title: Neurological symptoms among Sri Lankan farmers occupationally exposed to acetylcholinesterase-inhibiting insecticides.
abstract: BACKGROUND
  In many agricultural districts in Sri Lanka, pesticide poisoning is a leading cause of death. This study aims to evaluate the impact of pesticide use on Sri Lankan farmers' health.
  
  
  METHODS
  A total of 260 subjects were surveyed in both a low and a high exposure period. Acetylcholinesterase activity was measured and data on symptoms were collected with questionnaires.
  
  
  RESULTS
  Twenty-four percent of surveyed farmers had suffered at least once from acute pesticide poisoning. Farmers showed significantly more inhibition of cholinesterase activity than controls. Acute symptoms indicative for exposure to cholinesterase-inhibiting pesticides were associated with farming and a higher degree of cholinesterase suppression (more than 13% inhibition). Integrated Pest Management (IPM) training seemed to result in less insecticide use, and less cholinesterase inhibition.
  
  
  CONCLUSIONS
  Our results suggest that occupational acetylcholinesterase-inhibiting insecticide exposures have a negative impact on Sri Lankan farmers' health. Overall reduction in pesticide use seems the best option to protect farmers from the adverse effects of pesticides.
authors.affiliation: International Water Management Institute, Colombo, Sri Lanka. l.smit@iras.uu.nl
authors.forename: Lidwien A M
authors.initials: LA
authors.lastname: Smit
authors.forename: Berna N
authors.initials: BN
authors.lastname: van-Wendel-de-Joode
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.forename: Roshini J
authors.initials: RJ
authors.lastname: Peiris-John
authors.forename: Wim
authors.initials: W
authors.lastname: van der Hoek
mesh_terms: D000110:Acetylcholinesterase / Q000097:blood; D000328:Adult; D000383:Agriculture; D002800:Cholinesterase Inhibitors / Q000097:blood / Q000506:poisoning*; D005260:Female; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology; D016273:Occupational Exposure; D015995:Prevalence; D013188:Sri Lanka / Q000453:epidemiology
chemical_list: D002800:Cholinesterase Inhibitors; D007306:Insecticides; D000110:Acetylcholinesterase