Magnitude of behavioral deficits varies with job-related chlorpyrifos exposure levels among Egyptian pesticide workers.

Chronic occupational exposure to organophosphorus pesticides (OPs) is consistently associated with deficits on behavioral tests when compared to unexposed comparison groups. However, a dose-response relationship has yet to be established, leading some to doubt an association between occupational OP exposure and behavioral deficits. Pesticide application teams in Egypt who are primarily exposed to one OP, chlorpyrifos (CPF), were recruited into a field assessment. Trail Making A and the more challenging Trail Making B tests were administered to 54 engineers (who supervise the pesticide application process, usually from the side of the field), 59 technicians (who guide the pesticide applicators in the field), 31 applicators (who mix and apply pesticides using knapsack sprayers), and 150 controls (who did not work in the fields) at two different times during the OP application season as well as immediately after applications had ended and 1.5 months later. All participants were males since only males work on pesticide application teams in Egypt. Urinary levels of 3,5,6-trichloro-2-pyridinol (TCPy), a specific metabolite of CPF, confirmed the pattern of lower to higher CPF exposures from engineers to technicians to applicators, and these were all greater than urinary metabolite levels in controls. A consistent relationship between job title and performance speed on the behavioral task was observed: Controls had the best (fastest) performance on Trail Making A and B tests throughout the application season, and applicators had significantly slower performance than engineers on Trail Making A (p = 0.015) and B (p = 0.003). However, individual urinary TCPy, blood acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) levels did not predict individual performance. This study identifies a dose-related effect based on job title, which serves as a surrogate for chronic exposure in that differing job titles exhibit varying group exposure levels. The results establish that chronic occupational exposure to chlorpyrifos is neurotoxic and suggest that the classic biomarkers of recent CPF exposure are not predictive of chronic exposure effects

Neurobehavioral Evaluation for a Community with Chronic Exposure to Hydrogen Sulfide Gas

In May 2000, the Agency for Toxic Substances and Disease Registry of the US government conducted a health investigation in response to community concerns regarding ambient and indoor hydrogen sulfide (H2S), odor, and health symptoms in Dakota City, Nebraska. The objective was to determine whether adult residents in an area with repeated exposure to H2S showed poorer performance on neurobehavioral tests than unexposed residents. Study participants were required to meet age (≥16 years of age) and length of residency (2 years) eligibility requirements. A battery of computer-assisted standardized neurobehavioral tests was administered in English or Spanish. A questionnaire was used to collect information about participants, demographic and health status. Three hundred forty-five people agreed to participate. After the exclusion of 10 persons, analyses were conducted on 335 participants; 171 residents in the target area and 164 residents in the comparison area. The two groups were comparable in demographic characteristics and various health conditions. Overall, neurobehavioral test results for the target and comparison groups were similar. Residence in the H2S-exposed area was associated with marginally poorer performance on a test of memory, namely, match to sample score, and a test of grip strength. However, these differences were not significant. Deficits in overall neurobehavioral performance were not associated with exposure to H2S in this study

Neurobehavioral Evaluation for a Community with Chronic Exposure to Hydrogen Sulfide Gas

In May 2000, the Agency for Toxic Substances and Disease Registry of the US government conducted a health investigation in response to community concerns regarding ambient and indoor hydrogen sulfide (H2S), odor, and health symptoms in Dakota City, Nebraska. The objective was to determine whether adult residents in an area with repeated exposure to H2S showed poorer performance on neurobehavioral tests than unexposed residents. Study participants were required to meet age (≥16 years of age) and length of residency (2 years) eligibility requirements. A battery of computer-assisted standardized neurobehavioral tests was administered in English or Spanish. A questionnaire was used to collect information about participants, demographic and health status. Three hundred forty-five people agreed to participate. After the exclusion of 10 persons, analyses were conducted on 335 participants; 171 residents in the target area and 164 residents in the comparison area. The two groups were comparable in demographic characteristics and various health conditions. Overall, neurobehavioral test results for the target and comparison groups were similar. Residence in the H2S-exposed area was associated with marginally poorer performance on a test of memory, namely, match to sample score, and a test of grip strength. However, these differences were not significant. Deficits in overall neurobehavioral performance were not associated with exposure to H2S in this study

