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

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.