title: Depression Prevalence and Exposure to Organophosphate Esters in Aircraft Maintenance Workers.
abstract: BACKGROUND
  Previous studies found that aircraft maintenance workers may be exposed to organophosphates in hydraulic fluid and engine oil. Studies have also illustrated a link between long-term low-level organophosphate pesticide exposure and depression.
  
  
  METHODS
  A questionnaire containing the Patient Health Questionnaire 8 depression screener was e-mailed to 52,080 aircraft maintenance workers (with N = 4801 complete responses) in a cross-sectional study to determine prevalence and severity of depression and descriptions of their occupational exposures.
  
  
  RESULTS
  There was no significant difference between reported depression prevalence and severity in similar exposure groups in which aircraft maintenance workers were exposed or may have been exposed to organophosphate esters compared to similar exposure groups in which they were not exposed. However, a dichotomous measure of the prevalence of depression was significantly associated with self-reported exposure levels from low (OR: 1.21) to moderate (OR: 1.68) to high exposure (OR: 2.70) and with each exposure route including contact (OR: 1.68), inhalation (OR: 2.52), and ingestion (OR: 2.55). A self-reported four-level measure of depression severity was also associated with a self-reported four-level measure of exposure.
  
  
  CONCLUSIONS
  Based on self-reported exposures and outcomes, an association is observed between organophosphate exposure and depression; however, we cannot assume that the associations we observed are causal because some workers may have been more likely to report exposure to organophosphate esters and also more likely to report depression. Future studies should consider using a larger sample size, better methods for characterizing crew chief exposures, and bioassays to measure dose rather than exposure. Hardos JE, Whitehead LW, Han I, Ott DK, Waller DK. Depression prevalence and exposure to organophosphate esters in aircraft maintenance workers. Aerosp Med Hum Perform. 2016; 87(8):712-717.
authors.affiliation: U.S. Air Force School of Aerospace Medicine, Wright-Patterson AFB, OH, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Hardos
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Whitehead
authors.forename: Inkyu
authors.initials: I
authors.lastname: Han
authors.forename: Darrin K
authors.initials: DK
authors.lastname: Ott
authors.forename: D Kim
authors.initials: DK
authors.lastname: Waller
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D000401:Aircraft; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D004952:Esters; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D016273:Occupational Exposure / Q000009:adverse effects*; D010755:Organophosphates / Q000009:adverse effects*; D015995:Prevalence; D057566:Self Report; D012720:Severity of Illness Index
chemical_list: D000395:Air Pollutants, Occupational; D004952:Esters; D010755:Organophosphates