Increased risk for hypothyroidism after anticholinesterase pesticide poisoning: a nationwide population-based study

Exposure to pesticides and the risk of hypothyroidism: a systematic review and meta-analysis

BACKGROUND

Knowledge surrounding the association between exposure to pesticides and hypothyroidism is inconsistent and controversial.

METHODS

The aim of present study was, therefore, to review scientific evidence systematically and conduct a meta-analysis into the contribution of exposure to pesticides to hypothyroidism. PubMed, Scopus, Web of Science, and Google Scholar were searched. The findings are presented as OR, HR, PR, IRR, and 95% confidence interval (95%CI). A fixed-effect model using the inverse-variance method and random-effects inverse-variance model with DerSimonian-Laird method were used for estimating the pooled estimates. Cochran Q and I2 tests were used to confirm the heterogeneity of selected studies.

RESULTS

Twelve studies were included in the systematic review, and 9 studies in the meta-analysis. Epidemiological evidence suggested that exposure to insecticides including organochlorines, organophosphates, and pyrethroids increased risk of hypothyroidism (adjusted odds ratio (aOR) = 1.23, 95%CI = 1.14, 1.33 for organochlorines, aOR = 1.12, 95%CI = 1.07, 1.17 for organophosphates, aOR = 1.15, 95%CI = 1.03, 1.28 for pyrethroids). Exposure to herbicides also increased risk of hypothyroidism (aOR = 1.06, 95%CI = 1.02, 1.10). However, exposure to fungicides and fumigants was not found to be associated with hypothyroidism.

CONCLUSION

To increase current knowledge and confirm evidence to date future research needs to center on large-scale longitudinal epidemiological and biological studies, examination of dose-response relationships, the controlling of relevant confounding variables, using standardized and high sensitivity tools, and investigating the effects of environmental exposure.

Acute Pesticide Poisoning in Tobacco Farming, According to Different Criteria

BACKGROUND

Brazil is one of the world's largest pesticide consumers, but information on pesticide poisoning among workers is scarce.

OBJECTIVE

To evaluate acute pesticide poisoning among tobacco growers, according to different criteria.

METHODS

This was a two-step cross-sectional study with 492 pesticide applicators. It used a 25 question pesticide-related symptoms (PRS) questionnaire and medical diagnosis for comparison with toxicological assessment. Associations were evaluated using Poisson regression.

RESULTS

10.6% reported two or more PRS, while 8.1% reported three or more. Furthermore, 12.2% received a medical diagnosis of poisoning. According to toxicologists, possible cases accounted for 14.2% and probable cases for 4.3%. PRS increased during the period of greater exposure. Those exposed to dithiocarbamates, sulfentrazone, pyrethroids, fipronil and iprodione exhibited more PRS. The number of exposure types, multi-chemical exposure, clothes wet with pesticides and spillage on the body/clothes were associated with acute poisonings. All criteria showed sensitivity greater than 79% for probable cases but only greater than 70% for medical diagnosis when compared to possible cases, presenting substantial Kappa agreement.

CONCLUSION

The prevalence of acute pesticide poisoning is much higher than officially recorded. Trained physicians can screen for pesticide poisoning. It is necessary to improve workers' education to reduce pesticide use and exposure to them.

Insights into the recent advances in nano-bioremediation of pesticides from the contaminated soil

In the present scenario, the uncontrolled and irrational use of pesticides is affecting the environment, agriculture and livelihood worldwide. The excessive application of pesticides for better production of crops and to maintain sufficient food production is leading to cause many serious environmental issues such as soil pollution, water pollution and also affecting the food chain. The efficient management of pesticide use and remediation of pesticide-contaminated soil is one of the most significant challenges to overcome. The efficiency of the current methods of biodegradation of pesticides using different microbes and enzymes depends on the various physical and chemical conditions of the soil and they have certain limitations. Hence, a novel strategy is the need of the hour to safeguard the ecosystem from the serious environmental hazard. In recent years, the application of nanomaterials has drawn attention in many areas due to their unique properties of small size and increased surface area. Nanotechnology is considered to be a promising and effective technology in various bioremediation processes and provides many significant benefits for improving the environmental technologies using nanomaterials with efficient performance. The present article focuses on and discusses the role, application and importance of nano-bioremediation of pesticides and toxic pollutants to explore the potential of nanomaterials in the bioremediation of hazardous compounds from the environment.

