vvEPA
United States
Environmental Protection
Agency
Office of
Pesticide Programs
Washington DC 20460
EPA 540/9-80-003
July 1980
Pesticide
Chronic Neurological
Sequelae of Acute
Organophosphate
Pesticide Poisoning:
A Case-Control Study
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CHRONIC NEUROLOGICAL SEQUELAE
OF ACUTE ORGANOPHOSPHATE
PESTICIDE POISONING:
A CASE-CONTROL STUDY
Final Report
El don P. Savage, Ph.D., Project Director
Thomas J. Keefe, Ph.D., Director of Statistical Services
Lawrence M. Mounce, B.S., Field Studies Coordinator
Epidemiologic Pesticide Studies Center
Institute of Rural Environmental Health
Colorado State University
Fort Collins, Colorado 80523
James A. Lewis, M.D., Neurologist
Robert K. Heaton, Ph.D., Clinical Psychologist
Departments of Neurology and Psychiatry
University of Colorado Medical Center
Denver, Colorado 80220
Leland H. Parks, Ph.D., Assistant Project Director
Epidemiologic Studies Program, School of Medicine
Texas Tech University Health Services Centers
San Benito, Texas 78586
May 1980
Credit Line and Disclaimer
Conclusions are subject to change on the basis of additional information and
evidence. Information contained herein is not to be reprinted or published
without written permission of the Environmental Protection Agency. The views
expressed herein are those of the investigators and do not necessarily reflect
the official viewpoint of the Environmental Protection Agency. These investi-
gations were supported through a contract with the Epidemiologic Studies
Program, Health Effects Branch, Hazard Evaluation Division of the U.S. Environ-
mental Protection Agency, Washington, D.C. 20460.
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TABLE OF CONTENTS
Page
LIST OF TABLES Hi
ACKNOWLEDGEMENTS vl
INTRODUCTION 1
MATERIALS AND METHODS 3
Case Participants 3
Selection of Matched Pair Control Participants 4
Participant Interview 5
Quality Control Assurances 6
Pesticide Residue and Cholinesterase Testing.- 6
Physical Examinations 7
Neurological Evaluation 7
Electroencephalographic Examination .... 8
Neuropsychological Testing 8
Statistical Analysis 15
RESULTS 17
Demographic Data 17
Acute Organophosphate Pesticide Poisoning Histories 29
Physical Examination and Clinical Laboratory Data 30
Clinical Laboratory Results 33
Neurological Data 33
Neuropsychological Findings 51
Blood Pesticide Residues and ChE Assays 59
SUMMARY AND DISCUSSION 67
REFERENCES 71
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TABLE OF CONTENTS (Continued)
Page
APPENDICES 74
APPENDIX A: Data Forms A-l
Informed Consent A-2
Participant Selection A-4
Occupational History and Pesticide Exposure . . . A-5
Post-OP Poisoning A-6
History of Tobacco, Alcohol, Drug, and Medication Use A-8
Current Symptomology A-l2
Information Sheet A-15
APPENDIX B: Choiinesterase Procedure B-l
APPENDIX C: Serum Pesticide Residue Procedure C-l
APPENDIX D: Data Forms D-l
Post-Medical History D-2
Physical and Neurological Examination D-3
EEG Evaluation D-18
APPENDIX E: Organophosphate Insecticides Implicated in
Poisoning Episodes E-l
APPENDIX F: Statistical Analysis of the Neuropsychological
Evaluation F-l
APPENDIX G: Statistical Analysis of the Patient's Assessment
of Own Functioning G-l
APPENDIX H: Statistical Analysis of the Assessment by a
Relative of the Patient's Functioning H-l
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LIST OF TABLES
Table Page
1 Occupations of organophosphate pesticide poisoning cases ... 18
2 Age means and standard deviations (S.D.) of all study
participants 19
3 Mean Hollingshead social class and standard deviation (S.D.)
of case and control participants 20
4 Age and Hollingshead social position scales for study
participants by matched pairs 21
5 Elapsed time in days from last poisoning to neuropsychologi-
cal examination 29
6 Organophosphate pesticides implicated in the primary poisoning
incidents 31
7 Summary of abnormal conditions identified in participants
during physical examination 32
8 Summary of the statistical comparison of the cases and controls
with respect to selected laboratory test variables 34
9 Summary of the results of the encephalogram (EEG) evaluation
of case and control participants 35
10 Summary of the statistical comparison of the cases and controls
with respect to mental status, cranial nerves, and motor
system 38
11 Evaluation of case and control participants with respect to
the summary and components of the mental status test of the
neurological examination 39
12 Evaluation of case and control participants with respect to
the state of consciousness and mood from the mental status
test of the neurological examination 41
13 Evaluation of case and control participants with respect to
the cranial nerve score test of the neurological examination . 41
14 Evaluation of case and control participants with respect to
the knee jerk (right and left combined) test of the neurologi-
cal examination 42
15 Evaluation of case and control participants with respect to
the ankle jerk (right and left combined) test of the
neurological examination 42
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LIST OF TABLES (Continued)
Table Page
16 Evaluation of case and control participants with respect
to the motor system score test of the neurological
examination 42
17 Summary of the statistical comparison of the cases and
controls with respect to the sensory system 43
18 Evaluation of case and control participants with respect
to the pin upper right extremity test of the neurological
examination. 44
19 Evaluation of case and control participants with respect
to the pin upper left extremity test of the neurological
examination . 44
20 Evaluation of case and control participants with respect
to the pin lower right extremity test of the neurological
examination 45
21 Evaluation of case and control participants with respect
to the pin lower left extremity test of the neurological
examination 45
22 Evaluation of case and control participants with respect
to the vibration, right test of the neurological examina-
tion 46
23 Evaluation of case and control participants with respect
to the vibration, left test of the neurological examina-
tion 46
24 Evaluation of case and control participants with respect
to the sensory system score of the neurological examina-
tion 47
25 Summary of the statistical comparison of the cases and
controls with respect to integrative function and other
miscellaneous examinations ... 48
26 Evaluation of case and control participants with respect
to the finger-nose right test of the neurological examina-
tion 49
27 Evaluation of case and control participants with respect
to the finger-nose left test of the neurological examina-
tion 49
28 Evaluation of case and control participants with respect
to the integrative function score of the neurological
examination 50
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LIST OF TABLES (Continued)
Table Page
29 Evaluation of case and control participants with respect
to other miscellaneous exam scores of the neurological
examination 50
30 Psychological test score means, standard error of the
difference of means, and the probability level of the
analysis of variance test for the case-control comparison
for the Halstead-Reitan Battery and the WAIS Battery .... 52
31 Psychological test score means, standard error of the
difference of means, and the probability level of the
analysis of variance test for the case-control comparison
for the Peabody and Individual Achievement Test and Added
Ability Tests 53
32 Psychological test score means, standard error of the
difference of means, and the probability level of the
analysis of variance test for the case-control comparison
for the MMPI Battery 54
33 Patient's assessment of own functioning: Test score means,
pooled estimate of the standard error (S.E.) of each mean,
and probability level of the analysis of variance test for
the case-control comparison 57
34 Relative's assessment of patient's functioning: Test score
means, pooled estimate of the standard error (S.E.) of each
mean, and probability level of the analysis of variance test
for the case-control comparison 60
35 Analysis of variance summary with subgroup means and
standard deviations for the total organochlorine pesticide
residue in the blood 63
36 Analysis of variance summary with subgroup means and
standard deviations for red blood cell cholinesterase. ... 65
37 Analysis of variance summary with subgroup means and
standard deviations for plasma cholinesterase 66
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ACKNOWLEDGEMENTS
This study was conducted under Contract Number 68-01-4663 with the
Health Effects Branch, Hazard Evaluation Division, Office of Pesticides and
Toxic Substances, U.S. Environmental Protection Agency (EPA). Completion of
this study was the responsibility of organizations within three institutions:
Epidemiologic Pesticide Studies Center, Institute of Rural Environmental
HealtK, Colorado State University, Fort Collins, Colorado; Departments of
Neurology and Psychiatry, University of Colorado Medical Center, Denver,
Colorado; and Epidemiologic Studies Program, Texas Tech University School of
Medicine, San Benito, Texas. There were many individuals from these three
organizations who contributed greatly to the completion of this study:
Colorado State University University of Colorado Medical Center
Michael J. Aaronson, Ph.D. Patricia J. Burcar, M.D.
Janee L. Ahlers Robert K. Heaton, Ph.D.
Barbara A. Bonilla Susan K. Heaton
Linda J. Davis Susan Johnson
Sandra H. Ford James A. Lewis, M.D.
Lois J. Helwic Jody E. Trotter
Eugene G. Johnson Arthur T. Vogt, Ph.D.
Texas Tech University School of Medicine
Lawrence M. Mounce Vaughn F. Cox
Robert A. Rusczek Isabel Diaz
El don P. Savage, Ph.D. Edward D. Gomes
Barbara J. Stevens Darlene Hoover
Judith A. Tracy Lei and H. Parks, Ph.D.
John D. Tessari Elizabertha Simo
H. William Wheeler Jorge Viada, M.D.
We also acknowledge the assistance provided by Donald P. Morgan
M.D., Ph.D. (Director, Epidemiologic Studies Program, University of Iowa
School of Medicine, Iowa City, Iowa), who contributed valuable insight and
experience to the study design, John W. Kliewer, Ph.D., and Charles W. Miller,
Ph.D. (Field Studies Coordinators, Health Effects Branch, EPA), who maintained
liaison and continuity of support from the sponsor. Special recognition is
extended to the many persons who volunteered to serve as participants 1n this
study.
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INTRODUCTION
The increased use of organophosphate (OP) pesticides in the last three
decades has been accompanied by numerous acute organophosphate poisonings.
The World Health Organization (WHO) has stated that the problem of acute
pesticide poisonings is extensive and serious and may number as many as
500,000 cases annually throughout the world (1). In the United States, a
national study of hospitalized pesticide poisoning cases from 1971 through
1973 resulted in an estimated 8241 admissions of which 31% were due to
organophosphate pesticides. Of these, over 70% of the organophosphate
pesticide poisonings were due to occupational exposure (2).
The OP pesticides are cholinesterase inhibitors. In the poisoned
individual cholinergic synapses cannot degrade the transmitter, acetylcholine,
released during normal function. This condition leads to excitation,
followed by paralysis, of the extensive peripheral and central cholinergic
nervous system. Symptoms in patients experiencing OP poisonings include
flushing, dry mouth, fasciculations, tremors, restlessness, agitation, ataxia,
weakness, convulsions and coma; these symptoms develop immediately after
exposure. Once the cholinergic imbalance has been corrected the neurological
signs and symptoms usually disappear completely (3).
In acute OP poisonings plasma and/or red blood cell (RBC) cholinesterase
activity is depressed. Plasma depression may last from one to three weeks
while depression of RBC acetylcholinesterase may persist for as long as 12
weeks. If the treatment of acute organophosphate poisoning cases is inade-
quate, a delayed but invariably transient syndrome with similar features
may appear (4).
It has been shown in animal studies that the OP anticholinergic com-
pound, tri-£-cresyl phosphate (TOCP), can produce chronic and progressive
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degeneration of lower motor neurons (5). Bidstrup et al. have suggested that
the OP pesticides could produce a similar effect (6). The presence of long-
term neuropsychiatric disturbances in humans following acute exposure to OP
compounds has been reported by Gershon, Shaw and others (7,8). Drenth noted
a high percentage of electromyogram (EMG) abnormalities among workers in OP
production plants (9). Abnormal electroencephalograms (EEGs), similar to
those obtained from epileptic patients, have been observed by several investi-
gators in individuals following acute pesticide intoxications (10,11). Met-
calf and Holmes (12) described less dramatic abnormalities in the EEGs after
recovery from acute poisoning. Duffy et a!. (13) suggested that the persis-
tence of known short-term OP effects, when taken in conjunction with the
reported long-term behavioral effects of OP exposure, provide parallel evi-
dence that human exposure to OP compounds can culminate in brain function
alterations.
In spite of the number of investigators who have reported the above
findings, a number of other scientists have disagreed with these conclusions
(14,15). An epidemiologic analysis of patients following acute OP intoxica-
tions did not reveal increased incidence of psychiatric disorders (16).
Tabershaw and Cooper found no "serious sequela of high incidence" in patients
reported as having "occupational disease attributed to organic pesticides"
(17). Clark, in an extensive literature review of experimental animal
studies, was unable to find consistent evidence supporting the hypotheses
that exposure to OP pesticides may result in abnormal behavior (18).
Gallaher (19) and Hatcher and Wiseman (20) reported on acute poisoning cases
from the Rio Grande Valley in Texas.
Many of. these clinical studies have not included epidemiologic design.
For example, they have not included one or more of the following: matched
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controls, comple.te documentation of acute exposures, sufficient quantitative
measures of neurologic and behavioral functioning, and complete statistical
analyses. The major objective of this epidemiologic study which was designed
to overcome many of the aforementioned shortcomings, was to determine the
latent adverse health effects, if any, following an acute organophosphate
poisoning.
This study was a cooperative effort of the following institutions: the
Epidemiologic Pesticide Studies Center of the Institute of Rural Environmental
Health of Colorado State University (Colorado Center) in Fort Collins, Colorado;
the Epidemiologic Studies Program, Texas Tech University School of Medicine
(Texas Program) in Lubbock, Texas; and the Departments of Neurology and Psy-
chiatry, University of Colorado Medical Center (UCMC) in Denver, Colorado.
The Colorado Center served as coordinator on the project.
MATERIALS AND METHODS
The study population consisted of 100 individuals (cases) who had
previously experienced acute poisoning from OP pesticide exposures. Each
case was carefully matched by age, sex, race, occupation, and educational
level to a control participant. Participants in the control cohort had not
experienced organophosphate poisonings. The study was specifically designed
to detect any chronic neurological or neuropsychological effects in the case
participants.
Case Participants. A roster of potential case participants was compiled
from various health data records available in Colorado and Texas. The
Colorado roster consisted of approximately 443 organophosphate pesticide
poisoning cases, all of which occurred from 1950 through 1976. The potential
case participant roster in Texas consisted of about 400 individuals who had
experienced acute pesticide exposures from 1960 through 1976. After screening
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both the Colorado and Texas rosters for completeness of poisoning documenta-
tion, a revised roster of approximately 303 potential OP poisoned participants
was developed, and exhaustive attempts were made to locate all of the potential
participants. Of the 303 potential participants, a total of 200 (approximately
66%) were located.
The potential participants were carefully screened for acceptance. The
screening process criteria included: 1) a documented history of at least one
OP poisoning; 2) diagnosis by a physician including symptoms consistent with
OP poisoning; 3) a minimum age of 16 years at the time of follow-up contact;
and 4) an understanding of the English language sufficient to complete the
neuropsychological test. Participants were excluded if they had any of the
following in their medical histories: 1) organophosphate poisonings within
three months prior to testing; 2) diseases or injuries to the central nervous
system; 3) congenital defects of the central nervous system; or 4) alcohol,
drug, or narcotic abuse.
Of the 200 potential participants that were located, a total of 12 (6%)
were deceased; 47 persons (23.5%) did not meet the screening process criteria;
and 27 (13.5%) declined to participate in the study. The remaining 114
potential case participants agreed to participate in the study. Of these, a
total of 100 case participants completed the study.
Selection of Matched Pair Control Participants. Control participants
were selected and matched to corresponding case participants with respect to
age, sex, race, education, occupation, social position, and ethnic background.
Controls were identically matched for sex and race, and in the case of
Mexican Americans, for ethnic background. Age was matched to within one year
for participant ages 16 through 20; two years for ages 21-23; three years for
ages 24-25; and five years for ages 26 through 70. Persons younger than 15
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were excluded from the study because the adult neuropsychological test
battery is not appropriate for them, and persons older than 70 were excluded
because more extreme "normal aging" effects on neuropsychological performance
would'be expected for such subjects.
Education, occupation, and social position were matched within one level
based on scales prescribed by the Hollingshead Two Factor Index of Social
Position (21). The educational scale was divided into seven levels with the
highest level of educational achievement scored as 1 and the lowest level
scored as 7. The occupational scale was also divided into seven levels with
the highest level of occupational achievement scored as 1 and the lowest as
7- The social position index was composed of five levels with a score of 1
representing the highest level.
The control cohort participants were recruited primarily from the state
of Colorado and from the Lower Rio Grande Valley of Texas. A total of 35
participants were recruited through referrals from case and control parti-
cipants; 24 controls were recruited through businesses and public agencies;
37 participants were recruited through investigator solicitation; and in 4
cases recruitment reference source data were incomplete. Paired control parti-
cipants were matched to case participants on the basis of age, sex, race,
education, occupation, social position, and ethnic background. The controls
were also screened to make certain they did not have histories of drug or
alcohol abuse and that they had not previously experienced CNS injuries.
Participant Interview. Specially trained field epidemiologists inter-
viewed the matched pair case and control cohorts. The interview form
(Appendix A) included: demographic data, informed consent form, occupational
history, pesticide exposure history, OP poisoning history (for cases) and an
abbreviated medical history. In addition, the spouse or a close relative
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completed a questionnaire rating the participant's personality and several
functioning tests. The physical, neurological and neuropsychological
examinations were usually scheduled at the conclusion of the interviews.
Quality Control Assurances. A continuous effort was made to conduct
the study in Colorado and Texas in a similar manner. Two field epidemiologists
from the Texas Program worked with their counterparts at the Colorado Center
to standardize interview techniques and the recording of data to insure
uniformity.
The neuropsychological examiner who conducted tests on the Texas cohorts
was trained and supervised by personnel from the UCMC Neuropsychological
Laboratory. The physicians conducting the neurological evaluations in Texas
and Colorado worked together to standardize their procedures prior to the
start of the study and at intervals throughout the period of the study.
Physical exams, neurological testing and neuropsychological testing of
Colorado participants were performed at UCMC in Denver, and Texas participants
were evaluated at the Texas Program offices and at the office of a practicing
neurologist in Brownsville, Texas. These examinations took a total of two days
for each participant to complete. Since the protocol consisted of a blind
study design, the participants were instructed not to reveal whether they were
a case or control to the investigators conducting the physical, neurological
and neuropsychological evaluations. All participants received monetary com-
pensation as reimbursement for their time, travel, and expenses.
Pesticide Residue and Cholinesterase Testing. Blood samples were
collected from the participants at the time of neurological examination.
These samples consisted of a volume of 10 ml of venous blood collected in a
heparinized tube for Cholinesterase (ChE) assay (Appendix B) and another 10
ml of venous blood collected in a non-heparinized tube for chlorinated hydro-
carbon pesticide residue analyses.
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Physical Examinations. All case and control participants were given
medical examinations consisting of physical examinations, neurological
evaluations, electroencephalographic examinations, and neuropsychological
testing. The routine physical examination consisted of complete medical
histories, audiometric and ophthalmic examinations, and clinical 'blood
evaluations. The medical histories and routine physical exams were conducted
by the examining neurologist. The audiometric and ophthalmic examinations
were conducted by qualified technicians. Clinical blood evaluations were
performed at the hospital or office with which the examining neurologist was
associated. All data were thoroughly reviewed by the neurologist at UCMC.
Although every attempt was made to screen potential case participants and
controls prior to these evaluations, the results were used to eliminate
persons with suspect interfering factors. Standard forms used for the physi-
cal examination are contained in Appendix D. The participants were informed
of significant findings on their physical examination and, if indicated, they
were advised to seek independent medical follow-up. In addition, significant
findings of test results were summarized by the neurologist and given to the
participant's personal physician.
Neurological Evaluation. As previously mentioned, all subjects were
instructed not to reveal their status as either a case or a control partici-
pant during their neurological evaluation. The neurological history and
formal review of systems were recorded on standard forms by the examining
neurologist. This was followed by a neurological examination which consisted
of an evaluation of mental status, cranial nerve function, motor system
function, sensory system function, and tests of cerebellar function and
coordination. Tests used in each of these categories are shown in Appendix D.
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Electroencephalographic Examination. All study participants were
subjected to a routine clinical electroencephalogram on either 8 or 16
channel instruments, manufactured by either the Grass or Beckman Companies.
Electrodes were applied with paste according to the International 10-20
placement system. All tracings were recorded without patient sedation;
photic stimulation and hyperventilation were done on all participants, and
sleep phase recordings were obtained when possible. During the course of
the waking record, all patients had nine minutes of data from four channels
recorded onto a Vetter EM tape recorder for offline computer analysis. The
records were read visually in a standard clinical fashion and interpreted as
either normal or abnormal; details of the activity seen were recorded on a
research report form (Appendix E). Computer analysis was planned to supple-
ment the visual interpretation. Power spectral arrays were to be obtained
with a Nova 2/10 computer utilizing the Tukey-Cooley algorithm for a fast
Fourier transformation. Eight-second epochs were to be analyzed and presented
in a "hidden line" configuration as discussed by Bickford (22).
Neuropsychological Testing. The neurological technicians tested the
study participants without knowledge of the participant's status (case or
control). Each participant's testing was completed in a single work day.
/
The tests consisted of the Wechsler Adult Intelligence Scale (WAIS) (23)
and an expanded version of the test battery originally developed by Hal stead
(24) and Reitan (25). Numerous studies published over the last 30 years have
shown that these tests are sensitive to focal and diffuse cerebral lesions
caused by diverse neurologic conditions. Recent literature reviews are pre-
sented by Reitan and Davison (26) and Russel et al. (27).
The expanded Halstead-Reitan battery included measures of intelligence,
attention, various cognitive functions, motor proficiency, sensory-perceptual
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functions, aphasia and related disorders, and learning and memory. An objec-
tive personality test was also given in an effort to determine whether
pesticide-case participants showed increased tendencies toward psychiatric
disturbances. The following are brief descriptions of the specific tests
and test scores used in this study. More detailed descriptions can be
found in the references provided.
Wechsler Adult Intelligence Scale (MAIS) (23): The WAIS 1s a well known
and widely used measure of adult intelligence (28). Scores used 1n the WAIS
include the Verbal, Performance, Full Scale IQ Values, and the scaled scores
on the individual subtests (Information, Comprehension, Arithmetic, Similari-
ties, Digit Span, Vocabulary, Digit Symbol, Picture Completion, Block Design,
Picture Arrangement, and Object Assembly).
Halstead Category Test (24,29): This is a relatively complex nonverbal
test of abstraction and concept formation. The subject's goal 1n the first
six subtests is to determine a unifying principle that, when applied to each
item on the subtest, would give the correct answer. A seventh subtest is a
review group where the subject tries to remember the answer to Items seen in
the earlier subtests. The score is determined by the number of errors on
the total of 208 items.
Tactual Performance Test (24,29): In this test there are three trials
in which the subject is blindfolded and asked to place ten geometrically
shaped blocks into their correct spaces on a form board. The first trial 1s
done with the dominant hand, trial two with the nondominant hand, and on the
third trial both hands are used. The three trials are timed, and a maximum
of ten minutes is alloted for each trial. The measure used to reflect psycho-
motor problem solving efficiency is the time (minutes) taken per block for
the three trials combined.
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There are also two measures of incidental memory generated on the
Tactual Performance Test. The subject 1s not told in advance to remember
anything about the blocks or the board. However, after the three trials are
completed the board is removed, the blindfold is taken off, and the subject
is asked to draw a picture of the form board from memory. "Memory" points
are earned for correctly recalling the shapes on the board, and "location"
points for shapes correctly localized on the drawing. A maximum of ten
points is possible on each of the measures.
Speech Sounds Perception Test (24,29): This test requires sustained
attention, accurate perception of verbal auditory stimuli, and the ability
to match simple spoken words with their written versions on an answer sheet.
Sixty nonsense words are presented from a tape recorder, each having a
middle "ee" vowel sound and different consonant combinations at either end.
Each of the 60 spoken nonsense words must be selected (underlined) from among
4 written alternatives on the answer sheet. The score recorded is the number
of errors made on the 60 items.
Seashore Rhythm Test (24,29,30): This test requires sustained attention.
fine discrimination among nonverbal auditory stimuli, plus short-term memory
for such stimuli. The subject is presented 30 pairs of rhythms via a tape
recorder, and for each pair, is required to indicate whether the second
rhythm is the same or different than the first rhythm. The score recorded
is the number of correct judgments out of a possible 30.
Finger Oscillation Test (24,29): This test of upper extremities' motor
speed requires the subject to tap as fast as possible with the index finger,
using an apparatus which resembles a telegraph key. The mean number of taps
on five 10-second trials is recorded for each hand, and in this study these
two fingers are summed to give a final measure of tapping speed.
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Halstead Impairment Index (24,29): In current practice, this summary
measure of generalized neuropsychological deficit uses seven of the test
scores described above: Category; Tactual Performance Test Total Time,
Memory, and Location: Seashore Rhythm; Speech Sounds Perception; and Finger
Oscillation with the dominant hand only. The index is the proportion of
scores on these tests which is in the range characteristic of patients with
documented cerebral lesions. Higher index scores increase the probability
of impaired cerebral functioning.
Trail Making Test, Part B (29,31): This paper-and-pencil test requires
general alertness, spatial analysis, motor speed, and the ability to follow
correct sequences of numbers and letters in an alternating fashion. The
score is determined by the number of seconds taken to complete the test.
Aphasia Screening Examination (29,32): This is Reitan's modified ver-
sion of the Halstead-Wepman aphasia screening test (33). This test is
designed to screen for deficits in the participant's ability to: name common
objects; spell simple words; identify letters and numbers; read and write
simple words and short statements; enunciate; repeat a short statement and
explain its meaning; work simple mathematical problems; demonstrate the use
of a common object such as a key; and discriminate right from left. A
total aphasia score, which can range from 0 to 75, was derived from the
scoring and item weighing system of Russell et al. (27).
