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manufactured or formulated locally, in both urban and rural areas. Although
the last two decades have seen continuing growth in the number of these
industries, safety measures are generally poorly applied and workers lack
proper knowledge or training in the safe handling of these chemicals.
Acute, as well as chronic, pesticide poisonings have been reported among the
workers. Although acute health effects are reasonably well documented in
case studies or reports on animal experiments, the manifestations of chronic
pesticide intoxication are less well recognized or understood (Hayes 1982).
The health profiles of workers in two large-scale pesticide-formulating plants
in Egypt were studied in a 3-year, cooperative project, between the International
Development Research Centre and Cairo University, that began in April
1987. The objective of the study was to determine the prevalence of pesticide
intoxication among workers in the formulation industries and to correlate
epidemiologic data with pesticide exposure.
Materials and methods
Participants were a group of 200 employees from a rural plant located in the
middle of the Nile Delta about 100 km from Cairo and 100 employees from a
semiurban plant 5 km from Cairo. The rural plant, which is well established
and large, employs 1 200 people in the formulation of organochlorine, organophosphorous,
carbamate, and pyrethroid pesticides, as well as sulfur compounds.
The urban plant, with 600 employees, formulates pyrethroids,
organophosphorous compounds, and carbamates, as well as detergents and
other intermediate chemicals. The workers studied at these plants were
directly exposed to pesticides for at least 2 years.
A control group of 300 subjects consisted of 200 rural and 100 urban employees
from textile factories. The control groups were matched for age and socioeconomic
status with the subjects. They were not exposed to pesticides directly
or in their work.
A health profile of all participants was developed through the administration
of a questionnaire and a medical examination, in which special attention was
paid to liver pathology and impairment of the central and peripheral nervous
systems. In addition, 120 rural and 88 urban plant workers were examined by
three psychiatrists and the diagnoses recorded according to Egyptian Psychiatric
Association (1979). Other tests included electroencephalograms, electromyograms,
and sonography of the liver.
Clinical and biochemical laboratory investigations included liver function
tests, determination of acetylcholinesterase (AChE) activity, and definition of
the types and levels of pesticides found in blood samples. Urine and stool
samples were examined for the presence of bilharzia and other parasites. Air
samples were taken using personal samplers to assess the concentrations of
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