NEUROLOGICAL EFFECTS OF COMBINED EXPOSURE TO ORGANOPHOSPHATE AND PYRETHROID PESTICIDES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Author(s)
Harsimran Kaur1, Habieba Mohab, PharmD2, Rashid Muhammed, PhD3, Girish Thunga, PhD4;
1Manipal Academy of Higher Education Student Chapter, Research Scholar, Dist. Udupi, India, 2German University of Cairo, Cairo, Egypt, 3Manipal Academy of Higher Education, Manipal, India, 4Manipal college of pharmaceutical sciences, Udupi, India
1Manipal Academy of Higher Education Student Chapter, Research Scholar, Dist. Udupi, India, 2German University of Cairo, Cairo, Egypt, 3Manipal Academy of Higher Education, Manipal, India, 4Manipal college of pharmaceutical sciences, Udupi, India
OBJECTIVES: This systematic review and meta-analysis aimed to assess the neurological and neurobehavioral effects of combined OP and PYR pesticide exposure among occupational, accidental, and intentional modes of exposure.
METHODS: PubMed, Scopus, and Embase databases were comprehensively searched through February 2024. Studies assessing the neurological symptoms and/or neurobehavioral manifestations among those exposed to the combination of OP and PYR pesticides were included. Categorical results with respect to the neurological symptoms were collected in terms of frequency or percentage, and pooled data was presented as Risk Ratio (RR) with a 95% Confidence Interval (CI). RevMan web was used for conducting the meta-analysis and Comprehensive Meta-analysis software was used for analysis of publication bias. Publication bias was assessed using New-Castle Ottawa scale and JBI checklist.
RESULTS: We included eight studies involving 931 exposed individuals and 322 controls. Most studies reported occupational exposure. Exposed individuals reported an increased frequency of neurological symptoms including seizures, headaches, difficulty in understanding, and irritability compared to the unexposed. Our meta-analysis found a significantly increased risk of headache (RR: 1.81; 95%CI: 1.45-2.26; P<0.0001) and irritability (RR: 2.37;95%CI: 1.60-3.51; P<0.0001) in the exposed group. However, inconsistent effects on neurobehavioral performance were observed across studies. A few studies reported associations between certain PYR metabolites concentrations and neurotoxic symptoms.
CONCLUSIONS: We included eight studies involving 931 exposed individuals and 322 controls. Most studies reported occupational exposure. Exposed individuals reported an increased frequency of neurological symptoms including seizures, headaches, difficulty in understanding, and irritability compared to the unexposed. Our meta-analysis found a significantly increased risk of headache (RR: 1.81; 95%CI: 1.45-2.26; P<0.0001) and irritability (RR: 2.37;95%CI: 1.60-3.51; P<0.0001) in the exposed group. However, inconsistent effects on neurobehavioral performance were observed across studies. A few studies reported associations between certain PYR metabolites concentrations and neurotoxic symptoms.
METHODS: PubMed, Scopus, and Embase databases were comprehensively searched through February 2024. Studies assessing the neurological symptoms and/or neurobehavioral manifestations among those exposed to the combination of OP and PYR pesticides were included. Categorical results with respect to the neurological symptoms were collected in terms of frequency or percentage, and pooled data was presented as Risk Ratio (RR) with a 95% Confidence Interval (CI). RevMan web was used for conducting the meta-analysis and Comprehensive Meta-analysis software was used for analysis of publication bias. Publication bias was assessed using New-Castle Ottawa scale and JBI checklist.
RESULTS: We included eight studies involving 931 exposed individuals and 322 controls. Most studies reported occupational exposure. Exposed individuals reported an increased frequency of neurological symptoms including seizures, headaches, difficulty in understanding, and irritability compared to the unexposed. Our meta-analysis found a significantly increased risk of headache (RR: 1.81; 95%CI: 1.45-2.26; P<0.0001) and irritability (RR: 2.37;95%CI: 1.60-3.51; P<0.0001) in the exposed group. However, inconsistent effects on neurobehavioral performance were observed across studies. A few studies reported associations between certain PYR metabolites concentrations and neurotoxic symptoms.
CONCLUSIONS: We included eight studies involving 931 exposed individuals and 322 controls. Most studies reported occupational exposure. Exposed individuals reported an increased frequency of neurological symptoms including seizures, headaches, difficulty in understanding, and irritability compared to the unexposed. Our meta-analysis found a significantly increased risk of headache (RR: 1.81; 95%CI: 1.45-2.26; P<0.0001) and irritability (RR: 2.37;95%CI: 1.60-3.51; P<0.0001) in the exposed group. However, inconsistent effects on neurobehavioral performance were observed across studies. A few studies reported associations between certain PYR metabolites concentrations and neurotoxic symptoms.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HTA76
Topic
Health Technology Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Injury & Trauma, SDC: Neurological Disorders