Spatial Relations (27): This is a measure of constructional dyspraxia,
or degree of spatial distortion apparent in the subject's reproductions of
geometric designs. The score is based upon the subject's drawing of the
Greek cross from the aphasia screening exam and his scaled score on the WAIS
block design subtest (27,32).
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Reitan-Klove Sensory Perceptual Examination (29): During this examina-
tion, tests are administered for finger tip number writing imperception
(graph-esthesia), tactile finger recognition errors (finger dysgnosia), and
sensory suppressions (tactile, auditory, and visual extinction phenomena).
For each test, all error scores for both sides of the body are totaled to
provide a total perceptual error score.
Average Impairment Rating (27): This score is the average of the
ratings, which range from 0 (better than average) to 5 (severely impaired),
received by the participant on 11 of the Halstead-Reitan battery tests
described above and 1 WAIS measure. The Average Impairment Rating differs
from the Hal stead Impairment Index in that the former includes more tests
and reflects the degree of overall impairment rather than the range of
abilities affected.
Reitan-Klove Tactile Form Recognition (29): This test of stereognosis
requires the study participant to discriminate among four flat plastic
shapes by touch alone. A vertically positioned board is used, in which
copies of the shapes are mounted on the board. The score is derived from
the time (seconds) taken to complete 16 trials (8 trials with each hand).
Smedley Hand Dynamometer: This test of grip strength is often included
in the Halstead-Reitan battery for clinical and research investigations (26).
Two trials are given with each hand, and the average strength for each trial
is recorded in kilograms (kg). The final score is the sum of the mean scores,
Klove-Matthews Motor Steadiness Battery (26): The grooved pegboard test
and the hole-type steadiness test are used in this study. The grooved peg-
board (Lafayette Instrument Co., No. 32035) measures speed and fine motor
coordination with the upper extremities. This test requires the subject to
place 25 small metal pegs into holes on a horizontal board as quickly as
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possible. The holes have grooves on one side, so the pegs will not fit unless
they are positioned properly. A trial is given with each hand. The number of
seconds taken to place all 25 pegs are recorded and totaled. The hole-type
steadiness test (Lafayette Instrument Co., No. 32011) is a test of static
steadiness. The study participant is asked to hold a stylus in the center
of six successively smaller holes, trying not to let the stylus touch the
sides. The stylus is connected to a recorder. Both hands are tested for all
six holes, and error scores are totaled for the 12 trials.
Peabody Individual Achievement Test (34): The Reading Recognition,
Reading Comprehension and Spelling subtests are administered to provide
coverage of these academic skills. Percent!le scores are used.
Thurstone Word Fluency Test (35): In Part A of this written fluency test,
the study participant is given five minutes to write as many words as possible
that begin with the letter "S". In Part B the participant is given four
minutes to write as many four letter words as possible that begin with the
letter "C". The total score is the number of words written in these two
trials.
Word Finding Test (36): In this test of verbal 'problem solving ability,
the study participant attempts to guess the identity of a word from its con-
texts within a series of five sentences. After hearing each sentence, the
participant is given five seconds to guess the word. Then the next sentences
are presented successively to provide additional clues about the word. After
the test is completed the participant is given a point for each time the word
is correctly identified within the five-second deadline. There are 20 words,
each with five trials. A maximum score of 100 is theoretically attainable.
Wisconsin Card Sorting Test (37,38): In this test of perseverative
thinking, the study participant is given a deck of cards with printed figures
-13-
-------
that vary in number (one to four), shape (circle, square, triangle, cross),
and color (red, green, blue, yellow). Each card in the deck is sorted to
one of four stimulus cards that vary along the same dimensions. After each
sort, the participant is told only "right" or "wrong". The participant is
never told the correct sorting rule, which initially is set as color. As
soon as the participant sorts 10 cards in a row to color, the sorting rule
is changed (without warning) to shape. Any further sorts to color are
counted as perseverative responses. Then, after the participant makes 10
consecutive sorts according to shape, the rule is changed (again, without
warning) to number; further sorts to shape are counted as perseverative.
The test proceeds in this fashion until the participant successfully sorts
through six rule changes, or until 128 cards are sorted (whichever occurs
first). The score is the total number of perseverative responses.
Modified Reitan Story Memory Test, Part A (39): This is a test of
verbal learning and memory. During the learning phase the study participant
listens to a tape recording of a short story and is asked to repeat as much
of the story as possible. If the participant cannot give a minimum of 15
of the 28 pieces of information in the story, up to 4 more learning trials
are given to reach this criterion. Memory testing for the story is done four
hours after the learning phase is completed. Efficiency of learning is
operationally defined as the number of learning trials necessary to reach the
above criterion. The memory score is the percent change in the amount of
information reported at the last learning trial and the amount of information
recalled four hours later.
Minnesota Multiphasic Personality Inventory (MMPI): The MMPI provides
objective measures of major dimensions of psychopathology: Hypochondriasis;
depression; hysteria; psychopathic deviance; paranoia; psychasthenia;
schizophrenia; and mania (40-42).
-14-
-------
Each participant and an adult relative were asked to independently rate
the participant's functioning with respect to many abilities, objectively
assessed by the neuropsychological test battery. These independent ratings
were completed using questionnaires developed by the staff at the UCMC Neuro-
psychology Laboratory. Although these rating scores were not expected to be
as sensitive as standardized laboratory tests, the rating scores were included
to provide additional evaluation of the participants' everyday functioning,
as perceived by the participants themselves and by their close relatives.
Statistical Analysis. As previously described, each case was carefully
matched with a control participant within each of the two geographic locations
in this study. If the grouping of study participants by geographic location
were ignored, the standard paired t-test would be the appropriate statistical
analysis of any single quantitative variable (for example, Average Impairment
Rating or Halstead Impairment Index). Whereas matching of cases and controls
was made on the basis of age, education, and socioeconomic level, differences
did exist among pairs with respect to age, education, and socioeconomic level.
Such differences were important in order to avoid limitations of the study to
a restricted age, education, or socioeconomic group.
The statistical analysis appropriate for the study design was an analysis
of variance procedure typically referred to as a split-plot analysis but, in
this study, more appropriately called a "split-pair" analysis (43). If
differences in age and education were to exist among the Colorado and Texas
participants, then geographic location would be a potential source of varia-
tion.
The primary neuropsychological scores were correlated with both the
plasma and the RBC cholinesterase values, as well as with the total organo-
chlorine pesticide residues.
-15-
-------
Data from the comprehensive neurological examination were qualitative
in that the results of each specific neurological test were typically
recorded as "normal" or "abnormal". For some neurological tests, the results
were classified in more than two categories. Because of the matching of cases
with controls in this study, the proper unit for statistical analysis was the
matched pair rather than the individual case. Thus, in the case of a dichot-
omous outcome, the appropriate statistical test was McNemar's chi-square test
rather than the usual unpaired chi-square test (44). In the case of a poly-
chotomous outcome, the Stuart chi-square test for matched-pairs was applied
(45).
In addition to the analysis of variance of each neuropsychological score,
the set of 34 neuropsychological variables (i.e., the subtests from the WAIS,
Halstead-Reitan, Peabody, and Added Ability batteries) were analyzed simul-
taneously via a multivariate analysis of variance procedure for matched-
pairs designs (46). To further evaluate differences between the case and
control cohorts, each of the above four batteries of neuropsychological tests
were statistically analyzed via the same multivariate analysis of variance
procedure.
-16-
-------
RESULTS
Demographic Data. The study population consisted of 100 matched pairs
(41 pairs from Colorado and 59 pairs from Texas). Except for one pair, all
study participants belonged to the white race. With respect to ethnic group
there were 14 pairs of Mexican-Americans (6 pairs from Colorado and 8 pairs
from Texas). Most of the Mexican-American study participants belonged to
the agricultural labor force.
All of the participants were male except one matched pair of females.
It was anticipated at the start of the study that a number of female pairs
would be recruited; although it was never a goal of the study to study sex
differences. However* only one female pair could be recruited for the
study.
Ninety-six percent of the organophosphate pesticide poisonings were
occupationally related, and four percent were nonoccupationally related. The
occupations of the cases are summarized in Table 1. Agricultural aircraft
mixers-loaders-flagmen, accounted for 38 of the 96 occupationally related
cases; agricultural aircraft pilots and mechanics accounted for 19 of the
cases; formulating plant employees, 13; farmers and ranchers, 11; agricultural
specialty workers (greenhouse, nursery and ornamental plant workers and
horticulturalists), 7; and farm laborers and field workers, 4. No pest
control operators were among the cases studies. Of the four cases non-
occupationally related, two were children at the time of poisoning, one was
a machinist, and the fourth was a college student.
Table 2 presents the age means and standard deviations for the case
and control study cohorts. The mean age for all participants at the time of
the study was approximately 35 years. The difference between the age means
for the study and control participants was approximately four months. The
-17-
-------
Table 1. Occupations of organophosphate pesticide poisoning cases.
Neuro-organophosphate Study, 1979.
Occupational Group
Occupational ly Related Cases
Formulating Plant Worker
Agricultural Chemical Sales
Commercial Applicator Related
Aircraft Mixer-Loader, Fl agger
Pest Control Operators (PCOs)
Aircraft Spray Pilot, Mechanic
Ground Sprayer Crew
Farmer/ Rancher
Agricultural Worker - Misc. Related
Farm Laborer, Field Worker
Greenhouse Operator, Nursery-Ornamental
Worker, Horticulturist
Non-occupational ly Related Cases
Child
Machinist
Student
Colorado
9
0
0
11
0
2
2
6
1
2
6
1
1
0
Texas
4
1
0
27
0
17
0
5
0
2
1
1
0
1
Total
13
1
0
38
0
19
2
11
1
4
7
2
1
1
TOTAL
100
-18-
-------
mean age for the participants from Colorado was 39 years; the participants
from Texas were somewhat younger. The age of the study participants ranged
from 16 to 66.
Table 2. Age means and standard deviations (S.D.) of
all study participants*. Neuro-organophos-
phate Study. 1979.
All
Participants
Colorado
Participants
Texas
Participants
Mean
Mean
S.D.
Mean
S.D.
Cases
35.01
12.53
38.85
12.02
32.34
12.28
Controls
35.28
13.02
39.20
12.28
32.56
12.92
Cases and
Controls
35.15
12.75
39.02
12.08
32.45
12.55
*Data is based on age at time of physical and neurological
examinations.
A summary of the Hollingshead Index of Social Position, a function of
both education and occupation, is shown in Table 3. The mean value calculated
for all participants was 3.05. Although the mean Hollingshead social class
value fell within the lower middle class scale, the Hollingshead values for
the matched pairs represented a much wider range of social class positions.
As measured by the Hollingshead Index, Colorado participants were from a
slightly lower social class position than Texas participants. The age and
Hollingshead Index of Social Position are listed for the 100 matched pairs
in the study in Table 4.
-19-
-------
Table 3. Mean Hollingshead social class and standard
deviation (S.D.) of case and control partici-
pants*. Neuro-organophosphate Study, 1979.
Cases and
Cases Controls Controls
Mean 3.22 2.88 3.05
All
Participants S.D. 1.50 1.71 1.61
Colorado
Participants
Texas
Participants
Mean
S.D.
Mean
S.D.
3.15
1.59
3.27
1.45
3.44
1.16
2.49
1.92
3.29
1.39
2.88
1.74
*Data is based on age at time of physical and neurological
examinations.
-20-
-------
Table 4. Age and Hollingshead social position scales for study participants
by matched pairs. Neuro-organophosphate Study, 1979.
Study
Pair No.
1
2
3
4
5
6
7
8
9
10
11
12
13
.14
15
Case or
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Age at
Interview
36
34
36
32
57
52
37
35
40
39
40
45
46
42
47
45
54
55
40
40
45
49
23
24
43
45
40
42
36
33
Hoi'
Education
Scale
5
4
2
1
5
3
2
4
5
4
1
1
3
3
3
3
6
4
3
3
4
4
5
4
5
6
4
3
4
5
lingshead Social Position
Occupation
Scale
5
5
3
3
4
4
2
2
3
4
1
1
2
2
3
4
3
5
4
3
2
2
5
6
3
3
3
3
4
5
Index
Score
55
51
29
25
48
40
22
30
41
44
11
11
26
26
33
40
45
51
40
33
30
30
55
58
41
45
37
33
44
55
Social
Class
IV
IV
III
II
IV
III
II
III
III
IV
I
I
III
III
III
III
IV
IV
III
III
III
III
IV
IV
III
IV
III
III
IV
IV
-21-
-------
Table 4. (Continued)
Study
Pair No.
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Case or
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Age at
Interview
39
42
25
28
55
56
25
26
52
53
62
66
41
44
19
19
57
57
35
34
39
44
22
23
39
39
38
40
18
19
Holl
Education
Scale
3
3
4
4
2
2
4
4
2
3
6
6
4
4
4
4
3
3
2
3
6
6
3
3
3
3
7
7
4
4
lingshead Social Position
Occupation
Scale
5
4
5
4
3
3
6
6
2
3
7
5
4
3
7
7
4
3
4
3
5
6
7
5
5
5
7
7
7
7
Index
Score
47
40
51
44
29
29
58
58
22
33
73
59
44
37
65
65
40
33
36
33
59
66
61
47
47
47
77
77
65
65
Social
Class
IV
III
IV
IV
III
III
IV
IV
II
III
V
IV
IV
III
V
V
III
III
III
III
IV
V
V
IV
IV
IV
V
V
V
V
-22-
-------
Table 4 • (Continued)
Hollingshead Social Position
Study
Pair No.
31
32
33
34
35
36
37*
38
39
40
41
Case or
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Age at
Interview
36
35
19
19
44
46
48
44
23
22
36
34
19
20
46
45
48
48
26
26
62
64
Education
Scale
6
6
4
4
4
4
4
4
4
4
2
3
4
4
5
4.
1
2
4
4
4
4
Occupation
Scale
6
4
6
6
4
5
4
4
5
6
2
3
4
4
6
7
1
2
3
5
5
5
Index
Score
66
52
58
58
44
51
44
44
51
58
22
33
44
44
62
65
11
22
37
51
51
51
Social
Class
V
IV
IV
IV
IV
IV
IV
IV
IV
IV
II
III
IV
IV
V
V
I
II
III
IV
IV
IV
* Female pair.
-23-
-------
Table 4. (Continued)
Hoi 1 ings head Social Position
Study
Pair No.
42
43
44
45
46
47
48
49
50
51
52
53
54
Case or
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Age at
Interview
54
60
36
33
22
23
22
25
49
48
21
22
50
48
51
54
27
29
47
53
27
29
16
17
35
35
Education
Scale
3
4
1
1
4
4
4
4
5
4
4
4
4
4
1
2
2
2
1
1
5
3
5
5
1
1
Occupation
Scale
3
5
1
1
5
5
5
5
3
5
5
7
4
4
2
3
3
3
1
2
5
6
7
7
1
1
Index
Score
33
51
11
n
51
51
51
51
41
51
51
65
44
44
18
29
24
29
11
18
55
34
69
69
11
11
Social
Class
III
IV
I
I
IV
IV
IV
IV
III
IV
IV
V
IV
IV
II
III
II
III
I
II
IV
III
V
V
I
I
-24-
-------
Table 4. (Continued)
Hollingshead Social Position
Study
Pair No.
55
56
57
58
59
60
61
62
63
64
65
66
67
Case or
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Age at
Interview
53
54
34
31
26
26
26
24
22
20
25
26
23
23
36
36
27
29
29
32
39
42
25
25
31
30
Education
Scale
7
4
3
3
4
3
2
2
6
6
3
4
3
4
2
3
3
3
4
4
4
4
3
3
3
3
Occupation
Scale
2
3
5
2
6
7
4
3
5
6
4
6
5
5
3
4
3
3
3
6
4
2
5
3
5
3
Index
Score
42
37
47
26
58
61
36
29
59
66
40
58
47
51
29
40
33
33
37
58
44
30
47
33
47
33
Social
Class
III
III
IV
II
IV
V
III
III
IV
V
III
IV
IV
IV
III
III
III
III
III
IV
IV
III
IV
III
IV
III
-25-
-------
Table 4. (Continued)
Study
Pair No.
68
69
70
71
72
73
74
75
76
77
78
79
80
Case or
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Age at
Interview
19
19
47
47
27
24
25
25
28
32
17
17
27
27
27
28
22
21
23
24
26
28
17
17
20
19
Hn'
Education
Scale
4
5
6
5
4
2
3
3
5
3
5
5
2
2
4
4
3
3
5
7
4
3
4
4
6
5
l1ing«;hpaH ^nr-
Occupation
Scale
7
6
4
6
6
4
3
4
6
7
7
7
4
3
5
5
4
4
6
7
4
3
5
7
5
7
ial Pn<: it-
Index
Score
65
62
52
62
58
36
33
40
62
61
69
69
36
29
51
51
40
40
62
77
44
33
51
65
59
69
ion
Social
Class
V
V
IV
V
IV
III
III
III
V
V
V
V
III
III
IV
IV
III
III
V
V
IV
III
IV
V
IV
V
-26-
-------
Table 4. (Continued)
Hollingshead Social Position
Study
Pair No,
81
82
83
84
85
86
87
88
89
90
91
92
93
Case or
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Age at
Interview
22
23
19
18
29
28
56
55
50
51
52
53
55
56
47
48
26
27
64
66
56
57
31
26
23
22
Education
Scale
3
2
5
4
2
2
4
3
4
4
2
2
3
3
3
3
3
3
3
4
4
3
2
2
4
3
Occupation
Scale
3
2
5
7
2
2
4
3
7
5
3
1
3
2
3
4
5
4
3
3
4
7
3
2
5
7
Index
Score
33
22
55
65
22
22
44
33
65
51
29
15
33
26
33
40
47
40
33
37
44
61
29
22
51
61
Social
Class
III
II
IV
V
II
II
IV
III
V
IV
III
I
III
II
III
III
IV
III
III
III
IV
V
III
II
IV
V
-27-
-------
Table 4 . (Continued)
Hollinqshead Social Position
Study
Pair No.
94
95
96
97
98
99
100
Case or
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Case
Control
Age at
Interview
29
29
29
32
27
25
22
20
28
25
34
34
27
29
Education
Scale
3
2
2
2
3
3
4
4
3
3
3
4
4
4
Occupation
Scale
4
2
1
2
5
5
5
5
5
4
5
5
7
3
Index
Score
40
22
13
22
47
47
51
51
47
40
47
51
65
37
Social
Class
III
II
I
II
IV
IV
IV
IV
IV
III
IV
IV
V
III
-28-
-------
Acute Organophosphate Pesticide Poisoning Histories. The year of the
primary OP pesticide poisoning reported by the case participants ranged from
1950 to 1976. There were 11 participants in the case cohort who reported
more than one noteworthy OP pesticide poisoning: eight of these experienced
two poisonings, one experienced three poisonings, and two reported four
poisonings. One case reported a poisoning as early as July 1948. Documentary
information usually was not available on the multiple poisonings other than
for the primary incident.
The mean time for all cases from the primary poisoning to the time of
the neurological and neuropsychological examinations was about nine years.
The time from the index poisoning incident to the date of the neurological
and psychological examinations is important because examination close to the
time of poisoning could be measuring adverse results which were, in fact,
reversible acute poisoning responses rather than long-term effects. The
elapsed time from the last poisoning case to the date of neuropsychological
examination is given in Table 5 below for the case cohort. There was a longer
mean elapsed time for the Colorado cases, 4228 days (about 11 years, 7 months)
than for the Texas cases, 2574 days (about 7 years, 19 days). The mean
elapsed time from the date of the last poisoning case to neuropsychological
Table 5. Elapsed time in days from last poisoning to
neuropsychological examination. Neuro-
organophosphate Study, 1979.
All cases
Colorado
Texas
Number
of Cases
100
41
59
Range
117-9640
650-8065
117-9640
Mean
3252
4228
2574
-29-
-------
testing for all cases was 3252 days (about 8 years, 11 months). The shortest
time period from date of poisoning to date of examination was 117 days. It
is of interest that the RBC and plasma cholinesterase values on this person
were well within the normal range at the time of the study examinations.
Among the 100 case participants, 10 different OP pesticides were impli-
cated as the cause of the primary poisoning (Table 6). Detailed information
on these chemicals, such as chemical structure, toxicity, and uses is given
in Appendix F. Methyl parathion was implicated in 54 cases, more than any
other chemical; ethyl parathion was implicated in 42 poisonings. These two
chemicals accounted for 79% of the total episodes. The two chemicals are
very similar in structure, toxicological effects, in practical field use, and
sometimes they are applied in combination. Their predominance as a cause
of human poisoning may be explained by the fact that they have been in use
for a number of years, are highly toxic, and are among the most widely used
pesticides in the United States. All of the incidents involving methyl
parathion were among the Texas case participants, whereas ethyl parathion was
involved in poisonings in both Colorado and Texas.
Physical Examination and Clinical Laboratory Data. Abnormalities
detected during the physical examinations were recorded on the physical exam
forms (Appendix D). Table 7 summarizes the findings of the physical exami-
nation of case and control participants. Abnormalities were observed by the
examining physicians in 11 of the 15 categories on the physical examination
forms. Slightly more abnormalities were observed among the controls (48)
than among the cases (44), but the difference was not statistically signifi-
cant.
-30-
-------
Table 6. Organophosphate pesticides implicated in the primary
poisoning incidents*. Neuro-organophosphate Study,
Number of Cases
OP Pesticide
Methyl parathion
Para th ion
Disulfoton (Di-Syston)
Malathion
Mevinphos (Phosdrin)
Dicrotophos (Bidrin)
TEPP
Dioxathion (Delnav)
DEF
Phorate (Thimet)
TOTAL
Colorado
0
24
8
6
5
1
1
0
0
1
Texas
54
18
0
0
0
1
1
1
1
0
Total
54
42
8
6
5
2
2
1
1
1
122
*The occurrence of OP pesticides exceeds the number of cases in the
study because more than one OP pesticide was implicated in some
incidents.
-31-
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Table 7 . Summary of abnormal conditions identified in participants during
physical examination. Neuro-organophosphate Study, 1979.
n = 98 pairs
Category
General appearance
Skin
Head
Ears
Eyes
Nose
Mouth
Neck
Thorax
Breasts
Lungs
Heart
Vessels
Abdomen
Skeletal
Cases
3
10
0
2
3
0
0
0
0
1
7
2
3
2
11
Controls
1
11
0
0
4
0
0
0
1
0
7
4
6
4
10
Total
4
21
0
2
7
0
0
0
1
1
14
6
9
6
21
Total 44 48 92
-32-
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Skin and skeletal were the two most frequently recorded abnormalities
as each abnormality was observed 21 times. Abnormalities in the category of
the lungs was the third highest and occurred in 7% of the participants.
Abnormal breath sounds was the dominant finding among the lung abnormalities.
The frequency of occurrence of abnormalities in the other categories were
varied and no abnormalities were found in four categories. However, the
slight differences between cases and controls with respect to the physical
examination categories were not statistically significant.
Although no participants were excluded from the study due to physical,
audiometric, ophthalmic, or clinical blood examination results, three poten-
tial participants were excluded from the study because of previous medical
conditions identified during the medical history taken by the examining
physician.
Clinical Laboratory Results. The blood samples collected from the study
participants were evaluated using standard laboratory tests (Appendix D).
The results of 28 different laboratory tests were recorded for each partici-
pant. Results were recorded as normal and abnormal. Statistical analysis
of the hematology, creatinine, and urea nitrogen test results were based on
the chi-square test for matched pairs, as described in the Methods section.
None of these chi-square tests were statistically significant (Table 8).
Neurological Data. The neurological testing was an important aspect of
this study and included two categories: neurological examinations and the
electroencephalographic examinations. The neurological examinations shown
in Appendix D consisted of the following parts: mental status, cranial
nerves, motor system, sensory system, and integrative functions.
The electroencephalogram (EEG) is a relatively subtle indicator of
structural and functional integrity of the cerebral cortex. Evaluation of
-33-
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Table 8. Summary of the statistical comparison of the cases
and controls with respect to selected laboratory test
variables. Neuro-organophosphate Study, 1979.
Test Variable
Lab Tests
White blood cells
Red blood cells
Hemoglobin
Hematocrit
Lymphocytes
Eosinophiles
Urea nitrogen
Creatinine
Degrees of
Freedom
2
2
2
2
2
1
2
2
Chi-square
Statistic
2.00
.80
2.82
3.27
.04
1.23
2.14
1.93
p- Level
.368
.670
.244
.195
.980
.267
.343
.381
the EEG is usually a subjective process depending on pattern recognition by
the electroencephalographer. Recognition and descriptions of specific
patterns are often based on scientific intuition. The EEG has been an
important tool in determining overall cortical function in many clinical
and research situations.
Quantitative techniques of EEG evaluation recently have been developed.
One of the most important of these techniques is power spectral analysis. In
this technique, a channel of EEG data is recorded on FM magnetic tape. It is
subsequently converted to digital form for computer processing. In the com-
puter, epochs of data (usually 4 to 8 seconds length) undergo fast Fourier
analysis which results in a histogram displaying the energy distribution over
constituent frequencies within that epoch. Sequential epochs can be "stacked1
into a quasi-three dimensional display called a compressed spectral array by
-34-
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further computer processing. This gives a precise and accurate visual represen-
tation of the ongoing distribution of electrical energy within the frequency
spectrum of the EEG. Variability of this distribution also can be clearly
seen. This allows the EEG to be described in much more quantitative terms.
Thus, the power spectral array can be interpreted as showing "predominant
activity of 6 Hz with an approximately 1 Hz variability". Participant data
were referred to the EEG laboratory at UCMC for both routine clinical and
power spectral EEG analysis. Each subject was assigned a random number code
by the technician so that the neurology specialists were able to read the
records blind. The routine EEG was read in the usual manner by visual
analysis. During the early stage of the study, this was accompanied by the
power spectral plot and additional descriptive interpretation when appropriate.
