Genotoxicity and Cytotoxicity among Pesticide- Exposed Workers: A Systematic Review and Meta- Analysis

Achmad Ilham Tohari; Muhammad Rijal Fahrudin  Hidayat; Nabil  Athoillah; Muhammad Yuda  Nugraha; Elly Nurus  Sakinah; Supangat Supangat; Saekhol Bakri; Athira  Nandakumar

doi:10.33192/smj.v78i3.279093

Authors

Achmad Ilham Tohari PANAH Research Center, Faculty of Medicine, University of Jember, Jember, Indonesia.
Muhammad Rijal Fahrudin Hidayat PANAH Research Center, Faculty of Medicine, University of Jember, Jember, Indonesia.
Nabil Athoillah PANAH Research Center, Faculty of Medicine, University of Jember, Jember, Indonesia.
Muhammad Yuda Nugraha PANAH Research Center, Faculty of Medicine, University of Jember, Jember, Indonesia.
Elly Nurus Sakinah Department of Pharmacology, Faculty of Medicine, University of Jember, Jember, Indonesia.
Supangat Supangat Department of Pharmacology, Faculty of Medicine, University of Jember, Jember, Indonesia.
Saekhol Bakri Department of Public Health, Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
Athira Nandakumar Department of Epidemiology and Preventive Medicine, Kagoshima University, Kagoshima, Japan.

DOI:

https://doi.org/10.33192/smj.v78i3.279093

Keywords:

Carcinogen, Farmer, Micronucleus, Pesticide

Abstract

Objective: To provide updated evidence on genotoxicity and cytotoxicity among workers occupationally exposed to pesticides.

Materials and Methods: This systematic review and meta-analysis followed PRISMA guidelines. Studies assessing micronuclei and cytotoxicity biomarkers in occupationally pesticide-exposed workers were included. Pooled analyses used Mantel-Haenszel fixed- and random-effects models, and results were expressed as SMDs with 95% confidence intervals (CIs). The protocol was registered in PROSPERO (CRD42021279189).

Results: Micronucleus frequencies were significantly higher in lymphocytes (SMD 1.59; 95% CI 0.97–2.20; p<0.001; I2=96%) and buccal cells (SMD 1.20; 95% CI 0.67–1.73; p<0.00001; I2=97%) among exposed workers. Binucleated cells were also increased in lymphocytes (SMD 2.51; 95% CI 1.01–4.02; p<0.001; I2=98%) and buccal cells (SMD 0.56; 95% CI 0.04–1.08; p=0.03; I2=96%). No significant difference was observed for CBPI (SMD –0.18; 95% CI –0.90–0.54; p=0.63; I2=96%).

Conclusion: Occupational pesticide exposure is associated with increased micronucleus and binucleated cell frequencies, although high heterogeneity and potential confounding factors limit certainty. No significant association was found for CBPI. Subgroup analyses showed no sex-related differences, while concurrent smoking appeared to amplify genotoxic markers. The available evidence supports a protective effect of appropriate personal protective equipment against pesticide-induced genotoxicity.

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