With regard to coherence, there is a large body of in vivo laboratory studies which show long-term behavioral effects from early life exposure, albeit at doses which cause AChE inhibition.  EPA considers the results of the toxicological studies relevant to the human population, as qualitatively supported by the results of epidemiology studies. The lack of established MOA/AOP pathway does not undermine or reduce the confidence in the findings of the epidemiology studies.  When all the evidence is considered together, there are uncertainties with respect to a number of factors such as exposure assessment, lack of ability to make strong causal linkages, and unknown window(s) of susceptibility.  The epidemiology studies reviewed in the 2012/2014 and 2015/2016 literature reviews represent different investigators, locations, points in time, exposure assessment procedures, and outcome measurements.  Despite all these uncertainties and differences in study design, multiple investigators have identified associations with neurodevelopmental outcomes such as ADHD/behavioral problems and autism spectrum, in relation to OP exposure. There is evidence of delays in mental development in infants (24-36 months), attention problems and autism spectrum disorder in early childhood, and intelligence decrements in school age children who were exposed to OPs during gestation. Investigators reported strong measures of statistical association across several of these evaluations (odds ratios 2-4 fold increased in some instances), and observed evidence of exposures-response trends in some instances, e.g., intelligence measures. Thus, with respect to biological plausibility and coherence, although uncertainties remain, these uncertainties are diminished in the context of the qualitative similarity between the epidemiology studies.

4.0	10X FQPA Safety Factor for Infants and Children

As section 408(b)(2)(C) of the FFDCA instructs EPA, in making its "reasonable certainty of no harm" finding, that in "the case of threshold effects, an additional tenfold margin of safety for the pesticide chemical residue and other sources of exposure shall be applied for infants and children to take into account potential pre- and postnatal toxicity and completeness of data with respect to exposure and toxicity to infants and children." Section 408 (b)(2)(C) further states that "the Administrator may use a different margin of safety for the pesticide chemical residue only if, on the basis of reliable data, such margin will be safe for infants and children."  Given the totality of the evidence, there is sufficient uncertainty in the human dose-response relationship for neurodevelopmental effects which prevents the agency from reducing or removing the statutory 10X FQPA Safety Factor.  For the human health risk assessments for the OPs, a value of 10X will be applied.  Similarly, a database uncertainty factor of 10X will be retained for occupational risk assessments.  The agency will continue to evaluate the epidemiology studies and pursue approaches for quantitative or semi-quantitative comparisons between doses which elicit AChE inhibition and those which are associated with neurodevelopmental outcomes prior to a revised human health risk assessment.  The FQPA 10X Safety Factor or database uncertainty factor will be retained for OPs for the population subgroups that include infants, children, youths, and women of childbearing age for all exposure scenarios.

5.0	References

      Acosta-Maldonado, Brenda, Sánchez-Ramírez, Blanca, Reza-López, Sandra, and Levario-Carrillo, Margarita. Effects of exposure to pesticides during pregnancy on placental maturity and weight of newborns: A cross-sectional pilot study in women from the Chihuahua State, Mexico. Human and Experimental Toxicology 28(8) 451 - 459, 2009.
      Aldridge, J. E., Levin, E. D., Seidler, F. J., & Slotkin, T. A. (2005). Developmental exposure of rats to chlorpyrifos leads to behavioral alterations in adulthood, involving serotonergic mechanisms and resembling animal models of depression. Environ Health Perspect, 113(5), 527 - 531.
      al-Hachim, G.M., Fink, G.B., 1968a. Effect of DDT or parathion on open-field behavior of offspring from DDT- or parathion-treated mothers. Psychol Rep 22, 1193-1196.
      al-Hachim, G.M., Fink, G.B., 1968b. Effect of DDT or parathion on condition avoidance response of offspring from DDT or parathion-treated mothers. Psychopharmacologia 12, 424-427.
      Andersen, Helle R., Debes, Fróði, Wohlfahrt-Veje, Christine, Murata, Katsuyuki, Grandjean, Philippe. Occupational pesticide exposure in early pregnancy associated with sex-specific neurobehavioral deficits in the children at school age. Neurotoxicology and Teratology 47:1-9, 2015.
      Ankley, G. T., Bennett, R. S., Erickson, R. J., Hoff, D. J., Hornung, M. W., Johnson, R. D., et al. (2010). Adverse outcome pathways: a conceptual framework to support ecotoxicology research and risk assessment. Environ Toxicol Chem, 29(3), 730-741.
