Review Article
Organophosphate exposure and the chronic effects on farmers: a narrative review
AUTHORS
Jessica Perry1 MBBS, Researcher
Jacqueline Cotton2 BScAnSc(Hon) PhD, Lecturer/Researcher in Rural Health *
Muhammad Aziz Rahman3 PhD, Senior Researcher
Susan A Brumby4 PhD, Director National Centre for Farmer Health 
AFFILIATIONS
1, 2 Deakin University, Geelong, Victoria, Australia and National Centre for Farmer Health, Deakin University, Western District Health Service, Hamilton, Victoria 3300, Australia
3 National Centre for Farmer Health, Deakin University, Hamilton, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; and School of Nursing and Healthcare Professions, Federation University Australia and School of Nursing and Midwifery, La Trobe University, Australia
4 National Centre for Farmer Health, Deakin University, Western District Health Service, Hamilton, Victoria 3300, Australia
ACCEPTED: 1 September 2019
early abstract:
Objective: Organophosphates are a class of insecticides used globally by the agricultural industry for insect control. Acute consequences of organophosphate exposures are well known, while there has been limited research on their long-term effects.The objective of this review was to discuss the health effects of chronic organophosphate exposure in farmers.
Methods: Medline, Scopus and Web of Science were searched to find the relevant articles. Articles published only in English and until Decemember-2018 were reviewed. The selected articles were then divided into neurological (neurobehaviour, neurodevelopmental, neurological signs and symptoms) and non-neurological subheadings.
Results: Fifty-three articles for neurological effects and 17 articles for non-neurological effects were identified. Chronic organophosphates exposure was associated with deficits in the neurobehaviour subsets of attention and short-term memory, increased incidence of neurodegenerative diseases and effects on peripheral nerves and neurodevelopment. However, research to support non-neurological effects such as respiratory symptoms, increased cancer risk, endocrine disruption, cardiac issues, chronic fatigue and infertility, was limited.
Conclusion: Chronic organophosphate exposure was found to affect four of the five areas of described neurological effects in the literature. The a large proportion of the research in this area was not methodologically strong therefore few recommendations can be conclusively drawn. Future research is warranted to investigate the non-neurological effects of chronic exposure to ensure the occupational risks of low level chronic exposure are clearly communicated to farmers and farmworkers.
Implications for Rural Health: This review adds further evidence regarding neurological effects of chronic organophosphate exposure, which needs to be considered for regulation of organophosphates specifically for farmers.