During the later stages of the study, this was not possible due to instrumen-
tation problems.
Based on the visual analysis of EEG, as well as the descriptive inter-
pretation of the EEG, each study participant's EEG results were categorized
as normal or as abnormal (mild, moderate or severe). Analyses of the electro-
encephalogram results yielded a 1.06 chi-square value (p=.589, 2 degrees of
freedom); this value was not significant (Table 9).
Table 9. Summary of the results of the encephalogram (EEG)
evaluation of case and control participants.
Neuro-organophosphate Study, 1979.
Abnormal
Cases
Controls
Moderate
2
1
Mild
14
10
Normal
83
88
Tota
99
99
-35-
-------
Table 10 shows the summary of the statistical comparison of the cases
and controls with respect to mental status, cranial nerves and motor system.
The following six tables (Tables 11-16) contain a summary of the data used
.in calculating the chi-square values in summary Table 10. The mental status
evaluation was abnormal in 64 of 99 case participants. On the other hand,
45 out of 99 control participants had a mental status summary score of
abnormal in this important category. Based on the matched-pairs analysis,
this difference between the two cohorts was highly significant (p=.013t).
There were several components of the overall Mental Status evaluation:
State of Consciousness; Orientation; Language; Memory; Serial Subtraction;
Abstraction; and Mood. The results of the neurological evaluation of these
components of mental status are summarized in Table 11. Although the state
of consciousness results showed the cases to be more anxious than the controls,
the difference between these groups was not statistically significant. With
respect to Orientation (Time; Place; and Person) and Language (Pressure and
Structure), there was little or no difference between the cases and controls
(Table 10). Similarly, for three parts of the Memory evaluation (Numbers
Forward; Numbers Backward; and Remote Memory), the difference between cases
and controls was not statistically significant. However, one part of the
Memory component (Three-Pairs-of-Item) showed over twice as many abnormal
classifications in the cases as in the controls. Based on the matched-pairs
analysis, there was no significant difference between the cases and controls
in Serial Subtraction component. Of the ten abnormal classifications in
the Abstraction category, nine belonged to the case cohort (p=.028). The
neurological evaluation of Mood is an important aspect of Mental Status. It
is of considerable interest that six of the case participants and none of the
control participants were classified as "depressed" (p=.0003).
-36-
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The cranial nerve summary score (Table 10) showed no significant differ-
ence between the case and control participants. The individual components
of the, cranial nerve summary score such as bilateral neurosensory hearing,
eye mobility and sense of smell were not found to be significantly different
between the two cohorts. Table 12 shows that 64 cases were normal on the
cranial nerve summary score and that 59 controls were normal.
The motor system summary score is based on 23 components (see Appendix
D). Although there were no significant differences between the case and
control cohort summary scores (Table 10), the results of the individual
components did show some differences. In particular, in the knee jerk test,
the case cohort was significantly different from the control cohort (p=.024).
However, in the ankle jerk test, the difference between the case and control
cohorts is not statistically significant. The data on the selected components
of the motor system are presented in Tables 14 and 15, and the data on the
motor system summary score are presented in Table 16.
-37-
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Table 10. Summary of the statistical comparison of the cases and controls
with respect to mental status, cranial nerves, and motor system.
Neuro-organophosphate Study, 1979.
Test Variable
MENTAL STATUS
Mental Status Score
State of Consciousness
Orientation
Time
Place
Person
Language
Pressure
Structure
Memory
Numbers Forward
Numbers Backward
Three Pairs of Items
Remote
Serial Subtraction
Abstraction
Mood
CRANIAL NERVES
Cranial Nerve Score
MOTOR SYSTEM
Right and Left Knee Jerk
Right and Left Ankle Jerk
Motor System Score
Degrees of
Freedom
1
1
1
1
1
1
1
1
1
1
1
2
1
2
2
8
7
2
Chi -Square
Statistic
6.35
0.07
0.00
0.00
0.00
0.00
0.00
0.55
3.03
7.50
0.00
3.08
4.90
18.00
1.41
17.64
8.52
2.90
P-
Value
.013
.791
.481
.086
.006
.290
.028
.001
.494
.024
.289
.235
-38-
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Table 11. Evaluation of case and control participants with respect to the
summary and components of the mental status test of the neuro-
logical examination. Neuro-organophosphate Study, 1979.
Test Variable
Mental Status
Summary Cases
Controls
Orientation
Time Cases
Controls
Place Cases
Controls
Person Cases
Control s
Language
Pressure Cases
Controls
Structure Cases
Control s
Memory
Numbers Forward Cases
Controls
Numbers Backward Cases
Controls
Abnormal
64
45
1
0
0
1
0
0
0
1
0
0
23
18
25
14
Normal
35
54
98
99
99
98
99
99
99
98
99
99
76
81
74
85
Total
99
99
99
99
99
99
99
99
99
99
99
99
99
99
99
99
-39-
-------
Table 11 (continued)
Test Variable
Abnormal
Normal Total
Memory (continued)
Three Pairs of Items
Remote
Serial Subtraction
Abstraction
Cases
Controls
Cases
Controls
Cases
Controls
Cases
Controls
30
14
0
0
28
21
9
1
69
85
99
99
71
78
90
98
99
99
99
99
99
99
99
99
-40-
-------
Table 12. Evaluation of case and control participants with respect to the
state of consciousness and mood from the mental status test of
the neurological examination. Neuro-organophosphate Study,
1979.
Test Variable
Normal
Total
State of Consciousness
Cases
Controls
Mood Euphoric
Cases 1
Controls 0
8 91
6 93
Depressed Normal
6 92
0 99
99
99
99
99
Table 13. Evaluation of case and control participants with respect to the
cranial nerve score test of the neurological examination. Neuro-
organophosphate Study, 1979.
Abnormal
Cases
Controls
Normal
64
59
Nonsignificant
9
7
Significant
26
33
Total
99
99
-41-
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Table 14. Evaluation of case and control participants with respect to the
knee jerk (right and left combined) test of the neurological
examination. Neuro-organophosphate Study, 1979.
Cases
Controls
One 0
Other 0
2
2
One 0 One 1 One 1 One 2
Other 1 Other 1 Other 2 Other 2
1 75 9 10
6 64 9 16
Total
95
97
0 = Absent
1 = Normal
2 = Hyperactive
Table 15. Evaluation of case and control participants with respect to the
ankle jerk (right and left combined) test of the neurological
examination. Neuro-organophosphate Study, 1979.
One 0 One 0 One 1
Other 0 Other 1 Other 1
Cases 3 10 75
Controls 6 10 67
One 1 One 2
Other 2 Other 2 Total
1 8 97
0 14 97
0 = Absent
1 = Normal
2 = Hyperactive
Table 16. Evaluation of case and control participants with respect to
the motor system score test of the neurological examination.
Neuro-organophosphate Study, 1979.
Abnormal
Normal
Nonsignificant
Significant
Total
Cases
Controls
61
54
8
16
30
29
99
99
-42-
-------
The sensory system was further evaluated through a series of 10
different tests. The tests included response to pin pricks, touch, vibra-
tion, position identification, discrimination, graphesthesia, and stereog-
nosis (Appendix D). Table 17 summarizes the results of the statistical
analyses of the sensory system tests and the sensory system summary score.
There were no statistically significant differences between the case and
control cohorts on any of these tests or on the sensory system summary score.
Tables 18-24 contain the summary results of the sensory system tests.
Analyses showed there were slight differences in the pin prick lower left
extremity where a total of 96 controls were normal compared to 89 cases that
were normal (Table 21), but the results were not statistically significant
at the 5% level.
Table 17. Summary of the statistical comparison of the cases
and controls with respect to the sensory system.
Neuro-organophosphate Study, 1979.
Test Variable
SENSORY SYSTEM
Pin Upper Right Extremity
Pin Upper Left Extremity
Pin Lower Right Extremity
Pin Lower Left Extremity
Vibration, Right
Vibration, Left
Sensory System Score
Degrees of
Freedom
5
5
3
3
4
5
2
Chi -Square
Statistic
5.20
8.00
3.20
7.00
5.10
4.03
3.54
P-
Level
.392
.156
.362
.072
.277
.545
.170
-43-
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Table 18. Evaluation of case and control participants with respect to the pin upper right
extremity test of the neurological examination. Neuro-organophosphate Study, 1979.
Cases
Controls
Table 19.
Cases
Controls
Normal
94
92
Evaluation
extremity
Normal
93
95
Mild
0
2
of case
test of
Mild
0
2
Peripheral
Moderate
1
0
Severe
1
0
and control participants with
the neurological examination.
Peripheral
Moderate
1
0
Severe
1
0
Mild
2
3
Focal
Moderate Severe
0 0
1 Q
respect to the pin upper left
Neuro-organophosphate Study,
Mild
3
0
Focal
Moderate Severe
0 0
1 0
Total
98
98
1979.
Total
98
98
-------
Table 20. Evaluation of case and control participants with respect to the pin lower right
extremity test of the neurological examination. Neuro-organophosphate Study, 1979.
in
Cases
Controls
Table 21.
Cases
Control s
Normal
91
95
Evaluation
extremi ty
Normal
89
96
Mild
0
0
of case
test of
Mild
0
0
Peripheral
Moderate
2
0
Severe
1
0
and control participants wi
the neurological examination
Peripheral
Moderate
3
0
Severe
1
0
Mild
3
2
Focal
Moderate
0
0
Severe
0
0
th respect to the pin lower left
. Neuro-organophosphate Study,
Mild
4
1
Focal
Moderate
0
0
Severe
0
0
Total
97
97
1979.
Total
97
97
-------
Table 22. Evaluation of case and control participants with respect to the vibration, right test
of the neurological examination. Neuro-organophosphate Study, 1979.
Cases
Controls
Table 23.
Cases
Controls
Normal
74
66
Mild
10
13
Evaluation of case
of the neurological
Normal
70
65
Mild
13
16
Peripheral
Moderate
6
8
Severe
1
0
Mild
0
0
and control participants with respect
examination. Neuro-organophosphate
Peripheral
Moderate
5
6
Severe
1
0
Mild
2
2
Focal
Moderate Severe
0 0
2 0
to the vibration, left
Study, 1979.
Focal
Moderate Severe
0 0
2 0
Total
91
91
test
Total
91
91
-------
Table 24. Evaluation of case and control participants with respect to the
sensory system score of the neurological examination. Neuro-
organophosphate Study, 1979.
Abnormal
Cases
Control s
Normal
66
62
Nonsignificant
2
1
Significant
30
35
Total
98
98
-47-
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Table 25 is a summary of the matched-pairs analyses of selected integra-
tive function tests and other miscellaneous examinations. Appendix D includes
these esamination forms. A total of seven Individual component tests were
used in the integratiye function summary scores. These included posture,
balance, gait, cerebellar such as finger to nose, heel to shin, etc. Tables
26-29 show the normal and abnormal scores for the cases and controls in the
individual component tests. The integrative function summary score showed
that there were 77 cases normal and 85 controls normal out of 99 matched
pairs. Results of the summary score for the integrative function tests showed
no significant differences between the case and control cohorts.
Other miscellaneous examinations included examination of the skull,
carotids and back. These examinations are also included in Appendix D.
Based on the chi-square test for matched pairs (Table 25), there was no sta-
tistical difference between the case and control cohorts on the summary score
for other miscellaneous examinations (Table 24). As seen from Table 29,
there were 98 cases normal on the other miscellaneous examination summary
score and 95 controls who were classified as normal.
Table 25. Summary of the statistical comparison of the cases
and controls with respect to integrative function
and other miscellaneous examinations. Neuro-
organophosphate Study, 1979.
Test Variable
Finger-nose Right
Finger-nose Left
Integrative Function Score
Other Misc. Exam Scores
Degrees of
Freedom
3
3
2
2
Chi -Square
Statistic
3.92
0.60
3.38
2.00
P-
Level
.270
.896
.185
.368
-48-
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Table 26. Evaluation of case and control participants with respect to the finger-nose right test
of the neurological examination. Neuro-organophosphate Study, 1979.
VO
I
Abnormal Peripheral Abnormal Focal
Cases
Controls
Table 27.
Normal Mild
85 10
88 5
Evaluation of case
of the neurological
Moderate
0
2
and control
examination
Severe Mild
0 1
0 1
participants with respect
. Neuro-organophosphate
Moderate Severe
0 0
0 0
to the finger-nose
Study, 1979.
Total
96
96
left test
Abnormal Peripheral Abnormal Focal
Cases
Control s
Normal Mild
86 7
87 5
Moderate
2
3
Severe Mild
0 1
0 1
Moderate Severe
0 0
0 0
Total
96
96
-------
Table 28. Evaluation of case and control participants with respect to
the integrative function score of the neurological examina-
tion. Neuro-organophosphate Study, 1979.
Abnormal
Cases
Controls
Normal
77
85
Nonsignificant
2
0
Significant
20
14
Total
99
99
Table 29. Evaluation of case and control participants with respect to
other miscellaneous exam scores of the neurological examina-
tion. Neuro-organophosphate Study, 1979.
Abnormal
Cases
Control s
Normal
98
95
Nonsignificant
1
3
Significant
0
1
Total
99
99
-50-
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Neuropsychological Findings. Results of neuropsychological evaluations
sre presented in this section according to three subdivisions: objective
tests administered in the neuropsychological laboratory; results of the
participant-completed Patient Assessment of Own Functioning Inventory which
was administered at the time of neuropsychological examination; and results
of the Relative's Assessment of Patient-Functioning Inventory that was com-
pleted at the time of interview. As mentioned previously, these data were
analyzed via an analysis of variance procedure specific to designs involving
matched-pairs. The detailed results of the analysis of variance of the
neuropsychological test battery and the MMPI are presented in Appendix F.
These results are summarized in Tables 30-32, which present the mean score
for the case and control cohorts and the probability-level (p-level) for the
analysis of variance test comparing the case and control means.
Results of the Halstead-Reitan Battery revealed that the case cohort was
significantly more impaired than the control cohort on both summary measures
(Average Impairment Rating and Halstead Impairment Index). Although both of
the group means are in the normal range on these measures, 24 of the cases
and only 12 of the controls obtained scores in the "impaired" range on one or
both of the measurements. That is, on the basis of previously validated
limits (1.55 for the Average Impairment Rating and 0.5 for the Halstead Index),
twice as many case participants as control participants showed an overall
level of neuropsychological deficit that is within the range characteristic
of individuals with documented cerebral lesions. Based on the matched-pairs
chi-square analysis, this difference between the case and control cohorts was
statistically significant (p <.05). In the Halstead-Reitan battery, the
performance level of the cases was lower than that of the controls on nine
of the eleven individual tests; however, the difference between case and
-51-
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Table 30. Psychological test score means, standard error of the difference
of means, and the probability level of the analysis of variance
test for the case-control comparison for the Halstead-Reitan
Battery and the WAIS Battery. Neuro-organophosphate Study, 1979.
Variable
Neuropsychological Summary Scores
Average Impairment Rating
Hal stead Impairment Index
WAIS Verbal IQ
WAIS Performance IQ
WAIS Full Scale IQ
Halstead-Reitan Battery
Category
Trails-B
Speech Sounds Perception
Seashore Rhythm
Tactual Performance-Memory
Tactual Performance-Location
Tactual Performance-Time
Finger Oscillation Test3
Perceptual Disorders'^
Aphasia Exam'3
Snatial Relations'5
WAIS Subtest Scaled Scores
Information
Comprehension
Arithmetic
Similarities
Digit Span
Vocabulary
Digit Symbol
Picture Completion
Block Design
Picture Arrangement
Object Assembly
Means
Cases
1.07
0.30
105.40
108.41
107.05
39.55
75.31
7.78
26.65
7.62
4.57
13.07
100.80
4.68
5.59
2.81
10.73
11.32
11.15
11.10
9.80
10.49
9.71
11.13
11.24
10.02
10.60
Controls
0.91
0.23
111.86
110.13
111.77
31.57
67.72
5.92
27.16
7.78
4.45
11.88
103.69
4.17
4.55
2.71
11.83
12.13
12.40
12.09
10.95
11.68
10.64
11.00
11.75
9.95
10.72
S.E. p-level*
,05
.03
1.31
1.46
1,32
2.59
4.09
.51
.33
.17
.25
.77
1.41
.63
.58
.13
.28
.34
.32
.31
.43
,30
,26
,28
.38
,35
.33
<.001
.020
<.001
.242
<.001
.002
.067
.001
.120
.125
.042
.075
:.001
.020
:.001
.002
.008
:.001
:.001
.187
a) Scores summed for both hands
b) Ratings defined in Russell e_t al_. (1970)
The p-level is not shown if the F-ratio is less than unity.
-52-
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Table 31. Psychological test score means, standard error of the difference
of means, and the probability level of the analysis of variance
test for the case-control comparison for the Peabody Individual
Achievement Test and Added Ability Tests. Neuro-organophosphate
Study, 1979.
Variable
Peabody Individual Achievement Test
Reading Recognition
Reading Comprehension
Spelling
Added Ability Tests
Tactile Form Recognition3
Hand Dynamoneter
Grooved Pegboard9
Hole-Type Steadiness .
Wisconsin Card Sorting Test
Thurstone Word Fluency-Total
Word Finding Testc
Story Memory Test-Learning
-Memory
Means
Cases
29.00
54.32
35.19
20.34
96.87
148.34
59.39
17.07
43.92
36.04
1.87
.11
Controls
36.71
63.06
45.81
19.98
97.34
137.96
62.82
12.91
50.79
40.36
1.67
.10
S.E. p-level*
2.32
3.26
3.65
,75
,93
,26
6.76
.18
.33
.33
.02
.10
.001
.008
.004
.002
.001
.003
.002
.045
(a) Scores summed for both hands
(b) Score available for 91 of 100 pairs
(c) Score abailable for 99 of 100 pairs
* The p-level is not shown if the F-ratio is less than unity.
-53-
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Table 32. Psychological test score means, standard error of the difference
of means, and the probability level of the analysis of variance
test for the case-control comparison for the MMPI Battery.
Neuro-organophosphate Study, 1979.
Means
MMPI (T-Scores)
Lie (L)
Validity (F)
Defensiveness (K)
Hypochondriasis (Hs)
Depression (D)
Hysteria (Hy)
Psychopathic Deviate (Pd)
Masculinity Femininity (Mf)
Paranoia (Pa)
Psychasthenia (Pt)
Schizophrenia (Sc)
Hypomania (Ma)
Social Introversion (Si)
Cases Controls
p-level*
50.62
56.42
50.68
52.47
55.72
54.00
56.65
56.25
56.40
56.70
56.02
58.95
53.83
49.30
53.36
54.79
52.94
54.28
57.12
56.41
55.97
54.00
55.32
53.45
57.21
50.65
1.04
1.25
1.23
1.40
1.57
1.21
1.45
1.23
1.21
1.47
1.57
1.32
1.30
.114
.008
.018
.202
.095
.027
.200**
.058**
.119
.050
*The p-level is not shown if the F-ratio is less than unity.
**The p-level for the F-test for interaction in the analysis of variance was
significant at the 5% level of significance.
-54-
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control means was significant in only three of these nine tests. When com-
pared to their matched controls, the cases showed impairment on tests of
logical analysis and abstract reasoning (Category Test), fine discrimina-
tion among isolated speech sounds (Speech-Sounds Perception Test), and motor
speed with the upper extremities (Finger Oscillation Test); although not
statistically significant, the cases showed some impairment on tests of
efficiency in following sequential procedures (Trail Making Test, Part B)
and language skills (Aphasia Exam). There was no difference between the two
cohorts on the Sensory Perceptual Examination.
In general, both cohorts showed above average intellectual functioning
on the WAIS. However, the case cohort obtained a mean Full Scale IQ that was
almost five points lower than the mean of the control cohort. This difference
was highly significant (p <.001). The case cohort also did significantly
worse than the controls on all six verbal subtests and on one of the five
performance subtests (Digit Symbol).
The case cohort also performed at a significantly lower level than the
controls on the Reading Recognition, Reading Comprehension, and Spelling sub-
tests of the Peabody Individual Achievement Test. Cohort differences were
also significant on five of the ten "added" ability tests: tests of written
verbal fluency (Thurstone Word Fluency Test), verbal problem solving ability
(Word Finding Test), perserverative thinking (Wisconsin Card Sorting Test),
fine motor coordination with the upper extremities (Grooved Pegboard Test),
and learning (Story Memory Test-Learning). The case and control cohorts did
not differ significantly in the test of memory (Story Memory Test-Memory).
Although the mean scores from the MMPI are well within normal limits for
both case and control cohorts, results of four of the thirteen scales were
statistically significant. The differences on the Validity (F) and Defen-
siveness (K) scales do not imply any problems with the validity of either
-55-
-------
group's profiles, but they do suggest that the case participants were some-
what more likely than the controls to report emotional problems on the MMPI.
In addition, the case participants scored higher than the controls on the
MMPI Paranoia and Social Introversion scales. These findings suggest slightly
greater social anxiety and tendencies towards suspiciousness and/or sensi-
tivity to criticism or to other social stresses among the cases.
Table 33 summarizes the results of the statistical comparisons between
cohorts on the Patient Assessment of Own Functioning Inventory. Significant
cohort differences were obtained on 11 of the 32 items. All of the signifi-
cant differences indicated that the case cohort reported more problems with
their everyday functioning than did their matched pair.
It is also of interest that there appears to be some relationship between
the specific problem areas mentioned in the self-reports completed by case
participants and those cases shown to be most impaired on formal objective
testing in the neuropsychological laboratory. Thus, when compared to those
of the controls, the patient assessment of own functioning from the case
cohort disclosed somewhat more difficulty with verbal comprehension, word
finding abilities, reading and math skills, general problem solving, efficiency
in following directions and instructions, and manipulatory efficiency. Further-
more, the case cohort participant gave evidence of relative impairment in all
of these areas of formal neuropsychological testing. By contrast, there was
no difference between the case and control cohorts with respect to self-
assessments of memory; this result agrees with a similar result (i.e., no
significant difference) in the formal objective testing of memory abilities.
The statistical results for each of 32 items used in the Patient Assessment of
Own Functioning Inventory are presented in detail in Appendix G.
-56-
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Table 33. Patient's Assessment of Own Functioning: Test Score Means, Pooled Estimate of the Standard
Error (S.E.) of Each Mean, and Probability Level of the Analysis of Variance Test for the
Case Control Comparison. Neuro-organophosphate Study, 1979.
en
^j
i
Patient Self-Report: Memory
For verbal communications in last day or two
For events occurring in last day or two
For people met in last day or two
For things known a year or more ago
For people met a year or more ago
Losing track of time
Forgetting what patient is doing
Forgetting how to do things
Losing things by forgetting where they are
Forgetting obligations
Patient Self-Report: Language and Communication
Difficulties understanding speech of others
Difficulties recognizing printed or written words
Difficulties understanding reading material
Difficulties with enunciation
Difficulty thinking of names of things
Other word finding difficulties
Difficulty forming letters correctly
Difficulty spelling
Means
Cases
1.95
1.22
1.46
1.93
1.91
1.43
.79
.90
1.98
1.31
1.71
1.22
1.14
1.66
2.02
1.93
1.28
1.77
Controls
1.77
1.06
1.30
2.04
1.98
1.40
.76
.72
1.95
1.37
1.31
.80
.76
1.41
1.73
1.83
1.05
1.42
S.E.
.10
.11
.14
.12
.13
.11
.10
.09
.11
.11
.11
.11
.12
.13
.10
.14
.13
.14
P-level*
.210
.310
.014
.008
.024
.163
.037
.224
.071
-------
en
oo
Patient Self-Report: Use of Hands
Difficulty performing tasks with right hand
Difficulty performing tasks with left hand
Patient Self-Report: Perceptual Functions
Difficulty feeling with right hand
Difficulty feeling with left hand
Difficulty with vision
Patient Self-Report: Cognitive/Intellectual Functions
Thoughts seem confused or illogical
Distracted from what doing or saying
Confusion about where patient is
Difficulty finding way
Difficulty calculating
Difficulty planning and organizing activities
Difficulty solving problems
Difficulty following directions
Difficulty following instructions
Means
Cases
.69
1.21
.26
.25
.81
.96
1.23
.51
.46
1.05
1.03
.96
.84
1.12
Controls
.29
1.29
.12
.27
.48
.90
1.01
.42
.48
.66
.85
.69
.54
.69
S.E.
.11
.14
.06
.06
.10
.10
.10
.09
.09
.10
.11
.09
.10
.10
P-level*
.010
.126
.019
,133
.009
.241
.036
.044
.004
*The p-level is not given in cases for which the F-ratio is less than unity.
-------
Results of the Relative Assessment of Patient Functioning Inventory showed
few significant differences between the case cohort and control cohort (see
Table 34). As shown in Table 34, significant differences did occur on 4 of
30 items in the ability areas (p < .05). All of the significant differences
measured by the relative's assessment showed that the case cohort had more
difficulty in functioning than the control cohort. The difficulties were in
the general areas (language and communication, cognitive and intellectual
functions, and use of hands). In addition, results of the relatives' assess-
ment of the study participants were significantly different between the case
and control cohorts on 4 of the 22 personality scale items: depression, irri-
tability, social withdrawal, and confusion. The statistical results of the
individual relative's assessment evaluations are presented in detail in
Appendix H.
Blood Pesticide Residues and ChE Assays. Blood samples were taken from
each case and control participant at the time of their physical examination.
All blood samples were analyzed for organochlorine pesticide residues and for
cholinesterase depression. The results from the residue analyses, reported in
ppb, were then totaled for each participant to give a single cumulative organo-
chlorine pesticide residue value. The logarithm of these cumulative residue
values was statistically analyzed using the matched-pairs analysis of variance
procedures (Table 35). The mean residue value for the case cohort was 62.07
ppb, which was significantly higher than the corresponding mean value for the
controls, 33.33 ppb. The Texas participants in both the control and case
cohorts had significantly higher residue values than the Colorado participants.
One of the purposes of testing the cases and controls for ChE depression
was to determine if any of the participants showed-evidence of exposure to
OPs at the time of examination in as much as some of the controls as well as
-59-
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Table 34. Relative's Assessment of Patient's Functioning: Test Score Means, Pooled Estimate of the
Standard Error (S.E.) of Each Mean, and Probability Level of the Analysis of Variance
Test for the Case-Control Comparison. Neuro-organophosphate Study, 1979.
Relative Rating: Personality
Depression
Irritability
Seriousness
Withdrawal
Careless in appearance
Careless in activities
Suspiciousness
Confusion about what is happening
Confusion about what he/she is doing
Indifference
Unpredictable and changeable in attitudes
Unpredictable and changeable in behavior
Inappropriate in social situations
Selfish
Ujjset by new problems
Upset by changes in plans
Demanding of others' attention
Dependent upon others
Dependability
Desirability as family member
Means
Cases
2.04
2.15
2.64
1.74
1.05
1.27
1.66
1.03
.79
1.29
1.72
1.78
1.24
1.26
2.03
2.00
1.87
1.34
1.20
1.06
Controls
1.66
1.63
2.56
1.44
.88
1.17
1.45
.73
.67
1.16
1.50
1.44
1.23
1.36
1.78
1.88
1.87
1.26
1.04
.80
S.E.
.09
.11
.10
.11
.10
.11
.12
.10
.08
.09
.10
.10
.07
.11
.13
.13
.11
.11
.10
.11
P- level
.005
.001
-
.046
.150
-
.229
.036
.301
.287
.125
-
-
-
.175
-
_**
-
.280
.112
-------
i
CT>
Relative Rating: Personality (Continued)
Appreciation by others
Confabulation
Relative Rating: Memory
For verbal communications in last day or two
For verbal conmunications a year or more ago
For events occurring in last day or two
For events occuring a year or more ago
For people met in last day or two
For people met a year or more ago
Losing track of time
Forgetting what he/she is doing
Forgetting how to do things
Losing things by forgetting where they are
Forgetting obligations
Relative Rating: Language and Communication
Difficulties understanding speech of others
Difficulties recognizing printed or written words
Difficulties understanding reading material
Difficulties with enunciation
Difficulty thinking of names of things
Other word finding difficulties
Means
Cases
.85
.77
1.54
1.46
.65
1.02
.42
.96
1.02
.51
.37
1.58
1.30
1.12
.79
.68
.79
1.10
.92
Controls
.84
.70
1.45
1.51
.58
1.07
.62
1.13
1.07
.56
.28
1.68
1.29
.78
.47
.50
.66
.78
.69
S.E.
.09
.12
.12
.14
.10
.11
.10
.11
.13
.10
.07
.15
.12
.12
.11
.10
.12
.10
.09
P-level*
,176
.248
.049
.053
.198
.035
.087
-------
Relative Rating: Language and Communications (Cont'd)
Difficulties forming letters correctly when writing
Others have difficulty reading his/her writing
Difficulty spelling
Relative Rating: Use of Hands
Difficulty performing tasks with right hand
Difficulty performing tasks with left hand
Relative Rating: Cognitive/Intellectual Functions
Thoughts seem confused or illogical
Distracted from what doing or saying
Confusion about where patient is
Difficulty finding way
Difficulty calculating
Difficulty planning and organizing activities
Difficulty solving problems
Difficulty following directions
Difficulty following instructions
Means
rases
.60
.70
1.52
.38
.43
.68
.44
.25
.34
.97
.85
.81
.52
.75
Controls
.41
.66
1.39
.29
.94
.40
.55
.20
.24
.86
.81
.70
.60
.67
.09
.13
.13
.10
.12
.09
.07
.08
.07
.11
.09
.07
.08
.06
P-leyej*
.155
.003
.028
.297
.274
* The p-level is not given in cases for which the F-ratio is less than unity.
x
**The F-test for interaction between exposure groups and states is significant at the 5% level.
-------
Table 35
Analysis of Variance Summary*
with Subgroup Means and Standard Deviations
for the Total Grganochlorine Pesticide Residue in the Blood
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
as.
i
84
86
1
1
84
Mean
Square F-ratio
^29
13.30 15.77
.84
.91
10.13 12.63
.74 <1
.80
p- level
<.001
<.001
Total, adj.
171
.95
*The analysis of variance was performed on the logarithm of the cumulative
organochlorine pesticide residue.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
33.46
24. HO
82.67
78.40
62.07
66.19
Control s
22.94
13.01
40.81
35.24
33.33
29.40
Overall
28.20
20.00
61.74
64.03
47.70
53.06
-63-
-------
cases are in occupations where occupational or accidental exposure to ORs
is possible.
Laboratory data on RBC and plasma ChE were statistically analyzed using
the matched-pairs analysis of variance procedure; the results are presented
in Tables 36 and 37, respectively. The approximate lower limits of normal
for the pH STAT method are 8.0 yM/min/ml for RBC and 2.3 yM/min/nO for
plasma. As seen in Tables 36 and 37, both the case and control cohorts were
well above the lower limits of normal RBC ChE and plasma ChE. Thus, there
was no indication of recent exposure to OPs, and there was little likelihood
of possible effects from recent OP exposure on neurological test results.
Although the difference in plasma ChE between the case and control participants
was statistically significant, the mean plasma ChE for the case cohort was
actually higher than that for the control cohort.
Since the residue data showed a statistically significant difference
between the case and control cohorts, this variable was analyzed to determine
its potential influence on significant neurological findings. The organo-
chlorine residue level and ChE levels were therefore correlated with the five
most comprehensive neuropsychological measurements; on four of these five
measurements the control cohort performed significantly better than the case
cohort. The correlation analysis, however, failed to show any significant
association between organochlorine residue and any of the summary neuro-
psychological variables. Similarly, the correlations of the ChE levels with
the summary neuropsychological variables were not statistically significant.
In fact, none of the correlation coefficients exceeded .25. These results do
not support any assumptions of influence toward impaired neuropsychological
function from exposure to organochlorine pesticides.
-64-
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Table 36
Analysis of Variance Summary
with Suogroup Means and Standard Deviations
for Red Blood Cell Cholinesterase
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
85
1
84
86
1
1
84
Mean
Square F-ratio
11.25
442.38 72.31
6.12
6.21
1.99
-------
Table 37
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Plasma Cholinesterase
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of Degrees of
Variation Freedom
Between Pairs 85
States 1
Error A 84
Within Pairs 8&
Exposure 1
State & Exp. 1
Error B 84
Total, adj. 171
Colorado Mean
Participants <. -.
Texas Mean
Participants s D
Mean
Overall
S.D.
Mean
Square F-ratio p-level
1.29
.55 <1
.69
1J31
5.44 5.49 .021
.68 <1
.99
1.17
Cases Control s Overal 1
4.90 4.70 4.80
1.16 .73 .96
5.14 4.68 4.91
1.10 1.17 1.16
5.04 4.69 4.86
1.13 1.01 1.08
-66-
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SUMMARY AND DISCUSSION
A basic hypothesis of this research was that individuals with previous
documented acute organophosphate pesticide poisonings may experience latent
chronic neurological effects. This study was conducted by using matched-
pairs to compare a cohort of 100 previous organophosphate poisoning cases to
a cohort of 100 controls. The matching characteristics included age, sex,
race, ethnic background, and social economic factors. All participants and
controls came from the states of Colorado and Texas. In the blind study
design, each study participant received a physical examination, neurological
examination, electroencephalogram (EEC), and neuropsychological testing.
Blood samples were collected from each participant for analyses for organo-
chlorine pesticide residues and cholinesterase levels. In addition, the
blood samples were evaluated for hematology, morphology, urea nitrogen and
creatinine. All of the data obtained in this study were statistically
analyzed using appropriate matched-pairs analyses.
The results of the physical examination revealed no significant differ-
ences between the case and control cohorts. Evaluations of the blind phases
of this study revealed that the clinical EEG could not discriminate the case
cohort from the matched control cohort. However, there were some neurological
deficiencies (e.g., mental status exam and peripheral sensory findings) which
occurred more frequently in the case participants. Although only a few of
the differences between the two cohorts in the neurological examination were
significant, several major differences between the case and control cohorts
were found through the neuropsychological evaluations.
Each of the five summary scores and each of the 34 subtest scores from
the neuropsychological examination was analyzed using an (univariate) analysis
of variance procedure to determine the statistical significance for the
-67-
-------
difference between the case and control cohorts. In summary of the neuro-
psychological findings, it was found that the participants in the case cohort
were significantly worse than the controls on four of five summary measures,
and on 1.8 of 34 individual subtest scores used in the study. The differences
occurred on tests of widely varying abilities, including intellectual func-
tioning, academic skills, abstraction and flexibility of thinking, and simple
motor skills (speed and coordination). The case cohort did not perform
significantly better than the control cohort on any of the subtests.
A total of 24% of the case cohorts obtained HaTstead-Reitan Battery
summary scores in the range that strongly suggested cerebral damage or
dysfunction, whereas only 12% of the controls performed at the same level on
these tests. Based on the matched-pairs chi-square test, this difference in
proportions between the case and control cohorts was statistically signifi-
cant (p<.05). It should be noted that both cohorts showed above average
intellectual functioning on the WAIS Battery.
The overall difference between the case cohort and the cohort of matched
controls was further evaluated by analyzing simultaneously all 34 subtest
scores in the neuropsychological evaluation. This analysis (a multivariate
analysis of variance procedure for matched-pairs designs) found the total
difference between the two cohorts to be highly significant (p=.0076).
Furthermore, the lack of significance in the statistical test for "Inter-
action" in the multivariate analysis of variance confirms that the differ-
ence between the case and control cohorts was consistent for the study cohort
subgroups (i.e., Colorado and Texas). The subtests from each battery of
neuropsychological tests (i.e., WAIS, Halstead-Reitan, Peabody, and Added
Ability Tests) were also analyzed simultaneously using the same multivariate
analysis of variance procedure. For each battery of tests, the difference
-68-
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between the case and control cohorts was statistically significant (the
p-levels for the above four batteries were .0001, .0311, .0066, and .0055,
respectively). For each battery, this difference between case and control
cohorts was consistent for the two study subgroups from Colorado and Texas.
Results from the Patient Assessment of Own Functioning Inventory were
similar to the findings of the objective neuropsychological testing. In the
Patient Assessments, the difference between case and control cohorts was
significant with respect to everyday functioning on 10 of 32 aspects of
language and communication, memory, cognitive intellectual functions, and
perceptual functions. The case participants also demonstrated significantly
lower abilities in the same subject areas on objective tesing as they did on
the Patient Assessment Inventory.
Results from the inventory of Relative's Assessment of Patient Function-
ing showed fewer significant differences between the case and control cohorts
than either the'objective neuropsychological testing or the Patient Assess-
ment of Own Functioning Inventory. The Relative's Assessment showed the case
cohort to have significantly more problems on four of 22 personality scale
items: depression (p=.005); irritability (p=.001); confusion about what is
happening (p=.036); withdrawal (p=.046). Based on the relative's assessment
the case cohort was found to have significantly more difficulties in under-
standing speech of others (p=.049) and in thinking of names of things (p=.035)
The neurological and neuropsychological evaluations are obviously comple-
mentary in that each emphasizes different aspects of dysfunction. The
clinical neurological examinations focus primarily on sensory and motor
functioning with very little attention to the higher level cognitive and
intellectual functions that are very sensitively assessed by the neuropsy-
chological procedures. Both examinations found no differences between the
-69-
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case and control cohort participants with respect to sensory-perceptual
functioning. The neuropsychological exam found some mild impairment of fine
coordination and motor speed with the upper extremities in the case cohort.
The major neuropsychological differences between case and control cohorts
appeared on tests of abilities that receive limited evaluation in the
clinical neurological examination. The two methods of evaluation, taken
together, provide a more complete evaluation of brain function not possible
utilizing either examination alone.
There are two explanations for these results: chronic neurological
deficits do not exist in acutely poisoned subjects; or, the routine tools
used for evaluation of clinical patients lack sufficient sensitivity to
reliably detect the deficits. The data from the neuropsychological battery
clearly support the latter interpretation.
-70-
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41. Dahlstrb'm, W.G., G.S. Welsch, and I.E. Dahlstrb'm. An MMPI Handbook,
Vol. 1: Clinical Interpretation. University of Minnesota Press,
Minneapolis, 1972.
42. An MMPI Handbook. Vol. II: Research Application. University of
Minnesota Press, Minneapolis, 1975.
43. Winer, B.J. Statistical Principles in Experimental Design. McGraw Hill
Book Company, New York, 1962. pp. 191-195.
44. Fleiss, J.L. Statistical Methods for Rates and Proportions. John Wiley
& Sons, New York, 1973. pp. 72-80.
45. Stuart, A. A Test for Homogeneity of the Marginal Distribution in a
Two-Way Classification. Biometrika 42:412-416, 1955.
46. Morrison, D.F. Multivariate Statistical Methods. McGraw-Hill Book
Co., New York,
47. Milner, B. Some Effects or Frontal Lobectomy in Man. In: Fronta!
Granular Cortex and Behavior. J.M. Warren and K. Akert, eds. McGraw-
Hill, New York, 1964.
48. Drewe, E.A. The Effect of Type and Area of Brain Lesion on Wisconsin
Card Sorting Test Performance. Cortex 10:159-170, 1974.
49. Wechsler, D.E. A Standardized Memory Scale for Clinical Use. J.
Psychol. 19:89-95, 1945.
-73-
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APPENDICES
-74-
-------
APPENDIX A
Informed Consent Form: Consent to Serve as a Subject in Research
Participant Selection Form
Occupational History and Pesticide Exposure Record
Post-OP Poisoning Form
History of Tobacco, Alcohol, Drug, and Medication Use
Current Symptomology Form
Information Sheet
A-l
-------
CONSENT TO StRVE AS A SUBJECT IH RESEARCH
I consent to serve as a subject 1n the research Investigation entitled:
Chronic Adverse Effects __
The nature and general purpose of the experimental procedure and the known
risks Involved have been explained to me by •
He is authorized to proceed on the understanding that I may terminate my
service as a subject 1n this research at any time I so desire.
I understand the known risks are:1) Fainting during blood sampling;
2) Soreness of the arm due to leakage of blood into the subcutaneous tissues;*
3) Inflammation of the vein from vhich the blood was removed.
I realize that 1t 1s not possible to identify all potential risks in
an experimental procedure, and I believe that reasonable safeguards have
been taken to minimize both the known and the potential but unknown risks.
I understand also that medical record data will be used only for
scientific publications without Identification of Individuals and that my
signature on this document does not waive legal or human rights.
Witness Signed
(Investigator) (Subject)
Date of birth of Subject
Date
TO BE SIGNED IF SUBJECT IS A MINOR
I authorize to become a subject for the research
proposal as outlined above. The nature and general purpose of the project
has been satisfactorily explained to me by and I
wn satisfied that proper precautions are to be observed.
Signed
(Parent or Guardian)
Date
(To be Retained by the Principal Investigator)
-------
INFORMED CONSENT FORM
I. , do hereby voluntarily agree to
(Please Print)
serve as a subject in the investigation entitled CHRONIC ADVERSE
EFFECTS.
explained the study to me and
I understand that participation may involve the minimal risk of
venipuncture and the discomforts of the usual diagnostic and exami-
nation procedures involved. I understand that I am free to with-
draw this consent and discontinue participation at any time.
I further understand that if any information is developed during the
period of this study which would be of value to me and my personal
physical status, that such examining physician of the study will so
inform my family physician, as designated by me, with no obligation
to be assumed by the Texas Epidemiologic Study (Pesticides).
I have been given an opportunity to ask questions regarding this
matter and have received full and satisfactory answers to same.
SIGNED this day of , 19 .
(Signature of Subject)
Address:
Witness:
(Investigator)
To be sionified if subject is a minor:
I concur:
(Signature of parent or
guardian, if applicable)
A-3
-------
1. NAME
COLORADO EPIDEMIOLOGIC PESTICIDE STUDY CENTER Neuropsy
PARTICIPANT SELECTION SHEET P. E. _
Office Use Onlv
Study No.
Last
STREET OR BOX NO.
First
MI
Interviewer
CITY, STATE_
HOME PHONE_
AGE
ZIP
Social Security
Number
WORK
SEX
BIRTHDATE / /
RACE
2. Do you
Speak English Yes
Write English Yes
Read English Yes
_No
_No
No
3. Language spoken at home:
Speak Spanish Yes No
Write Spanish Yes No
Read Spanish Yes No
English only
Other
Spanish & English_
Mostly Spanish
Other
4. Any brain or nervous system defects, diseases, or injuries at birth or since birth?
No Yes If yes, please describe:
5. Personal Physician
Address
City, State
6. Years of school completed:
Under 7 years
7-9 years (Jr. High School)
10-12 years (High School)
13 - 16 years (College)
Over 16 years
ZIP
Years
A-4
-------
OCCUFATTOfNAL HISTORY AND PESTICIDE EXPOSURE RECORD
Naine——_____ Date
Study No. Interviewer
Occunational History and Exposure to Toxicants
1. Starting with present principal emoloyment, 11st In reverse chronologic order
your occupations back to age 20, and identify toxic materials (solvents, pesti-
cides, corrosives, dusts and gases) to which you were exposed in the course of
each occupation:
Start To
Occupation Mo Yr Mo Yr Toxic Exposures
1. Present
2.
3.
4.
5.
6.
7.
8.
2. List the pesticides to which you have had the greatest exposure 1n your life,
ranking them from maximum cumulative exposure to least exposure. Record your
best estimates of annual rates of use and cumulated use:
Average Total
Yrs of Days per Yr Cumulated
Pesticide Use U se_ Use
' 1. _________
2. -.
3. | ,
4. _____________ _______________
5. ___________
6. , ___________
7» _________ __ _______
8. ; _______
9. , . ______________ _______
A-5
-------
Colorado Post-OP Poisoning
Description of poisoning episode (provide the information below for each
poisoning episode if more than one has occurred):
Date of poisoning
Circumstance of poisoning:
[ J Exposure in manufacture or farm industry
[ [ Exposure in agricultural applicatio/i industry
[ | Exposure in structural or landscape pest control industry
[" j Exposure to environmental residues
11 Accidental ingestion
!j Suicidal ingestion
I" J Home accident, not involving ingestion
Other
Causative agent (or class of toxicant)
Is. the identity of the causative agent:
rn Certain P~| Probable (~~! Possible
Confirmation of causative agent:
[~ | Label or known exposure
[ r | Analysis of food or environmental sample
|1 Analysis of blood or urine for toxicant
Cholinesterase test
Did victim receive:
j ] Medical attention
[ ^ J Hospital admission
Antidotal therapy
Hospitalization longer than 48 hours
Medical management over 1 month
A-6
-------
What symptoms were the most persistent following poisoning? (List in order of
longest persistence):
Symntpm Duration, days
What was the duration of physical disability (inability to work) following the
episode?
What symptoms were the main basis of the disability?
Are you still aware of any symptoms or injuries persistent since the poisoning
episode?
Yes [~~\ No | If yes, list:
A-7
-------
History of Tobacco, Alcohol, Drug and
Medication Use
Have you ever used tobacco?
If yes, record:
Total years
Average use:
Yes
Cigarettes
Cigars
Pipefuls
Snuff
Chewi ng
Tobacco
Do you use tobacco now?
If yes. record:
Average use:
No
< 1 pk per day [~71 > 1 Pk per day
] < 5 per day
] < 5 per day
1 Occ
| J > 5 oer day
> 5 per day
Occ
LD
Daily
Dailv
Yes
No
Cigarettes I 1 < 1 pk per day ["! > 1 pk per day
Cigars i j < 5 per day I"""! > 5 per day
Pipefuls ! ! < 5 pe-.* day
n
Chewing
Tobacco
> 5 per day
Daily
_ ^__^
r [ Occ I \
Daily
A-8
-------
_If you used tobacco previously, but have since stopped, over how many years did
you use it regularly? ^
During this time, what was your average use?
Cigarettes {'_"J < 1 ok ner day {^j > 1 pk per dav
Cigars •[ } < 5 per day [^ '> 5 per day
Pipefuls j j < 5 per day j" | > 5 per day
Snuff [~~] Occ' Q Daily f~~1
Chewing
Tobacco [ | Occ F~~j Daily [_J
A-9
-------
Have you ever used beverage alcohol? Yes C_~] No ( ^]
If yes, record:
Total years
Average use:
.Beer | "'_] < 3 cans per day |" 1 > 3 cans per day
Wine j | < 12 oz per day | ~) > 12 oz per day
Dist sots I[ < 3 oz per day I| > 3 oz per day
Do you use beverage alcohol now? Yes [ 7] No
If so, record average current use:
Beer
1 j < 3 cans per day
> 3 cans per dav
W1ne |I < 12 oz per day [I > 12 oz per day
Dist spts [_7] < 3 oz per day | ] > 3 oz oer dav
If you used beverage alcohol previously, but have since stopped, over how many
years did you use it regularly?
During this time, what was your average use?
Beer | I < 3 cans oer day [
Wine | I < 12 oz ner day | j
Dist spts | 1 < 3 oz per.day [j
3 cans oer day
12 oz per dav
3 oz ner day
A-10
-------
Do you presently drink coffee? Yes | | No |~~[
If yes, about how many cups per day average?
Have you ever used narcotic or addictive drugs? Yes I [ No i I
Arc you taking narcotic or addictive drugs now? Yes | | No I I
If yes, identify
Are you presently taking any of the following tynes of medications regularly
(everv dav)? „ ' .. ...
• ' Yes No Identify
Sedatives or tranouilizers || )|
Antihistomines or cold pills || |1
Insulin || \|
Antidiabetic pills II ||
Muscle relaxants f "j Q
Seasickness pills I"""") | |
Aspirin or headache pills I I | |
Antidepressant pills I ] I 1
Drugs for stomach ulcers } I | I
Drugs for high blood pressure \ \ \ \
Sleeping medicine | j J~ "1
Strong laxatives or cathartics [ I
Antibiotics 1I \I
A-ll
-------
Current Symptomatology
During the past worj^ week, have you been aware of the following symptoms:
1. Headache
2. Dizziness
3. Irritability
4. Insomnia
5. Ringing in
the ears
6. Muscle
twitchings
7. Muscle
weakness
8. blurred
vision
9. Tingling or
numbness of
hands/feet
10. Poor coordin-
ation
11. Nasal conges-
tion
12. Nosebleed
13. Eye irritation
14. Sore throat
15. Sinus pain
16. Difficult
breathing
3
O
3
C
c
o
o
r- . (O
4-» C.
C O
O) T-
3 t^>
C rt>
Ol O
J- O
U- C
(O
4->
CO
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
•
Cough
Coughing of
blood
Wheezing
Chest pain
Heart
pounding
Poor
appetite
Naussa
Vomiting
Abdominal
pain
Diarrhea
Pain on
urination
Dark colored
uri ne
Skin irrita-
tion
Itching or
burning of
skin
Skin infection
Worsening of
chronic skin
disease
Joints swell-
ing or pain
Continuous
"
._,
„ .
Freouently
Occasional
•~*~WK_
._. — _
P—
(O
_o
"""}
\
i
_
!
A-12
-------
Did you lose consciousness at any time during the poisoning episode?
ID
Yes
No
If yes, about how many hours?
hours.
Did you experience cardiac arrest (heart stopped)?
r
Yes
No
Did you stop breathing?
Yes
Was oxygen administered?
Yes
No
Unknown
Unknown
Unknown
A-13
-------
Have you ever had: „ „
Yes No
Meningitis [ | I |
Encephalitis II I I
Epilepsy or convulsions | I | J
High blood pressure [ 1 I I
Diabetes If |[
Unconscious for 1 hour or more | | | |
Brain operation | | ) I
Arm, hand or wrist injury | ) I ]
If so, describe any residual impairment:
If alcoholism is or has been a problem, how much alcohol was used at peak?
Beer - cans per day
Wine - ounces per day
Distilled spirits - ounces per day
Have you ever had a blackout while or after drinking? Yes £^| No ||
After withdrawal from drinking, have you ever experienced shakes, seizures,
fits or DT's? Yes No
.seen or heard things that probably were not there? Yes j | No | \
Have you ever taken any medication or drugs for one month or longer? Yes Q No
If yes: Drug or Medication Dates from to
A-14
-------
INFORMATION SHEET
The Colorado Epidcmlologic Pesticide Study Center and the University of Colorado
Medical Center are cooperating in a study of possible long term effects of severe
exposure to organophosphnto pesticides. Persons who have been acutely exposed
to organophosphateH as well as matched persons (by age, occupation, etc.) who have
not been exposed, will be given a thorough physical and neurological examination.
The examinations will be given on two separate days at the University of Colorado
Medical Center and will consist of primarily painless neurological function tests.
A blood sample will be drawn during the physical examination.
Your appointment at the Neuropsychology
Lab is at 8:00 a.m. on
197 .
The Neuropsychology Lab is in Room 1G11
in the Psychiatric Hospital as shown on
your map.
Your appointment for your physical
exam and EEC is at _:_
on
197__.
Go to Admissions on the 1st floor of
Colorado General Hospital as shown on
your map and obtain your plastic
identification card. Then go to
Medical "C" in the northwest hall,
also on the 1st floor, for your
physical exam.
Bring your eye glasses if you have any.
Have 50c in coins ready as you entjer_ the parking garage or have 50p in coins
available as you leave the parking lot on the east side of Colorado General
Hospital.
When arriving for your physical exam, first go to the admissions office, tell them
you are a participant for the pesticide study and obtain a white plastic identi-
fication card. They will need to know your social security if & certain other information,
Ms. SueHeaton is in charge of the Neuropsychology Lab. Dr. Patricia Burcar is
the physician conducting the physical exams. Other people will also be
helping them.