      Barr DB, Ananth CV, Yan X, Lashley S, Smulian JC, Ledoux TA, Hore P, Robson MG. Pesticide concentrations in maternal and umbilical cord sera and their relation to birth outcomes in a population of pregnant women and newborns in New Jersey. Sci Total Environ. 2010;408:790 - 795.
      Berkowitz GS, Wetmur JG, Birman-Deych E, Obel J, Lapinski RH, Godbold JH, Holzman IR, Wolff MS. In Utero Pesticide Exposure, Maternal Paraoxonase Activity, and Head Circumference. Environmental Health Perspectives. 2004;112:388 - 391.
      Billauer-Haimovitch, H., Slotkin, T. A., Dotan, S., Langford, R., Pinkas, A., & Yanai, J. (2009). Reversal of chlorpyrifos neurobehavioral teratogenicity in mice by nicotine administration and neural stem cell transplantation. Behav Brain Res, 205(2), 499 - 504.
      Boobis, A. R., Cohen, S. M., Dellarco, V., McGregor, D., Meek, M. E., Vickers, C., et al. (2006). IPCS framework for analyzing the relevance of a cancer mode of action for humans. Crit Rev Toxicol, 36(10), 781-792.
      Boobis, A. R., Doe, J. E., Heinrich-Hirsch, B., Meek, M. E., Munn, S., Ruchirawat, M., et al. (2008). IPCS framework for analyzing the relevance of a noncancer mode of action for humans. Crit Rev Toxicol, 38(2), 87-96.
      Bouchard M.F., Bellinger D.C., Wright R.O., Weisskopf M.G., (2010). Attention-Deficit/Hyperactivity Disorder and Urinary Metabolites of Organophosphate Pesticides. PEDIATRICSDOI:10.1542/peds.2009-3058.
      Bouchard, M. F., Chevrier, J., Harley, K. G., Kogut, K., Vedar, M., Calderon, N., et al. (2011). Prenatal exposure to organophosphate pesticides and IQ in 7-year-old children. Environ Health Perspect, 119(8), 1189-1195.
      Braquenier J-B, Quertemont E, Tirelli E, Plumier J-C. Anxiety in adult female mice following perinatal exposure to chlorpyrifos. 2010. Neurotoxicol Teratol. 32:234-239, 2010
      Carr RL, Armstrong NH, Buchanan AT, Eells JB, Mohammed AN, Ross MK, Nail CA. Decreased anxiety in juvenile rats following exposure to low levels of chlorpyrifos during development. 2015. Neurotoxicol. 2015, http://dx.doi.org/10.1016/j.neuro.2015.11.016,
      Cartier, C., Warembourg, C., Le Maner-Idrissi, G., Lacroix, A., Rouget, F., Monfort, C., ... & Chevrier, C. (2016). Organophosphate Insecticide Metabolites in Prenatal and Childhood Urine Samples and Intelligence Scores at 6 Years of Age: Results from the Mother - Child PELAGIE Cohort (France). Environmental health perspectives, 124(5), 674.
      Ceh, K., Jezek, D., Zuzek, M.C., Cebulj-Kadunc, N., Majdic, G., 2012. Effects of organophosphate chlormephos on development and function of testes and brain. Slovenian Veterinary Research 49, 41-49.
      Chen L, Zhao T, Pan C, Ross JH, Krieger RI.  (2012) Preformed biomarkers including dialkylphosphates (DAPs) in produce may confound biomonitoring in pesticide exposure and risk assessment. J Agric Food Chem. 2012 Sep 12;60(36):9342-51. doi: 10.1021/jf303116p. Epub 2012 Sep 4.
      Clemens, G.R., Hartnagel, R.E., Bare, J.J., Thyssen, J.H., 1990. Teratological, neurochemical, and postnatal neurobehavioral assessment of METASYSTOX-R, an organophosphate pesticide in the rat. Fundam Appl Toxicol 14, 131-143.
      Crowder, L.A., Lanzaro, G.C., Whitson, R.S., 1980. Behavioral effects of methyl parathion and toxaphene exposure in rats. J Environ Sci Health B 15, 365-378.
