Baldi I, Gruber A, Rondeau V, et al. Neurobehavioral effects of long-term exposure to pesticides: results from the 4-year follow-up of the PHYTONER study

Laboratoire Santé Travail Environnement, EA 3672, Institut de Santé Publique d'Epidémiologie et de Développement, 146 rue Léo Saignat, 33076 Bordeaux cedex, France.
Occupational and environmental medicine (Impact Factor: 3.27). 02/2011; 68(2):108-15. DOI: 10.1136/oem.2009.047811
Source: PubMed


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.

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    • "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). "
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    • "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) [1], respiratory diseases such as chronic obstructive pulmonary disease [2,3], musculoskeletal pain [4,5], reproductive outcomes [6] and accidents [7]. 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 [1][5]) or asthma (particularly for farm exposure in the childhood [13,14]). "
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    • "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 [25] 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. "
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