Laboratoire Santé Travail Environnement, EA 3672, Institut de Santé Publique d'Epidémiologie et de Développement, 146 rue Léo Saignat, 33076 Bordeaux cedex, France.
Occup Environ Med. 2011 Feb;68(2):108-15. doi: 10.1136/oem.2009.047811. Epub 2010 Nov 22.
The aim of the PHYTONER study is to investigate the role of pesticides on neurobehavioral performances in French vineyard workers.
929 workers affiliated to the health insurance system for farmers in the Bordeaux area of south-western France were enrolled in the study in 1997-1998. They were contacted for a first follow-up in 2001-2003. Participants completed a questionnaire and nine neurobehavioral tests. They were classified according to their life-long pesticide exposure, as directly exposed, indirectly exposed or non-exposed. Educational level, age, sex, alcohol consumption, smoking, psychotropic drug use and depressive symptoms were taken into account in the analysis.
614 subjects were available for investigation at follow-up. Follow-up analysis confirmed that the risk of obtaining a low performance on the tests was higher in exposed subjects, with ORs ranging from 1.35 to 5.60. Evolution of performances over the follow-up period demonstrated that exposed subjects had the worst decreases in performance. The risk of having a two-point lower score on the Mini-Mental State Examination was 2.15 (95% CI 1.18 to 3.94) in exposed subjects.
These results suggest long-term cognitive effects of chronic exposure to pesticides and raise the issue of the risk of evolution towards dementia. The PHYTONER study is the first to provide prospective data on the natural history of neurological disorders associated with pesticide exposure.
PHYTONER 研究旨在探究农药对法国葡萄园工人神经行为表现的影响。
1997-1998 年，我们在法国西南部波尔多地区的农民健康保险系统中招募了 929 名工人参与这项研究。他们于 2001-2003 年接受了第一次随访。参与者完成了一份问卷和九项神经行为测试。他们根据其终身农药暴露情况进行分类，分为直接暴露、间接暴露或非暴露。在分析中考虑了教育程度、年龄、性别、酒精摄入、吸烟、精神药物使用和抑郁症状。
929 名参与者中有 614 名在随访时可进行调查。随访分析证实，暴露组的测试表现较差的风险更高，比值比（ORs）范围为 1.35 至 5.60。随访期间的表现变化表明，暴露组的表现下降最为严重。暴露组在简易精神状态检查中得分降低 2 分的风险为 2.15（95%可信区间 1.18 至 3.94）。
这些结果表明长期接触农药会导致认知功能受损，并提出了向痴呆症发展的风险问题。PHYTONER 研究首次提供了与农药暴露相关的神经障碍自然史的前瞻性数据。