      Dąbrowski, Sławomir, Hanke, Wojciech, Polańska, Kinga, Makowiec-Dąbrowska, Teresa, and Sobala, Wojciech. Pesticide exposure and birthweight: An epidemiological study in Central Poland. International Journal of Occupational Medicine and Environmental Health 16(1): 31-39, 2003.
      de Castro, V.L., Chiorato, S.H., Pinto, N.F., 2001. Relevance of developmental testing of exposure to methamidophos during gestation to its toxicology evaluation. Toxicol Lett 118, 93-102.
      Driver JH, Li Y, Ross JH, Krieger RI.  Dialkylphosphates (DAPs) in fruits and vegetables may confound biomonitoring in organophosphorus insecticide exposure and risk assessment.   J Agric Food Chem. 2008 Nov 26;56(22):10638-45. doi: 10.1021/jf8018084. 1,

      Donauer, S., Altaye, M., Xu, Y., Sucharew, H., Succop, P., Calafat, A. M., ... & Yolton, K. (2016). An Observational Study to Evaluate Associations Between Low-Level Gestational Exposure to Organophosphate Pesticides and Cognition During Early Childhood. American Journal of Epidemiology, 184(5), 410-418.
      Engel SM, Berkowitz GS, Barr DB, Teitelbaum SL, Siskind J, Meisel SJ, Wetmur JG, Wolff MS. Prenatal Organophosphate Metabolite and Organochlorine Levels and Performance on the Brazelton Neonatal Behavioral Assessment Scale in a Multiethnic Pregnancy Cohort. American Journal of Epidemiology. 2007;165:1397-1404.
      Engel SM, Wetmur J, Chen J, Zhu C, Barr DB, Canfield RL, Wolff MS. Prenatal Exposure to Organophosphates, Paraoxonase 1, and Cognitive Development in Childhood. Environmental Health Perspectives. 2011;119:1182-1188.
      Engel SM, Bradman A, Wolff MS, Rauh VA, Harley KG, Yang JH, Hoepner LA, Barr DB, Yolton K, Vedar MG, Xu Y, Hornung RW, Wetmur JG, Chen J, Holland NT, Perera FP, Whyatt RM, Lanphear BP, Eskenazi B. 2015. Prenatal organophosphorus pesticide exposure and child neurodevelopment at 24 months: an analysis of four birth cohorts. Environ Health Perspect 124:822-830;  http://dx.doi.org/10.1289/ehp.1409474.
      Eskenazi B, Harley K, Bradman A, Weltzien E, Jewell NP, Barr DB, Furlong CE, Holland NT. Association of in Utero Organophosphate Pesticide Exposure and Fetal Growth and Length of Gestation in an Agricultural Population. Environmental Health Perspectives. 2004;115:792 - 798.
      Eskenazi B, Marks AR, Bradman A, Harley K, Barr DB, Johnson C, Morga N, Jewell NP. Organophosphate Pesticide Exposure and Neurodevelopment in Young Mexican-American Children. Environmental Health Perspectives. 2007;115:792 - 798.
      Eskenazi, B., Huen, K., Marks, A., Harley, K. G., Bradman, A., Barr, D. B., & Holland, N. (2010). PON1 and neurodevelopment in children from the CHAMACOS study exposed to organophosphate pesticides in utero. Environ Health Perspect, 118(12), 1775-1781.
      Fiedler, N., Rohitrattana, J., Siriwong, W., Suttiwan, P., Strickland, P. O., Ryan, P. B., ... & Robson, M. G. (2015). Neurobehavioral effects of exposure to organophosphates and pyrethroid pesticides among Thai children. Neurotoxicology, 48, 90-99.
      FIFRA Scientific Advisory Panel. (2008b). "The Agency's Evaluation of the Toxicity Profile of Chlorpyrifos." Report from the FIFRA Scientific Advisory Panel Meeting of September, 2008. FIFRA Scientific Advisory Panel, Office of Science Coordination and Policy, Office of Prevention, Pesticides and Toxic Substances, U.S. Environmental Protection Agency. Washington, DC. Available: http://www.epa.gov/scipoly/sap/meetings/2008/index.html
      FIFRA Scientific Advisory Panel. (2010). February 2 - 4, 2010: Incorporation of Epidemiology and Human Incident Data into Human Risk Assessment.
      FIFRA Scientific Advisory Panel. (2012). Transmittal of the Meeting Minutes from the FIFRA Scientific Advisory Panel Meeting of April 10-12, 2012. FIFRA Scientific Advisory Panel, Office of Science Coordination and Policy, Office of Prevention, Pesticides and Toxic Substances, U.S. Environmental Protection Agency. Washington, DC. Available: http://www.epa.gov/scipoly/sap/meetings/2012/041012meeting.html
      Fortenberry G.Z., Meeker J.D., Sanchez B.N., et al., (2014). Urinary 3,5,6-tichloro-2-pyridinol (TCPY) in pregnant women from Mexico City: Distribution, temporal variability, and relationship with child attention and hyperactivity. International Journal of Hygiene and Environmental Health 217 (2014) 405-412.
      Fortenberry, GZ, Meeker, JD, Sánchez, BN, Barr, DB, Peterson, K, Bellinger, D, Schnaas, L, Solano-González, M, Ettinger, AS, Hernandez-Avila, M, Hu, H, Tellez-Rojoj, MM. Paraoxonase I polymorphisms and attention/hyperactivity in school-age children from Mexico City, Mexico. (2014a.) Environmental Research 132:342 - 349.
      Furlong, Melissa A., Engel, Stephanie M., Boyd Barr, Dana, Wolff, Mary S. Prenatal exposure to organophosphate pesticides and reciprocal social behavior in childhood. 2014. Environment International 70:125-131.
      Grandjean, Philippe, Harari, Raul, Barr, Dana B., Debes, Frodi. Pesticide exposure and stunting as independent predictors of neurobehavioral deficits in Ecuadorian school children. 2006. Pediatrics 117(3):e546-e556.
      Guodong D., Pei W., Ying T., Jun Z., et al., (2012). Organophosphate Pesticide Exposure and Neurodevelopment in Young Shanghai Children. Environ Sci. Technol. 2012, 46, 2911-2917.
      Gupta, R.C., Rech, R.H., Lovell, K.L., Welsch, F., Thornburg, J.E., 1985. Brain cholinergic, behavioral, and morphological development in rats exposed in utero to methylparathion. Toxicol Appl Pharmacol 77, 405-413.
      Handal A.J., Lozoff B., Breilh J., Harlow S.D., (2007). Effect of community of residence on neurobehavioral development in infants and young children in a flower-growing region of Ecuador. Environ Health Perspect. 2007 Jan;115(1): 128-33.
      Handal A.J., Lozoff B., Breilh J., Harlow S.D., (2007B). Neurobehavioral Development in Children with Potential Exposure to Pesticides. Epidemiology May 2007; 18: 312-320.
      Handal A.J., Lozoff B., Breilh J., Harlow S.D., (2008). Occupational Exposure to Pesticides During Pregnancy and Neurobehavioral Development of Infants and Toddlers. Epidemiology, Volume 19, number 6, November 2008.
      Harari, Raul, Julvez, Jordi, Murata, Katsuyuki, Barr, Dana, Bellinger, David C., Debes, Frodi, and Grandjean, Philippe. Neurobehavioral Deficits and Increased Blood Pressure in School-Age Children Prenatally Exposed to Pesticides. 2010. Environmental Health Perspectives 118(6): 890-896.
      Harley KG, Huen K, Schall RA, Holland NT, Bradman A, et al. Association of Organophosphate Pesticide Exposure and Paraoxonase with Birth Outcome in Mexican-American Women. PLoS ONE 2011; 6(8)1-10.
      Harley KG, Engel SM, Vedar MG, Eskenazi B, Whyatt RM, Lanphear BP, Bradman A, Rauh VA, Yolton K, Hornung RW, Wetmur JG, Chen J, Holland NT, Barr DB, Perera FP, Wolff MS. 2016. Prenatal exposure to organophosphorous pesticides and fetal growth: pooled results from four longitudinal birth cohort studies. Environ Health Perspect 124:1084-1092; http://dx.doi.org/10.1289/ehp.1409362.
      Hill AB (1965). The Environment and Disease: Association or Causation? Proc R Soc Med. May 1965; 58(5): 295 - 300.
      Howard, A. S., Bucelli, R., Jett, D. A., Bruun, D., Yang, D., & Lein, P. J. 2005. Chlorpyrifos exerts opposing effects on axonal and dendritic growth in primary neuronal cultures. Toxicol Appl Pharmacol, 207(2), 112-124.
      Icenogle, L. M., Christopher, N. C., Blackwelder, W. P., Caldwell, D. P., Qiao, D., Seidler, F. J., et al. (2004). Behavioral alterations in adolescent and adult rats caused by a brief subtoxic exposure to chlorpyrifos during neurulation. Neurotoxicol Teratol, 26(1), 95 - 101.
