Agriculture, Forestry, and Fishing

Participating core and specialty programs: Authoritative Recommendations, Engineering Controls, Exposure Assessment, Nanotechnology Research Center, and Occupational Health Equity.

Government agencies, employers, non-governmental organizations, workers, and researchers use NIOSH information to prevent neurologic disorders related to pesticide exposure among agricultural workers.

NOTE: Goals in bold in the table below are priorities for extramural research.

Health Outcome Research Focus Worker population* Research Type
A Neurologic disorders Health effects of chronic pesticide exposure at varying levels Agriculture and forestry subsectors; migrant workers, older workers and other vulnerable worker populations Basic/etiologic
Surveillance research
B Neurologic disorders Exposure assessment and new tools (esp. rapid assessment tools) Agriculture and forestry subsectors Basic/etiologic
C Neurologic disorders Interventions (e.g., training programs, product substitution testing) Agriculture and forestry subsectors, vulnerable workers Intervention
D Neurologic disorders Effective implementation strategies Agriculture and forestry subsectors, vulnerable workers Translation

*See definitions of worker populations

Activity Goal 1.1.1 (Basic/Etiologic Research): Conduct basic/etiologic research to better understand the relationship between chronic pesticide exposure and neurologic disorders among agriculture and forestry workers.

Activity Goal 1.1.2 (Intervention Research): Conduct studies to develop and assess the effectiveness of interventions to reduce neurologic disorders from pesticide exposure among agriculture and forestry workers.

Activity Goal 1.1.3 (Translation Research): Conduct translation research to understand barriers and aids to implementing effective interventions to reduce neurologic disorders from pesticide exposure among agriculture and forestry workers.



Agricultural workers are one of the major occupational groups exposed to pesticides [MacFarlane et al. 2013]. Pesticides are used extensively throughout the U.S., where more than 18,000 products are licensed for use [EPA 2002]. About 1.1 billion pounds of pesticides are used annually in the U.S., and widespread use results in pervasive occupational exposure [EPA 2011]. Every year physicians diagnose 10,000-20,000 pesticide poisonings among the estimated 2 million U.S. agricultural workers [EPA 1992].

Many pesticides have been studied for occupational effects, including organophosphate insecticides, fungicides, fumigants, and organochlorine and carbamate insecticides. Neurologic toxicity is one of the most prominent adverse health effects associated with pesticide exposure [Keifer and Firestone 2007]. At least 23 neurologic symptoms are typically associated with pesticide intoxication [Kamel et al. 2005].


Poisoning by acute high-level exposure to certain pesticides has well-known neurotoxic effects, but occupational health effects from chronic exposure to more moderate levels of pesticides is an area in need of study. Some other areas of need may include the role of genetic susceptibility, and more studies of pesticides other than organophosphates.

Current immediate research needs include basic research to evaluate and characterize potential health effects of chronic pesticide exposure at different levels, including low levels. Basic research is also needed to develop, test and apply better exposure assessment tools, including samplers, biomarkers and diagnostic tools to confirm cases of acute pesticide poisoning. Intervention research is needed to develop and test interventions, programs or strategies aimed at minimizing or preventing pesticide exposure among farmers. Finally, translation research to expand the high-quality implementation of evidence-based interventions, programs and strategies would be beneficial.

Non-governmental organizations, international organizations, and employers use NIOSH information to reduce renal disease related to occupational exposures among agricultural workers.

Health Outcome Research Focus Worker population Research Type
A Renal diseases Exposure assessment for chronic kidney disease of unknown etiology Agriculture subsector, Forestry subsector Basic/etiologic
B Renal diseases Pesticide-related surveillance Agriculture subsector, Forestry subsector Surveillance research

Activity Goal 1.2.1 (Basic/Etiologic Research): Conduct basic/etiologic research to better understand chronic kidney disease of unknown etiology among agriculture workers.

Activity Goal 1.2.2 (Surveillance Research): Conduct surveillance research to better understand the burden of chronic kidney disease among agricultural workers.


There is currently an epidemic of chronic kidney disease of unknown etiology (CKDu) around the world. Workers in industries with jobs that occur outdoors and with a high work load, such as agriculture, seem to be the most affected [Valcke et al. 2017]. Among agricultural industries, workers in sugarcane cultivation appear to have garnered more attention. Currently it is unclear what causes CKDu, however heat stress and exposure to pesticides are thought to be possible contributors.

