doi.org/10.1186/s12940-019-0494-2 25. Tiwari S, Sapkota N, Tiwari S, Sapkota B. Association between pesticide exposure and neurobehavioral performance of agricultural workers: A cross-sectional study. Brain and Behavior. 2022 Jul 1;12(7). DOI: 10.1002/brb3.2641 26. Mora AM, Baker JM, Hyland C, Rodríguez-Zamora MG, Rojas-Valverde D, Winkler MS, et al. Pesticide exposure and cortical brain activation among farmworkers in Costa Rica. NeuroToxicology. 2022 Dec 1;93:200–10. DOI10.1016/j.neuro.2022.10.004 27. Pawestri IN, Sulistyaningsih E. Neurobehavioral performance of Indonesian farmers and its association with pesticide exposure: A cross-sectional study. Clinical Epidemiology and Global Health. 2021 Jul 1;11:100754. https://doi.org/10.1016/j.cegh.2021.100754 28. Kumar D, Sinha SN. Chronic exposures to cholinesterase-inhibiting pesticides adversely affects the health of agricultural workers in India. Environmental Research. 2024 Jul 1;252. DOI: 10.1016/j.envres.2024.118961 29. Aguera RG, Freires C, Oliveira LO de, Monteiro LR, Lini RS, Romoli JCZ, et al. Risk evaluation of occupational exposure of southern Brazilian flower farmers to pesticides potentially leading to cholinesterase inhibition and metals exposure. Environmental Toxicology and Pharmacology. 2022 Jul 1;93:103874. DOI: 10.1016/j.etap.2022.103874 30. Filippi I, Lucero P, Bonansea RI, Lerda D, Butinof M, Fernandez RA, et al. Validation of exposure indexes to pesticides through the analysis of exposure and effect biomarkers in ground pesticide applicators from Argentina. Heliyon. 2021 Sep 1;7(9). https://doi.org/10.1016/j.heliyon.2021.e07921 31. Amoatey P, Al-Mayahi A, Omidvarborna H, Baawain MS, Sulaiman H. Occupational exposure to pesticides and associated health effects among greenhouse farm workers. Vol. 27, Environmental Science and Pollution Research. Springer; 2020. p. 22251–70. https://doi.org/10.1007/s11356-020-08754-9 32. Ramírez-Santana M, Zúñiga-Venegas L, Corral S, Roeleveld N, Groenewoud H, van der Velden K, et al. Reduced neurobehavioral functioning in agricultural workers and rural inhabitants exposed to pesticides in northern Chile and its association with blood biomarkers inhibition. Environmental Health: A Global Access Science Source. 2020 Jul 22;19(1). https://doi.org/10.1186/s12940-020-00634-6 33. Campdelacreu J. Parkinson's disease and Alzheimer disease: environmental risk factors. Neurología. 2014 Nov; 29(9):541–9. 34. Wirdefeldt K, Adami HO, Cole P, Trichopoulos D, Mandel J. Epidemiology and etiology of Parkinson’s disease: a review of the evidence. Eur J Epidemiol [Internet]. 2011 Jun 28 [cited 2024 Nov 16];26(S1):1–58. Available from: http://link.springer.com/10.1007/s10654-011-9581-62. 35. Chondrogiorgi M, Tzoulaki I, Evangelou E, Ntritsos G, Tseretopoulou X, Pappa M, et al. Pesticide exposure and parkinsonism: A systematic review and meta-analysis. Parkinsonism Relat Disord [Internet]. 2016 Jan [cited 2024 Nov 16];22:e127–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1353802015007403 2016;22. 36. Armenteros BFM. Enfermedad de Alzheimer y factores de riesgo ambientales. Rev Cuba Enf. 2017;33(1):159-172 37. Murray MT, Nowicki J. Alzheimer’s Disease. In: Textbook of Natural Medicine. 5th ed. Minnesota: Elsevier; 2020. p. 1090-1099.e3. 38. Mostafalou S, Abdollahi M. The link of organophosphorus pesticides with neurodegenerative and neurodevelopmental diseases based on evidence and mechanisms. Toxicology. 2018 Nov;409:44–52. 39. Ávila-Camargo A, Barreiro-Zambrano A, Sánchez-Calderón D, López-Michelena LI. Efectos cardiovasculares de la exposición ocupacional a pesticidas. Revista médica Risaralda [Internet]. 