For years, mysterious epidemics of kidney disease have been simmering within agricultural hotspots in the developing world, from tropical El Salvador to the South Asian highlands of Sri Lanka and India.
The deadly string of chronic kidney disease (CKD) outbreaks have barely made the news since it first struck farmworkers in the 1990s. Yet today, the World Health Organization (WHO) estimates more than 20,000 workers in Central America alone have died in the wake of the uptick in CKD.
What is driving kidney failures in these agricultural workers? Although the precise cause of the outbreaks remain disputed, political leaders have begun to reign in toxic pesticide imports as a stopgap reform to stem the loss of life. El Salvador and Sri Lanka have stepped up as the first two nations to ban mainstream agrochemicals for their suspected assault on the kidneys of young rural farmworkers.
Index of Suspicion
We know genetics, diet, and lifestyle all influence the prevalence of kidney disease. But what about the environment? Could environmental factors be driving outbreaks of kidney disease in developing nations?
Kidneys are the body’s filters. As blood flows through these critical organs, they efficiently filter out wastes and toxins and prepare their removal. But the kidneys’ ability to flush foreign agents is not unlimited. Accumulated stressors can and do lead to kidney failure.
The index of suspicion for agrochemical drivers of kidney disease is higher than ever. Added to a concomitant rise in demand for dialysis techs and renal physicians in afflicted countries, researchers and now politicians are beginning to take notice after years of inaction.
Amid growing evidence for a link between nephrotoxicity and agrochemicals, some political leaders now believe the abnormal rise in CKD cases can be traced to environmental causes—specifically, chemical pesticides and fertilizers widely used in the agricultural sector to grow massive quantities of crops for export.
El Salvador recently passed a landmark ban of 53 agricultural products. The Salvadoran ban includes old pariahs like DDT, as well as popular modern brands, like Monsanto’s Roundup and Dow’s 2,4-D. It’s the latest move meant to slow a crippling regional epidemic of kidney disease spreading along the impoverished Pacific coast of Central America.
Earlier this year, three chemicals were banned in Sri Lanka following a multiyear investigation that linked high CKD rates in the South Asian island nation to chemical agents in the fields. Researchers highlighted cadmium, arsenic, and lead among the dangerous ingredients found in common pesticides and herbicides.
But the pesticide theory has its discontents too. The impact of agrochemicals has been hotly contested for years, and the debate’s intensity is only increasing with the bans. Agribusiness is fighting back, deploying its political muscle in multiple nations to challenge emergent regulation.
Meanwhile, more researchers and green groups are discussing how residents of export crop-dependent nations deal with noxious environmental risk factors rarely seen at similar levels in advanced countries—such as unclean drinking water and lead exposure.
Handling contaminated soils and agrowaste directly exposes farmworkers to the heavy metals that leach from poisonous chemicals. Workers can also receive doses through the air they breathe and food and water they consume.
Cumulative biochemical exposure to heavy metals like lead can be life-threatening. But does it mean metallic pesticide residues are creating kidney failure epidemics in crop-heavy nations like Sri Lanka and El Salvador?
Are agrochemicals responsible for the deaths of thousands of young agricultural workers in the global South? As the issue heats up in the coming years and the number of fatalities continues to climb, the answers to these questions may be forthcoming.
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