ToxBol – a network addressing environment and health issues in Bolivia

The purpose with this network is to build a long-term research collaboration between Bolivian (Universidad Mayor de San Andrés), Swedish (Karolinska Institutet, Lund University), and French (Institut de Recherche pour le Développment IRD) universities and research institutes to address environmental problems in Bolivia and their impact on human health, a research area hitherto poorly studied. We build the network on projects focusing on 1) metal exposure from drinking water and food and toxicity, 2) pesticide exposure from plantation work and toxicity; and 3) susceptibility factors and toxicity.

The goal of the present project is to fill the huge data gap concerning exposure to toxic metals and pesticides and their potentially adverse effects on health in Bolivia. Toxic exposure and associated effects often differ depending on diet, nutrition, climate and genetics: data from individual countries is therefore highly warranted. The aim of the multi-disciplinary network ToxBol is to clarify how exposure to multiple metals via food and drinking water and pesticides via work environment exposure may impact health in Bolivia. This will be assessed in new cohorts from Bolivia and through the network as proposed. The results will be fundamental for the improvement of health risk assessments in Bolivia.

Specific aims:
1) follow-up our pilot studies indicating worrying levels of metals and pesticides, especially to increase the study participants in order to obtain more reliable results on variations in exposure in Bolivia (by region, age, gender, ethnicity etc.),
2) analysis of biological samples for biomarkers of exposure and toxic effects,
3) performance of risk assessment for the exposures identified,
4) workshops and seminars for spreading of the results and knowledge sharing


In the Bolivian highlands of the Andes Mountains, there are areas with high levels of metal exposure from drinking water and food, both naturally occurring, like inorganic arsenic, and mixed metals emission from e.g. mining industries. In fact, in these regions, repeated studies found arsenic in water sometimes at concentrations above 100 μg/L (WHO guideline value 10 μg/L). Arsenic is one of the most potent toxicants and carcinogens in the environment and has been associated with multiple severe health effects, including increased morbidity and mortality in children, several forms of cancer, cardiovascular and liver toxicity, and diabetes later in life. Susceptibility to arsenic exposure varies markedly between populations and individuals, and one key susceptibility factor is the arsenic metabolism. Very few data exist, however, on humans exposed to arsenic in Bolivia. Studies on exposure to arsenic, as well as other toxic elements, are therefore necessary to properly assess the risk in specific Bolivian populations.

We have for this purpose initiated a field study in the south of the Oruro department around the Poopó Lake area, 200 km south from La Paz. The origin of arsenic in these populations is mainly natural (volcanic). Our study population will include 250 indigenous women from different ethnicities. Urine and blood samples will be collected for arsenic and other toxic elements exposure analysis, and evaluation of biomarkers of toxicity and genetics. Our results will offer insights into arsenic toxicity and its metabolism in highly exposed populations, as well as collaborate to increase the local social awareness of naturally-contaminated water sources.

This study is part of PhD student Jessica de Loma Olson’s project plan.

Contact persons


Karin Broberg

Phone: +46-(0)8-524 874 05
Organizational unit: Metals and health


In Bolivia, farmers are exposed to pesticides most of the year because the climate allows several harvests per year. Moreover, Bolivian farmers have increased the use of pesticides to enter into a more competitive national as well as international market. There is little or no social protection which together leads to hazardous working conditions for the farmers. In order to control the large number of pests that can attack the crop, pesticides are used as mixtures including insecticides and fungicides etc. Exposure to pesticides thereby constitutes a possible major health risk for the Bolivian farmers.

In this study we are including 3 different rural communities (Sapahaqui, Villa Bolivar, Villa 14 de Septiembre) in Bolivia. Our study population consists of 300 farmers (men and women) evenly divided among these three communities which are studied by collecting urine and blood samples for determination of pesticide exposure, susceptibility and early markers of health effects. Moreover we will apply a questionnaire to map the use and handling of pesticides as well as health status and social habits (alcohol, tobacco, coca). Together this will constitute an cross sectional study on exposure, susceptibility and markers of effect from pesticide exposure.

This study is part of PhD student Jessika Barron Cuenca's project plan. LINK

Contact persons

Senior researcher

Kristian Dreij

Phone: +46-(0)8-524 875 66
Organizational unit: Biochemical toxicology

PhD student

Jessika Barron Cuenca

Organizational unit: Institute of Environmental Medicine (IMM), C6

International partners

Jacques Gardon, Institut de Recherche pour le Développement IRD, Marseille, France

Noemi Tirado, Instituto de Genética, Universidad Mayor de San Andrés, La Paz, Bolivia

National partners

Christian Lindh, Occupational and Environmental Medicine, Lund University


  • Swedish Research Council VR - Research Links
  • SIDA
  • Kungliga Fysiografiska sällskapet
  • Karolinska Institutet (KID)
BiomarkerCancer and OncologyEpidemiologyEpigeneticsGlobal HealthMetalsSustainable developmentToxicology