Cholinesterase homozygous genotype as susceptible biomarker of hypertriglyceridaemia for pesticide-exposed agricultural workers

PURPOSE

Dyslipidemia is an emerging metabolic disorder among pesticide-exposed agricultural workers, and this study was aimed to explore biomarkers of hypertriglyceridaemia susceptibility.

METHODS

This cross-sectional study recruited 72 pesticide-exposed subjects and 78 non-exposed controls. Lipid profile, cholinesterase activity, and thyroid hormones were analysed with routine assays. Six loci, including rs11206244 and rs2235544 for deiodinase 1, rs12885300 and rs225014 for deiodinase 2, rs1803274 for butyrylcholinesterase, and rs3757869 for acetylcholinesterase were genotyped using an improved multiplex ligation detection reaction technique.

RESULTS

Pesticide-exposed subjects showed higher levels of triglyceride than controls (p = 0.009), although there were comparable cholinesterase activity and genotype frequencies of all six loci between pesticide-exposed subjects and controls. Pesticide-exposed subjects with homozygous genotype of cholinesterase had increased triglyceride levels than controls (p < 0.05). The percentage of hypertriglyceridaemia was 28.6% and 8.8% for pesticide-exposed subjects and controls with homozygous butyrylcholinesterase genotype (p = 0.007) and 20.8% and 14.3% with homozygous acetylcholinesterase genotype (p = 0.792), respectively. Multivariate logistic regression analyses found that odds ratio of hypertriglyceridaemia is 21.92 and 4.56 for pesticide-exposed subjects with homozygous genotype of butyrylcholinesterase (p = 0.001) and acetylcholinesterase (p = 0.036), respectively.

CONCLUSIONS

Cholinesterase homozygous genotype might be a potential susceptible biomarker in screening pesticide-exposed agricultural workers vulnerable to hypertriglyceridaemia.

Acute Changes in Thyroid Hormone Levels among Thai Pesticide Sprayers

The objective of this study was to investigate the relationship of acute pesticide exposures and acute changes in thyroid hormones among Thai farmers. We recruited 78 farmers, who were scheduled to spray insecticides (chlorpyrifos and/or cypermethrin) or herbicides (paraquat and/or glyphosate). On the day before spraying, farmers collected their first morning void urine and went for blood collection. On the spray day, urine samples were collected at end of the spraying event and they were interviewed with questionnaires. The next morning, the first morning void urine and blood samples were collected. Blood samples were analyzed for thyroid hormones. Urine samples were analyzed for the metabolites of the pesticide sprayed. The results showed that the thyroid hormones, free triiodothyronine (FT3) and total triiodothyronine (T3) were significantly reduced as urinary chlorpyrifos metabolite increased the day after spraying. Total thyroxine (T4) significantly increased as cypermethrin metabolites increased the day after spraying. T4 significantly increased as urinary glyphosate levels increased; however, FT3 and T3 decreased significantly as urinary paraquat levels increased the day after spraying. These findings suggest that acute exposures to the pesticides chlorpyrifos, cypermethrin, paraquat and glyphosate can produce acute effects on the hypothalamic-pituitary-thyroid (HPT) axis, acutely altering thyroid hormone levels.

Longitudinal Study of Thyroid Hormones between Conventional and Organic Farmers in Thailand

