The Association between Pesticide Exposure and Neurological Signs and Symptoms in Farmers in Magelang District, Central Java, Indonesia

Ismail Setyopranoto; Ibnu Widya  Argo; Aulia Fitri  Ramadhani; Ery Kus  Dwianingsih; Whisnu Nalendra  Tama; Abdul  Gofir; Cempaka Thursina Srie  Setyaningrum; Andre Stefanus  Panggabean; Sri Sutarni; Rusdy Ghazali Malueka

doi:10.3889/oamjms.2020.5295

Authors

Ismail Setyopranoto Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Ibnu Widya Argo Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Aulia Fitri Ramadhani Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Ery Kus Dwianingsih Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta, Indonesia
Whisnu Nalendra Tama Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Abdul Gofir Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Cempaka Thursina Srie Setyaningrum Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Andre Stefanus Panggabean Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Sri Sutarni Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Rusdy Ghazali Malueka Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.5295

Keywords:

pesticide exposure, cholinesterase level, neuropathy, tremors

Abstract

BACKGROUND: Excessive use of pesticides is known to cause neurotoxicity. Chronic effects of pesticide poisoning include neuropathy and tremors.

AIM: This study aimed to determine the association between pesticide exposure and the occurrence of neurological signs and symptoms, especially neuropathy and tremor, in farmers.

METHODS: This was a cross-sectional study. The study location was Seloprojo Village, Ngablak District, Magelang Regency, Central Java Province. Farmers as subjects were recruited to determine neuropathy using Diabetic Neuropathy Symptom (DNS) and Diabetic Neuropathy Examination (DNE) scoring. Tremor events were measured with Tremor Rating Scale (TRS). Cholinesterase levels were examined using venous blood samples to determine the level of pesticide poisoning.

RESULTS: Of the 120 farmers studied, 68.3% experienced pesticide poisoning with cholinesterase levels below normal values. Weakness of the upper limb was found in 10 subjects (8.33%), while weakness of the lower limbs was found in 6 subjects (5%). There were 59.2% farmers who met the neuropathy criteria from the DNS score and those who met the neuropathic criteria from the DNE score were 6.7%. Tremor symptoms were found in 71.7% of the farmers. There was no significant association between cholinesterase levels and DNS score (p = 0.737), but there were significantly lower levels of cholinesterase (p = 0.046) in the neuropathy group measured with DNE score. There was no significant association between cholinesterase levels and TRS (p = 0.204).

CONCLUSION: Cholinesterase levels were significantly associated with neuropathy incidence measured with DNE criteria but statistically not related to tremors in farmers exposed to pesticides.

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