1. OCCUPATIONAL HEALTH DISORDERS OF PESTICIDES AMONG EXPOSED CHILDREN IN AGRICULTURE (MENOUFIYA GOVERNORATE) Gaafar MA et al. Presented by Ahmed Ismail, MD, MS

4. INTRODUCTION

5. Cotton Crop In Egypt Nearly one third of the Egyptian work force is employed in agriculture. Cotton Crop is one of the strategic crops in Egypt. Cotton agriculture relies on children and adolescents. Pesticides are used in Egypt on large scale with huge amounts of pesticides being applied. Children and adolescents work as pesticide applicators.

6. Farahat et al., (2003): Adult Pesticide mixer, loader & applicators. Neurobehavioral deficits in the exposed vs. control: Similarities, BVRT, Digit Span, Letter Cancellation test, Digit Symbol, Trail making A and B. Personality symptoms of neuroticism. Neurological symptoms, e.g. dizziness, numbness. e.g. dizziness, numbness. Amr et al., (1999): Adult pesticide applicators and formulators. Superficial or deep sensory loss and decrease or lost reflexes in their ankle or ankle and knee. Poor appetite, insomnia, low energy or fatigue, low self-esteem, poor concentration and feelings of hopelessness. Health effects in cotton workers in Egypt

7. Research on adolescent workers Rohlman et al., (2006): Adult and adolescent farm workers in USA. Neurobehavioral deficit is associated with longer duration of working and pesticide handling: Selective Attention, Match-to-Sample, Symbol-Digit, and Reaction Time.

8. Aim of the Study

9. The aim is to examine the health disorders arising from seasonal occupational exposure of agricultural children applying pesticides in Menoufiya governorate.

10. Subjects and Methods

11. Participants Children, 9-18 years old, 15. Exposed: pesticide applicators. Control: matched on age, SES, and educational level. Pesticide application The season extends from June to September. Fields are sprayed 4 times, about 30 days. Workday from 8 am-12 pm, then 3-7 pm.

12. Spraying time Type of pesticide Function June 6 – June 18 Organochlorine Organochlorine Growth stimulator Growth stimulator June 30 – July 5 OrganophosphateUrea Boll weevil July 17 – July 22 Pyrethroid White flies and Boll weevil August 15 – August 25 Organophosphate Urea Urea Boll weevil Boll weevil Spraying Schedule

13. Informed consent from the children and their guardian. Questionnaire, medical history and occupational exposure history. Medical Examination. S. Cholinesterase (OP biomarker). Neurobehavioral Test Battery: Information, Similarities, Arithmetic, Digit Span, Digit Symbol, Block Design, BVRT, Trail Making part A, Trail making part B and Eysenck Personality Questionnaire. Procedure

14. The tests of significance : t-test, chi-squared test, and Pearson correlation. Multiple linear regression (age and years of education). Holms correction of p-value. Statistical methods

15. Results

16. Only 8% reported use of Personal Protective Equipment; higher exposure. The mean number of days worked this season was 20 days. The mean number of years worked as applicators was 5 years. Participant characteristics

17. group< 15 year> 15 year NMeanSDt- testNMeanSDt-test Age exposed3012.772.45.63 2016.82.86.06 control3012.472.672016.83.85 Years of education exposed305.472.96.53 207.305.20.74 control305.872.94208.454.56 Weight in Kg exposed 3036.576.502.39*2052.356.223.66* control 3042.2011.162062.310.44 Height in m exposed 301.28.084.20*201.50.10.73 control 301.38.11201.53.14 BMI exposed 3021.732.00.222023.23.633.87* control 3021.592.672026.904.1 SmokingN0.% 2 No.% 2 exposed 15 53.6.2711 52.4.1 control 15 46.9 15 47.4 1 ) Demographic data in the two groups

18. Neurobehavioral Performance

20. Personality characteristics

23. Correlations with neurobehavioral performance Only one test (Trail making) had a significant correlation with S. Cholinesterase. All neurobehavioral tests were significantly correlated with the no. of days worked this season. All neurobehavioral tests were significantly correlated with the no. of years worked.

24. Neurological symptoms

26. Relations with neurological symptoms Exposed participants reporting neurological symptoms had a significantly decreased level of S. Cholinesterase (Arthralgia, Low back pain, Fatigue, Ankle and Knee reflexes, and Superficial sensation). The more years worked was significantly correlated with the reporting of more neurological symptoms (Blurred vision, Dizziness, Headache, Feeling depressed, Arthralgia, Low back pain, Tremors, Fatigue, Muscle power, Ankle and knee reflexes, and Superficial sensation).

27. Conclusions

28. The exposed group had significantly lower neurobehavioral performance. The exposed group reported significantly more personality problems. The exposed group had a significant lower level of S. cholinesterase. The exposed group reported significantly more neurological symptoms and signs. The longer the participants applied pesticides the worse their performance on the neurobehavioral tests and the more symptoms they reported.

29. These results show the adverse effects of pesticide on children. These findings along with the results in adult workers (Farahat et al., 2003), demonstrate the need for education and training for Egyptian cotton workers. These results and recommendations will be presented to the Agricultural ministry.

30. Thank You Ahmed Ismail