Many pesticides are endocrine-disrupting chemicals that can interfere with hormone levels. This study aimed to assess the longitudinal impact of exposure to pesticides on thyroid hormone levels, including Thyroid Stimulating Hormone (TSH), Free Triiodothyronine (FT3), Free Thyroxine (FT4), Triiodothyronine (T3), and Thyroxine (T4). Both conventional (i.e., pesticide using) and organic farmers were interviewed using questionnaires, and blood samples were collected at 7-9 a.m. to determine thyroid hormone levels for four rounds, with a duration of eight months between each round. A linear mixed model of the natural log of the individual hormone levels used random intercepts for subjects while controlling gender, baseline age, and body mass index (BMI) was used to compare between conventional and organic farmers or the impact of cumulative days of spraying insecticides, herbicides or fungicides. The estimated marginal means of the thyroid hormone levels (TSH, FT3, T3, and T4) estimated from the linear mixed models were significantly higher among the conventional farmers than organic farmers. As cumulative spray days of insecticide, herbicide or fungicide increased, TSH and FT3 increased significantly. FT4 decreased significantly as cumulative spray days of insecticide or fungicide increased. These findings suggest that the insecticides, herbicides, and fungicides sprayed by conventional farmers exert endocrine-disrupting activities, altering the hypothalamic-pituitary-thyroid (HPT) axis homeostasis.

Assessment of the endocrine-disrupting effects of diethyl phosphate, a nonspecific metabolite of organophosphorus pesticides, by in vivo and in silico approaches

Organophosphorus pesticides (OPs) remain one of the most commonly used pesticides, and their detection rates and residues in agricultural products, foods and environmental samples have been underestimated. Humans and environmental organisms are at high risk of exposure to OPs. Most OPs can be degraded and metabolized into dialkyl phosphates (DAPs) in organisms and the environment, and can be present in urine as biomarkers for exposure to OPs, of which diethyl phosphate (DEP) is a high-exposure metabolite. Epidemiological and cohort studies have found that DAPs are associated with endocrine hormone disorders, especially sex hormone disorders and thyroid hormone disorders, but there has been no direct causal evidence to support these findings. Our study explored the effects of chronic exposure to DEP on endocrine hormones and related metabolic indicators in adult male rats at actual doses that can be reached in the human body. The results showed that chronic exposure to DEP could cause thyroid-related hormone disorders in the serum of rats, causing symptoms of hyperthyroidism in rats, and could also lead to abnormal expression of thyroid hormone-related genes in the rat liver. However, DEP exposure did not seem to affect serum sex hormone levels, spermatogenesis or sperm quality in rats. The molecular interactions between DEP and thyroid hormone-related enzymes/proteins were investigated by molecular docking and molecular dynamics methods in silico. It was found that DEP could strongly interact with thyroid hormone biosynthesis, blood transport, receptor binding and metabolism-related enzymes/proteins, interfering with the production and signal regulation of thyroid hormones. In vivo and in silico experiments showed that DEP might be a potential thyroid hormone-disrupting chemical, and therefore, we need to be more cautious and rigorous regarding organophosphorus chemical exposure.

Pesticides With Potential Thyroid Hormone-Disrupting Effects: A Review of Recent Data

Plant Protection Products, more commonly referred to as pesticides and biocides, are used to control a wide range of yield-reducing pests including insects, fungi, nematodes, and weeds. Concern has been raised that some pesticides may act as endocrine disrupting chemicals (EDCs) with the potential to interfere with the hormone systems of non-target invertebrates and vertebrates, including humans. EDCs act at low doses and particularly vulnerable periods of exposure include pre- and perinatal development. Of critical concern is the number of pesticides with the potential to interfere with the developing nervous system and brain, notably with thyroid hormone signaling. Across vertebrates, thyroid hormone orchestrates metamorphosis, brain development, and metabolism. Pesticide action on thyroid homeostasis can involve interference with TH production and its control, displacement from distributor proteins and liver metabolism. Here we focused on thyroid endpoints for each of the different classes of pesticides reviewing epidemiological and experimental studies carried out both in in vivo and in vitro. We conclude first, that many pesticides were placed on the market with insufficient testing, other than acute or chronic toxicity, and second, that thyroid-specific endpoints for neurodevelopmental effects and mixture assessment are largely absent from regulatory directives.

Long-term outcomes and risk factors of thyroid dysfunction during pegylated interferon and ribavirin treatment in patients with chronic hepatitis C infection in Taiwan

BACKGROUND

This study aimed to investigate the occurrence and risk factors of thyroid dysfunction (TD) in patients with chronic hepatitis C (CHC) infection in Taiwan.

