Association of pesticide exposure with neurologic dysfunction and disease.
Association of pesticide exposure with neurologic dysfunction and disease.
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DOI：
10.1289/ehp.7135
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发表时间：
2004-06
影响因子：
10.4
通讯作者：
Hoppin JA
中科院分区：
文献类型：
--
作者：
Kamel F;Hoppin JA
急性高剂量暴露于某些杀虫剂的中毒具有众所周知的神经毒性效应，但长期暴露于中等水平的杀虫剂是否也具有神经毒性，则更具争议。大多数关于中度农药暴露的研究发现，神经系统症状和神经行为表现变化的发生率增加，反映出认知和精神运动功能障碍。很少有证据表明适度暴露与感觉或运动功能或周围神经传导障碍有关，但很少有研究考虑这些结果。农药神经毒性最敏感的表现可能是缺乏特异性的全身不适，与轻微的认知功能障碍有关，类似于海湾战争综合征的描述。大多数研究都集中在有机磷杀虫剂上，但也有一些发现了其他杀虫剂的神经毒性作用，包括杀菌剂、熏蒸剂、有机氯和氨基甲酸酯杀虫剂。接触杀虫剂也可能与帕金森病风险增加有关；包括杀虫剂、除草剂和杀菌剂在内的几类杀虫剂都与此有关。对其他神经退行性疾病的研究有限，也没有定论。未来的研究将需要改进对个体接触农药的评估，并考虑遗传易感性的作用。需要对有机磷以外的杀虫剂进行更多的研究。尚未解决的主要问题包括急性和慢性接触的相对重要性，在没有中毒的情况下适度接触的影响，以及与农药相关的神经毒性与神经退行性疾病的关系。
Poisoning by acute high-level exposure to certain pesticides has well-known neurotoxic effects, but whether chronic exposure to moderate levels of pesticides is also neurotoxic is more controversial. Most studies of moderate pesticide exposure have found increased prevalence of neurologic symptoms and changes in neurobehavioral performance, reflecting cognitive and psychomotor dysfunction. There is less evidence that moderate exposure is related to deficits in sensory or motor function or peripheral nerve conduction, but fewer studies have considered these outcomes. It is possible that the most sensitive manifestation of pesticide neurotoxicity is a general malaise lacking in specificity and related to mild cognitive dysfunction, similar to that described for Gulf War syndrome. Most studies have focused on organophosphate insecticides, but some found neuro-toxic effects from other pesticides, including fungicides, fumigants, and organochlorine and carbamate insecticides. Pesticide exposure may also be associated with increased risk of Parkinson disease; several classes of pesticides, including insecticides, herbicides, and fungicides, have been implicated. Studies of other neurodegenerative diseases are limited and inconclusive. Future studies will need to improve assessment of pesticide exposure in individuals and consider the role of genetic susceptibility. More studies of pesticides other than organophosphates are needed. Major unresolved issues include the relative importance of acute and chronic exposure, the effect of moderate exposure in the absence of poisoning, and the relationship of pesticide-related neurotoxicity to neurodegenerative disease.
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