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C. Solomon1,2, J. Poole1,2, K. T. Palmer1,2, R. Peveler2, D. Coggon1,2.MRC Epidemiology Resource Centre1 and Community Clinical Sciences2, University of Southampton, UK

Introduction: It has been proposed that repeated low level exposure to organophosphates, particularly in sheep dips, can cause a syndrome of “chronic organophosphate induced neurological disease” (COPIND), comprising various specified neurological symptoms. To explore this hypothesis, we analysed data from a survey of men aged 25–69 years in three rural areas.

Methods: Subjects (n = 34 486) were sent a postal questionnaire about various aspects of work and health, including: lifetime history of work with different categories of pesticide; the extent to which they had been bothered during the past seven days by each of five non-neurological somatic symptoms (summarised by a “somatising tendency” score); and experience of seven COPIND symptoms in the past month. The association of COPIND symptoms with potential risk factors was examined by modified Cox regression.

Results: Questionnaires were returned by 10 765 men (31%), including 9844 who provided full information on the seven COPIND symptoms. These symptoms tended to cluster within individuals, but the clustering was more marked among the 6109 men who had never worked with any pesticides (observed/expected with 4+ symptoms  = 98) than in the 1913 who had worked with sheep dip (observed/expected  = 48). Report of 4+ COPIND symptoms was strongly associated with somatising tendency (PR 21.1, 95% CI 14.4 to 30.9, for men in the highest category of somatisation), and after allowance for this, it was more common in past users of sheep dip than in those who had never worked with pesticides (PR 1.4, 95% CI 1.0 to 2.0). Within the group who had worked with sheep dip, risk was highest in those who had used sheep …

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