Neurological Effects of Combined Exposure to Organophosphate and Pyrethroid Pesticides: A Systematic Review and Meta-Analysis
Author(s)
Harsimran Kaur, PhD1, Habieba Mohab, B.Pharm2, Rashid Muhammed, PhD3, Girish Thunga, PhD4.
1Health Technology Assessment Resource Center, National Institute of Virology, Pune, India, 2German University of Cairo, Cairo, Egypt, 3Manipal Academy of Higher Education, Manipal, India, 4Manipal college of pharmaceutical sciences, Udupi, India.
1Health Technology Assessment Resource Center, National Institute of Virology, Pune, 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. Quality of included studies was assessed using the Newcastle-Ottawa scale and the 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 metabolite concentrations and neurotoxic symptoms.
CONCLUSIONS: Neurological symptoms were found to be more prevalent in individuals exposed to the combination of OP and PYR pesticides compared to non-exposed individuals. However, neurobehavioral performance was observed to be largely unaffected by exposure to these pesticides in most of the studies.
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. Quality of included studies was assessed using the Newcastle-Ottawa scale and the 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 metabolite concentrations and neurotoxic symptoms.
CONCLUSIONS: Neurological symptoms were found to be more prevalent in individuals exposed to the combination of OP and PYR pesticides compared to non-exposed individuals. However, neurobehavioral performance was observed to be largely unaffected by exposure to these pesticides in most of the studies.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH170
Topic
Clinical Outcomes, Epidemiology & Public Health, Study Approaches
Topic Subcategory
Public Health
Disease
Injury & Trauma, Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas