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Pesticide exposure link to ME/CFS
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'''Pesticides''' are chemicals that kill or harm pests. Pesticides include insecticides (which control insects) and herbicides (which control weeds). The main classes of insecticides are: [[organophosphate]]s, carbamates, pyrethroids, neonicotinoids and organochlorines. Common organophosphate pesticides include malathion, parathion and chlorpyrifos. ==Pesticide link to ME/CFS == ==== Organophosphates ==== In one study, Scottish sheep farmers using organophosphate-based sheep dip to protect their sheep against parasites were found to suffer much higher rates of myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS): the prevalence of ME/CFS in these farmers was 4 times the national UK average, implicating organophosphates as a probable causal factor in ME/CFS.<ref>{{Cite news | url=http://news.bbc.co.uk/1/hi/health/383003.stm | title = Health - Report raises sheep dip health fears | last = | first = | date = 1999 | work=BBC News|access-date=|archive-url=|archive-date=|url-status=|quote=Two years ago 60 sheep dippers in the Western Isles were found to be suffering from the chronic fatigue syndrome ME - four times the national average. Farmers who say exposure to the dips has affected their health complain of symptoms including excessive tiredness, headaches, limb pains, disturbed sleep, poor concentration, mood changes, and thoughts of suicide.}}</ref><ref>{{Cite news | url=http://news.bbc.co.uk/1/hi/scotland/906592.stm | title = Inquiry into sheep dip 'sickness' | last = | first = | date = 2000|work=BBC News|access-date=|archive-url=|archive-date=|url-status=|quote=}}</ref> Farmers who used organophosphate-based sheep dip were also found to be 10,000 times more likely to suffer from mental health disorders.<ref>{{Cite news | url=http://news.bbc.co.uk/1/hi/health/572960.stm | title = Controversial sheep dip withdrawn | last = | first = | date = 1999 | work=BBC News|access-date=|archive-url=|archive-date=|url-status=|quote=}}</ref> Across the UK, at least 500 farmers were left with debilitating health problems after using organophosphate sheep dip, and the [[Margaret of Mar, 31st Countess of Mar|Countess of Mar]], a life peer in the House of Lords who developed ME/CFS after coming into contact with sheep dip on her farm, has spent the past decades campaigning on the organophosphate issue.<ref>{{Cite news | url=https://www.theguardian.com/environment/2015/apr/20/revealed-government-knew-of-farm-poisoning-risk-but-failed-to-act | title = Revealed: government knew of farm poisoning risk but failed to act | last = | first = | date = 2015 | work=The Guardian|access-date=|archive-url=|archive-date=|url-status=|quote=}}</ref> ME/CFS researcher Professor [[Peter Behan]] studied the organophosphate link to ME/CFS, and talks about it in [https://www.heraldscotland.com/news/12076750.Symptoms_of_a_wider_malaise/ this 1997 newspaper article]. In [[Gulf War Illness]] (some types of which resemble ME/CFS), most of the toxic exposures and vaccinations that soldiers were exposed to have been ruled out as playing a causal role in GWI. Except for organophosphates, which the studies found strong evidence of playing a role. ==== Organochlorines ==== Another class of pesticides called organochlorines (which includes DDT and dieldrin) have also been linked to ME/CFS.<ref>{{Cite journal | last = Dunstan | first = R. H. | last2 = Donohoe | first2 = M. | last3 = Taylor | first3 = W. | last4 = Roberts | first4 = T.K. | last5 = Murdoch | first5 = R.N. | last6 = Watkins | first6 = J.A. | last7 = McGregor | first7 = N.R. | date = 1995-09-18 | title = A preliminary investigation of chlorinated hydrocarbons and chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/7565234|journal=The Medical Journal of Australia|volume=163|issue=6|pages=294–297|issn=0025-729X|pmid=7565234}}</ref><ref>{{Cite journal | last = Dunstan | first = R. H. | last2 = Roberts | first2 = T.K. | last3 = Donohoe | first3 = M. | last4 = McGregor | first4 = N.R. | last5 = Hope | first5 = D. | last6 = Taylor | first6 = W.G. | last7 = Watkins | first7 = J.A. | last8 = Murdoch | first8 = R.N. | last9 = Butt | first9 = H.L. | date=Jun 1996 | title = Bioaccumulated chlorinated hydrocarbons and red/white blood cell parameters|url=https://www.ncbi.nlm.nih.gov/pubmed/8809349|journal=Biochemical and Molecular Medicine|volume=58|issue=1 | pages = 77–84|issn=1077-3150|pmid=8809349|doi=|pmc=|quote=|access-date= | authorlink3 = | authorlink4 = Neil McGregor | author-link5 = |via= | authorlink9 = Henry Butt}}</ref> However most organochlorines were banned in the 1980s, with some exceptions such as dicofol which is banned in Europe but still used on cotton and fruit crops in the US, and DDT which is still used for malaria control in Africa and parts of Asia. ==== Pyrethroids ==== Pyrethroids are synthetic compounds similar to the pyrethrins produced by Chrysanthemum flowers. Pyrethroids are considered less toxic to human than organophosphates, but nevertheless are also linked to ME/CFS.<ref>{{Cite web|url=http://www.iacfsme.org/Portals/0/pdf/Nacul%20vol17%20n1.pdf | title = Is there an association between exposure to chemicals and chronic fatigue syndrome? Review of the evidence. Bulletin of International Association for CFS/ME | last = Nacul | first = Luis Carlos | authorlink=Luis Nacul | last2 = Lacerda | first2 = Eliana Mattos | authorlink2 = Eliana Lacerda | date = 2009 | website = |archive-url=|archive-date=|url-status=|access-date= | last3 = Sakellariou | first3 = Dikaios}}</ref> == Broad range of diseases linked to pesticides == An article in ''The Herald''<ref>{{Cite news | url=https://www.heraldscotland.com/news/12076750.symptoms-of-a-wider-malaise/ | title = Symptoms of a wider malaise | last = | first = | date = March 2, 1997|work=The Herald Scotland|access-date=2019-10-07|archive-url=|archive-date=|url-status=|quote=}}</ref> summarizes the wide range of diseases that are associated with pesticide exposure:<ref>{{Cite web|url=https://www.beyondpesticides.org/assets/media/documents/health/pid-database.pdf | title = Wide Range of Diseases Linked to Pesticides | last = Owens | first = Kagan | authorlink= | last2 = Feldman | first2 = Jay | authorlink2 = | date = 2010 | website = |archive-url=|archive-date=|url-status=|access-date= | last3 = Kepner | first3 = John}}</ref> * '''Asthma''' — 41 studies linking pesticides to asthma. Studies show that pesticides not only trigger asthma attacks, but are also a root cause of asthma. * '''Birth defects''' — 19 studies linking pesticides to fetal and birth defects. * '''Cancer''' — 260 studies linking pesticides to various forms of cancer: 30 studies linking pesticides to brain cancer, 11 studies linking pesticides to breast cancer, 40 studies linking pesticides to leukemia, 46 studies linking pesticides to lymphoma, 23 studies linking pesticides to prostate cancer, 7 studies linking pesticides to soft tissue sarcoma. * '''Learning and developmental disorders''' — 26 studies linking pesticides to these disorders: 8 studies linking pesticides to ADHD, 5 studies linking pesticides to autism. * '''Diabetes''' — 6 studies linking pesticides to diabetes. * '''Parkinson’s disease''' — 65 studies linking pesticides to Parkinson’s. * '''Reproductive health effects''' — 22 studies linking pesticides to reproductive health issues. These include decreased fertility in both males and females, an androgenic (demasculinizing) effects, increased rates of miscarriage, altered sex ratios and altered maturity. Pesticides are associated with '''autoimmune disease''': a study of nearly 77,000 women found that those who personally mixed or applied insecticides for 20 years had double the rate of the autoimmune conditions rheumatoid arthritis and systemic lupus erythematosus.<ref>{{Cite journal | last = Parks | first = Christine G. | last2 = Walitt | first2 = Brian T. | last3 = Pettinger | first3 = Mary | last4 = Chen | first4 = Jiu-Chiuan | last5 = de Roos | first5 = Anneclaire J. | last6 = Hunt | first6 = Julie | last7 = Sarto | first7 = Gloria | last8 = Howard | first8 = Barbara V. | date = Feb 2011 | title = Insecticide use and risk of rheumatoid arthritis and systemic lupus erythematosus in the Women's Health Initiative Observational Study|url=https://www.ncbi.nlm.nih.gov/pubmed/20740609|journal=Arthritis Care & Research|volume=63|issue=2|pages=184–194|doi=10.1002/acr.20335|issn=2151-4658|pmc=3593584|pmid=20740609|quote=|access-date=|via=}}</ref> Organophosphate pesticide exposure is linked to psychiatric changes that result in '''suicidal thoughts''' and '''suicidal ideation''' (suicidality), and may lead to suicide.<ref>{{Cite journal | last = Wesseling | first = Catharina | last2 = Joode | first2 = Berna van Wendel de | last3 = Keifer | first3 = Matthew | last4 = London | first4 = Leslie | last5 = Mergler | first5 = Donna | last6 = Stallones | first6 = Lorann | date = 2010-11-01 | title = Symptoms of psychological distress and suicidal ideation among banana workers with a history of poisoning by organophosphate or n-methyl carbamate pesticides|url=https://oem.bmj.com/content/67/11/778|journal=Occupational and Environmental Medicine|language=en|volume=67|issue=11 | pages = 778–784|doi=10.1136/oem.2009.047266|issn=1351-0711|pmid=20798019}}</ref><ref>{{Cite journal | last = London | first = L. | last2 = Flisher | first2 = A.J. | last3 = Wesseling | first3 = C. | last4 = Mergler | first4 = D. | last5 = Kromhout | first5 = H. | date = Apr 2005 | title = Suicide and exposure to organophosphate insecticides: cause or effect?|url=https://www.ncbi.nlm.nih.gov/pubmed/15776467|journal=American Journal of Industrial Medicine|volume=47|issue=4|pages=308–321|doi=10.1002/ajim.20147|issn=0271-3586|pmid=15776467|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last= Jaga | first = Kushik | last2 = Dharmani | first2 = Chandrabhan | date = Jan 2007 | title = The interrelation between organophosphate toxicity and the epidemiology of depression and suicide|url=https://www.ncbi.nlm.nih.gov/pubmed/17508698|journal=Reviews on Environmental Health|volume=22|issue=1 | pages = 57–73|issn=0048-7554|pmid=17508698|doi=|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Ghimire | first = Shree Ram | last2 = Parajuli | first2 = Sarita | date = 2016-02-04 | title = Chronic organophosphate-induced neuropsychiatric disorder: a case report|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745950/|journal=Neuropsychiatric Disease and Treatment|volume=12|pages=275–277|doi=10.2147/NDT.S91673|issn=1176-6328|pmc=4745950|pmid=26893566}}</ref> == Organophosphate exposure during pregnancy causes a 7-point IQ drop in children == A large study in an agricultural community in California found that children who were exposed to organophosphate pesticides during pregnancy had poorer scores for working memory, processing speed, verbal comprehension, perceptual reasoning and intelligence quotient (IQ). Children with the highest prenatal exposures to organophosphates had an IQ which was 7 points lower on average compared to children with the lowest prenatal organophosphate exposures. Organophosphate exposure was determined by measuring organophosphate metabolites in the urine. In this study postnatal exposure to organophosphates was not correlated to poorer intellectual development, only prenatal exposure.<ref>{{Cite journal | last = Bouchard | first = Maryse F. | last2 = Chevrier | first2 = Jonathan | last3 = Harley | first3 = Kim G. | last4 = Kogut | first4 = Katherine | last5 = Vedar | first5 = Michelle | last6 = Calderon | first6 = Norma | last7 = Trujillo | first7 = Celina | last8 = Johnson | first8 = Caroline | last9 = Bradman | first9 = Asa | date = Aug 2011 | title = Prenatal exposure to organophosphate pesticides and IQ in 7-year-old children | url =https://www.ncbi.nlm.nih.gov/pubmed/21507776|journal=Environmental Health Perspectives|volume=119|issue=8|pages=1189–1195|doi=10.1289/ehp.1003185|issn=1552-9924|pmc=3237357|pmid=21507776|quote=|access-date=|via=}}</ref> Another large study in New York City found that inner-city children whose mothers had the highest organophosphate exposures during pregnancy (as measured by organophosphate metabolites in the mother's urine) had an IQ which was on average 6.7 points lower compared to children whose mother's had the lowest exposure.<ref>{{Cite journal | last = Factor-Litvak | first = Pam | last2 = Insel | first2 = Beverly | last3 = Calafat | first3 = Antonia M. | last4 = Liu | first4 = Xinhua | last5 = Perera | first5 = Frederica | last6 = Rauh | first6 = Virginia A. | last7 = Whyatt | first7 = Robin M. | date = 2014-12-10 | title = Persistent Associations between Maternal Prenatal Exposure to Phthalates on Child IQ at Age 7 Years|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4262205/|journal=PLoS ONE|volume=9|issue=12|doi=10.1371/journal.pone.0114003|issn=1932-6203|pmc=4262205|pmid=25493564}}</ref> In a study in a farming valley in Mexico employing pesticides agriculturally, the researchers asked children in the valley to draw a person using pencil and paper. The children from the valley were unable to do draw a person: their drawings looked unintelligible, nothing like the human subjects they were asked to draw. But when the researchers asked children of similar age in an adjacent foothills region which did not use pesticides to draw a person, the children from the foothills were quite capable of producing intelligible drawings of a person.<ref>{{Cite journal | last = Guillette | first = E A | last2 = Meza | first2 = M M | last3 = Aquilar | first3 = M G | last4 = Soto | first4 = A D | last5 = Garcia | first5 = I E | date = Jun 1998 | title = An anthropological approach to the evaluation of preschool children exposed to pesticides in Mexico.|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1533004/|journal=Environmental Health Perspectives|volume=106|issue=6|pages=347–353|issn=0091-6765|pmc=1533004|pmid=9618351|doi=|quote=|access-date=|via=}}</ref> The image shows a representative example of the children's drawings from the study. [[File:Drawings by children exposed and not exposed to pesticides.jpeg|none|frame|Intelligible drawings by children in the foothills who were not exposed to pesticides (left), compared to the unintelligible drawings made by children in the valley who were exposed to pesticides from agriculture (right)]] == Biological effects of pesticides == ==== Pesticides cause structural changes in the basal ganglia of the brain ==== Studies on asymptomatic agricultural workers exposed to pesticides found micro-structural changes in their substantia nigra, a region in the basal ganglia of the brain.<ref>{{Cite journal | last = Du | first = Guangwei | last2 = Lewis | first2 = Mechelle M. | last3 = Sterling | first3 = Nicholas W. | last4 = Kong | first4 = Lan | last5 = Chen | first5 = Honglei | last6 = Mailman | first6 = Richard B. | last7 = Huang | first7 = Xuemei | date = Jan 2014 | title = Microstructural changes in the substantia nigra of asymptomatic agricultural workers|url=https://www.ncbi.nlm.nih.gov/pubmed/24334261/|journal=Neurotoxicology and Teratology|volume=41 | pages = 60–64|doi=10.1016/j.ntt.2013.12.001|issn=1872-9738|pmc=3943901|pmid=24334261|issue=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Lewis | first = Mechelle M. | last2 = Sterling | first2 = Nicholas W. | last3 = Du | first3 = Guangwei | last4 = Lee | first4 = Eun-Young | last5 = Shyu | first5 = Grace | last6 = Goldenberg | first6 = Michael | last7 = Allen | first7 = Thomas | last8 = Stetter | first8 = Christy | last9 = Kong | first9 = Lan | date = Sep 2017 | title = Lateralized Basal Ganglia Vulnerability to Pesticide Exposure in Asymptomatic Agricultural Workers|url=https://www.ncbi.nlm.nih.gov/pubmed/28633499/|journal=Toxicological Sciences: An Official Journal of the Society of Toxicology|volume=159|issue=1|pages=170–178|doi=10.1093/toxsci/kfx126|issn=1096-0929|pmc=5837257|pmid=28633499|quote=|access-date=|via=}}</ref> Basal ganglia injury was also found in Gulf War illness patients.