Chlorpyrifos (CPF) is applied seasonally in Egypt by adolescent agricultural workers and the extent of occupational exposure and the potential for environmental CPF exposure in this population is poorly understood. Adolescent pesticide applicators (n=57; 12–21 years of age) and age matched non-applicators (n=38) from the same villages were followed for 10 months in 2010, spanning pre-application through post-application. Eight urine and 5 blood samples were collected from participants within this time period. Blood acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) (exposure/effect biomarker) and urine 3,5,6-trichloro-2-pyridinol (TCPy) (exposure biomarker) were used to assess occupational CPF exposures in pesticide applicators and environmental exposures in non-applicators. Applicators demonstrated significantly higher TCPy concentration and BChE depression than non-applicators throughout CPF application. This difference persisted for 4–7 weeks after the cessation of agricultural spraying. However, both groups exhibited significantly elevated TCPy and depressed BChE, compared to their respective baseline. The peak TCPy levels during the spray season (95% confidence interval) for non-applicators and applicators reached 16.8 (9.87–28.5) and 137 (57.4–329) ug/g creatinine, respectively. BChE levels (95% confidence intervals) during the spray were 1.47 (1.28–1.68) for non-applicators and 0.47 (0.24–0.94) U/ml for applicators. The longitudinal assessment of CPF biomarkers provided robust measures of exposure and effect throughout CPF application in adolescents and revealed significant exposures in both applicators and non-applicators. Biomarker data in the non-applicators, which mirrored that of the applicators, indicated that non-applicators received environmental CPF exposures. This suggests that similar exposures may occur in other residents of this region during periods of pesticide application.

ObjectivesOccupational exposure of organophosphorus pesticides, such as chlorpyrifos (CPF), in adolescents is of particular concern because of the potential vulnerability of the developing neurological system. The objectives of this study were to examine how neurological symptoms reported over the application season vary across time, whether these effects are reversible postapplication and if there are associations between CPF biomarkers and neurological symptoms in an adolescent study population.SettingThe longitudinal study was conducted in two agricultural districts of Menoufia Governorate, Egypt between April 2010 and January 2011.ParticipantsMale adolescent participants, including CPF applicators (n=57) and non-applicators (n=38), were recruited.Primary and secondary outcome measuresSelf-reported data for 25 neurological symptoms were collected at 32 time points over the 8-month period before, during and after the application season. Additionally, urine and blood samples were collected to measure urine trichloro-2-pyridinol (TCPy), a CPF-specific biomarker and blood cholinesterase activity.ResultsApplicators and non-applicators report the highest numbers of symptoms during the application season, followed by a reduction in symptoms after the application ended. Applicators reported a greater percentage of neurological symptoms, relative to baseline, than non-applicators after accounting for potential covariates. Among the applicators, cumulative TCPy was positively and significantly associated with the average percentage of symptoms (B=4.56, 95% CI 3.29 to 5.84; p<0.001). Significant associations (p=0.03–0.07) between the change in butyrylcholinesterase activity from the preapplication to the postapplication season and several domains of neurological symptoms were also found, even after adjusting for potential covariates.ConclusionsThese observations demonstrate changes in the reporting of symptoms across the application season, showing an increase in symptom reporting during application and recovery following the end of pesticide application. These findings reinforce the growing concern regarding the neurotoxic health effects of CPF in adolescent applicators in developing countries and the need for developing and implementing intervention programmes.

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Chlorpyrifos (CPF) is a commonly used organophosphate insecticide (OP). In adults, exposure to OPs has been inconsistently associated with reduced lung function. OP exposure and lung function has not been assessed in adolescents. The objective of this study was to assess CPF exposure and lung function among Egyptian adolescents. We conducted a 10-month study of male adolescent pesticide applicators (n = 38) and non-applicators of similar age (n = 24). Urinary 3,5,6-trichloro-2-pyridinol (TPCy), a CPF-specific metabolite, was analyzed in specimens collected throughout the study. Spirometry was performed twice after pesticide application: day 146, when TCPy levels were elevated and day 269, when TCPy levels were near baseline. Applicators had higher levels of TCPy (mean cumulative TCPy day 146 = 33,217.6; standard deviation (SD) = 49,179.3) than non-applicators (mean cumulative TCPy day 146 = 3290.8; SD = 3994.9). Compared with non-applicators, applicators had higher odds of reporting wheeze, odds ratio = 3.41 (95% CI: 0.70; 17.41). Cumulative urinary TCPy was inversely associated with spirometric measurements at day 146, but not at day 269. Although generally non-significant, results were consistent with an inverse association between exposure to CPF and lung function.

Handwashing (HW) with water and soap is one of the cheapest and most effective ways of protecting oneself and others against the coronavirus. Here, the HW knowledge, attitudes, and practices of Saudi adults were assessed during the COVID-19 pandemic using a cross-sectional study conducted between May 8 and June 8, 2020, during a partial lockdown period. A web-based validated questionnaire was distributed through different social media platforms, and the sociodemographic characteristics of the participants, seven items related to knowledge, four items related to attitudes, and thirteen items related to the practice of HW were assessed. A total of 1323 (51% male and 49% female) adults from all regions of Saudi Arabia responded to the questionnaire. The overall mean (± SD) was 5.13 (± 1.18) for knowledge of HW and COVID-19, 2.79 (± 0.77) for attitude toward HW, and 7.8 (± 2.56) for HW practice. A multiple linear regression analysis revealed factors associated with knowledge to be age and family income. Sex, educational level, family income, and HW knowledge were associated with negative and neutral attitude, whereas age, sex, family income, and HW knowledge were associated with practice. These results suggest that HW knowledge was strongly associated with positive attitudes toward HW and correct HW practice in Saudi adults during the COVID-19 lockdown.

Objectives: To evaluate the awareness of Saudis in Qassim region, Saudi Arabia on multiple sclerosis )MS(. Methods:A cross-sectional study was conducted on 350 Saudis in Qassim, Saudi Arabia between January 2019 and June 2019 using a pre-designed questionnaire including socio-demographic data and questions evaluating knowledge about MS. Original ArticlesResults: The majority of studied participants were adult females )74%(, between 20-30 year-old )45.1%( and with high education level or above )80.6%(. Nearly one third of the studied group had good knowledge regarding MS )31.7%(. Half of the studied group knew that central nervous system )CNS( is the system affected by MS, 52% reported that vitamin D deficiency, family history of MS, personal history of autoimmune disease, viruses, and obesity are the factors which increase the risk of developing MS. Approximately, 62.9% knew that blurred and double vision, numbness, paralysis or weakness and difficulty in concentration and memorizing are symptoms of MS. Female participants and those knowing someone having MS had a significant good knowledge level regarding MS than others. Getting knowledge from combined sources from internet or social media; family, friends or neighbors and health workers was significantly more prevalent among those with good knowledge. Conclusion:Most of the study participants had limited knowledge regarding MS. Planning health education programs for the public is essential.

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