title: A clinical neurological, neurophysiological, and neuropsychological study of sheep farmers and dippers exposed to organophosphate pesticides.
abstract: OBJECTIVE
  To classify clinical diseases of the subjects with abnormal indices of peripheral neuropathy identified in field studies of sheep farmers and dippers exposed to organophosphate pesticides. To explore what neuropsychological profiles, if any, may be associated with neurophysiological damage in these subjects.
  
  
  METHODS
  A case-control study (79 subjects) nested within the cross sectional study (685 subjects) of sheep farmers from the field study. Three groups with no, possible, and probable or definite neuropathy according to field studies were recruited. Investigations comprised symptoms of neuropathy, neurologial signs, motor and sensory nerve conduction, electromyography, quantitative sensory testing, and neuropsychological tests.
  
  
  RESULTS
  The incidence of clinical neuropathy increased from 7% in the no neuropathy group to 52% in the probable or definite neuropathy group based on nerve conduction measurements or presence of neurological signs. Sensory abnormalities were found more often than motor deficits. Small diameter nerve fibres were also affected more than large fibres.
  
  
  CONCLUSIONS
  The neuropathy is predominantly sensory and is characteristic of distal, chronic neuropathy with no acute features. Small fibre populations are affected more than large fibre populations. Increasing severity of neuropathy was associated with anxiety and depression as measured in the neuropsychological tests.
authors.affiliation: Imperial College School of Medicine, London, UK.
authors.forename: G A
authors.initials: GA
authors.lastname: Jamal
authors.forename: S
authors.initials: S
authors.lastname: Hansen
authors.forename: A
authors.initials: A
authors.lastname: Pilkington
authors.forename: D
authors.initials: D
authors.lastname: Buchanan
authors.forename: R A
authors.initials: RA
authors.lastname: Gillham
authors.forename: M
authors.initials: M
authors.lastname: Abdel-Azis
authors.forename: P O O
authors.initials: PO
authors.lastname: Julu
authors.forename: S F
authors.initials: SF
authors.lastname: Al-Rawas
authors.forename: F
authors.initials: F
authors.lastname: Hurley
authors.forename: J P
authors.initials: JP
authors.lastname: Ballantyne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D000822:Animal Husbandry; D000818:Animals; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003943:Diagnostic Techniques, Neurological; D004576:Electromyography / Q000187:drug effects; D005260:Female; D006801:Humans; D007306:Insecticides / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects; D009483:Neuropsychological Tests; D016273:Occupational Exposure / Q000009:adverse effects; D009943:Organophosphorus Compounds; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D012678:Sensation Disorders / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D012756:Sheep
chemical_list: D007306:Insecticides; D009943:Organophosphorus Compounds