Br J Biomed Sci 1994 Dec;51(4):345-57
Man evolved as a hunter-gatherer,
and the invention and spread of agriculture was followed by changes in
diet, the environment and population densities which have resulted
in globally high prevalences of anaemias due to nutritional deficiencies
of iron, folate and (locally) vitamin B12, to infestations by hookworm
and schistosomes, to malaria, and to the natural selection for the genes
for sickle-cell diseases, beta-thalassaemias, alpha-thalassaemias, glucose-6-phosphate
dehydrogenase deficiency, ovalocytosis and possibly (locally) elliptocytosis.
The present explosion of population is driving an expansion of agriculture,
especially the cultivation of rice, and this has led often to disastrous
increases of transmission of malaria, schistosomiasis and other diseases,
to widespread chemical pollution, and to degradation of the environment.
Anaemia, as the commonest manifestation of human disease, is a
frequent consequence. The urgent need for increased food production
is matched by the urgent need for assessment and control of the health
impact of agricultural development.