Am Fam Physician. 2005 Jun 1;71(11) Online.
to the editor: I appreciated the informative editorial, "Health Effects from Pesticide Exposure,"1 by Dr. Calvert.
Recent research links chronic low-level pesticide exposure to many health problems. Pesticide exposure was linked to significantly higher wheezing rates in a study in the United States of 20,468 farmers.2 Long-term agricultural pesticide exposure also has been linked to slower peripheral nerve velocities3 and significantly poorer memory, concentration, motor speed, and color vision.4 Other recent studies have linked chronic low-level pesticide exposure with higher rates of Alzheimer's and Parkinson's disease5 and higher rates of impotence.6
I hope that American Family Physician will continue to provide updated articles on health effects of pesticides and other environmental hazards.
1. Calvert GM. Health effects from pesticide exposure. Am Fam Physician 2004;69:1613-4,1616.
2. Hoppin JA, Umbach DM, London SJ, Alavanja MC, Sandler DP. Chemical predictors of wheeze among farmer pesticide applicators in the Agricultural Health Study. Am J Respir Crit Care Med 2002;165:683-9.
3. Peiris-John RJ, Ruberu DK, Wickremasinghe AR, Smit LA, van der Hoek W. Effects of occupational exposure to organophosphate pesticides on nerve and neuromuscular function. J Occup Environ Med 2002;44:352-7.
4. Baldi I, Filleul L, Mohammed-Brahim B, Fabrigoule C, Dartigues JF, Schwall S, et al. Neuropsychologic effects of long-term exposure to pesticides: results from the French Phytoner study. Environ Health Perspect 2001;109:839-44.
5. Baldi I, Lebailly P, Mohammed-Brahim B, Letenneur L, Dartigues JF, Brochard P. Neurodegenerative diseases and exposure to pesticides in the elderly. Am J Epidemiol 2003;157:409-14.
6. Oliva A, Giami A, Multigner L. Environmental agents and erectile dysfunction: a study in a consulting population. J Androl 2002;23:546-50.
in reply: Curtis raises important concerns about chronic health effects that may be related to pesticide exposure. We agree that the evidence supporting these associations continues to build. However, much of this evidence is based on epidemiologic studies. All epidemiologic studies have limitations, and no one study is sufficient to support a causal link between pesticide exposure and chronic illness. This includes the findings from the Agricultural Health Study,1 which is a large prospective cohort study consisting of approximately 90,000 subjects who are pesticide applicators or spouses of pesticide applicators. This study will be an important source of information on health outcomes associated with pesticide exposure. Recent findings from this study,1 which is scheduled to continue through the year 2020, are available online at: http://www.aghealth.org/publications.html. The uncertainty regarding pesticide toxicity does not mean we can ignore the information we have. As was stated in my editorial,2 the reduction of pesticide exposure should be encouraged, including adoption of integrated pest management practices,3 compliance with all pesticide label instructions, and, when necessary, revision of public policies and regulations.
1. Alavanja MC, Sandler DP, McMaster SB, Zahm SH, McDonnell CJ, Lynch CF, et al. The Agricultural Health Study. Environ Health Perspect 1996;104:362-9.
2. Calvert GM. Health effects from pesticide exposure. Am Fam Physician 2004;69:1613-4,1616.
3. U.S. Environmental Protection Agency. Pesticides and food: what "integrated pest management means." Accessed online March 21, 2005, at: http://www.epa.gov/pesticides/food/ipm.htm.
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