2024 Dec [cited 2024 Nov 6];30(1):107-118. DOI: https://doi.org/10.22517/25395203.25444. 40. López Michelena LI, Giraldo Luna CM, Yepes Boada A, Colmenares Ardila LF, Martínez Burgos M, Niño Bernal DC. Exposición a plaguicidas y desarrollo de leucemia en trabajadores del sector agrícola [Internet]. 2024 Dec [cited 2024 Nov 6]. Available from: https://repositorio.unbosque.edu.co/items/f8687996-78e3-4f2e-ae30-9f55a86a99bc 41. Toro-Osorio BM, Rojas-Rodríguez AE, Díaz-Zapata JA. Levels of serum cholinesterase in coffee growers from the caldas department, Colombia. Revista de Salud Publica. 2017 Jul 1;19(3):318–24. 42. Caro-Gamboa LJ, Forero-Castro M, Dallos-Baez AE. Cholinesterase inhibition as a biomarker for the surveillance of the occupationally exposed population to organophosphate pesticides. Ciencia Tecnología Agropecuaria. 2020 Jul 2;21(3). 43. Insecticide Resistance Action Committee. Insecticide Mode of Action Training slide deck IRAC MoA Workgroup [Internet]. 2019 [cited 2025 Jan 17]. Available from: https://irac-online.org/documents/tutorial-on-moa-mechanisms/?ext=pdf 44. Instituto Colombiano Agropecuario. Subgerencia de protección vegetal restricciones, prohibiciones y suspensión de registros de plaguicidas de uso agrícola en colombia [Internet]. Instituto Colombiano Agropecuario. 2021 [cited 2025 Jan 17]. Available from:https://www.ica.gov.co/getdoc/b2e5ff99-bd80-45e8-aa7a-e55f0b5b42dc/plaguicidas-prohibidos.aspx |
dc.rights.en.fl_str_mv |
Attribution-NonCommercial-ShareAlike 4.0 International |
dc.rights.coar.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
dc.rights.uri.none.fl_str_mv |
http://creativecommons.org/licenses/by-nc-sa/4.0/ |
dc.rights.local.spa.fl_str_mv |
Acceso abierto |
dc.rights.accessrights.none.fl_str_mv |
https://purl.org/coar/access_right/c_abf2 |
rights_invalid_str_mv |
Attribution-NonCommercial-ShareAlike 4.0 International http://creativecommons.org/licenses/by-nc-sa/4.0/ Acceso abierto https://purl.org/coar/access_right/c_abf2 http://purl.org/coar/access_right/c_abf2 |
dc.format.mimetype.none.fl_str_mv |
application/pdf |
dc.publisher.program.spa.fl_str_mv |
Especialización en Seguridad y Salud en el Trabajo |
dc.publisher.grantor.spa.fl_str_mv |
Universidad El Bosque |
dc.publisher.faculty.spa.fl_str_mv |
Facultad de Medicina |
institution |
Universidad El Bosque |
bitstream.url.fl_str_mv |
https://repositorio.unbosque.edu.co/bitstreams/46cbe6c1-f62c-4ce8-a93d-33f953460724/download https://repositorio.unbosque.edu.co/bitstreams/54514bba-b4f7-4adc-b26e-efa53047d70e/download https://repositorio.unbosque.edu.co/bitstreams/6fa9b7cc-4b01-4842-bdf4-f6781c6bcbba/download https://repositorio.unbosque.edu.co/bitstreams/d229abbd-cd50-4942-aa29-991a580812dd/download https://repositorio.unbosque.edu.co/bitstreams/9d72c7cf-bad9-4d92-ab0f-a819432b8782/download https://repositorio.unbosque.edu.co/bitstreams/31f5c025-f80b-4531-b8f9-39d6ef77a8de/download https://repositorio.unbosque.edu.co/bitstreams/3758eee0-6719-4a22-9054-6dab9ed0bbe5/download https://repositorio.unbosque.edu.co/bitstreams/c5c2e5d5-e7ca-4ba4-9ed0-f175719ddeff/download https://repositorio.unbosque.edu.co/bitstreams/0ff4a53c-b632-413d-945a-22c5dde87cd7/download |
bitstream.checksum.fl_str_mv |
5495bddb2a834d377e9deff17582107a 17cc15b951e7cc6b3728a574117320f9 39f37438e348dbaff9ad94eadf03b742 39f37438e348dbaff9ad94eadf03b742 a5716acb81c92b38e3453e4692f36f55 de6e670c8a914efb23b6d1b7af57855d 5643bfd9bcf29d560eeec56d584edaa9 0dc8946c5b124f5e16b5a00b6edf1bbe 0d7bb9fd424d693d4c6b8ee19a74ea89 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 MD5 MD5 MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositorio Institucional Universidad El Bosque |
