title: Chlorpyrifos and neurodevelopmental effects: a literature review and expert elicitation on research and policy.
abstract: BACKGROUND
  Organophosphate pesticides are widely used on food crops grown in the EU. While they have been banned from indoor use in the US for a decade due to adverse health effects, they are still the most prevalent pesticides in the EU, with Chlorpyrifos (CPF) being the most commonly applied. It has been suggested CPF affects neurodevelopment even at levels below toxicity guidelines. Younger individuals may be more susceptible than adults due to biological factors and exposure settings.
  
  
  METHODS
  A literature review was undertaken to assess the evidence for CPF contributing to neurodevelopmental disorders in infants and children. Other literature was consulted in order to formulate a causal chain diagram showing the origins, uptake, and neurological effects of animal and human exposure to CPF.The causal chain diagram and a questionnaire were distributed online to scientific experts who had published in relevant areas of research. They were asked to assess their confidence levels on whether CPF does in fact contribute to adverse neurodevelopment outcomes and rate their confidence in the scientific evidence. A second questionnaire queried experts as to which kind of policy action they consider justifiable based on current knowledge. In a special workshop session at the EuroTox congress in Dresden in 2009 the results of both questionnaires were further discussed with invited experts, as a basis for a policy brief with main messages for policy makers and stakeholders.
  
  
  RESULTS
  Most experts who responded to the first questionnaire felt that there was already enough evidence to support a ban on indoor uses of CPF in the EU. However, most felt additional research is still required in several areas. The responses from the first questionnaire were used to formulate the second questionnaire addressing the feasibility of government action. In turn, these expert participants were invited to attend a special session at the EuroTox congress in Dresden in 2009.
  
  
  CONCLUSIONS
  Some of the evidence that CPF contributes to neurodevelopmental disorders is still disputed among experts, and the overall sense is that further research and public awareness are warranted. There have been campaigns in North America making the potential exposure concerns known, but such information is not widely known in the EU. The ability of government action to produce change is strongly felt in some quarters while others believe better knowledge of consumer use trends would have a greater impact.
authors: University Hospitals Bristol NHS Foundation Trust, England. M.Saunders@bristol.ac.uk
authors: Margaret
authors: M
authors: Saunders
authors: Brooke L
authors: BL
authors: Magnanti
authors: Sara
authors: S
authors: Correia Carreira
authors: Aileen
authors: A
authors: Yang
authors: Urinda
authors: U
authors: Alamo-Hernández
authors: Horacio
authors: H
authors: Riojas-Rodriguez
authors: Gemma
authors: G
authors: Calamandrei
authors: Janna G
authors: JG
authors: Koppe
authors: Martin
authors: M
authors: Krayer von Krauss
authors: Hans
authors: H
authors: Keune
authors: Alena
authors: A
authors: Bartonova
mesh_terms: D002648:Child; D002657:Child Development / Q000187:drug effects; D004390:Chlorpyrifos / Q000378:metabolism / Q000633:toxicity*; D004781:Environmental Exposure; D004782:Environmental Health; D005062:European Union; D005104:Expert Testimony; D005260:Female; D006291:Health Policy; D006801:Humans; D007306:Insecticides / Q000378:metabolism / Q000633:toxicity*; D008297:Male; D009420:Nervous System / Q000187:drug effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D007306:Insecticides; D004390:Chlorpyrifos