Organophosphate and carbamate insecticide exposure is related to lung function change among smallholder farmers: A prospective study

Martin Rune Hassan Hansen*, Erik Jørs, Annelli Sandbæk, Daniel Sekabojja, John C. Ssempebwa, Ruth Mubeezi, Philipp Staudacher, Samuel Fuhrimann, Torben Sigsgaard, Alex Burdorf, Bo Martin Bibby, Vivi Schlünssen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

14 Citations (Scopus)


Introduction and aim Exposure to some insecticides may cause airway obstruction, but existing evidence is limited by cross-sectional designs and inadequate confounder control. We investigated the relation between organophosphate and carbamate insecticides and pulmonary function in a prospective study accounting for important confounders. Methods In a cohort of 364 smallholder farmers in Uganda (69% women), participants underwent pre-bronchodilator spirometry at baseline (September/October 2018) and at two follow-up visits (November/December 2018 and January/February 2019). Exposure to carbamate and organophosphate insecticides was assessed using haemoglobin-adjusted erythrocyte acetylcholinesterase (AChE/Hb). Less than 3% of participants were lost to follow-up. We calculated Z-scores for FEV 1, FVC and FEV 1 /FVC using the Global Lung Function Initiative equations. Data were analysed in linear mixed and fixed effect models accounting for family relationships and repeated measures of exposure and outcome. Results Low AChE/Hb was significantly associated with low FEV 1 Z-score in both unadjusted and adjusted analyses. Compared with individuals with AChE/Hb 25.90 U/g (50 th percentile, reference), those with lower AChE/Hb 24.50 U/g (35 th percentile) had mean FEV 1 Z-score 0.045 (0.003 to 0.087) lower, and persons with higher AChE/Hb 27.30 U/g (65 th percentile) had a mean FEV 1 Z-score 0.043 (-0.002 to 0.087) higher compared with the reference. Similar, but numerically smaller and statistically non-significant effects were seen for Z-scores of FVC and FEV 1 /FVC. Conclusion Exposure to organophosphate and carbamate insecticides may lead to lung function decline. Our results add to the growing evidence of health effects in relation to exposure to organophosphate and carbamate insecticides, underlining the importance of minimising exposure.

Original languageEnglish
Pages (from-to)780-789
Number of pages10
Issue number8
Publication statusPublished - 1 Aug 2021

Bibliographical note

Funding Information:
Funding This project was supported by grants from Aarhus University Research Foundation (project number 81231) and the National Research Centre for the Working Environment (project number 10322). Neither of the funders played any role in study design, data collection/analysis, drafting of the manuscript or the decision to publish.

Publisher Copyright:


Dive into the research topics of 'Organophosphate and carbamate insecticide exposure is related to lung function change among smallholder farmers: A prospective study'. Together they form a unique fingerprint.

Cite this