Not very many appointment times for this study are available, so we appreciate
your efforts to keep your appointments. If you find you cannot make your
appointment, please call either:
Dr. Burcar 's secretary at the EEC Lab, Medical Center (303) 394-7771 or
Lawrence Mounce, Pesticide Center, Colorado State University (303) 491-7038
Thank you for your participation and have an enjoyable time.
A-15
-------
11 Perm,t|\
Student Ipark.ng V.1
- ,Labs Lot I
Colorado Blvd V
h || Public Parking
Lot f
7-66
-------
Dates
Time:
Texas Tech University School of Medicine, Epidemiologic Studies
Program, Pesticides Laboratory, 152 East Stenger, San Benito, Texas,
Datet
Time :
Valley Community Hospital, Ted Hunt Blvd.. Brownsville, Texas
(Laboratory then to EEG Lab (Mrs. Diaz)
Dr. Jorge Viada, 500 N. Paredes, Brownsville, Texas (for neurological
exam).
A-17
79
SoutW.
vv
-------
APPENDIX B
Cholinesterase Procedure
B-l
-------
CHOLINESTERASE PROCEDURE
Apparatus and Reagents
1. Radiometer titration equipment, type SBR2c/SBUl/TTA3
2. Clinical centrifuge
3. Hematocrit centrifuge
4. Saline solution (0.9%)
Weigh 9.0 gm reagent grade sodium chloride and dissolve in
distilled water, q.s. 1000 ml. Stable indefinitely.
5. Substrate solution: Acetylcholine iodide (0.11 N)
Weigh 0.7510 gm acetylcholine iodide and make up to 25.0 ml
in distilled water. Keep refrigerated. Solutions are stable
for two weeks. (Or keep frozen.)
6. Titrant stock solution: (1.0 N NaOH)
Weigh 4.0 gm reagent grade sodium hydroxide. Dissolve in
distilled water, q.s. 100 ml. Store in screw-cap polyethylene
bottle. Minimize exposure to atmosphere.
7. Titrant working solution (approximately - 0.0125 N)
Pipette 5.0 ml titrant stock solution of NaOH into 500 ml
polyethylene bottle. Add 400 ml distilled water. Mix well
before use. Minimize exposure to atmosphere.
8. Primary standard potassium acid phthalate solution (0.1678 mg/ml)
Dry small amount of KHP in oven overnight before weighing.
Cool to room temperature in a dessicator. Weigh 0.1678 gm
KHP and make up to 1000 ml with saline solution.
Operation of Radiometer Titration Equipment
Turn instrument on: (warm until thermometer in water bath is 39°C, in
reaction vessel 37°C).
B-2
-------
1. Titrigraph - line switch to "on"
2. Water bath - motor switch to "on"
t
3. pH meter - #4 switch to manual
4. Titrator - selector switch (#15) to upscale
5. Nitrogen on
6. Thermometer probe - switch to "on"
Standardization of Instrument With Buffers
A high buffer, pH 7.38, and a low buffer, pH 6.84, are taken from the
refrigerator. Using one vial of each, place in separate reaction vessels with
stirring frogs. Place in wanning jackets to warm.
Place the vessel on the stirrer-buret for measurement:
1. Pull the vessel support down and turn to the left, and at the same
time remove the electrode soaker (buffer) from the electrodes.
2. Pull the titrant delivery tube up above the electrodes.
3. Rinse the electrodes well with distilled water and touch tips with
Kim-Wipe.
4. Put the vessel, containing the buffer to be measured, in the therroo-
jacket (containing water) and place both over electrodes. At the
same time, move the vessel support under the thermojacket and up
into place.
Reading the Buffers
The high buffer (pH 7.38) is read first. The scale zero dial (#20) is
set at 7. To read, push button #2 on the pH-meter to "read". It will take a
few seconds for the needle on the meter to stabilize and for the temperature
to reach 37°C. After it appears to be stable, a reading is taken. If this
is not pH 7.38, the buffer adjustment (#5) is turned until it does. Put on
.stand-by. This buffer is removed, the electrodes rinsed well, and the low
B-3
-------
buffer put on. The scale zero dial is set at 6. This buffer should read
6.84 after stabilization of the needle and temperature. If it does, the
instrument is calibrated, and the NaOH can be standardized. If it does not
read 6.84, the instrument must be calibrated.
To calibrate the instrument:
1. Put 7.38 buffer in vessel.
2. Set meter to 7.778 (red line) by turning buffer adjustment.
3. Remove vessel, rinse electrodes well.
4. Put on 6.84 buffer.
5. Read pH with scale zero set on 7. adjust sample temperature control
to 7.24.
6. Set scale zero to 6 and change reading of buffer to read actual pH
6.84 by turning buffer adjustment.
7. Check by putting 7.38 buffer back on electrodes. It should read
7.38. If it does not, the above procedure must be repeated. Be
sure to rinse electrodes well.
Standardization of NaOH
1. Fill titrant reservoir with titrant working solution.
2. Push the delivery tube just a little below the electrodes.
3. Rinse out the tubing and delivery tube several times with the
titrant.
4. Measure volumetrically 3 ml of standard potassium acid phthalate
into each of three titration vessels containing stirring frogs.
5. The vessel is placed in the thermojacket and allowed to warm for
a few minutes.
6. Check end point- push #12 in; the reading should be 6.92 or 6.93
(scale zero set at 6).
B-4
-------
7- Proportional Band (#16) set at 2
8. Automatic stop in
9. To titrate NaOH:
a. Place vessel in thermojacket on electrodes
b. Stirring motor on
c. Read (#2) on
d. Recorder on
e. Push start (#11)
f. Titrator will stop automatically at pH 7
10. Refill the syringe and place the pen back on zero after each run.
11. Standardization should be repeated to obtain 3 consecutive titra-
tions with no more than 1 recorder unit variation.
12. The 3 readings, in recorder units (RU) are averaged, then divided
into 0.493 to obtain the normality of the NaOH. (See Calculations
for further detail.)
Procedure: Titration of ChE
1. Settings
a. Scale zero (#20) - 7
b. End point - 7.92 (same)
c. Automatic and manual stops both in (#13 and #14)
d. Proportional band set on 0.1
2. Plasma analysis
a. Pipette 0.15 ml of plasma to reaction vessel with stirring frog.
b. Add 4.2 ml normal saline.
c. Place reaction vessel on instrument and allow sample to reach
37°C. (Stirring motor on.)
B-5
-------
d. Add titrant manually until pH is at or slightly above 8.0.
e. Refill syringe.
f. Add 0.6 ml of acetylcholine iodide substrate with a 1.0 ml
hydrodermic syringe (Tuberculin) through an attached needle,
directly into the reaction mixture.
g. Push "start" (#11) and release "automatic".
h. As pH reaches 8.0 and valve opens, turn on recorder.
i. Let run for at least 3 minutes. Each vertical division of the
chart paper represents 1 minute.
3. Whole blood analysis
a. Mix whole blood thoroughly by inversion-, prepare hemolysate
as follows: into clean, dry test tube, pipette 4.5 ml distilled
water. Add 0.5 ml whole blood. Mix until hemolysis is complete.
(This is a 1:10 dilution - maintain proportions regardless of
volume prepared.)
b. Pipette 0.5 ml of the whole blood hemolysate into a reaction
vessel with stirring frog.
c. Add 4.2 ml of normal saline.
d. Repeat steps c-e in No. 2 above.
e. Add 0.1 ml acetylcholine iodide substrate to reaction vessel.
f. Titrate as for plasma.
4. Both plasma and whole blood should be analyzed in duplicate.
:alculations: Normality of NaOH
KHP MW = 204.23 gm
1 meq KHP = 204.23 mg
Standard KHP solution = 0.1678 mg/ml
1 RU = 0.005 ml
Normality of NaOH = 0.1678 mg/ml x 3 ml = 0.493
204.23 mg/meq x 0,005 ml/RU x # RU # RU
B-6
-------
Calculations: Rate of Chollnesterase Activity
Record the chart units at the beginning of the 3 minutes and at the end.
The first is subtracted from the second to obtain the recorder units (RU)
for the 3 minute period, The recorder units for each test are multiplied by
the plasma factor or the whole blood factor to obtain the plasma or whole
blood cholinesterase. The plasma and whole blood factors are calculated as
follows:
Plasma factor = (0.005 ml/RU) (Normality NaOH) (1000 pinoles/meg)
(3 minutes) (0.15 ml plasma)
Whole blood factor = (0.005 ml/RU) (Normality NaOH) (1000 umoles/meg)
(3 minutes) (0.05 ml whole blood)
Calculate the red blood cell (RBC) cholinesterase as follows:
RBC ChE = WB ChE - [Plasma ChE x (1 - Hematocrit expressed as decimal)]
Hematocrit expressed as decimal
Results are reported in pmoles/min/ml in each case.
REFERENCES
Michel, H.O.: An Electromtric Method for the Determination of Red Blood Cell
and Plasma Cholinesterase Activity, J. Lab. Clin. Med., 34: 1564, 1949.
Nabb, D.P. and Whitfield, F.: Determination of Cholinesterase by an Automated
pH-Stat Method, Arch. Environmental Health, 1_5_: 147, 1969.
Pearson, J.R. and Walker, 6.F.: Conversion of Acetocholinesterase Activity
Values from the Michel to the pH-Stat Scales, Arch. Environmental Health, 16_:
809, 1968.
Jensen-Holm, J., Lausen, H.H., Milthers, K. and Moller, K.O.: Determination
of the Activity in Blood and Organs by Automatic Titration, Acta Pharmacol.
et. Toxicol., 15: 384, 1959.
B-7
-------
APPENDIX C
Serum Pesticide Residue Procedure
C-l
-------
SERUM PESTICIDE RESIDUE PROCEDURE
Principle
A 2 ml aliquot of serum is extracted with 6 millileters of hexane
in a round-bottom tube. The extraction is conducted for 2 hours on a
slow-speed rotating mixer. The formation of emulsion is unlikely, but
if it should occur, centrifugation may be used to effect separation of
the layers. A 5 ml aliquot of the hexane layer is quantitatively trans-
ferred to a graduated test tube. The extract is concentrated under
a nitrogen stream and the final volume is adjusted to correspond to
the expected concentration of the pesticide residue. A suitable aliquot
is analyzed by electron capture gas chromatography.
Apparatus and Reagents
1. Rotary mixing device, "Roto-Rack , Fisher Scientific
Company, Catalog #14-057.
2. Tubes, Culture, 16 x 125 mm, fitted with screw caps, size
15-415 with Teflon-faced rubber liners, Corning #9826.
3. Syringe, 100 pi, Hamilton #710 or equivalent.
4. Vortex Genie mixer.
5. Pi pet, Mohr type, 1 ml in 0.01 ml grad., Corning #7063 or
equivalent.
6. Pipets, transfer, 2, 5, and 6 ml Corning #7100 or equivalent.
7. Six-place tube carrier, stnls. steel. May be fabricated
at local tin shop per attached sketch.
8. Centrifuge with head to accommodate the Corning #9826 tube,
capable of speed of 2,000 rpm.
9. Hexane, distilled in glass, pesticide grade.
C-2
-------
Procedure
1. Mix blood serum sample thoroughly and, with a volumetric
pi pet, transfer 2 ml to a 15 ml round bottom culture tube.
2. Add 6 ml hexane from a volumetric pi pet. Tightly stopper
the culture tube with a Teflon-lined screw cap. Place tube
on rotator.
3. Set rotator speed at 50 rpm and rotate for 2 hours.
4. With a volumetric pi pet, transfer 5 mis of the hexane extract
to a 13 ml concentrator tube. Evaporate the extract under
nitrogen to a volume of 1 ml.
5. Stopper the concentrator tube and hold on the Vortex mixer,
set for high speed, for ca 30 seconds for volumes of 6 ml
or less. It is safer practice to mix a full minute for
larger volumes.
6. Proceed with the electron capture gas chromatography of
the extract.
Calculations
The following equation is applicable when all volumes specified
in the method are followed precisely, with no exceptions:
p.p.b. = ^Px 0.6
where a = nanograms of pesticide in standard peak
b = height of sample peak
c = height of standard peak
x = total volume of final extract in microliters
y = microliters of extract injected
Example: nanograms in standard peak = 0.3
height of sample peak = 80 mm.
height of standard peak = 90 mm.
total volume of final extract = 1,000 yl.
volume of final extract injected = 5 ul.
_ n . 0.3 x 80 x 1000
p.p.b. - 90 x 5x 0.6 = 32 p.p.b
C-3
-------
SPECIAL NOTE:
All analytical research and the subsequent collaborative study
of the method was conducted with each laboratory following the
procedure exactly as written. In all probability, a serum sample
of less than 2 ml can be analyzed with confidence provided the
same serum to hexane ratio is followed.
However, the precision resulting from the use of reduced volumes
is not known. If such a deviation must be made, the final cal-
culation may be accomplished by using the following basic equation:
c d
where a, b and c are the same as given for the simplified
equation.
d = ml (or grams) in original sample.
e = dilution factor obtained as follows:
ml of hexane added to serum x final extract volume (yl)
aliquot volume of extract (ml) x jol injected
Example: Assuming that the same serum used to illustrate the
simplified equation was available in a volume less than
2 ml.
nanograms in standard peak = 0.3
height of sample peak = 61.5 mm.
height of standard peak = 90 mm.
ml of serum in original sample = 1.6
ml of hexane added to serum = 5
final extract volume = 1,000 pi
volume of extract aliquot = 4 ml
injection volume = 5 ul
Dilution factor (e) = 5 x ] >00°
4x5 "
p.p.b = 0.3 x 61.5 x 250 =32
90 x 1.6
Reporting Limits - Detectability
The analytical Chemistry Committee has established the following
minimum reporting limits for chlorinated pesticides in serum:
3-BHC, lindane, aldrin, heptachlor, heptachlor epoxide,
o,p'-DDE, p,p'-DDE, dieldrin -------------- 1 part per billion.
Endrin, o,p'-DDT, p,p'-DDD, p,p'-DDT ...... 2 parts per billion.
C-4
-------
REFERENCE
Dale, W.E., Curley, A., and Cueto, C.: Hexane Extractable Chlorinated
Insecticides in Human Blood, Life Sciences 5: 47, 1966.
C-5
-------
APPENDIX D
Past Medical History
Physical and Neurological Examination
Electroencephalographic Evaluation Form
D-l
-------
PAST MEDICAL HISTORY
Name
Date
Hospital No.
Study No.
Interviewer
If any of the illnesses, diseases or surgical
occurred in your lifetime, record the date of
the subsequent course of the condition.
procedures listed below have
onset or occurrence, and indicate
DISEASE
IS
Allergy to: (specify)
medicine
load
gross, dust, etc.
other
Gout
Asthma
Arthritis (specify)
Bleeding tendency
Bronchitis
Cancer/Tumor (specify)
Cysts
Diabetes Mellltus
i Adrenal Disease (specify)
Chronic Dermatitis
Brain Injury
Epilepsy
Glaucoma
Cataracts
Geltar
Hyper thyroid Ism
Hypothyreldlsm
Abnormal EKC
Heart Disease (spec.) or 2)
ONSET
3» Mo. Yr.
, 1 ,
. 1 ,
, 1 ,
, 1 ,
. 1 ,
. 1 .
. 1 .
. 1 ,
. 1 ,
. 1 .
. 1 ,
. 1 .
. 1 ,
. 1 .
. I .
, 1 .
. 1 I
, I ,
. 1 .
. 1 ,
. 1 .
. 1 .
. 1 ,
. 1 ,
, 1 i
, 1 ,
X
CD
"5*
u
43
£ Persistent
under B
i Persistent 1
No B j
T)
*
"i
jp
48
D-2
DISEASE
i j
Intestinal Parasites
Kidney Disease (ipec.1 or 2)
Lung Disease (spec. 1 or 2)
Nervoui Cand. /Breakdown
Peptic Ulcer
Sinusitis
Stroke
Tuberculosis
Venereal Disease (specify)
Colitis
Gall Bladder Disease
Liver Disease (specify)
Anemia (specify)
Other Diseases or Injuries!
(•peclfy)
Surgery! (specify)
ONSET
I«Mo. Yr.
, 1 ,
, I ,
• 1 i
. 1 .
. 1 ,
. 1 .
. 1 ,
. 1 .
. 1 ,
. 1 ,
i 1 .
. 1 .
, f .
, 1 .
, 1 .
. 1 .
i 1 .
i 1 .
. 1 .
1
. 1 .
. 1 .
1 ' 1
0?
"5*
d
41
^
X
X
£ Persistent 1
under R |
X
X
s
c
ft
*<*
« O
e Z
a.
49
s
X
X
s
J Sell 1
Limited J
X1
//j
-------
! MEDICAL RECORD. This form contains
medical information the disclosure or re-
j lease o( vinich is restricted by 5 U.S.C.
I 552. (b) (6): 40 CFR. Part 2.
ENVIRONMENTAL. PROTECTION AGENCY
DIVISION OF PESTICIDE COMMUNITY STUDIES
Chombl.e, G.orgio 30341
PHYSICAL AND NEUROLOGICAL EXAMINATION
FORM APPROVE I
OMB NO. 57-ROO1
PARTICIPANT'S NAME
Form
10
,C, , , ,
Cord
Code Jj
s
PARl
Project
Cod. L_
e
riCIPANT'S
File
J 1 ID L
ADDRESS
AMA
1 ) 10 | |
to
INTER V
Int.rvi.w
1 1 1 1 1 1 1 1 1 Oat. • 1 I 1 1 1 1
20
EWER'S
NAME
Visit .
J ID I , 1 ,
28
Physical Doto: Height i | i in. Weight
30 32
Blood Pressur* — Systolic
Ib. T.mp«ratur. (_
30
Diottolic I
Pull* Rat* |_
3t
1/min.
Ey. Exam. Uncorr*ct«d: R |2 |0 I I I I L I 2 | 0 I I I I Corr.ct.d: R 121 ol I I I L I 3 I ol I I I
2
0
01
02
03
04
OS
06
07
08
09
10
11
12
13
14
IS
la
17
"TT
ABINT
8 '3
For each category b.low
If abnormal circl* th. nu
1 0
GENERAL APPEARANCE:
1 . hydration
5. development
SKIN:
1 . temperature
5. diaphoresis
HEAD:
EARS:
1. pinna
EYES:
1. lids
5. fundi
NOSE:
1 . mucosa
MOUTH:
1. lipi
5. mucosa
NECK:
1. stiffness
THORAX:
1. shape
BREASTS:
1 . masses
LUNGS:
1. (remit us
5. rubs
HEART:
1. PMI
5. murmurs
VESSELS:
1. pulse*
ABDOMEN:
1 . masses
5. hernia
PELVIC & RECTAL:
1. masses
GENITOURINARY:
LYMPHATICS:
1. cervical
SKELETAL:
1. back
mark X in the Not Tested
Tib.r(s) preceding th* abna
2. cyanosis
6. acute distress
2. cyanosis
6. jaundice
2. tympanum
2. sclerae
6. pupils
2. obstruction
2. gums
6. tonsils
2. masses
2. expansion
2. discharge
2. breath sounds
6. ranch!
2. rhythm
6. thrills
2. venous distentton
2. organomegaly
2. hemorrhoids
2. epitrochl*or
2. clubbing
(NT) or Abnormal (AB)
rmalities .
3. chronic distress
7. nails
3. plethora
7. pigmentation
3. external canal
3. visual fields
3. tongue
3. thyroid
3. symmetry
3. tenderness
3. rales
3. rubs
3. bruits
3. bowel sounds
3. tenderness
3. axillary
3. joint motion
column or if Normal leave blank.
4. hair
0 «.k., | | | 1 1 1 1 1
4. spider nevi
9 ».t,.r I I I I I I 1 I
0 _.u-.l | 1 1 1 1 1 1
0 n,k.r 1 1 1 1 1 1 1 1
4. conjunctiva*
0 n.t,.r! 1 1 1 1 1 1 1
0 _.LT. 1 1 1 1 1 1 1 1
4. f.eth
a ~.kT. 1 | I I I I I I
4. trachea
0 _.h.,l 1 1 1 1 1 1 1
9 „,(,., 1 1 1 1 1 1 1 1
9 -.1-, 1 1 1 1 1 1 1 1
4. percussion
9 „.!.., 1 1 1 1 1 1 I 1
4. sounds
9 ~,h., 1 1 1 1 1 1 1 1
4. an.urysm
9 *<>..rl 1 1 1 1 1 1 1
4. tenderness
9 ».h.rl 1 1 1 1 1 1 1
4. prostate
9 »,k., 1 1 1 1 1 1 1 1
9 .,k..l 1 1 1 1 1 1 1
4. inguinal
9 .th., 1 1 1 1 1 1 1 1
9 «.(,.,! 1 1 1 1 1 1 1
1 1 1 1 j
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
1 1 1 1 i
1 1 1 1 1
1 1 1 1 1
1 1 1 1 _J
1 1 1 1 1
1 1 1 1 1
111!)
1 1 1 I_J
1 1 1 1 1
1 1 1 i 1
1 1 1 1 1
1 1 ! ! 1
1 1 1 1 1
EPA 9510-3
REV 3-71
PACE 1 OF 2 PACES
D-3
-------
C_ Nl Hospital *
' 7
Patient Name Date of Exam / /
13
Address Phone No.
MENTAL STATUS
(UNLESS OTHERWISE STATED CODE 0=NORMAL, 1=NS, 2=ABN)
State of Consciousness:
Jo
] delerious or manic
2 very aroused
3 Anxious
4 normal
5 lethargic
6 obtunded
7 comatose
Orientation: time place person (Normal: oriented x 3)
a*
Language: pressure (Rate, spontoniety) Structure (Quality, coherence)
l
-------
Abstraction (comparison of similar items): ( Ability to recognize concrete and
abstract similar qualities, i.e. apple,
orange, lie; mistake)
Mood: euphoric normal depressed
_
Mental Status Score
37
D-5
-------
CRANIAL NERVES
COMMENTS
I. _ Sense of smell
(normal: appreciates odor bilaterally)
II. __ Acuity farOU OD OS
nearOU OD OS
(Snellen fraction for acuity)
Visual field (confrontation)
(Normal: full, visual fields by finger con-
frontation)
_ _ Ophthalmoscopic
(Note vessels, disc)
III, IV, VI. Pupil (size, response)
(Normal: pupils equal, round, reactive to
to light and accomodation)
Mobility
(Normal: extra ocular movements full, conjugate)
_ Nystagmus
(Normal: none)
V. _ _ Sensation
£"(0 (Normal: intact)
_ _ Jaws
&$ (Normal: strength with jaws open & closed)
VII. _ _ Symmetry (resting)
*/
_ _ Voluntary movement
&3 (Normal: forehead wrinkling, eye closure, smile
complete and symmetrical)
_ _ Lip reflexes
feO>~ (Abnormal: presence of snout, root reflexes)
VIII. _ _ ^ Acuity (fingers or wrist-watch)
f> 8 (Normal: intact to finger friction of ticl'.
of wrist watch)
D-6
-------
CRANIAL NERVES
R L COMMENTS
Tympanic Membrane
70
(X/ X. Gag; voice
(Normal: gag present and symmetrical, normal
quality of voice)
XI. Muscle strength
7S~ (Measure strength of trapezius, stemodei-
domestoid)
XII. Tongue Movement
77 (Measure side to side/ smooth rapid movements)
Cranial Nerve Score
w
D-7
-------
CARD 2_
"6
Involuntary Movement
R L
MOTOR SYSTEM
I(P
7F
'zo
*T-
35
Bulk
(note symmetry and
degree of wasting)
0 = Normal
1 = Mild wasting
2 = Moderate wasting
3 = Complete atrophy
Tone
0 = Normal
1 = Decreased
2 = Increased
Strength
0 = Normal
1 = Mild weakness
2 = Marked weakness
3 = Paralysis
"3*
Stretch Reflexes
COMMENTS
Face
Head
Hands
(Fasciculations, myoclonus, chorea, tremors)
Shoulders
Arms
Thighs
Calves
Arms
Legs
Deltoids
Biceps
Triceps
Wrist extensors
Quadriceps
Gastrocs
BJ
TJ
BR
D-8
-------
MOTOR SYSTEM
R L COMMENTS
KJ
AJ
Rote os (0) absent; (1) hypoactive; (2) normal; or (3) hyperactive
Grasp reflex (Abnormal reflex)
Abdominals (Present except after major
abdominal surgery, in
multiparous women)
Plantar reflex (Normal: toes down
Abnormal: toes up or fan)
Motor System Score
D-9
-------
Pin
Touch
Location: 1=PERIF, 2=Focal
Degree: l=Mild, 2=Mod., 3=Severe
SENSORY SYSTEM
Vibration
(Test with tuning fork at
toes, fingers)
Position
(Ability to identify
up/down movement)
2 point Disc rim motion
(Normal: .5 cm)
Graphesthesia
(Ability to identify numbers
drawn in hand)
Stereognosis.
(Ability to identify coin
and its denomination with
fingers)
Other (detail)
upper ext.
lower ext.
(detail abnormality)
upper ext.
lower ext.
(detail abnormality)
(detail abnormality)
fingers
toes
fingers
RIGHT
LEFT
Location Degree Location Degree
6 ~~7~
Sensory System Score
D-10
-------
3 A.
Posture
Balonce
(detail abnormality)
Gait
Cerebellar
(Note accuracy and
smoothness
INTEGRATIVE FUNCTIONS
_(Note standing & sitting posture;
resting position of limbs)
_(Measure ability to tandem walk,
stand with feet together with and
without eyes closed
RIGHT
LEFT
Location Degree Location Degree
Finger-nose
Heel-shin
Rapid alt. movement
hands
feet
Integrative function score
OTHER
Skull (palpation for masses, depressions, auscultation for bruits)
Carotids (palpation of pulses, auscultation for bruits)
Back (alignment, tenderness, range of motion)
Score, other
D-ll
-------
SPECIFIC NEUROLOGIC FINDINGS
loO
SPECIFIC NEUROLOGIC DIAGNOSES
CODE:
1. Clinical Hearing Loss
2. Suspension Tremor
3. Intension Tremor
4. Dementia
5. Peripheral Neuropathy
6. Anxiety
D-12
-------
PESTICIDE STUDY - SUMMARY SHEET
Nome
Stud/ No. _C
/
Date of Birth
/
3
Form S 1 Hospital No.
/ Dote Examined
s~ -~7j"rx~ ao~
Handedness (1 = right, 2 = left, 3 = ambidextrous)
as
1. CC (0 = none/ 1 = NS, 2 = sig.)
2. HPI (as CC)
a. ONSET
(1 -recent, 2= past)
b. SEVERITY
(l=mild,
, 3=severe)
c. DURATION
(l=constont, 2=interm)
3. PH(asCC)
4. FH (as CC)
5. ROS (as CC)
6. EEG: Type: Normal _
Abnormal Slow
7
_ Sharp
Abnormal
/O
Location: Diffuse
Epileptiform
Focal: RF_
LF
MS
Integro-
CRN Motor Sensory tive Othe
32
30
ft
47
6V
<*£(
Ir 3
ft
(1=mild, 2=rooderate, 3=severe)
RP
LP
RT
LT
RO_
LO
D-13
-------
PESTICIDE STUDY - SUMMARY SHEET
7. HEARING TEST:
Neurosensory loss
Conductive loss
Right
Left
(0=none 2=moderate)
3=severe)
8. LAB TESTS (O^ormal, l=decrease, 2=increase)
Blood count
WBC
RBC
Hgb
Hct
MCV
a?
HH
A?
30
MCH
MCHC
Platelets
Differential
Neut. seg.
Neut/Unseg.
Lymph
Mono
Baso
Eosin
Urea Nit.
Creatinine
9. RBC MORPHOLOGY (0=normol, l=obnormal)
Macrocytes Fragmenh
Microcytes Microsphero
Poiychrom Targets
Elliptocytes Rouleaux
Teardrops H-J Bodies
Hypochrom _ Nuc RBC/IOO WBC
*T
*¥
*d
!"3T
D-14
-------
HEARING CONSERVATION QUESTIONNAIRE
Name
FORM H
Study No. _C
I ~9T ~3
A. How do you rate your hearing? L
(Exc=3, good=2/ fair=l, poor=0) R
B. Exposure to noise
1. Does noise bother you?
Hospital *
Problems
Problems
2.a. Were you exposed to noise today?
b. If so/ how long? (hrs)
3.a. Is your job noisy?
b. Do you wear protection?
4.a. Were you exposed to noise in the military?
b. Did you wear protection?
5.a. Are you exposed to noise recreationally?
b. Do you wear protection?
c. Snowmobile
d. Tropshooting, hunting
e. Rock music
f. Heavy equipment
g. Other
~sr
TO ~TT
~3T3
"55*
53
T7
"55
D-15
-------
HEARING CONSERVATION QUESTIONNAIRE
C. Medical History
1. Are there hearing problems In your family? Parents
Self
Other
2. Do you have a cold today?
3. Do you have any allergies?
4. Have you ever had
a. ear surgery
b. ear infections
c. ringing in ears
d. dizziness
e. mumps
f . measles
g. prolonged fever
h. other
5. Are you currently on medication? Type
6. Have you ever had a hearing test?
a. if so, when? 19
51
D-16
-------
Addendum to Pesticide Questionnaire
Do you wear glasses?
How long have you worn glasses?
For distance
For reading
Have you ever had a sudden change on visual acuity?
When did this change occur? _ 19
Summary _
Have you had any physical difficulties with your sex life?
If yes, year of onset. 19_
Type of dysfunction: organic
psychology cal
Summary
D-17
-------
VISUAL EEG ANALYSIS
Electroencephalographic Evaluation Form
1 . Awake:
Alpha:
Beta:
Patient
EEG '
date
Technical
absent/ / distribution:
abundance: hi / / mod / / lo/ /
avg. freq. Hz (variability: lo / / ihod f~J Hi / /)
avg. amp. uV (var: lo/ / mod/ / hi / /)
blocking: complete / / mod/ / slight/ / none
comment:
absent /"/ distribution:
abundance: hi / / mod / / lo / /
avg. freq. Hz (var: lo /7* mod / / hi/ /)
avg. amp. uV (var: lo / / mod/ / hi /~7)
comment:
Theta:
absent /_/
abundance: hi
avg. freq.
avg. amp.
comment:
distribution:
mod TV lo/T
_Hz (var: lo /V" mod 77 hi/T)
uV (var: \v £T mod/ / hi/ /)
D-18
-------
Delta:
absent/~7 distribution:
abundance: hi / / mod / / lo / /
avg. freq. Hz (var: lo /'/ mod/ / hi/ /)
avg. amp. uV (var: lo /"7* mod/ / hi/ /)
comment:
Mu:
absent /~7
avg.. freq.
avg. amp.
comment:
abundance: hi /~~/ mod/ •/ lo/ /
Hz (var: lo/ / mod/ / hi,
uV (var: lo / / mod/ / hi / /)
2. Sleep:
Lambdoidal:
absent / /
absent / /
abundance: hi / / mod / / lo / /
avg. amp. yV (var: ' / / mod/ / hi/ /)
comment:
K-complex: absent /7
comment:
D-19
-------
Sigma: absent/ /
ovg. freq. _ Hz
avg. amp. uV
comment:
3. Photic: not done/ /
following: none / / slight/"/ mod / / good / /
freq. range: _
amp: lo/ / mod / / hi/7
comment:
4. HV: not done
response: none/"/ slight/7 mod/7 good/ /
comment:
5. Paroxysmal activity: none / /
focal /7
general /7
IMPRESSION:
D-20
-------
APPENDIX E
Organophosphate Insecticides Implicated In Poisoning Episodes
E-l
-------
ORGANOPHOSPHATE INSECTICIDES IMPLICATED IN POISONING EPISODES
INTRODUCTION
The synthetic pesticide compounds belonging to the organophosphorus (OP)
insecticide group are all derivatives of phosphoric acid; but more importantly,
all possess the ability to inhibit the cholinesterase enzymes. Due to the
irreversible inhibition of the cholinesterases, excess acetylcholine accumu-
lates at certain nerve endings in the body and causes these nerves to remain
in an excited state. The constant nerve excitation manifests itself in a
wide variety of symptoms. Those symptoms most commonly present include head-
ache, vision problems, abnormal eye pupils, profuse sweating, tearing, and
increased respiratory secretions. More severe cholines.terase inhibition can
be evidenced by nausea, vomiting, fluid-filled lungs, heart rate changes,
muscle weakness, respiratory paralysis, confusion, convulsions or coma, and
death.
Several factors influence the course of illness resulting from exposure
to the organophosphorus compounds. Firstly, the OPs are classified by their
mode of action into two general groups. One group comprises the direct
cholinesterase inhibitors and the second group contains the compounds that
must be transformed in the body before inhibition can take place. Therefore,
the onset of illness can be immediate after exposure by direct inhibitors or
can be delayed up to 12 hours after exposure by indirect inhibitors. Most OP
insecticides are indirect inhibitors.
The second and third influencing factors are exposure route and dose, and
are broadly described as circumstances of exposure. Man's body can readily
absorb the OP compounds when they are ingested or inhaled. However, when
exposure through the skin takes place, absorption is usually slower but is more
prolonged. Such differences in type of exposure and length of exposure
E-2
-------
result in differences in dose or the relative amount of compound to which a
person is subject. Ultimately, the dose of the specific OP compound will
determine the time of symptom onset, duration of symptoms, and severity
of the illness.
To measure the relative toxicity (ability to cause illness) of a
compound, a unit called LD5Q is used. The LD5Q is the dose of a compound
that is lethal for 50% of the exposed population. LD™ values are obtained
for animals such as rats; however, as a general guide for the understanding
of LD50, the following table is presented:
Acute Oral LD5Q For Probable Lethal Oral Dose of Technical
Any Animal (ing/kg) Material for a Human Adult
< 5 A few drops
5-50 A "pinch" to 1 teaspoonful
50 - 500 1 teaspoonful - 2 tablespoonsful
500 - 5000 1 ounce - 1 pint (1 Ib.)
5000 - 15,000 1 Pint - 1 quart (2 Ibs.)
The effects of organophosphate exposure can be treated and reversed ,by
administering atropine and pralidoxime (2-PAM). Atropine lessens the severity
of the symptoms and 2-PAM releases the cholinesterase enzymes from the bond
of the OP compound. After the cholinesterase enzymes are released, the ace-
tylcholine is broken down and the nerves are relaxed.
The above paragraphs briefly summarize the toxicity characteristics of the
organophosphorus compounds. Discussions of the individual compounds implicated
in a poisoning episode are presented in the following pages. For more detailed
information, the reader is encouraged to consult the following references that
were used to compile this appendix.
E-3
-------
Phorate (Thimet*)
CHEMICAL NAME: 0,0-Diethyl S-( (ethylthio) methyl) phosphorodithioate
CHEMICAL STRUCTURE: CH3~
yf-
«,3 ^,.2
TOXICITY: Phorate is highly toxic by skin contact, inhalation, or swallowing.
Acute oral LD5Q values in male and female white rats are 2.3 mg/kg and 1.1
mg/kg, respectively. The dermal LD5Q values for male and female white rats
are 6.2 mg/kg and 2.5 mg/kg, respectively.
The dangerous dose for man is unknown but small.
USES: Phorate is a soil and systemic insecticide that employs contact and
fumigant activity. Many important pests such as mites, aphids, cutworms,
whiteflies, and leafhoppers are controlled by this insecticide. Phorate is
used on a variety of crops that includes alfalfa, barley, beans, cotton, corn,
potatoes, lettuce, tomatoes, rice, sugar, beets, peanuts, and wheat. Addition-
ally, seeds are treated with phorate.
Since phorate is persistent in the soil and is distributed throughout the plant,
this insecticide protects plants for 4 to 12 weeks after treatment.
E-4
-------
Mevinphos (Phosdrin*)
CHEMICAL NAME: 2-Methoxycarbonyl-l-methylvinyl dimethyl phosphate
» ~. , °
CHEMICAL STRUCTURE:
— 0 — C»=CH — C— 0 — CH
TOXICITY: The oral LD5Q values (rat) are 6.1 mg/kg (male) and 3.7 mg/kg (female),
The corresponding dermal LD™ values are 4.7 mg/kg and 4.2 mg/kg.
Mevinphos is a direct cholinesterase inhibitor that is highly toxic. The
dangerous dose for man is unknown but is characterised by rapid onset of
symptoms, especially those of visual disturbance. Illness was noted in
an individual within 45 minutes of the first exposure.
USES: Mevinphos is a commonly used systemic insecticide-acaricide that is
used to control aphids, mites, grasshoppers, cutworms, leaf hoppers,
caterpillars, and many other insects on a broad range of field, forage,
vegetable and fruit crops. Since mevinphos dissipates quickly, it can be
applied 1-7 days prior to harvest (depending on crop and application rates).
E-5
-------
Parathion (Ethyl Parathion)
CHEMICAL NAME: 0,0-Diethyl 0-(p-nitrophenyl) phosphorothioate.
CHEMICAL STRUCTURE:
TOXICITY: The acute and dermal LDj-Q values for male and female rats is as
follows: 13 mg/kg (male), 3.6 mg/kg (female) orally and 21 mg/kg (male)
»
6.8 mg/kg (female) dermally.
Parathion is extremily toxic to warm-blooded animals through inhalation and
skin absorption at low doses. Accidental exposure of children to open or
"empty" containers has been a major and dramatic source of fatal poisonings.
USES: Parathion was the first commercially successful organophosphte insecticide
This chemical is effective against numerous insect pests and is currently
registered for a large number and variety of uses.
E-6
-------
DEF
CHEMICAL NAME: S,S,S-Tributylphosphorotrithioate
CHEMICAL STRUCTURE: (of active ingredient)
(CH3CH2CH2CH2S)3P = 0
TOXICITY: The oral LD&0 value in the rat is 200 mg/kg while the dermal
LD5Q value is greater than 1000 mg/kg. Little is known about toxic
doses to man.
USES: DEF is a defoliant that is registered for use on cotton.
Dicrotophos (Bidrin*)
CHEMICAL NAME: Dimethyl cis-2-dimethyl-carbomoyl-l-methylvinyl phosphate
CHEMICAL STRUCTURE: ™ n n rn
\
CH3°
TOXICITY: Acute oral LD5Q (rat) is 22 mg/kg.
Very little is known about Bidrin poisoning in man; However, it is very
toxic to bees.
USES: Bidrin is contact and systemic insecticide used to control pests on
cotton, soybeans for seed, and ornamental plants. Several of the important
target pests for Bidrin are aphids, mites, boll weevils, stinkbugs, and leaf
hoppers. Additionally, Bidrin is injected into elm trees to control the
spread of Dutch Elm disease.
By its property of entering the plant tissue rapidly, Bidrin is rather selec-
tive and allows many benificial insects to survive.
E-7
-------
Malathion
CHEMICAL NAME: O.Or-Dimethyl S-(l ,2-dicarbethoxyethyl) phosphorodithioate
s o
CHEMICAL STRUCTURE: CH 0 I I
P — S— CH C —OC2H5
CH30 | 0
CH2—C ~OC2H5
TOXICITY: The acute oral LD™ values for male and female white rats are 1375
mg/kg and 1000 tng/kg, respectively. The dermal LD™ value for both male and
female rats is greater than 4444 mg/kg.
Malathion is absorbed by all portals but skin absorption is inefficient.
This compound is comparatively "safe" since most of the malathion in the
body is degraded in the liver to harmless materials. Clearly, a relatively
large dose of malathion is required to produce illness. When illness does
occur due to this indirect cholinesterase inhibitor, the chances of recovery
are good.
USES: Malathion usage is particularly indicated when a high degree of safety
to mammals is necessary. A tolerance level of 135 ppm for forage, grass,
and green hay allows grazing or harvesting on the day of application.
Malathion controls a wide variety of insects such as aphids, spider mites,
scale insects, houseflies, and mosquitoes. Other sucking and chewing insects
that attack fruits, vegetables, ornamentals, and storage products are con-
trolled by malathion.
E-8
-------
C.-0
Dioxathion (Delnav*)
CHEMICAL NAME: 2,3-p-Dioxanedithiol S,S -bis-(0,0-diethyl phosphorodithioate)
CHEMICAL STRUCTURE:
H r^Q^ IJ
"2L NHC-S-MOC^H,-),
TOXICITY: The acute oral LD5g values for male and female rats are 43 mg/kg
and 23 mg/kg, respectively. The corresponding dermal LD5Q values are 235
mg/kq (male) and 63 mg/kg (female) dioxathion is readily.obsorbed through
the skin in man.
USES: Dioxathion is a non-volatile, stable insecticide-miticide used for the
control of mites on cotton, grapes, ornamentals, citrus fruits, and certain
other fruits such as apples and pears. Ticks, lice, hornflies, and sheep
ked are controlled on cattle, goats, sheep, and hogs when dioxathion is
applied as a spray or dip.
Methyl Parathion
CHEMICAL NAME: 0,0,-Dimethyl-0-p-nitrophenyl phosphorothioate
CHEMICAL STRUCTURE: C^O S
yp.Q.^ N\ -Np2
CH3° \-=-/
TOXICITY: The acute oral LQ5Q values for rats are 14 mg/kg (male) and 24
mn/kg (female). Both the male and female rats have an acute dermal LDg^ equal
to 67 mg/kg.
Methyl parathion may be absorbed by any route and the dangerous dose is
unknown. All confirmed cases of human poisoning have had a substantial dose.
USES: The insecticide methyl parathion is used for the control of a wide range
of insect pests; however, it is very effective against the boll weevil.
E-9
-------
Disulfoton (Di-Syston*)
CHEMICAL NAME: 0,0-Diethyl S-(2-(ethylthio) ethyl) phosphorodithioate
CHEMICAL STRUCTURE: C?H,-0-
TOXICITY: The acute oral LDcn values in male and female rats are 6.8 mg/kg
bl)
and 2.3 mg/kg, respectively. The dermal LD5Q values for white rats are
15 mg/kg (male) and 6 mg/kg (female).
Little is known regarding the single and repeated dosages that would be
harmful to man. However, men have been known to tolerate 3.75 mg daily
for 24 days (approx. 0.05 mg/kg/day) by experiencing only a 15% depression
in plasma cholinesterase.
USES: Disulfoton is a systemic insecticide when sprayed on plants that controls
many species of insects and mites. Disulfoton is particularly effective
against sucking insects and control may last for 6 to 8 weeks.
E-10
-------
TEPP
CHEMICAL NAME: Tetaethyl pyrophosphate
CHEMICAL STRUCTURE: °H3 CH2 °v jj ~ /° CH2 CH3
P.-0-P
CH3— CH2—0X X0—CH2 — CH3
TOXICITY: The oral and dermal LDcn values for male white rats are 1.05 mg/kg
and 2.4 mg/kg, respectively.
TEPP is a direct cholinesterase inhibitor and is very toxic to all warm-
blooded animals including man. A single oral dose that caused severe symptoms
in man was approximately .35 mg/kg.
USES: TEPP is a contact insecticide that is very effective against mites and
other soft-bodied insects. TEPP is registered for use on vine and bush crops,
forage and field crops, vegetables and citrus fruits, and deciduous fruits
and nuts. Additionally. TEPP is used in greenhouses. Since TEPP decomposes
very rapidly into harmless compounds, this compound is used on crops shortly
before harvest.
E-ll
-------
APPENDIX F
Analysis of Variance Summaries with Subgroup Means and Standard
Deviations for the Summary Scores and Subtest Scores
of the Neuropsychological Evaluation
Halstead-Reitan Battery
WAIS Battery
Peabody Achievement Battery
Added-Ability-Tests Battery
MMPI Battery
F-l
-------
Table F-l
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Average Impairment Rating Neuropsychological Summary Score
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
2564.45
23144.35 9.83
2354.45
1209.51
12848.05 11.71
537.31 <1
1097.60
p-level
.002
<.001
Total, adj.
199
1883.57
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.18
0.52
1.00
0.36
1.07
0.44
Control s
1.06
0.4.7
0.81
0.34
0.91
0.42
Overal 1
1.12
0.49
0.90
0.36
0.99
0.43
F-2
-------
Table F-2
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Hal stead Impairment Index Neuropsychological Summary Score
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio p-level*
7.02
101.08 16.68 <.001
6.06
4.68
25.21 5.59 .020
.49 <1
4.51
Total, adj.
199
11.74
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
3.90
2.91
2.36
2.02
2.99
2.53
Control s
3.07
2.50
1.73
1.89
2.28
2.25
Overall
3.49
2.73
2.04
1.97
2.64
2.42
*In order to avoid rounding error, computations were based on ten times
the Hal stead Index.
F-3
-------
Table F-3
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the WAIS Verbal IQ Neuropsychological Summary Score
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
231.35
9.41 <1
233.61
105.23
2086.58 24.25
5 on * i
. £.\J < I
86.03
p- level
<.001
Total, adj.
199
167.97
Cases Controls Overal1
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
105.85
12.91
105.09
12.62
105.40
12.68
111.93
13.27
111.81
12.02
111.86
12.48
108.89
13.36
108.45
12.73
108.63
12.96
F-4
-------
Table F-4
Analysis of Variance Summary
with Subgroup Means and Standard .Deviations
for the WAIS Performance IQ Neuropsychological Summary Score
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
150.65
171.69 1.14
150.44
106.29
147.92 1.39
11.43 <1
106.83
p- level
.288
.242
Total, adj.
199
128.36
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
107.59
11.48
108.98
11.37
108.41
11.38
Control s
108.73
10.82
111.10
11.57
110.13
11.27
Overal 1
108.16
11.01
110.04
11.47
109.27
11.33
F-5
-------
Table F-5
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the WAIS Full Scale IQ Neuropsychological Summary Score
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
98
100
1
1
98
Mean
Square F- ratio
194.78
1 0 CT -.1
1 d.OJ < 1
196.64
96.81
1113.92 12.75
7.09 <1
87.35
p- level
<.001
Total, adj.
199
145.55
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
106.98
•
12.21
107.10
11.99
107.05
12.02
Control s
111.24
11.90
112.14
11.65
111.77
11.70
Overal 1
109.11
12.17
109.62
12.04
109.41
12.06
F-6
-------
Table F-6
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Category Subtest Score of the Halstead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
627.95
5293.86 9.12
580.34
365.28
3184.02 9.49
459.99 1.37
335.55
p-level
.003
.002
.244
Total, adj.
199
495.96
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
43.90
23.99
36.53
21.50
39.55
22.73
Control s
39.56
25.85
26.02
15.08
31.57
21.17
Overal 1
41.73
24.88
31.27
19.23
35.56
22.27
F-7
-------
Table F-7
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Trails-B Subtest Score of the Hal stead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
1218.31
6022.15 5.15
1169.28
853.32
2880.41 3.44
355.74 <1
837.71
p- level
.025
.067
Total, adj.
199
1034.89
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
80.29
34.58
71.85
27.95
75.31
30.95
Controls
75.90
44.74
62.03
20.13
67.72
33.06
Overall
78.10
39.80
66.94
24.74
71.52
32.17
F-8
-------
Table F-8
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Speech Sounds Perception Subtest Score of the Halstead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
18.44
.28 <1
18.63
14.60
172.98 13.40
21.51 1.67
12.91
p- level
.001
.199
Total, adj.
199
16.51
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
7.34
4.76
8.09
4.23
7.78
4.45
Control s
6.27
3.43
5.68
3.42
5.92
3.42
Overal 1
6.81
4.16
6.88
4.01
6.85
4.06
F-9
-------
Table F-9
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Seashore Rhythm Subtest Score of the Halstead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
4.48
2.60 <1
4.50
5.46
13.01 2.45
11.82 2.22
5.31
p- level
.120
.140
Total, adj.
199
4.97
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
26.81
2.15
26.54
2.33
26.65
2.25
Control s
26.73
2.18
27.46
2.17
27.16
2.19
Overal 1
26.77
2.15
27.00
2.29
26.91
2.23
F-10
-------
Table F-10
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Tactual Performance-Memory Subtest Score of the Ha1 stead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
2.21
1.46 <1
2.22
1.41
1.28 <1
.05 <1
1.43
p- level
— —«—
____
Total, adj.
199
1.81
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
7.54
1.55
7.68
1.14
7.62
1.32
Control s
7.66
1.43
7.86
1.35
7.78
1.38
Overall
7.60
1.48
7.77
1.24
7.70
1.35
F-ll
-------
Table F-ll
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Tactual Performance-Location Subtest Score of the Ha1 stead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
5.70
3.40 <1
5.72
3.12
.72 <1
.34 <1
3.17
p-level
Total, adj.
199
4.40
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
4.46
2.24
4.64
1.77
4.57
1.97
Controls
4.24
2.17
4.59
2.28
4.45
2.23
Overall
4.35
2.19 ;
4.62
2.03
4.51
2.10
F-12
-------
Table F-12
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Tactual Performance-Time Subtest Score of the Halstead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
50.51
179.58 3.65
49.19
30.75
71.30 2.39
20.47 <1
29.85
p- level
.059
.125
Total, adj.
199
40.58
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
14.59
8.07
12.02
4.77
13.07
6.42
Control s
12.63
6.96
11.35
5.80
11.88
6.30
Overal 1
13.61
7.55
11.69
5.29
12.48
6.37
F-13
-------
Table F-13
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Finger Oscillation Test Subtest Score of the Halstead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
237.50
9805.70 70.11
139.85
106.55
417.89 4.21
508.64 5.12
99.27
p- level
<.001
.042
.026
Total, adj.
199
171.69
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
90.49
14.77
107.96
8.52
100.80
14.33
Control s
97.20
13.17
108.20
7.84
103.69
11.64
Overal 1
93.84
14.31
108.08
8.15
102.24
13.10
F-14
-------
Table F-14
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Perceptual Disorders Subtest Score of the Halstead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
27.83
263.25 10.36
25.42
19.47
13.26 <1
16.65 <1
19.57
p- level
.002
Total, adj.
199
23.62
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
6.40
7.62
3.48
3.36
4.68
5.67
Control s
5.20
4.68
3.45
3.11
4.17
3.90
Overal 1
5.80
6.31
3.47
3.22
4.42
4.86
F-T5
-------
Table F-15
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Aphasia Exam Subtest Score of the Halstead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
27.16
20.20 <1
27.23
16.90
54.08 3.24
.12 <1
16.69
p- level
.075
Total, adj.
199
22.01
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
6.00
5.87
5.31
4.62
5.59
5.15
Controls
4.90
4.65
4.31
3.78
4.55
4.15
Overall
5.45
5.29
4.81
4.23
5.07
4.69
F-16
-------
Table F-16
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Spatial Relations Subtest Score of the Halstead-Reitan Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHQSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
1.00
13.25 15.23
.87
.90
.50 <1
1 . 04 1 . 28
.81
p- level
<.001
.261
Total, adj.
199
.95
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
2.42
.74
3.09
.97
2.81
.94
Controls
2.49
.98
2.86
1.01
2.71
1.01
Overal 1
2.45
.86
2.98
.99
2.76
.97
F-17
-------
Table F-17
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Information Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
9.61
.00 <1
9.71
4.49
60.50 15.53
6.77 1.74
3.90
p- level
<.001
.190
Total, adj.
199
7.04
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
10.95
2.57
10.58
2.55
10.73
2.55
Controls
11.61
2.70
11.98
2.62
11.83
2.65
Overal 1
11.28
2.64
11.28
2.67
11.28
2.65
F-18
-------
Table F-18
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Comprehension Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
10.22
20.58 2.04
10.11
6.17
32.81 5.53
2.16 <1
5.93
p- level
.157
.020
Total, adj.
199
8.18
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
11.83
3.27
10.97
2.70
11.32
2.96.
Control s
12.39
2.77
11.95
2.67
12.13
2.71
Overal 1
12.11
3.02
11.46
2.72
11.73
2.86
F-19
-------
Table F-19
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Arithmetic Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
11.06
9 en ^1
.00
-------
Table F-20
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Similarities Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
8.94
1 . 60 <1
9.01
5.08
49.01 10.49
.61 <1
4.67
p- level
.002
v—
Total, adj.
199
7.00
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
10.93
2.80
11.22
2.69
11.10
2.72
Control s
12.05
2.46
12.12
2.52
12.09
2.48
Overal 1
11.49
2.68
11.67
2.63
11.60
2.65
F-21
-------
Table F-21
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Digit Span Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
9.02
.29 <1
9.11
9.74
66.13 7.18
5.19 <1
9.21
p-level
.008
Total, adj.
199
9.38
Cases Controls Overal1
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
9.56
2.29
9.97
2.87
9.80
2.64
11.10
3.15
10.85
3.50
10.95
3.35
10.33
2.84
10.41
3.22
'10.38
3.06
F-22
-------
Table F-22
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Vocabulary Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State a Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
98
Mean
Square F- ratio
9.16
2 no ^i
. Uo < 1
9.23
4.99
70.81 16.28
1 OK .-1
1 . £0 < 1
4.35
p-level
<.001
Total, adj.
199
7.06
Colorado
Participants
Texas
Participants
(Keral 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
10.71
2.80
10.34
2.68
10.49
2.72
Control s
11.71
2.63
11.66
2.38
11.68
2.47
Overal 1
11.21
2.74
11.00
2.61
11.09
2.66
F-23
-------
Table F-23
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Digit Symbol Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
otate a txp.
Error B
Degrees of
Freedom
99
1
98
100
1
98
Mean
Square F- ratio
9.21
13.28 1.45
9.16
3.88
43.25 12.32
on <]
3.51
p- level
.230
<.001
Total, adj.
199
6.53
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
9.44
2.69
9.90
2.47
9.71
2.56
Control s
10.29
2.42
10.81
2.51
10.64
2.48
Overal 1
9.87
2.58
10.39
2.53
10.18
2.56
F-24
-------
Table F-24
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Picture Completion Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
6.63
65.59 10.87
6.03
3.84
.85 <1
.11 <1
3.90
p- level
.001
Total, adj.
199
5.23
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
10.42
1.87
11.63
2.60
11.13
2.39
Control s
10.34
2.00
11.46
2.21
11.00
2.18
Overal 1
10.38
1.92
11.54
2.40
11.07
2.29
F-25
-------
Table F-25
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Block Design Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
7.69
9.64 1.26
7.67
7.37
13.01 1.76
.32 <1
7.38
p-level
.265
.187
Total, adj.
199
7.53
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
11.02
3.11
11.39
2.51
11.24
2.76
Controls
11.44
2.77
11.97
2.68
11.75
2.72
Overal 1
11.23
2.93
11.68
2.60
11.50
2.74
F-26
-------
Table F-26
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Picture Arrangement Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
7.15
43.30 6.39
6.78
5.88
.25 <1
2.12 <1
5.97
p- level
.013
Total, adj.
199
6.51
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
9.59
2.37
10.32
2.69
10.02
2.57
Control s
9.27
2.65
10.42
2.37
9.95
2.54
Overal 1
9.43
2.50
10.37
2.52
9.99
2.55
F-27
-------
Table F-27
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Object Assembly Subtest Score of the WAIS Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source Of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
5.98
6.79 1.14
5.97
5.47
.72 <1
.02 <1
5.57
p- level
.289
Total, adj.
199
5.72
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
10.39
2.60
10.75
2.40
10.60
2.47
Control s
10.49
2.48
10.88
2.21
10.72
2.32
Overall
10.44
2.52
10.81
2.29
10.66
2.39
F-28
-------
Table F-28
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Reading Recognition Subtest Score of the Peabody Achievement Test
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
612.63
1290.72 2.13
605.71
297.17
2972.21 11.01
288.34 1.61
269.96
p-level
.147
.001
.304
Total, adj.
199
454.10
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
33.49
20.29
25.88
20.87
29.00
20.87
Control s
38.32
21.54
35.59
20.98
36.71
21.15
Overall
35.90
20.94
30.74
21.40
32.86
21.31
F-29
-------
Table F-29
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Reading Comprehension Subtest Score of the Peabody Achievement Test
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
_ XI&J&
341.73 <1
1171.19
S&2.78
3819.38 7.16
362.01 <1
531.60
p- level
—
.008
—
Total, adj.
199
861.29
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
54.37
31.56
54.29
31.10
54.32
31.13
Control s
59.88
28.46
65.27
25.78
63.06
26.90
Overal 1
57.12
29.99
59.78
28.98
58.69
29.35
F-30
-------
Table F-30
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Spelling Subtest Score of the Peabody Achievement Test
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
_ 154JJ9_
1180.67 <]
1550.52
_722^Q_
5639.22 8.47
1348.48 2.03
665.74
p-level
—
.004
.158
Total, adj.
199
1132.47
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
35.39
32.43
35.05
32.50
35.19
32.31
Controls
39.78
35.29
50.00
33.23
45.81
34.29
Overal 1
37.59
33.76
42.53
33.57
40.50
33.65
F-31
-------
Table F-31
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Tactile Form Recognition Subtest Score of the Neuropsychological Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
25.49
265.06 11.50
23.04
28.06
6.58 <1
22.67 <1
28.33
p- level
.001
Total, adj.
199
26.77
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
19.37
4.85
21.02
6.06
20.34
5.63
Control s
18.20
3.04
21.22
5.24
19.98
4.70
Overall
18.78
4.07
21.12
5.64
20.16
5.18
F-32
-------
Table F-32
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Hand Dynamometer Subtest Score of the Neuropsychological Battery
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
330.78
424.37 1.29
329.83
182.47
10.90 <1
23.96 <1
185.84
p- level
.259
Total, adj.
199
256.25
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
94.71
21.59
98.37
12.64
96.87
16.89
Controls
96.01
16.25
98.26
14.42
97.34
15.16
Overal 1
95.36
19.00
98.32
13.50
97.10
16.01
F-33
-------
Table F-33
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Grooved Pegboard Subtest Score of the Neuropsychological Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
738.87
8458.37 12.80
660.10
585.81
5387.20 10.13
1078.45 2.03
531.79
p- level
<.001
.002
.157
Total, adj.
199
661.96
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
158.93
35.95
140.98
24.56
148.34
30.89
Control s
142.98
19.79
134.48
15.80
137.96
17.95
Overal 1
150.95
29.93
137.73
20.82
143.15
25.73
F-34
-------
Table F-34
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Hole-Type Steadiness Subtest Score of the Neuropsychblogical Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
2044.85
3549.38 1.75
2029.50
2331.18
588.25 <1
7333.09 3.19
2297.90
p- level
.189
.077
Total, adj.
199
2188.74
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
71.71
55.23
50.83
33.74
59.39
44.79
Control s
60.61
51.84
64.36
47.08
62.82
48.87
Overal 1
66.16
53.52
57.59
41.34
61.11
46.78
F-35
-------
Table F-35
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Wisconsin Card Sorting Subtest Score of the Neuropsychological Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
9H.
1
89
91
1
1
89
Mean
Square F- ratio
88. LI
980.47 12.48
78.59
77.92
785.08 11.17
50.82 <1
70.28
p- level
.01
.001
Total, adj.
181
82.24
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
19.5
13.43
15.75
8.70
17.07
10.68
Control s
16.78
7.49
10.81
5.15
12.91
6.68
Overal 1
18.14
10.87
13.28
7.53
14.99
9.12
F-36
-------
Table F-36
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Thurstone Word Fluency Subtest Score of the Neuropsychological Battery
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
3Q9-.Qa
255.18 <1
309.64
afi8^41
2359.85 9.49
124.69 <1
248.56
p-level
.003
Total, adj.
199
288.66
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
43.51
14.05
44.20
15.55
43.92
14.89
Control s
48.49
16.45
52.39
19.46
50.79
18.30
Overall
46.00
15.41
48.30
18.01
47.36
16.99
F-37
-------
Table F-37
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Word Finding Subtest Score of the Neuropsychological Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
98
1
97
99
1
1
97
Mean
Square F-ratio
144.07
.60 ^
145.55
96.01
853.14 9.67
91.53 1.04
88.25
p- level
....
.002
.310
Total, adj.
197
119.92
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
36.35
11.15
35.58
11.36
36.09
11.23
Control s
39.35
12.74
40.85
8.33
40.24
10.31
Overall
38.10
11.96
38.21
10.26
38.17
10.95
F-38
-------
Table F-38
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Story-Learning Subtest Score • of the Neuropsycholog-fcal Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
7.81
.17 <1
.79
.50
2.00 4.11
.30 <1
.49
p-level
.045
Total, adj.
199
.64
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.95
1.02
1.81
.75
1.87
.87
Controls
1.66
.62
1.68
.78
1.67
.71
Overall
1.81
.85
1.75
.76
1.77
.80
F-39
-------
Table F-39
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Story-Memory Subtest Score of the Neuropsychological Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of Degrees of
Variation Freedom
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Total, adj.
Colorado
Participants
Texas
Participants
Overall
99
1
98
100
1
1
98
199
Mean
S.D.
Mean
S.D.
Mean
S.D.
Mean
Square F-ratio p-level
.024
.013 <1
.024
.015
.007 <1
.003 <1
.015
.019
Cases Controls Overall
.10 .10 .10
.20 .11 .16
.12 .11 .12
.12 .12 .12
.11 .10 .11
.16 .12 .14
F-40
-------
Table F-40
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Lie Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
52.91
4.48 <1
53.40
53.86
87.12 1.61
2.92 <1
54.04
p-level
_--
.207
— „
Total, adj.
199
53.39
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
50.59
8.49
50.64
8.12
50.62
8.23
Control s
48.98
5.67
49.53
6.60
49.30
6.22
Overal 1
49.78
7.23
50.09
7.39
49.96
7.31
F-41
-------
Table F-41
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Validity Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
116.86
7.45 <1
117,98
83.54
468.18 5.99
229.88 2.94
78.12
p-level
—
.016
.090
Total, adj.
199
100.12
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
54.90
7.24
57.48
11.59
56.42
10.08
Control s
54.42
12.60
52.63
7.16
53.36
9.75
Overal 1
54.66
10.22
55.05
9.90
54.89
10.01
F-42
-------
Table F-42
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Defensiveness Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
100.46
115.43 1.15
100.31
82.64
844.61 11.18
14.50 <1
75.56
p- level
.286
.001
Total, adj.
199
91.50
Cases Controls Overall
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
51.27
8.94
50.27
10.16
50.68
9.64
56.02
9.50
53.93
8.75
54.79
9.08
53.65
9.47
52.10
9.62
52.74
9.57
F-43
-------
Table F-43
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Hypochondriasis Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
1544..Q
1650.27 11.89
138.83
89.05
151.38 1.73
172.45 1.97
87.56
p- level
<.001
.191
.164
Total, adj.
199
131.41
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
52.44
10.46
52.49*
12.48
52.47
11.64
Controls
54.66
9.31
51.75
7.94
52.94
8.60
Overal 1
53.55
9.90
52.12
TO. 42
52.71
10.21
F-44
-------
Table F-44
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Depression Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
J65.22_
1922.80 13.05
147.29
J23J33_
103.68 <1
47.70 <1
124.00
p-level
<.001
___
—
Total, adj.
199
144.02
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
58.85
10.27
53.54
13.13
55.72
12.27
Control s
58.59
12.94
51.29
9.89
54.28
11.74
Overal 1
58.72
11.61
52.42
11.63
55.00
12.00
F-45
-------
Table F-45
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Hysteria Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
95.74
270.94 2.88
93.95
78.02
489.85 6.67
124.69 1.70
73.34
p-level
.093
.011
.195
rotal, adj.
199
86.83
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
54.44
10.86
53.68
9.54
54.00
10.05
Controls
59.46
8.01
55.49
8.14
57.12
8.28
Overal 1
56.95
9.81
54.59
8.87
55.56
9.32
F-46
-------
Table F-46
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Psychopathic Deviate Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
_ 131,48
3.79 <1
132.78
. 105.11
2.88
-------
Table F-47
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Masculinity-Feminity Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
109.46
542.32 5.16
105.04
75.07
3.92 <1
27.51 <1
76.28
p- level
.025
Total, adj.
199
92.18
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
57.78
10.98
55.1.9
8.02
56.25
9.38
Control s
58.39
8.51
54.29
10.44
55.97
9.36
Overal 1
58.09
9.77
54.74
9.28
56.11
9.60
F-48
-------
Table F-48
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Paranoia Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
67.36
7.15 <]
67.97
76.69
288.00 3.92
172.67 2.35
73.55
p-level
- — — —
.051
.128
Total, adj.
199
72.05
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
55.51
8. SO
57.02
8.75
56.40
8.80
Controls
55.34
8.54
53.07
7.60
54.00
8.03
Overal 1
55.43
8.67
55.04
8.40
55.20
8.49
F-49
-------
Table F*r49
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Psychasthenia Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
.125.35
21.41 <1
126.41
112.28
95.22 <1
500.31 4.61
108.49
p- level
.034
Total, adj.
199
118.78
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
55.20
9.72
57.75
12.60
56.70
11.59
Control s
57.61
11.69
53.73
8.74
55.32
10.18
Overal 1
56.40
10.75
55.74
11.04
56.01
10.90
F-50
-------
Table F-50
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Schizophrenia Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F- ratio
194.04
.00 <]
194.04
133.12
330.25 2.65
756.98 6.07
124.74
p- level
-___
.107
.015
Total, adj.
199
163.42
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
53.68
9.89
57:64
16,14
56.02
14.00
Control s
55.78
13.14
51.83
9.75
53.45
11.37
Overall
54.73
11.61
54.74
13.60
54.74
12.78
F-51
-------
Table F-51
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Hypomania Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
111.12
98.95 <1
111.24
97.43
11.05 <1
106.35 1.08
98.22
p- level
—
.301
Total, adj.
199
104.24
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
54.39
8.29
62.12
12.13
58.95
11.34
Control s
54.88
7.72
58.83
12.12
57.21
10. 68
Overal 1
54.63
7.96
60.48
12.19
58.08
11.02
F-52
-------
Table F-52
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for the Social Introversion Subtest Score of the MMPI Battery
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
99
1
98
100
1
1
98
Mean
Square F-ratio
94.44
82.87 <1
94.56
_ _82.27
505.62 5.93
71.03 <-|
85.31
p- level
.017
Total, adj.
199
91.89
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
55.32
10.72
52.80
9.34
53.83
9.96
Control s
50.71
8.77
50.61
9.18
50.65
8.97
Overal 1
53.01
10.01
51.70.
9.29
52.24
9.59
F-53
-------
APPENDIX G
Analysis of Variance Summaries with Subgroup Means and
and Standard Deviations for Scores from the
Patient's Assessment of Own Functioning
G-l
-------
Table Q-l
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Own Verbal
Communications in Last Day or Two
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F-ratio
.79
.07 <1
.80
.97
1.54 1.58
.36 <1
.97
p-level*
—
.210
__
Total, adj.
*The p-level Is not shown when the F-ratio 1s less than unity.
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.87
1.11
2.00
1.00
1.95
l.T)4
Control s
1.80
.95
1.74
.73
1.77
.82
Overal 1
1.83
1.02
1.87
.88
1.86
.94
G-2
-------
TableG-2
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Events
Occurring in Last Day or Two
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F-ratio
1.04
.17 <1
1.05
1.13
1.20 1.05
.31 <1
1.14
p- level1*
__
.310
—
Total, adj.
*The p-level is not shown when the F-ratio 1s less than unity.
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.31
1.26
1.16
1.05
1.22
1.14
Control s
1.05
.89
1.07
.98
1.06
.94
Overal 1
1.18
1.09
1.12
1.01
1.14
1.04
G-3
-------
Table G-3
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of People Met
in Last Day or Two
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
1.41
.52 <1
1.42
1.73
1.04 <1
1.70 <1
1.74
p- level*
—
—
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.28
1.21
1.58
1.49
1.46
1.38
Control s
1.36
1.14
1.27
1.11
1.31
1.12
Overal 1
1.32
1.17
1.43
1.32
1.38
1.26
G-4
-------
Table G-4
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient Assessment of Things Known a Year or More Ago
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
.85
.40 <1
.86
1.23
.64 <1
.05 <1
1.25
p- level*
--
—
—
Total, adj.
* The p-level Is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
2.00
.89
1.87
1.19
1.93
1.07
Control s
2.08
1.08
2.02
.89
2.04
.97
Overal 1
2.04
.99
1.94
1.05
1.98
1.02
G-5
-------
Table G-5
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of People Met a Year or More Ago
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
1.60
7.14 4.63
1.54
1.63
.19 <1
2.03 1.23
1.65
p-leveV
.034
—
.270
Total, adj.
*The p-level 1s not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.55
1.20
2.16
1.41
1.91
1.36
1.87
1.19
2.06
1.19
1.98
1.19
1.71
1.20
2.11
1.30
1.95
1.27
G-6
-------
TableG-6
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Losing Track of Time
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
1.65
7.58 4.79
1.58
1.09
.05 <1
.40 <1
1.11
p- level*
.031
—
—
Total, adj.
* The p-level Is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.13
.99
1.64
1.37
1.43
1.25
Control s
1.21
1.12
1.53
1.07
1.40
1.10
Overall
1.17
1.05
1.58
1.22
1.41
1.17
G-7
-------
TableG-7
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Forgetting What He's Doing
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
.94
.03 <1
.95
.90
.02 <1
1.03 1.14
.91
p-level*
—
—
.290
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
t Cases
.71
.90
.84
1.03
.78
.98
Control s
.87
1.07
.69
.86
.76
.95
Overal 1
.79
.98
.76
.95
.77
.96
G-8
-------
Table 6-8
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Forgetting How to do Things
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
.97
.72 <1
.97
.77
1.55 2.05
1.07 1.42
.76
p- level*
—
.155
.287
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.74
.86
1.02
1.13
.90
1.03
Control s
.74
.83
.71
.81
.72
.81
Overal 1
.74
.84
.86
.99
.81
.93
G-9
-------
Table G-9
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Losing Things by
Forgetting Where They Are
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F-ratio p-leveT*
.89
.10 <1
.90
1.12
.05 <1
.40 <1
1.14
Total, adj.
*The p-level is not shown when the F-rat1o is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.90
.92
2.04
1.19
1.98
1.08
Control s
1.97
1.13
1.93
.77
1.95
.92
Overal 1
1.93
1.02
1.98
1.00
1.96
1.01
G-10
-------
Table G-10
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Forgetting Own Obligations
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
92
94
1
1
92
Mean
Square F- ratio
.J.JZ.
3.45 3.00
1.15
1J11
.19 <1
.27 <1
1.16
p- level*
.086
— _
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.10
1.07
1.46
1.23
1.31
1.17
Controls
1.26
1.07
1.46
.90
1.37
.97
Overal 1
1.18
1.07
1.46
1.07
1.34
1.08
G-ll
-------
Table G-ll
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulties
Understanding Other's Speech
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F-ratio
1.04
.51 <1
1.05
1.28
7.68 6.29
.03 <1
1.22
p-leveV
__
.014
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.67
1.18
1.74
1.08
1.71
1.11
Control s
1.23
1.04
1.36
.99
1.31
1.01
Overal 1
1.45
1.12
1.56
1.05
1.51
1.08
G-12
-------
TableG-12
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulties
Recognizing Printed or Written Words
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
93
Mean
Square F- ratio
1.52
.00 <1
1.53
1.27
8.51 7.36
2.95 2.55
1.16
p- level*
•--
.008
.114
Total, adj.
*The p-level is not shown when the F-ratio 1s less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.08
1.31
1.33
1.25
1.22
1.27
Control s
.95
1.05
.69
1.03
.80
1.04
Overal 1
1.01
1.18
1.01
1.18
1.01
1.18
G-13
-------
Table 6-13
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessments of His Difficulties
Understanding Reading Material
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
1.24
.03 <1
1.25
1.36
6.89 5.30
1.38 1.06
1.30
p- level"
—
.024
.306
Total, adj.
*The p-level 1s not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.05
1.23
1.20
1.31
1.14
1.28
Control s
.87
1.03
.67
.90
.76
.96
Overal 1
.96
1.13
.94
1.15
.95
1.14
G-14
-------
Table G-14
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulties with Enunciation
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio
.89
.47 <1
.89
1.49
2.91 1.98
1.99 1.36
1.47
p-level*
-_
.163
.247
Total, adj.
*The p-level 1s not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.60
1.09
1.70
1.24
1.66
1.18
1.60
.98
1.28
.98
1.41
.99
1.60
1.03
1.49
1.13
1.53
1.09
G-15
-------
Table G-15
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Difficulty
Thinking of Names of Things
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
1.72
.63 <1
1.74
.90
3.92 4.50
.41 <1
.87
p- level*
—
.037
—
Total, adj.
*The p-level is not shown when the F-ratio 1s less than unity.
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.90
1.25
2.11
1.09
2.02
1.16
Control s
1.72
1.19
1.74
1.07
1.73
1.12
Overal 1
1.81
1.22
1.93
1.09
1.88
1.14
G-16
-------
Table 6-16
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty
Finding Words Other Than Names of Things
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F-ratio p-leveT1
.98
.91 <1
.98
.95
.43 <1
.00 <1
.97
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.85
1.01
1.98
1.15
1.93
1.09
1.74
.88
1.89
.85
1.83
.86
1.80
.94
1.94
1.01
1.88
.98
G-17
-------
Table G-17
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Difficulty
Forming Letters Correctly
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F-ratio
1.54
.00 <1
1.56
1.60
2.35 1.50
4.12 2.63
1.57
p- level"
—
.224
.108
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.10
1.12
1.40
1.38
1.28
1.28
1.23
1.33
.93
1.14
1.05
1.22
1.17
1.22
1.16
1.28
1.16
1.25
G-18
-------
Table G-18
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty in Spelling
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
2.23
.06 <1
2.26
1.78
5.86 3.35
.45 <1
1.75
p- level*
__
.071
__
Total, adj.
* The p-level 1s not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.74
1.41
1.80
1.43
1.77
1.42
1.50
1.45
1.36
1.38
1.42
1.40
1.62
1,42
1.58
1.42
1.60
1.42
G-19
-------
Table 6-19
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty
Performing Tasks with Right Hand
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F-ratio
1.47
2.57 1.76
1.46
1.17
7.68 6.92
.17 <1
1.11
p- level*
.188
.010
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.80
1.38
.62
1.45
.69
1.41
Control s
.46
.88
.16
.63
.29
.76
Overal 1
.63
1.16
.39
1.13
.49
1.15
G-20
-------
Table G-20
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty Feeling
With Right Hand
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
.43
1.97 4.76
.41
.39
.90 2.39
.96 2.54
.38
p- level*
.032
.126
.115
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Cases Controls Overall
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
.46
1.21
.11
.37
.26
.84
.15
.37
.09
.29
.12
.32
.31
.90
.10
.33
.19
.64
G-21
-------
Table G-21
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty
Performing Tasks with Left Hand
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of Degrees of Mean
Variation Freedom Square F-ratio p-level*
Between Pairs 93 2.58
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
1
92
94
1
1
92
1.23 <1
2.59
1.95
.26 <1
4.87 2.51
1.94
—
—
.117
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.31
1.54
1.14
1.42
1.21
1.47
Control s
1.00
1.41
1.49
1.62
1.29
1.55
Overal 1
1.15
1.48
1.32
1.53
1.25
1.50
G-22
-------
Table G-22
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty
Feeling With Left Hand
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
13
1
92
94
1
1
92
Mean
Square F- ratio
^5Q_
.37 <1
.50
.35
.02 <1
1.71 5.02
.34
p- level*
___
—
.027
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.41
1.02
.13
.34
.24
.71
Control s
.21
.47
.31
.66
.27
.59
Overal 1
.31
.80
.22
.53
.26
.65
G-23
-------
Table G-23
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Difficulty With
His Vision
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
1.11
6.18 5.84
1.06
.93
5.11 5.71
.08 <1
.89
p- level11
.018
.019
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.00
1.15
.67
1.11
.81
1.13
Controls
.72
.94
.31
.74
.48
.85
Overal 1
.86
1.05
.49
.96
.64
1.01
G-24
-------
Table G-24
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Thoughts
Seeming to be Confused or Illogical
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F-ratio
.86
.04 <1
.87
.89
.14 <1
.37 <1
.90
p-level*
—
—
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.92
.91
.98
.92
.96
.91
Control s
.97
1.03
.85
.92
.90
.96
Overal 1
.95
.96
.92
.92
.93
.94
G-25
-------
Table G-25
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Distraction
From What Doing or Saying
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F-ratio
.94
.19 <1
.95
.96
2.17 2.30
.88 <1
.94
p- level*
—
.133
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.18
1.04
1.26
1.08
1.23
1.06
1.13
.96
.93
.80
1.01
.87
1.16
.99
1.09
.96
1.12
.97
G-26
-------
Table G-26
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Confusion
About Where He is
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F- ratio
.70
.01 <1
.71
.72
.35 <1
.24 <1
.73
p- level1*
—
—
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.47
.76
.54
.84
.51
.81
Control s
.47
.98
.39
.81
.42
.88
Overall
.47
.87
.46
.82
.47
.84
G-27
-------
Table G-27
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of Difficulty Finding
His Way
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F- ratio
.62
.27 <1
.63
.71
.02 <1
.11 <1
.72
p- level"
—
—
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.47
.80
.44
.77
.46
.78
Controls
.55
.98
.43
.77
.48
.86
Overall
.51
.89
.44
.76
.47
.82
G-28
-------
Table G-28
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Calculating
Difficulty
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F-ratio
1.67
.74 <1
1.68
1.04
7.04 7.15
.34 <1
.98
p- level*
—
.009
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.08
1.28
1.04
1.27
1.05
1.27
Control s
.79
1.21
.57
.86
.66
1.02
Overal 1
.93
1.25
.81
1.11
.86
1.16
G-29
-------
Table 6-29
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty
NEUROLOGICAL SEQUlYW A^T^iG^oV^PHATE^fsTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
1.19
1.25 1.05
1.19
1.12
1.54 1.39
2.22 2.00
1.11
p- level*
.308
.241
.160
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.00
1.17
1.06
1.22
1.03
1.20
Control s
1.08
1.11
.69
.77
.85
.94
Overal 1
1.04
1.13
.87
1.03
.94
1.08
G-30
-------
Table G-30
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty
Solving Problems.
