Associations of Chemical Exposures with Psychological Distress and Depression Diagnosis among Waste Pickers in Brasilia, Brazil: A Cross-Sectional Study

Introduction: Waste pickers face chemical exposures. We evaluated whether chemical exposure is associated with psychological distress and depression. Methods: A 2017 cross-sectional survey included 1,141 waste pickers working in the Estrutural open dump in Brasilia, Brazil. Participants self-reported occupational exposure to 11 chemical categories, 17 psychological distress symptoms, and depression diagnoses. Associations of chemical exposure with mean psychological distress scores and depression prevalence were assessed, adjusted for age, sex, marital status, and income. Results: Mean psychological distress score was higher among those exposed to any chemical (mean of 8.1 vs 6.1; adjusted mean difference [aMD]: 1.8 [0.9, 2.7]) and higher among those exposed to each of 11 chemical categories, for example, smoke (aMD: 1.2 [0.6, 1.7]), batteries (aMD: 1.5 [1.0, 1.9], and oils (aMD: 1.3 [0.9, 1.8]). Depression was more prevalent among those exposed to oils (16.6% vs 10.6%; adjusted prevalence difference [aPD]: 6.3% [95% CI: 2.3, 10.2]), cleaning products (aPD: 5.4% [1.2, 9.5]), medications (aPD: 4.7% [0.6, 8.8]), and aerosols (aPD: 5.3% [1.3, 9.3]) but, not smoke, batteries, greases, insecticides, solvents, paints, chemical containers, or any chemical. Conclusion: These associations highlight the need to consider policy level protections for waste pickers to reduce chemical exposure and guard against psychological distress. Further research is necessary to explore which specific chemicals, within broad chemical categories, are associated with psychological distress and depression.