Studying Health Outcomes in Farmworker Populations Exposed to Pesticides

A major goal of studying farmworkers is to better understand how their work environment, including exposure to pesticides, affects their health. Although a number of health conditions have been associated with pesticide exposure, clear linkages have yet to be made between exposure and health effects except in cases of acute pesticide exposure. In this article, we review the most common health end points that have been studied and describe the epidemiologic challenges encountered in studying these health effects of pesticides among farmworkers, including the difficulties in accessing the population and challenges associated with obtaining health end point data. The assessment of neurobehavioral health effects serves as one of the most common and best examples of an approach used to study health outcomes in farmworkers and other populations exposed to pesticides. We review the current limitations in neurobehavioral assessment and strategies to improve these analytical methods. Emerging techniques to improve our assessment of health effects associated with pesticide exposure are reviewed. These techniques, which in most cases have not been applied to farmworker populations, hold promise in our ability to study and understand the relationship between pesticide exposure and a variety of health effects in this population

Behavioral observation used to estimate pesticide exposure for farm workers in Brazil

Assessment of the harm caused by exposure to pesticides requires that a measure of exposure be available. While such information is available without difficulty in controlled laboratory studies, estimating the exposure of humans who have been exposed in the real world is difficult. The difficulty is increased if exposures have taken place over an extended time period and the documentation of specifics is unavailable. Three methods of exposure assessment have previously been used: comparison of exposed and non-exposed groups, estimation of exposures through self-report of the individuals, and estimation of exposure through assessment of biomarkers or environmental levels. Each approach imposes limitations. We propose an additional approach - estimation of the degree of exposure for individuals through direct observation of their behavior and their use of personal protective equipment (PPE) during periods of exposure. We also obtain opinions from experts regarding the risk associated with the various behaviors and PPE use and combine these with the observations to create a personal risk index for each individual. By including information on chemicals in use during this period, we can characterize recent (observed) exposure for that individual. By these steps, the degree of risk may be determined for recent (observed) exposure. An estimate of long-term risk resulting from work-related exposures can be obtained for individuals by summing across their work histories

A Computer-based Training Intervention for Work Supervisors to Respond to Intimate Partner Violence

Objectives: Intimate partner violence (IPV), commonly known as domestic violence is a problem throughout the world. An estimated 36% to 75% of employed abused woman are monitored, harassed and physically assaulted by their partners or ex-partners while trying to get to work and while at work. The objective of this research is to evaluate the effectiveness of interactive training to increase knowledge, change perceptions and develop an intention to address domestic violence that spills over into the workplace. Methods: Community-based participatory research approaches were employed to develop and evaluate an interactive computer-based training (CBT) intervention, aimed to teach supervisors how to create supportive and safe workplaces for victims of IPV. Results: The CBT intervention was administered to 53 supervisors. All participants reacted positively to the training, and there was a significant improvement in knowledge between pre- and post-training test performance (72% versus 96% correct), effect size (d) = 3.56. Feedback from focus groups was more productive than written feedback solicited from the same participants at the end of the training. Conclusion: Effective training on the impacts of IPV can improve knowledge, achieving a large effect size, and produce changes in perspective about domestic violence and motivation to address domestic violence in the workplace, based on questionnaire responses

A Training Intervention for Supervisors to Support a Work-Life Policy Implementation

Background: Effective policy implementation is essential for a healthy workplace. The Ryan-Kossek 2008 model for work-life policy adoption suggests that supervisors as gatekeepers between employer and employee need to know how to support and communicate benefit regulations. This article describes a workplace intervention on a national employee benefit, Family and Medical Leave Act (FMLA), and evaluates the effectiveness of the intervention on supervisor knowledge, awareness, and experience with FMLA. Methods: The intervention consisted of computer-based training (CBT) and a survey measuring awareness and experience with FMLA. The training was administered to 793 county government supervisors in the state of Oregon, USA. Results: More than 35% of supervisors reported no previous training on FMLA and the training pre-test revealed a lack of knowledge regarding benefit coverage and employer responsibilities. The CBT achieved: (1) a significant learning effect and large effect size of d = 2.0, (2) a positive reaction to the training and its design, and (3) evidence of increased knowledge and awareness regarding FMLA. Conclusion: CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA