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‘Dippers' flu’ and its relationship to PON1 polymorphisms
  1. Nicola Cherry1,
  2. Michael Mackness2,
  3. Bharti Mackness2,
  4. Martin Dippnall3,
  5. Andrew Povey3
  1. 1Department of Medicine, University of Alberta, Edmonton, Canada
  2. 2Universitat Rovira i Virgili, Center de Recerca Biomedica, Hospital Universitari de Sant Joan, Reus, Spain
  3. 3Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
  1. Correspondence to Nicola Cherry, Community and Occupational Medicine Program, Department of Medicine, 5-30 University Terrace, 8303-112 St, Edmonton, Alberta T6G 1K4, Canada; ncherry{at}


Objectives Sheep-dippers report an acute flu-like condition (dippers' flu: DF) but the cause and relation to chronic disability are unknown.

Methods In a case-referent study previously reported, 175 sheep dippers with chronic disability and 234 referents, sheep dippers in good health, completed an interview with information on dipping, type of pesticide used and health for each year 1970–2000 and gave blood for typing of PON1 polymorphisms.

Results Reports of DF were much higher (66.3% 116/175) in the chronically unwell than in those without chronic ill-health (18.0% 42/234: OR=8.99 95% CI 5.69–14.21). No significant relation was seen between reported exposures and DF in those with chronic illness, but risk was higher with concentrate handling in those without. An R allele at position 192 on PON1 related to reports of DF both in those with chronic illness (OR=2.04 95% CI 1.08–3.87) and in those who started dipping after 1969 and were not chronically unwell (OR=2.52 95%CI 1.00–6.37). Interaction between handling diazinon concentrate and PON1 (192R) increased the risk of DF. No precipitating factor was identified in a case-crossover analysis. In the group without chronic illness those with 192R developed DF earlier (risk ratio 2.49 95%CI 1.03-6.02).

Conclusion ‘Dippers’ flu' and chronic ill-health attributed to dipping share a common polymorphism (192R). The interaction between handling diazinon concentrate and PON1 genotype supports the conclusion that organophosphates may cause DF. Sheep dippers who are still healthy but experience ‘dippers’ flu' may be wise to further limit exposures to organophosphates.

  • Epidemiology
  • agriculture
  • pesticides

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  • This report is based on work carried out at the University of Manchester, Manchester, UK.

  • Funding This study was funded by the UK Health and Safety Executive (3837/R70.002).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Manchester.

  • Provenance and peer review Not commissioned; externally peer reviewed.