Malekirad Ali Akbar, Faghih Mahya, Mirabdollahi Mansuoreh, Kiani Mahdi, Fathi Arezoo, Abdollahi Mohammad
Biology Department, Payame Noor University, Iran.
Arh Hig Rada Toksikol. 2013;64(1):1-8. doi: 10.2478/10004-1254-64-2013-2296.
About 25 million agricultural workers in the developing world suffer from at least one episode of poisoning each year, mainly by anticholinesterase-like organophosphates (OPs). The objective of this cross-sectional study was to establish the OP toxicity in 187 occupationally exposed farmers in terms of neurocognitive impairment, mental health status, clinical symptoms, diabetes, and haematological factors. The exposed group was compared to 187 healthy age-, sex-, and education-matching controls. Neurocognitive impairment was measured using the Subjective Neurocognition Inventory (SNI) and mental health status using the General Health Questionnaire-28 (GHQ-28). The subjects were also tested for fasting blood glucose (FBG), blood urea nitrogen (BUN), cholesterol (CL), triglycerides (TG), creatinine, oral glucose tolerance test (GTT), high-density lipoprotein (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP). The exposed farmers showed higher FBG (p<0.001), BUN (p=0.007), CL (p<0.001), oral GTT (p<0.001), and lower AST (p<0.001), ALP (p<0.001), and creatinine (p=0.004) than controls. The rates of anxiety/ insomnia and severe depression were also significantly higher in the farmers than in controls (p=0.015 and p<0.001, respectively). Meanwhile, the rate of social dysfunction was significantly lower than in controls (p<0.001). Disorders affecting psychomotor speed, selective attention, divided attention, verbal memory, nonverbal memory, prospective memory, spatial functioning, and initiative/energy were all lower in the farmers (p<0.001). Farmers showed clinical symptoms eczema, saliva secretion, fatigue, headache, sweating, abdominal pain, nausea, superior distal muscle weakness, inferior distal muscle weakness, inferior proximal muscle weakness, breath muscle weakness, hand tingling, foot tingling, epiphoria, polyuria, miosis, dyspnoea, bradycardia, and rhinorrhoea, which all significantly correlated with the number of working years. These findings indicate that farmers who work with OPs are prone to neuropsychological disorders and diabetes.
发展中世界约有2500万农业工人每年至少经历一次中毒事件，主要是由类抗胆碱酯酶有机磷农药（OPs）导致。这项横断面研究的目的是从神经认知障碍、心理健康状况、临床症状、糖尿病和血液学因素方面确定187名职业接触OPs的农民的OPs毒性。将暴露组与187名年龄、性别和教育程度匹配的健康对照组进行比较。使用主观神经认知量表（SNI）测量神经认知障碍，使用一般健康问卷-28（GHQ-28）测量心理健康状况。还对受试者进行空腹血糖（FBG）、血尿素氮（BUN）、胆固醇（CL）、甘油三酯（TG）、肌酐、口服葡萄糖耐量试验（GTT）、高密度脂蛋白（HDL）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和碱性磷酸酶（ALP）检测。与对照组相比，暴露组农民的FBG（p<0.001）、BUN（p=0.007）、CL（p<0.001）、口服GTT（p<0.001）较高，而AST（p<0.001）、ALP（p<0.001）和肌酐（p=0.004）较低。农民中焦虑/失眠和重度抑郁的发生率也显著高于对照组（分别为p=0.015和p<0.001）。同时，社会功能障碍的发生率显著低于对照组（p<）。影响精神运动速度、选择性注意力、分散注意力、言语记忆、非言语记忆、前瞻性记忆、空间功能和主动性/精力的障碍在农民中也较低（p<0.001）。农民出现湿疹、唾液分泌、疲劳、头痛、出汗、腹痛、恶心、上肢远端肌无力、下肢远端肌无力、下肢近端肌无力、呼吸肌无力、手部刺痛、足部刺痛、流泪过多、多尿、瞳孔缩小、呼吸困难、心动过缓和流涕等临床症状，所有这些症状均与工作年限显著相关。这些发现表明，接触OPs的农民易患神经心理障碍和糖尿病。