Potential sources of hazardous chemicals in agriculture include pesticides, fertilizers, organic solvents, metals, sterilization compounds, gasses from confined animal wastes and silos, and plant residues [Keifer et al. 2010]. Farmers and farm workers are exposed to high levels of pesticides during the preparation and application of pesticide spray solutions, and while cleaning the spraying equipment [Damalas and Koutroubas 2016]. Exposure to pesticides may lead to acute poisonings, as well as chronic adverse health effects from long term, low-level exposure [Damalas and Koutroubas 2016]. During 2007–2011, 2,606 total cases (0.9/100,000) and 833 cases in agriculture (18.6/100,000) of acute occupational pesticide-related illness and injury were identified in 12 states; most affected were those exposed to insecticides or herbicides [Damalas 2016]. Additional studies suggest that farmworkers and their families may face higher levels of agricultural pesticide exposure in their homes [Trunnelle et al. 2013, 2014; Sugeng 2016].

Herbicide application for utility line clearance and other vegetation control tasks is common in forestry [Green 1991]. However, there is limited literature on the magnitude and distribution of chemical exposures and associated adverse health effects among forestry workers. Low levels of certain pesticides have been found on seedlings and on the skin of Canadian tree planters, coupled with evidence of increased exposure potential due to poor hygiene conditions [Gorman et al. 2011].


Most of the NIOSH-funded Agricultural Safety and Health Centers (Ag Centers) have been involved in research that address pesticide exposure. These centers have already established partners and facilities, and developed methods to approach research in this area. Prior research has led to additional research questions involving new technologies and procedures to develop and use pesticides/herbicides for agricultural use. NIOSH has also developed a network of partners through the SENSOR pesticide surveillance initiative to provide pesticide surveillance in cooperating states. This network can be tapped by researchers to continue work in this area. Additional surveillance needs include acute occupational pesticide-related illness and injury surveillance through SENSOR to determine the magnitude and underlying causes of over-exposure to pesticides in the workplace.

CDC [2016]. Acute occupational pesticide-related illness and injury—United States, 2007–2011. MMWR 63(55):11-16.

Damalas CA, Koutroubas SD [2016]. Farmers’ exposure to pesticides: toxicity types and ways of prevention. Toxics 4(1):1-10.

EPA [1992]. Regulatory impact analysis of worker protection standard for agricultural pesticides. Washington, D.C.: U.S. Environmental Protection Agency.

EPA [2002]. Promoting safety for America’s future. FY 2002 Annual Report. Washington, D.C.: U.S. Environmental Protection Agency, Office of Pesticide Programs.

EPA [2011]. Pesticides industry sales and usage. 2006 and 2007 market estimates. Washington, DC: U.S. Environmental Protection Agency, EPA Report No. EPA-733-R-11-001.

Green LM [1991]. A cohort mortality study of forestry workers exposed to phenoxy acid herbicides. Br J Ind Med 48(4):234-238.

Gorman Ng M, Stjernberg E, Koehoorn M, Demers PA, Davies HW [2011]. Exposure to pesticides and metal contaminants of fertilizer among tree planters. Ann Occup Hyg 55(7):752-763.

Kamel F, Engel LS, Gladen BC, Hoppin JA, Alavanja MC, Sandler DP [2005]. Neurologic symptoms in licensed private pesticide applicators in the agricultural health study. Environ Health Perspect 113(7): 877.

Keifer MC, Firestone J [2007]. Neurotoxicity of pesticides. J Agromedicine 12(1):17–25.

Keifer M, Gasperini F, Robson M [2010]. Pesticides and other chemicals: minimizing worker exposures. J Agromedicine 15(3):264-274.

MacFarlane E, Carey R, Keegel T, El-Zaemay S, Fritschi L [2013]. Dermal exposure associated with occupational end use of pesticides and the role of protective measures. Saf Health Work 4(3):136-141.

Sugeng AJ [2016]. From field to home: assessing air infiltration and soil track-in transport pathways of agricultural pesticides into farmworkers’ home and identifying risk factors for increased in-home pesticide levels. Dissertation. Tucson, AZ: University of Arizona.

Trunnelle KJ, Bennett DH, Ahn KC, Schenker MB, Tancredi DJ, Gee SJ, Stoecklin-Marois MT, Hammock BD [2014]. Concentrations of the urinary pyrethroid metabolite 3-phenoxybenzoic acid in farm worker families in the MICASA study. Environ Res 131:153-159.

Trunnelle KJ, Bennett DH, Tancredi DJ, Gee SJ, Stoecklin-Marois MT, Hennessy-Burt TE, Hammock BD, Schenker MB [2013]. Pyrethroids in house dust from the homes of farm worker families in the MICASA study. Environ Int, 61:57-63.

Valcke M, Levasseur ME, da Silva AS, Wesseling C [2017]. Pesticide exposures and chronic kidney disease of unknown etiology: an epidemiologic review. Environ Health 16(1), 49.

Page last reviewed: April 24, 2018