Neurologic symptoms in licensed pesticide applicators in the Agricultural Health Study
Neurologic symptoms in licensed pesticide applicators in the Agricultural Health Study
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DOI：
10.1177/0960327107070582
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发表时间：
2007-03-01
影响因子：
2.8
通讯作者：
Sandler, D. P.
中科院分区：
文献类型：
--
作者：
Kamel, F.;Enge, L. S.;Sandler, D. P.
暴露于高水平的许多农药具有急性和长期的神经系统后果，但对长期暴露于中等水平农药的神经毒性知之甚少。我们分析了从1993年到1997年参加农业健康研究的18782名白人男性持证农药施药者的横断面数据。施药者提供了终生使用农药的信息，以及23种通常与农药中毒相关的神经系统症状。在入组前一年内出现>= 10症状的风险增加与累积使用农药、亲自混合或施用农药、与农药有关的医疗保健、诊断出的农药中毒以及涉及个人高度接触农药的事件有关。最大的风险与使用有机磷和有机氯杀虫剂有关。在按入组前一年的农药使用情况分层，或排除有农药中毒史或高暴露事件的施药者后，结果相似。使用可能涉及个人高度接触的农药施用方法与更大的风险相关。反映几个神经系统领域的症状组，包括情感、认知、自主和运动功能以及视觉，也与农药暴露有关。这些结果表明，神经系统症状与累积暴露于中等水平的有机磷和有机氯杀虫剂有关，而与近期暴露或中毒史无关。
Exposure to high levels of many pesticides has both acute and long-term neurologic consequences, but little is known about the neurotoxicity of chronic exposure to moderate pesticide levels. We analysed cross-sectional data from 18 782 Caucasian, male, licensed pesticide applicators, enrolled in the Agricultural Health Study from 1993 to 1997. Applicators provided information on lifetime pesticide use, and 23 neurologic symptoms typically associated with pesticide intoxication. Increased risk of experiencing >= 10 symptoms during the year before enrollment was associated with cumulative pesticide use, personally mixing or applying pesticides, pesticide-related medical care, diagnosed pesticide poisoning, and events involving high personal pesticide exposure. Greatest risk was associated with use of organophosphate and organochlorine insecticides. Results were similar after stratification by pesticide use during the year before enrollment, or exclusion of applicators with a history of pesticide poisoning, or high-exposure events. Use of pesticide application methods likely to involve high personal exposure was associated with greater risk. Groups of symptoms reflecting several neurologic domains, including affect, cognition, autonomic and motor function, and vision, were also associated with pesticide exposure. These results suggest that neurologic symptoms are associated with cumulative exposure to moderate levels of organophosphate and organochlorine insecticides, regardless of recent exposure or history of poisoning.