<ref>{{Cite journal | last = Haley | first = R. W. | last2 = Fleckenstein | first2 = J.L. | last3 = Marshall | first3 = W.W. | last4 = McDonald | first4 = G.G. | last5 = Kramer | first5 = G.L. | last6 = Petty | first6 = F. | date = Sep 2000 | title = Effect of basal ganglia injury on central dopamine activity in Gulf War syndrome: correlation of proton magnetic resonance spectroscopy and plasma homovanillic acid levels|url=https://www.ncbi.nlm.nih.gov/pubmed/10987894|journal=Archives of Neurology|volume=57|issue=9|pages=1280–1285|doi=10.1001/archneur.57.9.1280|issn=0003-9942|pmid=10987894|pmc=|quote=|access-date=|via=}}</ref> ==== Organophosphates cause immunosuppression ==== A study in sheep found that the organophosphate pesticide parathion suppressed both the IgM and IgG immune antibody responses, which is thought to be due to the cholinergic stimulation caused by organophosphates.<ref>{{Cite journal | last = Casale | first = G. P. | last2 = Cohen | first2 = S. D. | last3 = DiCapua | first3 = R.A. | date = Apr 1983 | title = The effects of organophosphate-induced cholinergic stimulation on the antibody response to sheep erythrocytes in inbred mice|url=https://www.ncbi.nlm.nih.gov/pubmed/6857660|journal=Toxicology and Applied Pharmacology|volume=68|issue=2|pages=198–205|doi=10.1016/0041-008x(83)90004-2|issn=0041-008X|pmid=6857660|pmc=|quote=|access-date=|via=}}</ref> This may in part explain why organophosphate exposure is a risk factor for ME/CFS, as this disease is usually precipitated by a viral infection, and immunosuppression during the acute phase of infection may allow the virus to breach into tissues compartments such as the brain which it would normally not reach. Exposure to immunosuppressive corticosteroids during acute viral infection is also a risk factor for developing ME/CFS from the infection (see [[corticosteroids given during acute viral infection may trigger myalgic encephalomyelitis]]). == Routes of human exposure to pesticides == Pesticides can enter the body through the mouth, skin, eyes or lungs. Sources of pesticide exposure include garden pesticide sprays used by you or your neighbor, which can be tracked into the house on shoes. Agricultural exposure may occur in rural areas through crop spraying. Pesticide exposure can also occur through treating wood with preservatives, and treating livestock with anti-parastitic preparations, such as sheep dip. == The pesticide malathion multiplies its toxicity 1000-fold indoors == The household organophosphate pesticide malathion is particularly dangerous if a significant quantity is spilt in an indoor environment (in a house, workplace, garage or barn): although malathion itself is rated as "class III slightly toxic" in its pesticide toxicity class, the breakdown product of malathion called malaoxon is 33 times more toxic than malathion,<ref>{{Cite web|url=http://npic.orst.edu/factsheets/archive/malatech.html#mode | title = Malathion — Technical Fact Sheet. National Pesticide Information Center. | last = | first = | authorlink= | date = |website=|archive-url=|archive-date=|url-status=|access-date=}}</ref> and 1,000 times more toxic than malathion in terms of its acetylcholinesterase activity.<ref>{{Cite journal | last = Rodriguez | first = O. P. | last2 = Muth | first2 = G.W. | last3 = Berkman | first3 = C.E. | last4 = Kim | first4 = K. | last5 = Thompson | first5 = C.M. | date = Feb 1997 | title = Inhibition of various cholinesterases with the enantiomers of malaoxon | url =https://www.ncbi.nlm.nih.gov/pubmed/8975790|journal=Bulletin of Environmental Contamination and Toxicology|volume=58|issue=2|pages=171–176|doi=10.1007/s001289900316|issn=0007-4861|pmid=8975790|pmc=|quote=|access-date=|via=}}</ref> Thus when malathion is spilt indoors, because it is not dispersed by the wind or rain, it will remain indoors, and as it breaks down into malaoxon, the toxicty is increased by 1000 times, thereby becoming highly toxic to the inhabitants. Absorption or ingestion of malathion into the human body also results in its metabolism to malaoxon. The oxon breakdown products of malathion, parathion and chlorpyrifos (malaoxon, paraoxon and chloroxon) have also been shown to be 10 to 100 times more toxic than their parent compound to amphibians.<ref>{{Cite journal | last = Sparling | first = D. W. | last2 = Fellers | first2 = G. | date = Jun 2007 | title = Comparative toxicity of chlorpyrifos, diazinon, malathion and their oxon derivatives to larval Rana boylii|url=https://www.ncbi.nlm.nih.gov/pubmed/17218044|journal=Environmental Pollution (Barking, Essex: 1987)|volume=147|issue=3 | pages = 535–539|doi=10.1016/j.envpol.2006.10.036|issn=0269-7491|pmid=17218044|pmc=|quote=|access-date=|via=}}</ref> == Detoxification of pesticides == Organophosphate pesticides are detoxified from the body by an enzyme called paraoxonase, whose gene is [[Paraoxonase 1| PON1]]. Mutations in the PON1 gene greatly reduce the ability of paraoxonase to detoxify organophosphates.<ref>{{Cite journal | last = Mackness | first = Bharti | last2 = Durrington | first2 = Paul | last3 = Povey | first3 = Andrew | last4 = Thomson | first4 = Stuart | last5 = Dippnall | first5 = Martin | last6 = Mackness | first6 = Mike | last7 = Smith | first7 = Ted | last8 = Cherry | first8 = Nicola | date = Feb 2003 | title = Paraoxonase and susceptibility to organophosphorus poisoning in farmers dipping sheep | url =https://www.ncbi.nlm.nih.gov/pubmed/12563177|journal=Pharmacogenetics|volume=13|issue=2 | pages = 81–88|doi=10.1097/01.fpc.0000054058.98065.38|issn=0960-314X|pmid=12563177|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Costa | first = Lucio G. | last2 = Richter | first2 = Rebecca J. | last3 = Li | first3 = Wan-Fen | last4 = Cole | first4 = Toby | last5 = Guizzetti | first5 = Marina | last6 = Furlong | first6 = Clement E. | date = Jan 2003 | title = Paraoxonase (PON 1) as a biomarker of susceptibility for organophosphate toxicity|url=https://www.ncbi.nlm.nih.gov/pubmed/12519632|journal=Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals|volume=8|issue=1|pages=1–12|doi=10.1080/13547500210148315|issn=1354-750X|pmid=12519632|pmc=|quote=|access-date=|via=}}</ref> The person-to-person variation in the ability of paraoxonase to detoxify organophosphate is in the range of 10- to 40-fold, and is determined in part by four SNP mutations in the PON1 gene.<ref>{{Cite journal | last = Rozek | first = Laura S. | last2 = Hatsukami | first2 = Thomas S. | last3 = Richter | first3 = Rebecca J. | last4 = Ranchalis | first4 = Jane | last5 = Nakayama | first5 = Karen | last6 = McKinstry | first6 = Laura A. | last7 = Gortner | first7 = David A. | last8 = Boyko | first8 = Edward | last9 = Schellenberg | first9 = Gerard D. | date = 2005-09-01 | title = The correlation of paraoxonase (PON1) activity with lipid and lipoprotein levels differs with vascular disease status|url=http://www.jlr.org/content/46/9/1888|journal=Journal of Lipid Research|language=en|volume=46|issue=9|pages=1888–1895|doi=10.1194/jlr.M400489-JLR200|issn=0022-2275|pmid=15995178}}</ref> Individuals who have PON1 mutations which make paraoxonase less active are much more susceptible to the damage caused by organophosphates. The hormone leptin markedly decreases plasma PON1 activity.<ref>{{Cite journal | last = Bełtowski | first = Jerzy | last2 = Wójcicka | first2 = Grazyna | last3 = Jamroz | first3 = Anna | date = Sep 2003 | title = Leptin decreases plasma paraoxonase 1 (PON1) activity and induces oxidative stress: the possible novel mechanism for proatherogenic effect of chronic hyperleptinemia|url=https://www.ncbi.nlm.nih.gov/pubmed/12957679|journal=Atherosclerosis|volume=170|issue=1|pages=21–29|doi=10.1016/s0021-9150(03)00236-3|issn=0021-9150|pmid=12957679|pmc=|quote=|access-date=|via=}}</ref> High leptin is found in obesity. Organophosphate and carbamates pesticides do not bioaccumulate to a great degree, and so are removed from the body quickly (the metabolic half-live of organophosphates in the body is in the range of hours to days).<ref>{{Cite web|url=http://www.inchem.org/documents/pims/chemical/pimg001.htm#SectionTitle:6.3%20%20Biological%20half-life%20by%20route%20of%20exposure | title = Organophosphorus pesticides | last = | first = | authorlink = | date = |website=INCHEM|archive-url=|archive-date=|url-status=|access-date=}}</ref> They also have low environmental persistence. Organochlorines pesticides on the other hand are environmentally persistent and bioaccumulate in the body fat tissues, so can remain in the body for years or decades (this is the reason organochlorines were banned and largely replaced by organophosphates and carbamates). One study found organochlorines are expelled during sweating in a sauna.<ref>{{Cite journal | last = Genuis | first = Stephen J. | last2 = Lane | first2 = Kevin | last3 = Birkholz | first3 = Detlef | date = 2016 | title=Human Elimination of Organochlorine Pesticides: Blood, Urine, and Sweat Study|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069380/|journal=BioMed Research International|volume=|doi=10.1155/2016/1624643|issn=2314-6133|pmc=5069380|pmid=27800487}}</ref> Some ME/CFS patients with high blood levels of organochlorines achieved remission from their symptoms after a detoxification regimen comprising choline and ascorbic acid.<ref>{{Cite journal | last = Richardson | first = John | date = 2000-01-01 | title = Four Cases of Pesticide Poisoning, Presenting as “ME,” Treated with a Choline and Ascorbic Acid Mixture|url=https://doi.org/10.1300/J092v06n02_03|journal=Journal of Chronic Fatigue Syndrome|volume=6|issue=2|pages=11–21|doi=10.1300/J092v06n02_03|issn=1057-3321}}</ref> == Call to ban all organophosphate pesticides == A systematic review in PLOS Medicine is calling for a blanket ban of all organophosphate pesticides.<ref>{{Cite journal | last = Hertz-Picciotto | first = Irva | last2 = Sass | first2 = Jennifer B. | last3 = Engel | first3 = Stephanie | last4 = Bennett | first4 = Deborah H. | last5 = Bradman | first5 = Asa | last6 = Eskenazi | first6 = Brenda | last7 = Lanphear | first7 = Bruce | last8 = Whyatt | first8 = Robin | date = 2018-10-24 | title = Organophosphate exposures during pregnancy and child neurodevelopment: Recommendations for essential policy reforms|url=https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002671|journal=PLOS Medicine|language=en|volume=15|issue=10| pages = e1002671|doi=10.1371/journal.pmed.1002671|issn=1549-1676|pmc = 6200179|pmid=30356230}}</ref> The paper says that widespread use of organophosphate pesticides to control insects has resulted in ubiquitous human exposures, and that compelling evidence indicates that prenatal organophosphate exposure at low levels is putting children at risk for cognitive and behavioral deficits and for neurodevelopmental disorders. The authors point out that there is no safe level of exposure to any organophosphate pesticide for pregnant women, whose babies suffer disorders ranging from impaired mental and motor skills and memory loss to autism and attention-deficit hyperactivity disorder. The paper also describes how high exposures to organophosphate pesticides are responsible for poisonings and deaths, particularly in developing countries. The United Nations estimates that 200,000 people die each year from pesticide poisonings, about 99% of them in the developing world.<ref>{{Cite news | url=https://www.theguardian.com/environment/2018/oct/24/entire-pesticide-class-should-be-banned-for-effect-on-childrens-health | title = Ban entire pesticide class to protect children's health, experts say | last = | first = | date = 2018 | work=The Guardian|access-date=|archive-url=|archive-date=|url-status=|quote=200,000 people still die each year from pesticide poisonings, according to UN estimates, about 99% of them in the developing world. A further 110,000 suicides using pesticides take place each year.}}</ref> == See also == * [[Paraoxonase-1]] gene * [[Margaret of Mar, 31st Countess of Mar|Countess of Mar]] * [[John Richardson]] == Learn more == * [http://pan-international.org Pesticide Action Network (PAN) International] * [http://www.panna.org Pesticide Action Network USA] * [https://www.pan-uk.org Pesticide Action Network UK] * [https://www.beyondpesticides.org Beyond Pesticides] * [http://www.pesticidescampaign.co.uk Website of UK pesticide campaigner and journalist Georgina Downs] == References == {{reflist}} [[Category:Triggers and risk factors]] [[Category:Environmental toxicology]]
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