repository.mail.fl_str_mv |
bibliotecas@biteca.com |
_version_ |
1828164406647717888 |
spelling |
López Michelena, Luis IgnacioGiraldo Luna, Clara MargaritaGonzález Russi, Gyra AlejandraGómez Esteban, NataliaBarrera Barrera , Julián DavidGonzález Russi, Gyra Alejandra [0009-0003-4623-1357]Gómez Esteban, Natalia [0009-0002-7386-6641]Barrera Barrera, Julián David [0009-0003-3304-638X]2025-02-12T13:05:09Z2025-02-12T13:05:09Z2025-01https://hdl.handle.net/20.500.12495/13931instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coResumen: Introducción: La exposición ocupacional a plaguicidas se ha correlacionado con alteraciones del sistema nervioso central dando lugar a enfermedades como la enfermedad de Parkinson y las demencias. Este estudio tuvo como objetivo identificar la evidencia existente sobre las alteraciones neurocognitivas en trabajadores expuestos a plaguicidas. Metodología: Se realizó un scoping review en los motores de búsqueda PubMed, Clinical Key, SpringerLink, Web of Science y Elsevier. Las palabras claves fueron "Pesticides", “Cognitive Dysfunction", "Neurocognitive Disorders", "Neurological Disorders" y “Cognitive Function", y se incluyeron investigaciones publicadas entre 2019 y 2024. Los criterios de inclusión fueron delineados con las características de la población, el concepto y el contexto (PCC): trabajadores expuestos a plaguicidas, desarrollo de alteraciones neurocognitivas y exposición ocupacional a plaguicidas. Resultados: La revisión incluyó 20 artículos, destacando la asociación entre exposición ocupacional a plaguicidas y el desarrollo de enfermedades neurocognitivas como EA, EP y deterioro cognitivo. Varios plaguicidas tienen asociaciones estadísticamente significativas con las alteraciones neurocognitivas; además, existen varios factores de riesgo como el tiempo de exposición, frecuencia de aplicación y el uso insuficiente de EPP. La inhibición de enzimas como la AChE y la BChE se relaciona con déficits neurocognitivos. Conclusiones: La exposición ocupacional a plaguicidas se relaciona con el desarrollo de alteraciones neurocognitivas, principalmente la EP y la EA, además de afectar funciones cognitivas esenciales como la memoria y la atención. Se han identificado varios plaguicidas específicos que aumentan el riesgo de patologías neurocognitivas (clorpirifos, β-hexaclorociclohexano, diclorodifenildicloroetileno, paraquat, rotenona, diquat, 2,4,5-T y trifluralina). Sin embargo, todos los grupos de plaguicidas se han relacionado con la aparición de alteraciones neurocognitivas.Especialista en Seguridad y Salud en el TrabajoEspecializaciónAbstract: Background: Occupational exposure to pesticides has been related with central nervous system alterations, leading to diseases such as Parkinson's disease and dementia. This study aimed to identify evidence on neurocognitive impairments in workers exposed to pesticides. Methodology: A scoping review was conducted using the searchers PubMed, Clinical Key, SpringerLink, Web of Science and Elsevier. The keywords used were "Pesticides," "Cognitive Dysfunction," "Neurocognitive Disorders," "Neurological Disorders," and "Cognitive Function," including studies published between 2019 and 2024. The inclusion criteria were defined considering population, concept, and context (PCC): workers exposed to pesticides, development of neurocognitive impairments and occupational exposure to pesticides. Results: The review included 20 articles that shows the association between occupational exposure to pesticides and the development of neurocognitive diseases such as AD, PD and cognitive impairment. Several