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Meet our 20 Pioneers under 40 in Environmental Public Health: Ana Maria Mora, MD, PhD

August 9, 2018

Ana Maria Mora, MD, PhD is passionate about sharing what she has learned through her work in environmental public health with everyone. While she spends half of her time in Northern California studying the effects of early-life exposure to pesticides in children living in the Salinas Valley, she spends a lot of her time on research projects that impact the health of people in the country she where she was born and that she calls home, Costa Rica.

While there is attention being given to the field of environmental health here in the U.S., she notes “that in Costa Rica, we’re always behind on research on environmental health topics. There are a lot of epidemiologists and exposure scientists in the US, but in Costa Rica we are very few [epidemiologists and exposure experts]; and the problem that we face is that some people refuse to believe that findings from studies conducted outside of our country can be applicable to our population.”

In Costa Rica, her focus now is on the effects of pesticide exposure in farm workers. This project is done with partners from the Swiss Tropical and Public Health Institute, UC Berkeley, Stanford University, and Universidad Nacional in Costa Rica.

The goal is to study “the interrelation of the institutional determinants of pesticide exposure but also the human health impact and environmental impact of pesticide use in tropical settings,” Dr. Mora says.

One thing they are finding is that pesticide use and exposure is dependent on different factors in tropical settings than it is in the U.S. 

“We have learned that pesticide use differs depending on meteorological conditions. For example, in banana plantations in Costa Rica, the more it rains, the more they spray aerially with fungicides,” Dr. Mora explains.

In terms of education, she believes that, in low and middle-income countries such as Costa Rica, there is a lack of education surrounding the use and possible health effects of pesticides. And, there could be more education related to what can be done to help protect those who use pesticides from coming in direct contact with them so often.

“In the study of farm workers that we conducted recently, we found that not only farm owners do not provide protective equipment to their workers but also workers make the decision of not using the equipment when provided,” Dr. Mora shares.

Some of this is due to lack of understanding of the importance, but not all. There is also a cultural side to it in many of the countries. 

“Farm workers would tell us that ‘if I use the equipment, they [the farm owners] are going to perceive me as a weak person, as someone who is going to get sick, and they aren’t going to hire me. If I don’t use it and I show that I am brave and strong, then they are more likely to continue hiring me’,” Dr. More explains.

One other obstacle to the use of personal protective equipment (PPE) in these tropical settings is that the equipment isn’t optimized for the conditions there.

“Studies have shown that skin absorption actually increases when you use some of these types of equipment while sweating. Maybe workers start their day using all the protective equipment, and when they get hot they start taking it off,” Dr. Mora says.

So, what can be done if using PPE isn’t a feasible option? The first step is to understand the risks of direct contact with pesticides.

“I think we need to improve access to protective equipment, but also on education on how to handle pesticides and on integrative pest management. We need to make sure that, if farm owners decide to use pesticides in their crops, they use the smallest amount possible and protect their workers and communities nearby,” Dr. Mora explains.

Some of the shifts and tips could be simple ones. Maybe they won’t be able to use PPE, but most people could be convinced to make easy, daily changes, like washing hands and taking off shoes.

“Farm workers could make small changes that would reduce the pesticide exposure of their families, like taking off their shoes and leaving them at the door, showering before they interact with their children or other family members when coming back from work, [and] washing their work clothes separately from the rest of the family’s,” Dr. Mora suggests.

These are minor changes that could have a great impact on the health of these farm workers and their families. It’s just a matter of connecting with them and sharing what has been learned from work with pesticide research in other parts of the world.

Looking towards the future, Dr. Mora has a simple hope.

“I would really like people to understand how important the field [of environmental public health] is and feel motivated to start working on it. I am hoping that we are going to get better at translating the findings from our studies into public policy and also reach out in more accessible ways to the general population so that we can make a change,” Dr. Mora shares.

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We wanted to find the best young researchers and advocates who might change the future of environmental health. So, we asked a panel of luminaries in environmental health to nominate rising stars who are doing pioneering work. After a rigorous selection process, we invited 20 of these nominees to be our 20 Pioneers under 40 in Environmental Public Health.

In June, we held our final webinar in the series. In addition to these presentations, we got to sit down and learn a little bit more about the researchers. While we did talk about their research, we also learned how they first got interested in the field and what this work means to them, plus a few tips for staying healthy.

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