title: Neurobehavioral effects of long-term exposure to pesticides: results from the 4-year follow-up of the PHYTONER study.
abstract: OBJECTIVE
  The aim of the PHYTONER study is to investigate the role of pesticides on neurobehavioral performances in French vineyard workers.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Laboratoire Santé Travail Environnement, EA 3672, Institut de Santé Publique d'Epidémiologie et de Développement, 146 rue Léo Saignat, 33076 Bordeaux cedex, France. isabelle.baldi@isped.u-bordeaux2.fr
authors.forename: Isabelle
authors.initials: I
authors.lastname: Baldi
authors.forename: Anne
authors.initials: A
authors.lastname: Gruber
authors.forename: Virginie
authors.initials: V
authors.lastname: Rondeau
authors.forename: Pierre
authors.initials: P
authors.lastname: Lebailly
authors.forename: Patrick
authors.initials: P
authors.lastname: Brochard
authors.forename: Colette
authors.initials: C
authors.lastname: Fabrigoule
mesh_terms: D000328:Adult; D000382:Agricultural Workers' Diseases / Q000139:chemically induced* / Q000453:epidemiology; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology; D015986:Confounding Factors, Epidemiologic; D004812:Epidemiologic Methods; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D010575:Pesticides / Q000633:toxicity*
chemical_list: D010575:Pesticides