pesticides have statistically significant associations with neurocognitive alterations; additionally, multiple risk factors were identified, including exposure duration, application frequency, and insufficient use of PPE. The inhibition of enzymes such as AChE and BChE is linked to neurocognitive deficits. Conclusions: Occupational exposure to pesticides is associated with the development of neurocognitive impairments, primarily PD and AD, affecting essential cognitive functions such as memory and attention. Several pesticides have been identified as a risk factor for neurocognitive disorders (chlorpyrifos, β-hexachlorocyclohexane, dichlorodiphenyldichloroethylene, paraquat, rotenone, diquat, 2,4,5-T, and trifluralin). However, all pesticide groups have been associated to the onset of neurocognitive alterations.application/pdfAttribution-NonCommercial-ShareAlike 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-sa/4.0/Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2PlaguicidasExposición ocupacionalEnfermedades del sistema nerviosoEnfermedad de AlzheimerEnfermedad de Parkinson658.38PesticidesOccupational exposureDiseases of the central nervous systemAlzheimer's diseaseParkinson's diseaseScoping review: alteraciones neurocognitivas en trabajadores expuestos a plaguicidasScoping review: neurocognitive disorders in workers exposed to pesticidesEspecialización en Seguridad y Salud en el TrabajoUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. Departamento Administrativo Nacional de Estadística. 3er Censo Nacional Agropecuario [Internet]. Bogotá; 2015 Jul [cited 2024 Oct 22]. Available from: https://www.dane.gov.co/files/CensoAgropecuario/entrega-definitiva/Boletin1-Uso-del-suelo/1-Boletin.pdf.2. Richardson JR, Fitsanakis V, Westerink RHS, Kanthasamy AG. Neurotoxicity of pesticides. Vol. 138, Acta Neuropathologica; 2019. p. 343–62.3. Ministerio de Ambiente y Desarrollo Sostenible. Lo que todos debemos saber sobre Contaminantes Orgánicos Persistentes [Internet]. Bogotá; 2017 [cited 2024 Oct 22]. Available from: https://quimicos.minambiente.gov.co/wp-content/uploads/2021/05/Cartilla_Conociendo_los_COP_2017.pdf4. Gallo Ó, Hawkins D, Luna-García J, Torres-Tovar M. Trabajo decente y saludable en la agroindustria en América Latina. Revisión sistemática resumida. Revista Facultad Nacional de Salud Pública. 2019 May 31;37(2). DOI: https://doi.org/10.17533/udea.rfnsp.v37n2a035. Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editors. Harrison's Principles of Internal Medicine. 21st ed. New York: McGraw-Hill Education; 2022.6. Weinberg MS, Holiman JJ. Neurocognitive Disorders. In: Ferri’s Clinical Advisor. 2022. p. 1059-1061.7. Aloizou AM, Siokas V, Vogiatzi C, Peristeri E, Docea AO, Petrakis D, et al. Pesticides, cognitive functions and dementia: A review. Toxicology Letters. 2020 Jun 15;326:31–51.8. Flores-Gutierrez CA, Torres-Sanchez ED, Reyes-Uribe E, Torres-Jasso JH, Reyna-Villela MZ, Rojas-Bravo D, et al. The Association between Pesticide Exposure and the Development of Fronto-Temporal Dementia-Cum-Dissociative Disorders: A Review. Vol. 13, Brain Sciences; 2023.9. Hayden KM, Norton MC, Darcey D, Østbye T, Zandi PP, Breitner JCS, et al. Occupational exposure to pesticides increases the risk of incident AD. Neurology [Internet]. 2010 May 11 [cited 2024 Nov 16];74(19):1524–30. Available from: https://www.neurology.org/doi/10.1212/WNL.0b013e3181dd4423.10. Steenland K, Wesseling C, Román N, Quirós I, Juncos JL. Occupational pesticide exposure and screening tests for neurodegenerative disease among an elderly population in Costa Rica. Environmental Research. 