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.
"Although pesticides help control agricultural pests and organisms harming human activities, they may present a risk for human health. Severe pathologies such as cancers, neurodegenerative diseases or reproductive disorders are suspected of being connected to exposure to pesticides, particularly for specific populations such as farmers and their children (Bailey et al., 2011; Baldi et al., 2011; Inserm, 2013; Koutros et al., 2011; Merhi et al., 2008). In the general population, dietary intake is considered to be the main route of exposure to most pesticides (Cao et al., 2011; Lu et al., 2006; Nougadère et al., 2012). "
[Show abstract][Hide abstract] ABSTRACT: The French system for monitoring dietary exposure to pesticide residues and its scoring method are presented. This system aims both to assess acute and chronic risks to the general population and to identify food commodities and pesticides that need to be better monitored and/or regulated thanks to 6 priority levels. The method combines four chronic and acute dietary risk indicators based on the results of the most recent national monitoring programmes and maximum residue levels, in connection with individual and national food consumption data. The probability of exceeding the toxicological reference values was estimated for children and adults, for 522 pesticides and their metabolites. Food contributors were detailed and a minimum number of samples to be taken per food was proposed. The majority of the pesticides (87%) was scored at the lowest priority level 1. For pesticides classified in levels 2 to 5, there is a need to refine the assessment. The monitoring should also be extended to include newly authorised substances in levels 2 to 4. Carbendazim, dimethoate, dithiocarbamates and imazalil merit particular attention as they scored at level 6 and are frequently quantified in fruits and vegetables, meaning that risk managers should take corrective measures in order to ensure consumer safety.
Food Control 07/2014; 41(1):32–48. DOI:10.1016/j.foodcont.2013.12.025 · 2.81 Impact Factor
"Several studies reported that this population has a greater risk of several cancers (non-Hodgkin's lymphoma, Hodgkin's disease, multiple myeloma, prostate, connective tissue, skin, stomach, and brain) , respiratory diseases such as chronic obstructive pulmonary disease [2,3], musculoskeletal pain [4,5], reproductive outcomes  and accidents . Some others also reported higher risk for neurologic diseases such as Parkinson’s disease [8,9] or cognitive decline and dementia [10-12]. On the other hand, some findings also suggested that this population would less often suffer from other conditions, such as cardiovascular diseases [1,5,6], some types of cancer (lung, colon, oesophagus and bladder ) or asthma (particularly for farm exposure in the childhood [13,14]). "
[Show abstract][Hide abstract] ABSTRACT: The health of the agricultural population has been previously explored, particularly in relation to the farming exposures and among professionally active individuals. However, few studies specifically focused on health and aging among elders retired from agriculture. Yet, this population faces the long-term effects of occupational exposures and multiple difficulties related to living and aging in rural area (limited access to shops, services, and practitioners). However, these difficulties may be counter-balanced by advantages related to healthier lifestyle, richer social support and better living environment. The general aim of the AMI cohort was to study health and aging in elderly farmers living in rural area through a multidisciplinary approach, with a main focus on dementia.
The study initially included 1 002 participants, randomly selected from the Farmer Health Insurance rolls. Selection criteria were: being 65 years and older; living in rural area in Gironde (South-Western France); being retired from agriculture after at least 20 years of activity and being affiliated to the Health Insurance under own name. The study started in 2007, with two follow-up visits over 5 years. Baseline visits were conducted at home by a neuropsychologist then by a geriatrician for all cases suspected of dementia, Parkinson's disease and depression (to confirm the diagnosis), and by a nurse for others. A large panel of data were collected through standardised questionnaires: complete neuropsychological assessment, material and social living environment, psychological transition to retirement, lifestyle (smoking, alcohol and diet), medications, disability in daily living, sensory impairments and some clinical measures (blood pressure, depression symptomatology, anxiety, visual test, anthropometry...). A blood sampling was performed with biological measurements and constitution of a biological bank, including DNA. Brain MRI were also performed on 316 of the participants. Finally, the three-year data on health-related reimbursements were extracted from the Health System database (medications, medical and paramedical consultations, biological examinations and medical devices), and the registered Long-Term Diseases (30 chronic diseases 100% covered by the Insurance System).
AMI is the first French longitudinal study on health and aging set up in a population of elderly farmers living in rural area through a multidisciplinary approach.
BMC Public Health 07/2012; 12(1):558. DOI:10.1186/1471-2458-12-558 · 2.26 Impact Factor
"One method that has been utilized is to reconstruct chronic exposures according to retrospective report of the level as well as the duration of exposure. In the PHYTHONER study, Baldi and colleagues  have documented a detrimental impact of long-term pesticide exposures on neurocognitive functioning among French vineyard workers using this approach. In countries where high levels of arsenic exposure have been documented for decades (e.g., areas of China, Bangladesh, and Mexico), researchers have historical data regarding exposure levels that can be utilized to create models of chronic exposure. "
[Show abstract][Hide abstract] ABSTRACT: Exposure to elements in groundwater (toxic or beneficial) is commonplace yet, outside of lead and mercury, little research has examined the impact of many commonly occurring environmental exposures on mental abilities during the aging process. Inorganic arsenic is a known neurotoxin that has both neurodevelopmental and neurocognitive consequences. The aim of this study was to examine the potential association between current and long-term arsenic exposure and detailed neuropsychological functioning in a sample of rural-dwelling adults and elders. Data were analyzed from 434 participants (133 men and 301 women) of Project FRONTIER, a community-based participatory research study of the epidemiology of health issues of rural-dwelling adults and elders. The results of the study showed that GIS-based groundwater arsenic exposure (current and long-term) was significantly related to poorer scores in language, visuospatial skills, and executive functioning. Additionally, long-term low-level exposure to arsenic was significantly correlated to poorer scores in global cognition, processing speed and immediate memory. The finding of a correlation between arsenic and the domains of executive functioning and memory is of critical importance as these are cognitive domains that reflect the earliest manifestations of Alzheimer's disease. Additional work is warranted given the population health implications associated with long-term low-level arsenic exposure.
International Journal of Environmental Research and Public Health 03/2011; 8(3):861-74. DOI:10.3390/ijerph8030861 · 2.06 Impact Factor
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