Symptoms of psychological distress and suicidal ideation among banana workers with a history of poisoning by organophosphate or n-methyl carbamate pesticides.
OBJECTIVE
Neuropsychiatric disorders and increased suicide rates have been associated with exposure to cholinesterase inhibiting organophosphates. This study examined symptoms of psychological distress, including suicidal ideation, among banana workers in Costa Rica previously exposed to a cholinesterase inhibiting pesticide.


METHODS
78 workers who had received medical attention 1-3 years previously for occupational pesticide poisoning were recruited: 54 had been exposed to organophosphate, 24 to carbamate, and 43 and 35, respectively, had single and multiple poisoning episodes with a cholinesterase inhibitor. Referents were 130 non-poisoned workers randomly selected from company payrolls. Psychological distress symptoms during the month prior to interview were obtained using the Brief Symptom Inventory (BSI), which has a general severity index and nine subscale scores. Differences in abnormal BSI scores (T score≥63) were assessed through multivariate logistic regression for all poisoned and for subcategories of poisoned as compared to non-poisoned workers.


RESULTS
Organophosphate poisoned workers reported significantly more symptoms than non-poisoned on all but one symptom dimension. Significant trends of increasing symptoms with increasing number of previous poisonings were seen for somatisation, obsessive-compulsiveness, interpersonal sensitivity, depression and anxiety. Carbamate poisoned workers only had increased scores for somatisation. The ORs for suicidal thoughts were: all poisoned 3.58 (95% CI 1.45 to 8.84); organophosphate poisoned 3.72 (1.41 to 9.81); carbamate poisoned 2.57 (0.73 to 9.81); and 2.65 and 4.98, respectively for 1 and ≥2 poisonings (trend p=0.01).


CONCLUSIONS
This cross-sectional study showed a relationship between acute occupational poisoning with organophosphates and psychological distress including suicidal ideation. Stronger designs are needed to address causality.
Wesseling
Catharina
C
Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, PO Box 86-3000, Heredia, Costa Rica. Ineke_wesseling@yahoo.com
van Wendel de Joode
Berna
B
Keifer
Matthew
M
London
Leslie
L
Mergler
Donna
D
Stallones
Lorann
L
D000293:Adolescent; D000328:Adult; D000382:Agricultural Workers' Diseases / Q000139:chemically induced*; D002219:Carbamates / Q000506:poisoning; D002800:Cholinesterase Inhibitors / Q000506:poisoning; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D028521:Musa; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D062025:Organophosphate Poisoning; D010575:Pesticides / Q000506:poisoning*; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000139:chemically induced*; D059020:Suicidal Ideation; D055815:Young Adult
D002219:Carbamates; D002800:Cholinesterase Inhibitors; D010575:Pesticides; C036868:methyl carbamate