2013 Jan;120:96–101.11. Baldi I, Lebailly P, Mohammed-Brahim B, Letenneur L, Dartigues JF, Brochard P. Neurodegenerative diseases and exposure to pesticides in the elderly. American Journal of Epidemiology. 2003 Mar 1;157(5):409–14.12. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Vol. 169, Annals of Internal Medicine. American College of Physicians; 2018. p. 467–73.13. Schneider Medeiros M, P. Reddy S, P. Socal M, Schumacher-Schuh AF, Mello Rieder CR. Occupational pesticide exposure and the risk of death in patients with Parkinson’s disease: An observational study in southern Brazil. Environmental Health: A Global Access Science Source. 2020 Jun 17;19(1). DOI:10.1186/s12940-020-00624-814. Silvestre GCSB, Ferreira MJM, Figueiredo Sue EFMR, Silva CAL, Siqueira HH, Silva AMC. Parkinson disease and occupational and environmental exposure to pesticides in a region of intense agribusiness activity in Brazil: a case-control study. Journal of Occupational and Environmental Medicine. 2020 Dec 1;62(12):e732–7. DOI: 10.1097/JOM.000000000000204315. Perrin L, Spinosi J, Chaperon L, Kab S, Moisan F, Ebaz A. Pesticides expenditures by farming type and incidence of Parkinson disease in farmers: A French nationwide study. Environ Res [Internet]. 2021 Jun [cited 2024 Nov 16];197:111161. DOI: 10.1016/j.envres.2021.11116116. Sturm ET, Castro C, Mendez-Colmenares A, Duffy J, Burzynska AAZ, Stallones L, et al. Risk Factors for Brain Health in Agricultural Work: A Systematic Review. Int J Environ Res Public Health [Internet]. 2022 Mar 13;19(6). Available from: http://www.ncbi.nlm.nih.gov/pubmed/35329061. DOI:10.3390/ijerph1906337317. Brown EG, Goldman SM, Coffey CS, Siderowf A, Simuni T, Meng C, et al. Occupational Pesticide Exposure in Parkinson’s Disease Related to GBA and LRRK2 Variants. Journal of Intelligent and Fuzzy Systems. 2024 Jun 4;14(4):737–46 DOI: 10.3233/JPD-24001518. de Graaf L, Boulanger M, Bureau M, Bouvier G, Meryet-Figuiere M, Tual S, et al. Occupational pesticide exposure, cancer and chronic neurological disorders: A systematic review of epidemiological studies in greenspace workers. Environ Res [Internet]. 2022 Jan 1 [cited 2024 Nov 16];203:111822. DOI10.1016/j.envres.2021.11182219. Shrestha S, Parks CG, Umbach DM, Richards-Barber M, Hofmann JN, Chen H, et al. Pesticide use and incident Parkinson’s disease in a cohort of farmers and their spouses. Environmental Research. 2020 Dec 1;191. DOI: 10.1016/j.envres.2020.11018620. Arab A, Mostafalou S. Neurotoxicity of pesticides in the context of CNS chronic diseases. Vol. 32, International Journal of Environmental Health Research; 2022. p. 2718–55. DOI: 10.1080/09603123.2021.198739621. Lini RS, Scanferla DTP, de Oliveira NG, Aguera RG, Santos T da S, Teixeira JJV, et al. Fungicides as a risk factor for the development of neurological diseases and disorders in humans: a systematic review. Vol. 54, Critical Reviews in Toxicology; 2024. p. 35–54. DOI: 10.1080/10408444.2024.230348122. Wongta A, Hongsibsong S, Xu ZL, Chantara S, Pattarawarapan M, Sapbamrer R, et al. The Relationship of Organophosphate Pesticide Exposure and Cognitive Decline Among Residents of an Agricultural Area in Northern Thailand. Journal of Health Research. 2023;37(6):372–9. DOI: 10.56808/2586-940X.103523. Rosales-Rimache J, Machado-Pereyra P, Bendezu-Quispe G. Relationship between Butyrylcholinesterase Activity and Cognitive Ability in Workers Exposed to Chlorpyrifos. Safety. 2023 Mar 1;9(1). DOI: 10.3390/safety901001224. Medehouenou TCM, Ayotte P, Carmichael PH, Kröger E, Verreault R, Lindsay J, et al. Exposure to polychlorinated biphenyls and organochlorine pesticides and risk of dementia, Alzheimer’s disease and cognitive decline in an older population: A prospective analysis from the Canadian Study of Health and Aging. Environmental Health: A Global Access Science Source. 