title: An epidemiological study of the relations between exposure to organophosphate pesticides and indices of chronic peripheral neuropathy and neuropsychological abnormalities in sheep farmers and dippers.
abstract: OBJECTIVE
  To investigate the hypothesis that chronic low level exposure to organophosphates (OPs) in sheep dips is related to clinically detectable measures of polyneuropathy.
  
  
  METHODS
  The design was a cross sectional exposure-response study of sheep dippers and other non-exposed groups. The study group consisted of 612 sheep dipping farmers, 53 farmers with no sheep dipping experience, and 107 ceramics workers. Retrospective exposure information was obtained by questionnaire based on stable and easily identifiable features of sheep dipping found during the first phase of the study; in particular, estimates of handling concentrate and splashing with dilute dip. Neurological assessments were based on a standard neuropathy symptoms questionnaire, and thermal and vibration quantitative sensory tests.
  
  
  RESULTS
  Adjusted for confounders there was a weak positive association between cumulative exposure to OPs and neurological symptoms, the significance of which was dependent on the inclusion of a few individual workers with extremely high exposure. There was no evidence of an association between cumulative exposure and the thermal or vibration sensory thresholds. However, separating the effects of exposure intensity and duration showed a higher prevalence of symptoms, primarily of a sensory type, among sheep dippers who handled the OP concentrate. There was also evidence that sensory and vibration thresholds were higher among concentrate handlers, the highest exposed group of dippers.
  
  
  CONCLUSIONS
  The findings showed a strong association between exposure to OP concentrate and neurological symptoms, but a less consistent association with sensory thresholds. There was only weak evidence of a chronic effect of low dose cumulative exposure to OPs. It is suggested that long term health effects may occur in at least some sheep dippers exposed to OPs over a working life, although the mechanisms are unclear.
authors.affiliation: Institute of Occupational Medicine, 8 Roxburgh Place, Edinburgh EH8 9SU, UK.
authors.forename: A
authors.initials: A
authors.lastname: Pilkington
authors.forename: D
authors.initials: D
authors.lastname: Buchanan
authors.forename: G A
authors.initials: GA
authors.lastname: Jamal
authors.forename: R
authors.initials: R
authors.lastname: Gillham
authors.forename: S
authors.initials: S
authors.lastname: Hansen
authors.forename: M
authors.initials: M
authors.lastname: Kidd
authors.forename: J F
authors.initials: JF
authors.lastname: Hurley
authors.forename: C A
authors.initials: CA
authors.lastname: Soutar
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000139:chemically induced* / Q000453:epidemiology; D000822:Animal Husbandry; D000818:Animals; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007306:Insecticides / Q000008:administration & dosage / Q000009:adverse effects*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D009943:Organophosphorus Compounds; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D012678:Sensation Disorders / Q000139:chemically induced / Q000453:epidemiology; D012737:Sex Factors; D012756:Sheep; D011795:Surveys and Questionnaires
chemical_list: D007306:Insecticides; D009943:Organophosphorus Compounds