Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA; Oregon Health and Science University, Portland, OR, USA.
Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA; Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt.
Neurotoxicology. 2019 Sep;74:1-6. doi: 10.1016/j.neuro.2019.05.002. Epub 2019 May 8.
Exposure to environmental chemicals, including organophosphorus pesticides, is associated with behavioral disorders such as attention deficit hyperactivity disorder (ADHD). However, the impact of occupational pesticide exposure on ADHD development in adolescents has not been examined.
We examined the association between exposure to chlorpyrifos and ADHD symptoms among adolescents in Egypt.
Adolescent pesticide applicators and non-applicators, 12-21 years old, participated in a 10-month longitudinal study examining health effects from pesticide exposure. Repeated urine and blood samples were collected at various time points during the 10-months to assess biomarkers of chlorpyrifos exposure (urinary trichloro-2-pyridinol or TCPy) and effect (blood acetyl cholinesterase activity and butyryl cholinesterase activity). Parents from a subset of the cohort (N = 64) completed the Short Form of Conners' Parent Rating Scale - Revised. Poisson regressions were used to examine the associations between the number of ADHD symptoms and occupation and biomarkers.
Pesticide applicators had significantly more symptoms of ADHD than participants in the non-applicator group. Urinary TCPy levels were associated with increased symptoms, demonstrating a dose-response effect. Applicators with ADHD reported applying pesticides for more hours during the application season and had greater cumulative TCPy levels than participants without ADHD. One fourth of all applicators met the criteria for an ADHD diagnosis (having 6 or more reported symptoms).
This study provides preliminary evidence of an association between occupational exposure to chlorpyrifos and ADHD symptoms among adolescent pesticide applicators in spite of its limited small sample size. There is a critical need to investigate the susceptibility of children and adolescents to repeated occupational and environmental exposures to pesticides because the developing brain may be uniquely sensitive to the neurotoxic effects of these agents.
接触环境化学物质，包括有机磷杀虫剂，与行为障碍有关，如注意缺陷多动障碍（ADHD）。然而，职业性农药接触对青少年 ADHD 发展的影响尚未得到检验。
我们研究了埃及青少年接触氯吡硫磷与 ADHD 症状之间的关系。
12-21 岁的青少年农药施用者和非施用者参加了一项为期 10 个月的纵向研究，以检验农药暴露对健康的影响。在 10 个月的时间里，在不同时间点采集重复的尿液和血液样本，以评估氯吡硫磷暴露（尿三氯-2-吡啶醇或 TCPy）和效应（血液乙酰胆碱酯酶活性和丁酰胆碱酯酶活性）的生物标志物。队列的一部分家长（N=64）完成了康纳斯父母简短量表-修订版。泊松回归用于检验 ADHD 症状的数量与职业和生物标志物之间的关系。
与非施用者相比，施用者报告的 ADHD 症状明显更多。尿 TCPy 水平与症状增加有关，呈现出剂量-反应关系。报告患有 ADHD 的施用者在施药季节中施用农药的时间更长，累积 TCPy 水平高于没有 ADHD 的参与者。所有施用者中有四分之一符合 ADHD 诊断标准（报告有 6 个或更多症状）。
尽管本研究样本量有限，但这项研究提供了职业性接触氯吡硫磷与青少年农药施用者 ADHD 症状之间关联的初步证据。由于儿童和青少年的大脑在发育过程中可能对这些物质的神经毒性作用特别敏感，因此迫切需要调查儿童和青少年对反复职业和环境暴露于农药的敏感性。