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
1.15
2.51 2.21
1.13
.77
3.32 4.55
1.92 2.63
.73
p- level*
.140
.036
.108
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.97
1.16
.94
1.03
.96
1.08
Control s
.95
.94
.51
.74
.69
.86
Overal 1
.96
1.05
.73
.92
.82
.98
G-31
-------
Table G-31
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty
Following Directions
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of Degrees of Mean
Variation Freedom Square F- ratio p-level*
Between, Pairs_ g_3 jj]
States i 2.68 2.46 .120
Error A 92 1.09
Wi thjnj>aijrs 14 1JJ3. _
Exposure 1 4.17 4.16 .044
State & Exp. 1 .64 <1
Error B 92 1.00
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.05
1.26
.69
1.05
.84
1.15
Control s
.62
.99
.49
.81
.54
.89
Overal 1
.83
1.14
.59
.94
.69
1.03
G-32
-------
Table G-32
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Patient's Assessment of His Difficulty
Following Instructions
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
WHhin Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
1.05
1.22 1.17
1.04
1.03
8.51 8.94
.95 1.00
.95
p- level*
.282
.004
.319
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.13
1.28
1.11
1.15
1.12
1.20
Control s
.87
.77
.56
.71
.69
.75
Overal 1
1.00
1.06
.84
.99
.90
1.02
G-33
-------
APPENDIX H
Analysis of Variance Summaries with Subgroup Means and
Standard Deviations for Scores from the
Assessment by a Relative of the Patient's Functioning
H-l
-------
Table H-l
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Depression
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
.91
3.49 3.95
.88
.86
6.89 8.56
.08 <1
.80
p- level"
.050
.005
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
2.18
1.07
1.94
.97
2.04
1.02
1.85
.88
1.53
.77
1.66
.82
2.01
.99
1.74
.90
1.85
.94
H-2
-------
Table H-2
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Irritability
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
9J
1
90
92
1
1
90
Mean
Square F- ratio
L.15
.62 <1
1.16
L.23
12.52 11.24
.23 <1
1.11
p- level*
» —
.001
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Cases Controls Overal1
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
2.26
1.06
2.07
1.16
2.15
1.12
1.66
1.15
1.61
.90
1.63
1.00
1.96
1.14
1.84
1.06
1.89
1.09
H-3
-------
Table H-3
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Seriousness
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio p-leveT1
1.00
.16 <1
1.01
.94
.27 <1
.11 <1
.96
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Cases Controls Overall
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
2.70
1.20
2.59
1.00
2.64
1.08
2.57
.84
2.56
.92
2.56
.88
2.64
1.03
2.57
.96
2.60
.98
H-4
-------
Table H-4
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Withdraw!
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
j^A
1.74 1.86
.94
1.05
4.22 4.10
.23 <1
1.03
p- level*
.176
.046
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.90
1.23
1.63
.98
1.74
1.09
Control s
1.51
.79
1.39
.94
1.44
.88
Overal 1
1.70
1.05
1.51
.96
1.59
1.00
H-5
-------
Table H-5
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Carelessness in Appearance
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Degrees of
Freedom
93
1
92
Mean
Square F- ratio
.88
1.11 1.28
.87
p-level*
.262
Within_Pa_l£S 9J KOT. _
Exposure 1 2.13 2.11 .150
State & Exp. 1 .16 <1
Error B 92 1.01
Total, adj.
*The p-level 1s not shown when the F-ratlo 1s less than unity.
Cases Controls Overall
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.67
1.03
1.76
1.07
1.72
1.05
1.38
.88
1.60
.87
1.51
.88
1.53
.96
1.68
.98
1.62
.97
H-6
-------
Table H-6
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Carelessness in Activities
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F-ratio
1.08
.23 <1
1.09
1.02
.44 <1
.39 <1
1.03
p- level1*
w •• —
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.28
1.00
1.26
.99
1.27
.99
Control s
1.08
1.04
1.24
1.08
1.17
1.06
Overall
1.18
1.02
1.25
1.03
1.22
1.02
H-7
-------
Table H-7
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Suspiciousness
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F-ratio
1.42
.10 <1
1.44
1*45
2.13 1.47
.24 <1
1.45
p- level*
— — —
.229
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.59
1.19
1.71
1.27
1.66
1.24
Control s
1.46
1.23
1.44
1.12
1.45
1.16
Overal 1
1.53
1.20
1.57
1.20
1.55
1.20
H-8
-------
Table n-8
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment.of Patient's Confusion About
What is Happening
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PEST-ICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
.79
.07 <1
.80
.96
4.22 4.53
.17 <1
.93
p- level*
—
.036
—
Total, adj.
*The p-level is not shown when the F-ratio 1s less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
.97
1.01
1.07
1.01
1.03
1.00
.74
.85
.72
.83
.73
.84
.86
.94
.90
.94
.88
.93
H-9
-------
Table H-9
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Confusion About
What He/She is Doing
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PEST-ICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
9j4
1
1
92
Mean
Square F-ratio
.71
.07 <1
.71
^2.
.64 1.08
.05 <1
.60
p- level11
—
.301
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.74
.82
.82
.80
.79
.80
Control s
.67
.93
.67
.72
.67
.81
Overal 1
.70
.87
.74
.76
.73
.80
H-10
-------
Table H-10
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Indifference
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F- ratio
.93
.00 <1
.94
.70
.78 1.15
1.84 2.70
.68
p- level*
—
.287
.104
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.18
.91
1.38
.86
1.29
.88
Control s
1.28
.89
1.08
.94
1.16
.92
Overal 1
1.23
.90
1.23
.91
1.23
.90
H-ll
-------
Table H-ll
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Unpredictable
and Changeable Attitudes
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
1.41
.42 <1
1.42
.99
2.37 2.40
.00 <1
.99
p- level11
—
.125
—
Total, adj.
*The p-level is not shown when the F-ratio .is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.67
1.03
1.76
1.18
1.72
1.12
Control s
1.44
1.10
1.54
1.06
1.50
1.07
Overal 1
1.55
1.06
1.65
1.12
1.61
1.10
H-12
-------
Table H-12
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Unpredictable
and Changeable Behavior
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F- ratio
1.36
.14 <1
1.37
1.00
5.56 5.80
.15 <1
.96
p- level*
___
.018
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Cases Controls Overal1
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
<; n.
1.72
1.12
1.83
1.16
1.78
1.14
1.44
1.10
1.43
.95
1.44
1.01
1.58
1.11
1.63
1.07
1.61
1.09
H-13
-------
Table H-13
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Inappropriateness
in Social Situations
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
9J
1
T
91
Mean
Square F-ratio
ja.
.35 <1
.82
u.54
.01 <1
.00 <1
.56
p- level*
—
—
—
Total, adj.
*The p-level 1s not shown when the F-rat1o 1s less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.28
.86
1.20
.94
1.24
.90
Control s
1.28
.79
1.18
.70
1.23
.74
Overal 1
1.28
.82
1.19
.83
1.23
.82
H-14
-------
Table H-14
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Selfishness
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PEST-ICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio
1.34
.01 <1
1.36
1.06
.44 <1
.53 <1
1.07
p-level*
—
—
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.33
1.20
1.21
1.00
1.26
1.08
Controls
1.31
1.22
1.40
1.03
1.36
1.11
Overal 1
1.32
1.20
1.31
1.02
1.31
1.10
H-15
-------
Table H-15
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Propensity to
be Upset by New Problems
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
_91
1
91
-22.
1
1
90
Mean
Square F- ratio
. J*35_
1.16 <1
1.34
1*55.
2.88 1.87
1.34 <1
1.54
p-leveV1
___
.175
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
2.03
1.11
2.04
1.28
2.03
1.21
Control s
1.97
1.39
1.64
1.02
1.78
1.19
Overal 1
2.00
1.25
1.84
1.17
1.91
1.20
H-16
-------
Table H-16
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Propensity
to be Upset by Changes in Plans
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
1.44
.06 <1
1.46
1.65
.65 <1
2.04 1.23
1.66
p- level*
—
.270
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.90
1.25
2.07
1.40
2.00
1.34
2.03
1.31
1.78
1.02
1.88
1.15
1.96
1.27
1.93
1.23
1.94
1.24
H-17
-------
Table H-17
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Demands of Others'
Attention
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PEST-ICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Degrees of
Freedom
91
1
90
Mean
Square F-ratio
1 11
1.47 1.29
1.14
p-level*
.259
Wi hinPa1rs 9U21
Exposure
State & Exp.
Error B
1
1
90
.00 <1
12.91 11.85
1.09
—
.001
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.45
1.01
2.17
1.06
1.87
1.09
Control s
2.08
1.00
1.72
1.12
1.87
1.08
Overal 1
1.76
1.04
1.94
1.11
1.87
1.08
H-18
-------
Table H-18
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Dependency
Upon Others
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F-ratio p-level*
1.59
8.38 5.54 .021
1.51
1.11
.34 <1
.01 <1
1.13
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.10
1.00
1.52
1.31
1.34
1.20
Controls
1.00
1.12
1.44
1.09
1.26
1.12
Overall
1.05
1.06
1.48
1.20
1.30
1.16
H-19
-------
Table H-19
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Dependability
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING;
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
1.50
.70 <1
1.50
1.04
1.21 1.18
2.08 2.03
1.02
p-level*
—
.280
.157
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.26
1.27
1.17
1.22
1.20
1.24
Control s
.85
1.09
1.18
.91
1.04
1.00
Overal 1
1.05
1.19
1.18
1.08
1.12
1.12
H-20
-------
Table H-20
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Desirability
as a Family Member
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
-88.
1
87
89
1
1
87
Mean
Square F- ratio
.91 <1
1.14
1.16
2.97 2.58
.08 <1
1.15
p-level*
— — —
.112
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.00
1.15
1.10
1.25
1.06
1.20
Controls
.69
.92
.88
.92
.80
.92
Overal 1
.85
1.04
.99
1.10
.93
1.07
H-21
-------
Table H-21
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Others' Appreciation
of Patient
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESHCIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F-ratio
.86
.75 <1
.86
.68
.01 <1
.00 <1
.70
p- level*
—
—
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.77
.71
.91
.98
.85
.87
Control s
.77
.81
.89
.94
.84
.89
Overal 1
.77
.76
.90
.96
.84
.88
H-22
-------
Table H-22
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Confabulation
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
89_
88
90
1
1
88
Mean
Square F-ratio
_ J J3_
.07 <1
1.24
1.22
.20 <1
.47 <1
1.24
p- level"
_ __
___
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
$.D.
Mean
S.D.
Cases
.68
1.07
.83
1.26
.77
1.18
Control s
.74
1.13
.67
.96
.70
1.03
Overall
.71
1.09
.75
1.12
.73
1.11
H-23
-------
Table H-23
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Memory of
Verbal Communications in Last Day or Two
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
93
1
92
94
1
1
92
Mean
Square F- ratio
1.40
.64 <1
1.41
1.39
.43 <1
.00 <1
1.41
p- level*
—
—
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Cases Controls Overall
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.62
1.16
1.49
1.39
1.54
1.29
1.51
1.12
1.40
1.03
1.45
1.06
1.56
1.14
1.44
1.22
1.50
1.18
H-24
-------
Table H-24
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Memory Regarding
Verbal Communications a Year or More Ago
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
87
1
86
88
1
1
86
Mean
Square F-ratio p-level*
.83
.26 <1
.84
1.59
.14 <1
.18 <1
1.62
Total, adj.
*The p-level is-not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.46
1.12
1.45
1.28
1.46
1.20
Controls
1.59
1.12
1.45
.89
1.51
.99
Overall
1.53
1.11
.45
1.10
1.48
1.10
H-25
-------
Table H-25
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Memory of
Events Occurring in Last Day or Two
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
.97
.00 <1
.98
.87
.19 <1
.05 <1
.89
p- level*
—
_ _ m.
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
..67
.93
.63
1.09
.64
1.02
Controls
.56
.91
.59
.90
.58
.90
Overal 1
.62
.92
.61
.99
.61
.96
H-26
-------
Table H-26
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Memory of
Events Occurring a Year or More Ago
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PEST-ICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
88
1
87
89
1
1
87
Mean
Square F-ratio
1J3&
.28 <1
1.00
1.08
.09 <1
.01 <1
1.10
p-level*
« « •_
™ «• —
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.08
1.01
.98
1.12
1.02
1.07
1.10
1.05
1.04
.92
1.07
.98
1.09
1.02
1.01
1.02
1.04
1.02
H-27
-------
Table H-27
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Memory of
People Met in Last Day or Two
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F-ratio
.96
.06 <1
.96
.95
1.76 1.86
.04 <1
.95
p- level*
—
.176
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.38
.75
.48
.82
.42
.79
Control s
.62
1.25
.62
1.04
.62
1.13
Overal 1
.50
1.03
.54
.94
.52
.98
H-28
-------
Table H-28
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Memory
of People Met a Year or More Aqo
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio
1.40
2.57 1.86
1.38
1.03
1.41 1.35
.04 <1
1.04
p- level11
.177
.248
—
Total, adj.
* The p-level is not shown when the F-ratio 1s less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
1.08
.97
.87
1.11
.96
1.05
1.29
1.31
1.02
1.01
1.13
1.15
1.18
1.15
.94
1.06
1.04
1.10
H-29
-------
Table H-29
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Losing Track
of Time
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F-^atio
1.97
.01 <1
2.00
1.46
.09 <1
.71 <1
1.49
p- level1*
—
—
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.10
1.31
.96
1.32
1.02
1 n
Control s
1.00
1.26
1.11
1.37
1.06
i •&
Overal 1
1.05
1.28
1.04
1.34
1.04
1 •*!
H-30
-------
Table H-30
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Propensity
to Forget What He is Doing
NEUROLOGICAL 'SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
.99
2.97 3.08
.96
.90
.13 <1
.79 <1
.91
p- level*
.083
—
Total, adj.
*The p-level 1s not shown when the F-ratio 1s less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D,
Cases
.58
.79
.46
1.10
.50
.98
Control s
.79
1.23
.40
.68
.56
.96
Overall
.68
1.04
.43
.91
.53
.97
H-31
-------
Table H-31
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Tendency to
Forget How to Do Things
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
-93.'
1
1
91
Mean
Square F- ratio
.47
.00 <1
.48
^L
.34 <1
.12 <1
.51
p- level*
—
—
—
Total, adj.
* The p-level is not shown when the F-ratio 1s less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.33
.62
.39
.94
.37
.82
Control s
.31
.57
.26
.56
.28
.56
Overal 1
.32
.59
.32
.77
.32
.70
H-32
-------
Table H-32
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Tendency
to Lose Things by Forgetting Where They Are
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
9J
1
1
91
Mean
Square F- ratio
1.42
.11 <1
1.44
2^.02
.44 <1
2.37 1.13
2.11
p-level*
_ »
__-
.291
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.47
1.22
1.66
1.44
1.58
1.35
Control s
1.84
1.24
1.56
1.34
1.68
1.30
Overal 1
1.66
1.24
1.61
1.39
1.63
1.33
H-33
-------
Table H-33
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Tendency
to Forget Obligations
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F- ratio
1.48
.93 <1
1.49
1.30
.01 <1
.43 <1
1.32
p- level*
—
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean •><
S.D.
Mean
S.D.
Mean
S.D.
1.16
1.15
1.40
1.33
1.30
1.26
T.26
1.03
1.31
1.15
1.29
1.10
1.21
1.09
1.36
1.24
1.30
1.18
H-34
-------
Table H-34
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Understanding Speech of Others
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio p-leveV
1.22
.77 <1
1.23
1.37
5.28 3.98 .049
1.19 <1
1.33
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.10
1.12
1.14
1.28
1.12
1.21
Control s
.95
1.23
.65
.86
.78
1.04
Overal 1
1.03
1.17
.89
1.11
.95
1.14
H-35
-------
Table H-35
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Recognizing Printed or Written Words
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio
1.25
.11 <1
1.27
1.23
4.62 3.85
.01 <1
1.20
p- level*
—
.053
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.81
1.20
.78
1.33
.79
1.27
Control s
.51
.96
.44
.88
.47
.91
Overall
.66
1.09
.61
1.13
.63
1.11
H-36
-------
Table H-36
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Understanding Reading Material
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
89
1
88
90
1
1
88
Mean
Square F- ratio
1.07
.01 <1
1.09
*$&.
1.42 1.68
.29 <1
.84
p-leveV
__.
.198
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.62
1.09
.72
1.17
.68
1.13
Control s
.54
.87
.47
.75
.50
.80
Overal 1
.58
.98
.59
.98
.59
.98
H-37
-------
Table H-37
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
With Enunciation
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F-ratio
1.45
.34 <1
1.46
1.23
.79 <1
.36 <1
1.24
p-level*
—
—
___
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
.79
1.07
.79
1.15
.79
1.11
.76
1.24
.58
1.18
.66
1.20
.78
1.15
.69
1.17
.72
1.16
H-38
-------
Table H-38
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Thinking of Names of Things.
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F-ratio
.97
1.28 1.33
.96
1.03
4.57 4.58
.02 <1
1.00
p- level*
.253
.035
—
Total, adj.
v The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.18
.96
1.04
1.10
1.10
1.04
Control s
.90
1.03
.70
.86
.78
.94
Overal 1
1.04
1.00
.87
1.00
.94
1.00
H-39
-------
Table H-39
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Thinking of Words Other Than Names of Things.
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F-ratio
.95
1.82 1.93
.94
.82
2.42 3.00
.02 <1
.81
p- level"
.169
.087
__-
Total, adj.
*The p-level is not shown when the F-ratio 1s less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.03
.84
.85
1.06
.92
.97
Control s
.82
.94
.60
.87
.69
.90
Overall
.92
.89
.72
.97
.81
.94
H-40
-------
Table H-40
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Forming Letters Correctly When Writing
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
89
1
88
90
1
1
88
Mean
Square F- ratio
1.20
1.31 1.10
1.20
.78
1.61 2.05
.03 <1
.78
P-level*
.298
.155
Total, adj.
*The p-level Is not shown when the F-ratio 1s less than unity.
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.68
1.16
.54
1.02
.60
1.08
Controls
.53
1.01
.33
.81
.41
.90
Overall
.60
1.08
.43
.92
.51
.99
H-41
-------
Table H-41
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of the Difficulty Others
Have Reading Patient's Writing
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
63
1
62
64
1
1
62
Mean
Square F- ratio
1.26
.77 <1
1.27
1.13
.07 <1
1.26 1.10
1.15
p- level1*
—
—
.298
Total, adj.
*The p-level 1s not shown when the F-ratio 1s less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.68
1.19
•72
1.00
.70
1.08
Control s
.86
1.30
.50
.94
.66
1.12
Overal 1
.77
1.24
.61
.97
.68
1.09
H-42
-------
Table H-42
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Spelling
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
_9Q_
1
89
_91
1
1
89
Mean
Square F- ratio
2^01
.02 <1
2.03
1.47
.79 <1
3.88 2.67
1.45
p-level"
—
.106
Total, adj.
*The p-level 1s not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
1.36
1.39
1.64
1.47
1.52
1.43
Control s
1.56
1.31
1.25
1.10
1.38
1.20
Overal 1
1.46
1.34
1.44
1.31
1.45
1.32
H-43
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Table H-43
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for RelativeTs Assessment of Patient's Difficulty
Performing Tasks With Right Hand
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
-92.
1
91
93
1
1
91
Mean
Square F- ratio
LDJ
1.79 1.78
1.01
.97
.34 <1
.29 <1
.98
p- level*
.186
—
---
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.54
1.10
.26
.94
.38
1.01
Control s
.36
1.16
.24
.84
.29
.98
Overal 1
.45
1.12
.25
.89
.33
1.00
H-44
-------
Table H-44
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Performing Tasks With Left Hand
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
88
1
87
89
1
1
87
Mean
Square F- ratio
1.44
.76 <1
1.44
1.39
11.89 9.43
2.37 1.88
1.26
p- level*
—
.003
.174
Total, adj.
*The p-level Is not shown when the F-rat1o 1s less than unity.
Cases Controls Overall
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
.49
.80
.38
1.01
.43
.93
.73
1.22
1.10
1.44
.94
1.36
.61
1.03
.74
1.29
.68
1.19
H-45
-------
Table H-45
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Whether Patient's
Thoughts Seem Confused or Illogical
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
_90.
1
89
91
1
1
89
Mean
Square F-ratio
-ZS
.00 <1
.80
.77
3.71 5.01
.22 <1
.74
p-level*
—
.028
___
Total, adj.
*The p-level 1s not shown when the F-rat1o is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.64
.84
.71
1.09
.68
.99
Control s
.44
.82
.36
.69
.40
.74
Overal 1
.54
.83
.54
.92
.54
.88
H-46
-------
Table H-46
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Whether Patient
is Distracted From What Doing or Saying
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F- ratio
.81
.15 <1
.82
.59
.66 1.10
.01 <1
.60
p- level*
—
.297
—
Total, adj.
* The p-level is not shown when the F-ratio 1s less than unity.
Col orado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.40
.60
.46
.82
.44
.73
Controls
.53
.80
.57
1.02
.55
.93
Overal 1
.46
.70
.52
.92
,50
.84
H-47
-------
Table H-47
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Whether Patient
is Confused About Where He is
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio
.36
.13 <1
.36
.41
.14 <1
2.18 5.52
.40
p -level*
—
—
.021
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.41
.82
.14
.52
.25
.68
Control s
.10
.38
.27
.66
.20
.56
Overal 1
.26
.65
.20
.60
.22
.62
H-48
-------
Table H-48
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Finding His Way
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING-
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio
.50
1.40 2.85
.49
.55
.44 <1
.11 <1
.56
p- level*
.095
—
—
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.47
.86
.24
.62
.34
.73
Control s
.32
.81
.19
.65
.24
.72
Overal 1
.40
83
.22
.63
.29
.73
H-49
-------
Table H-49
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Calculating
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
89
1
88
-9Q_
1
1
88
Mean
Square F- ratio
.94
.07 <1
.95
L.Q1
.56 <1
1.94 1.92
1.01
p-leveV
—
— _
.169
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.87
.99
1.04
.97
.97
.98
Controls
1.00
1.12
.75
.90
.86
1.00
Overal 1
.93
1.05
.89
.94
.91
.99
H-50
-------
Table H-50
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Planning and Organizing Activities
NEUROLOGICAL SEQUELAE OF ACUTE OR6ANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
90
1
89
91
1
1
89
Mean
Square F- ratio
.74
1.47 2.02
.73
.76
.05 <1
.41 <1
.78
p- level*
.159
—
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Cases Controls Overall
Colorado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
.68
.66
.96
.98
.85
.87
.76
.82
.85
.91
.81
.87
.72
.74
.91
.94
.83
.87
H-51
-------
Table H-51
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Solving Problems
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
89
1
88
90
1
1
88
Mean
Square F-ratio
.78
.19 <1
.78
.47
.56 1.21
1.16 2.53
.46
p- level*
—
.274
.115
Total, adj.
*The p-level is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.68
.67
.91
.95
.81
.85
Control s
.76
.68
.66
.76
.70
.73
Overal 1
.72
.67
.78
.86
.76
.79
H-52
-------
Table H-52
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Foil owing Directions
NEUROLOGICAL SEQUELAE OF ACUTE OKGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
92
1
91
93
1
1
91
Mean
Square F-ratio p-level*
.49
.42 <1
.49
.53
.34 <1
.63 1.20 .276
.53
Total, adj.
* The p-ltevel is not shown when the F-ratio is less than unity.
Colorado
Participants
Texas
Participants
Overall
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.64
.67
.43
.57
.52
.62
Controls
.59
.85
.61
.76
.60
.80
Overall
.62
.76
.52
.68
.56
.71
H-53
-------
Table H-53
Analysis of Variance Summary
with Subgroup Means and Standard Deviations
for Relative's Assessment of Patient's Difficulty
Following Instructions
NEUROLOGICAL SEQUELAE OF ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:
A CASE - CONTROL STUDY
Source of
Variation
Between Pairs
States
Error A
Within Pairs
Exposure
State & Exp.
Error B
Degrees of
Freedom
91
1
90
92
1
1
90
Mean
Square F- ratio
.51
1.06 2.12
.50
.36
.27 <1
.34 <1
.36
p- level*
.149
—
—
Total, adj.
* The p-level is not shown when the F-ratio is less than unity.
Col orado
Participants
Texas
Participants
Overal 1
Mean
S.D.
Mean
S.D.
Mean
S.D.
Cases
.79
.70
.72
.60
.75
.64
Control s
.82
.73
.57
.63
.67
.68
Overal 1
.80
.71
.65
.62
.71
.66
H-54
4U.S. GOVERNMENT PRINTING OFFICE: 1980 311-132/61 1-3
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