Occupational exposure to pesticides and neurobehavioral outcomes. Impact of different original and recalled exposure measures on the associations

Samuel Fuhrimann, William Mueller, Aggrey Atuhaire, Ruth Mubeezi, Johan Ohlander, Andrew Povey, Ioannis Basinas, Martie Van tongeren, Kate Jones, Karen s Galea, Hans Kromhout

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Several measures of occupational exposure to pesticides have been used to study associations between exposure to pesticides and neurobehavioral outcomes. This study assessed the impact of different exposure measures for glyphosate and mancozeb on the association with neurobehavioral outcomes based on original and recalled self-reported data with 246 smallholder farmers in Uganda.

The association between the 6 exposure measures and 6 selected neurobehavioral test scores was investigated using linear multivariable regression models. Exposure measures included original exposure measures for the previous year in 2017: (i) application status (yes/no), (ii) number of application days, (iii) average exposure-intensity scores (EIS) of an application and (iv) number of EIS-weighted application days. Two additional measures were collected in 2019: (v) recalled application status and (vi) recalled EIS for the respective periods in 2017.

Recalled applicator status and EIS were between 1.2 and 1.4 times more frequent and higher for both pesticides than the original application status and EIS. Adverse associations between the different original measures of exposure to glyphosate and 4 neurobehavioral tests were observed. Glyphosate exposure based on recalled information and all mancozeb exposure measures were not associated with the neurobehavioral outcomes.

The relation between the different original self-reported glyphosate exposure measures and neurobehavioral test scores appeared to be robust. When based on recalled exposure measures, associations observed with the original exposure measures were no longer present. Therefore, future epidemiological studies on self-reported exposure should critically evaluate the potential bias towards the null in observed exposure–response associations.
Original languageEnglish
Article numberwxae025
JournalAnnals of Work Exposures and health
Publication statusPublished - 4 Jun 2024


  • exposure assessment
  • exposure misclassification
  • farmers
  • glyphosate
  • mancozeb
  • neurobehavioral outcomes
  • pesticides
  • recall
  • Uganda

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