2019 Jun 14;18(1). https://doi.org/10.1186/s12940-019-0494-225. Tiwari S, Sapkota N, Tiwari S, Sapkota B. Association between pesticide exposure and neurobehavioral performance of agricultural workers: A cross-sectional study. Brain and Behavior. 2022 Jul 1;12(7). DOI: 10.1002/brb3.264126. Mora AM, Baker JM, Hyland C, Rodríguez-Zamora MG, Rojas-Valverde D, Winkler MS, et al. Pesticide exposure and cortical brain activation among farmworkers in Costa Rica. NeuroToxicology. 2022 Dec 1;93:200–10. DOI10.1016/j.neuro.2022.10.00427. Pawestri IN, Sulistyaningsih E. Neurobehavioral performance of Indonesian farmers and its association with pesticide exposure: A cross-sectional study. Clinical Epidemiology and Global Health. 2021 Jul 1;11:100754. https://doi.org/10.1016/j.cegh.2021.10075428. Kumar D, Sinha SN. Chronic exposures to cholinesterase-inhibiting pesticides adversely affects the health of agricultural workers in India. Environmental Research. 2024 Jul 1;252. DOI: 10.1016/j.envres.2024.11896129. Aguera RG, Freires C, Oliveira LO de, Monteiro LR, Lini RS, Romoli JCZ, et al. Risk evaluation of occupational exposure of southern Brazilian flower farmers to pesticides potentially leading to cholinesterase inhibition and metals exposure. Environmental Toxicology and Pharmacology. 2022 Jul 1;93:103874. DOI: 10.1016/j.etap.2022.10387430. Filippi I, Lucero P, Bonansea RI, Lerda D, Butinof M, Fernandez RA, et al. Validation of exposure indexes to pesticides through the analysis of exposure and effect biomarkers in ground pesticide applicators from Argentina. Heliyon. 2021 Sep 1;7(9). https://doi.org/10.1016/j.heliyon.2021.e0792131. Amoatey P, Al-Mayahi A, Omidvarborna H, Baawain MS, Sulaiman H. Occupational exposure to pesticides and associated health effects among greenhouse farm workers. Vol. 27, Environmental Science and Pollution Research. Springer; 2020. p. 22251–70. https://doi.org/10.1007/s11356-020-08754-932. Ramírez-Santana M, Zúñiga-Venegas L, Corral S, Roeleveld N, Groenewoud H, van der Velden K, et al. Reduced neurobehavioral functioning in agricultural workers and rural inhabitants exposed to pesticides in northern Chile and its association with blood biomarkers inhibition. Environmental Health: A Global Access Science Source. 2020 Jul 22;19(1). https://doi.org/10.1186/s12940-020-00634-633. Campdelacreu J. Parkinson's disease and Alzheimer disease: environmental risk factors. Neurología. 2014 Nov; 29(9):541–9.34. Wirdefeldt K, Adami HO, Cole P, Trichopoulos D, Mandel J. Epidemiology and etiology of Parkinson’s disease: a review of the evidence. Eur J Epidemiol [Internet]. 2011 Jun 28 [cited 2024 Nov 16];26(S1):1–58. Available from: http://link.springer.com/10.1007/s10654-011-9581-62.35. Chondrogiorgi M, Tzoulaki I, Evangelou E, Ntritsos G, Tseretopoulou X, Pappa M, et al. Pesticide exposure and parkinsonism: A systematic review and meta-analysis. Parkinsonism Relat Disord [Internet]. 2016 Jan [cited 2024 Nov 16];22:e127–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1353802015007403 2016;22.36. Armenteros BFM. Enfermedad de Alzheimer y factores de riesgo ambientales. Rev Cuba Enf. 2017;33(1):159-17237. Murray MT, Nowicki J. Alzheimer’s Disease. In: Textbook of Natural Medicine. 5th ed. Minnesota: Elsevier; 2020. p. 1090-1099.e3.38. Mostafalou S, Abdollahi M. The link of organophosphorus pesticides with neurodegenerative and neurodevelopmental diseases based on evidence and mechanisms. Toxicology. 