METHODS

The data in this study were obtained from the Taiwan National Health Insurance Research (Taiwan NHIR) database between 2001 and 2013. CHC patients treated with pegylated interferon/ribavirin (PEG-IFN/RBV) were enrolled as case patients, and nontreated CHC patients were enrolled as controls and were matched at a control:case ratio of 3:1 by index date, age (± 3 years), and sex. We compared the cumulative incidence of TD between the cohorts at follow-up until 2013.

RESULTS

During the study period, 3810 cases and 9393 controls were included in the study. Among the study subjects, 173 (4.5%) case patients and 244 (2.6%) controls were diagnosed with TD during the follow-up period. The types of TD were hypothyroidism (42.9%), hyperthyroidism (31.2%), and thyroiditis (25.9%). Compared to controls during the 13-year follow-up, patients treated with PEG-IFN/RBV had a higher incidence rate of TD (P < 0.0001), as determined using the Kaplan-Meier method. Cox proportional hazards regression analysis showed that female sex (adjusted hazard ratio (HR): 1.49; 95% confidence interval (CI): 1.23-1.75; P < 0.001), treatment with PEG-IFN/RBV (HR: 1.68; 95% CI: 1.38-2.06; P < 0.001), hyperlipidemia (HR: 1.38; 95% CI: 1.12-1.71; P < 0.001), and past history of goiter (HR: 6.40; 95% CI: 5.00-8.18; P < 0.001) were independent predictors for the development of TD.

CONCLUSIONS

PEG-IFN/RBV treatment may be an independent risk factor for thyroid dysfunction among patients with hepatitis C virus (HCV) infection. Monitoring thyroid function keenly during PEG-IFN/RBV therapy in patients with chronic HCV infection is recommended for clinicians, especially for female patients and for patients with a history of hyperlipidemia and goiter.

Occupational exposure to pesticides and thyroid function in Brazilian soybean farmers

INTRODUCTION

Agriculture production has been supported especially by the use of pesticides for crop protection and pest control. Although the agricultural production has been increased by pesticides use, these substances also reach non-target organisms and may become a risk to the health of farmers. Several epidemiological studies in human have investigated the association between exposure to pesticides and altered serum levels of thyroid hormones, reporting both positive and negative results. Overall, the impact of pesticides on human thyroid function is still limited.

OBJECTIVE

The aim of this study was to access serum levels of free thyroxin (FT4), total triiodothyronine (TT3), thyroid-stimulating hormone (TSH), and butyrylcholinesterase (BChE) in soybean farmers in southern Brazil.

METHODS

The exposed group was composed by 46 rural workers and 27 subjects not exposed to pesticides composed the control group. All subjects had blood samples collected by venipuncture in order to analyze the serum levels of FT4, TT3, TSH and BChE.

RESULTS

The results showed a significant decreasing in TSH and increasing in TT3 and FT4 in rural workers, compared to control group. BChE levels were lower in exposed group than in control group. The results suggest that farmers are exposed to mixtures of pesticides with endocrine disruptor properties.

Thiocholine-triggered reaction in personal glucose meters for portable quantitative detection of organophosphorus pesticide

A portable and user-friendly method using personal glucose meters for on-site quantitative detection of organophosphorus pesticide (OP) was developed. The inhibition of organophosphorus compounds on acetylcholinesterase (AChE) leads to reduced yields of thiocholine formed by the enzymatic hydrolysis of acetylthiocholine chloride. Ferricyanide ([Fe(CN)₆]^3-), the mediator used in glucose test strips for electron transfer to the electrode, can be rapidly reduced to ferrocyanide ([Fe(CN)₆]^4-) by thiocholine. This reaction enables direct measurement of thiocholine by personal glucose meters in the same way as measuring the glucose in blood, offering an interesting choice to quantify OP. After incubation of AChE for 30 min and enzymatic reaction of 10 min, the yield of thiocholine was measured by a personal glucose meter, achieving detection limit of 5 μg L^-1 for paraoxon. The proposed method was successfully applied to the detection in apples and cucumbers, presenting promising potential for on-site OP detection in food samples.