2018 Nov;409:44–52.39. Ávila-Camargo A, Barreiro-Zambrano A, Sánchez-Calderón D, López-Michelena LI. Efectos cardiovasculares de la exposición ocupacional a pesticidas. Revista médica Risaralda [Internet]. 2024 Dec [cited 2024 Nov 6];30(1):107-118. DOI: https://doi.org/10.22517/25395203.25444.40. López Michelena LI, Giraldo Luna CM, Yepes Boada A, Colmenares Ardila LF, Martínez Burgos M, Niño Bernal DC. Exposición a plaguicidas y desarrollo de leucemia en trabajadores del sector agrícola [Internet]. 2024 Dec [cited 2024 Nov 6]. Available from: https://repositorio.unbosque.edu.co/items/f8687996-78e3-4f2e-ae30-9f55a86a99bc41. Toro-Osorio BM, Rojas-Rodríguez AE, Díaz-Zapata JA. Levels of serum cholinesterase in coffee growers from the caldas department, Colombia. Revista de Salud Publica. 2017 Jul 1;19(3):318–24.42. Caro-Gamboa LJ, Forero-Castro M, Dallos-Baez AE. Cholinesterase inhibition as a biomarker for the surveillance of the occupationally exposed population to organophosphate pesticides. Ciencia Tecnología Agropecuaria. 2020 Jul 2;21(3).43. Insecticide Resistance Action Committee. Insecticide Mode of Action Training slide deck IRAC MoA Workgroup [Internet]. 2019 [cited 2025 Jan 17]. Available from: https://irac-online.org/documents/tutorial-on-moa-mechanisms/?ext=pdf44. Instituto Colombiano Agropecuario. Subgerencia de protección vegetal restricciones, prohibiciones y suspensión de registros de plaguicidas de uso agrícola en colombia [Internet]. Instituto Colombiano Agropecuario. 2021 [cited 2025 Jan 17]. Available from:https://www.ica.gov.co/getdoc/b2e5ff99-bd80-45e8-aa7a-e55f0b5b42dc/plaguicidas-prohibidos.aspxspaORIGINALTrabajo de grado.pdfTrabajo de grado.pdfapplication/pdf414659https://repositorio.unbosque.edu.co/bitstreams/46cbe6c1-f62c-4ce8-a93d-33f953460724/download5495bddb2a834d377e9deff17582107aMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-82000https://repositorio.unbosque.edu.co/bitstreams/54514bba-b4f7-4adc-b26e-efa53047d70e/download17cc15b951e7cc6b3728a574117320f9MD55Carta de autorizacion.pdfapplication/pdf171491https://repositorio.unbosque.edu.co/bitstreams/6fa9b7cc-4b01-4842-bdf4-f6781c6bcbba/download39f37438e348dbaff9ad94eadf03b742MD57Anexo 1 Acta de aprobacion.pdfapplication/pdf171491https://repositorio.unbosque.edu.co/bitstreams/d229abbd-cd50-4942-aa29-991a580812dd/download39f37438e348dbaff9ad94eadf03b742MD58Anexo 2.pdfapplication/pdf146512https://repositorio.unbosque.edu.co/bitstreams/9d72c7cf-bad9-4d92-ab0f-a819432b8782/downloada5716acb81c92b38e3453e4692f36f55MD59Anexo 3.pdfapplication/pdf2200681https://repositorio.unbosque.edu.co/bitstreams/31f5c025-f80b-4531-b8f9-39d6ef77a8de/downloadde6e670c8a914efb23b6d1b7af57855dMD510CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81160https://repositorio.unbosque.edu.co/bitstreams/3758eee0-6719-4a22-9054-6dab9ed0bbe5/download5643bfd9bcf29d560eeec56d584edaa9MD56TEXTTrabajo de grado.pdf.txtTrabajo de grado.pdf.txtExtracted texttext/plain43226https://repositorio.unbosque.edu.co/bitstreams/c5c2e5d5-e7ca-4ba4-9ed0-f175719ddeff/download0dc8946c5b124f5e16b5a00b6edf1bbeMD511THUMBNAILTrabajo de grado.pdf.jpgTrabajo de grado.pdf.jpgGenerated Thumbnailimage/jpeg5189https://repositorio.unbosque.edu.co/bitstreams/0ff4a53c-b632-413d-945a-22c5dde87cd7/download0d7bb9fd424d693d4c6b8ee19a74ea89MD51220.500.12495/13931oai:repositorio.unbosque.edu.co:20.500.12495/139312025-02-13 03:02:36.54http://creativecommons.org/licenses/by-nc-sa/4.0/Attribution-NonCommercial-ShareAlike 4.0 Internationalrestrictedhttps://repositorio.unbosque.edu.coRepositorio Institucional Universidad El Bosquebibliotecas@biteca.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 |