      Johnson, F.O., Chambers, J.E., Nail, C.A., Givaruangsawat, S., Carr, R.L., 2009. Developmental chlorpyrifos and methyl parathion exposure alters radial-arm maze performance in juvenile and adult rats. Toxicol Sci 109, 132-142.
      Kofman, Ora, Berger, Andrea, Massarwa, Ali, Friedman, Alon, and Abu Jaffar, Abed. Motor Inhibition and Learning Impairments in School-Aged Children Following Exposure to Organophosphate Pesticides in Infancy. Pediatric Research. 60:88-92, 2006.
      Koutroulakis, D., Sifakis, S., Tzatzarakis, M.N., Alegakis, A.K., Theodoropoulou, E., Kavvalakis, M.P., Kappou, D., Tsatsakis, A.M. Dialkyl phosphates in amniotic fluid as a biomarker of fetal exposure to organophosphates in Crete, Greece; association with fetal growth. Reproductive Toxicology 46 (2014) 98 - 105.
      Lazarini, C.A., Lima, R.Y., Guedes, A.P., Bernardi, M.M., 2004. Prenatal exposure to dichlorvos: physical and behavioral effects on rat offspring. Neurotoxicol Teratol 26, 607-614.
      Lehotzky, K., Szeberenyi, M.J., Kiss, A., 1989. Behavioral consequences of prenatal exposure to the organophosphate insecticide sumithion. Neurotoxicol Teratol 11, 321-324.
      Levin, E. D., Addy, N., Nakajima, A., Christopher, N. C., Seidler, F. J., & Slotkin, T. A. (2001). Persistent behavioral consequences of neonatal chlorpyrifos exposure in rats. Brain Res Dev Brain Res, 130(1), 83 - 89.
      Levin, E. D., Addy, N., Baruah, A., Elias, A., Christopher, N. C., Seidler, F. J., et al. (2002). Prenatal chlorpyrifos exposure in rats causes persistent behavioral alterations. Neurotoxicol Teratol, 24(6), 733 - 741.
      Levin, E.D., Timofeeva, O.A., Yang, L., Petro, A., Ryde, I.T., Wrench, N., Seidler, F.J., Slotkin, T.A., 2009. Early postnatal parathion exposure in rats causes sex-selective cognitive impairment and neurotransmitter defects which emerge in aging. Behav Brain Res 208, 319-327.
      Lima, C.S., Dutra-Tavares, A.C., Nunes, F., Nunes-Freitas, A.L., Ribeiro-Carvalho, A., Filgueiras, C.C., Manhaes, A.C., Meyer, A., Abreu-Villaca, Y., 2013. Methamidophos exposure during the early postnatal period of mice: immediate and late-emergent effects on the cholinergic and serotonergic systems and behavior. Toxicol Sci 134, 125-139.
      Lizardi, Patricia Sanchez, O'Rourke, Mary Kay, and Morris, Richard J. The effects of organophosphate pesticide exposure on Hispanic children's cognitive and behavioral functioning. Journal of Pediatric Psychology 33(1): 91 - 101, 2008.
      Llop S., Julvez J., Marina L.S., Vizcaino E., et al., (2013).  Prenatal and postnatal insecticide use and infant neuropsychological development in a multicenter birth cohort study. Environment International 59(2013) 175-182.
      Lovasi GS, Quinn JW, Rauh VA, Perera FP, Andrews HF, Garfinkel R, Hoepner L, Whyatt R, Rundle A. Chlorpyrifos Exposure and Urban Residential Environment Characteristics as Determinants of Early Childhood Neurodevelopment. American Journal of Public Health. 2011;101(1):63-70. doi: 10.2105/AJPH.2009.168419. Epub 2010 Mar 18.
      Lu, et al. Assessing the association between pesticide exposure and cognitive development in rural Costa Rican children living in organic and conventional coffee farms. Int J Adolesc Med Health. 2009; 21(4): 609-621
      Mamczarz J, Pescrille JD, Gavrushenko L, Burke RD, Fawcett WP, DeTolla Jr, LJ, Chen H, Pereira EFR, Albuquerque EX. 2016. Spatial learning impairment in prepubertal guinea pigs prenatally exposed to the organophosphorus pesticide chlorpyrifos: Toxicological implications. Neurotoxicol. 56:17-28, 2016
      Marks AR, Harley K, Bradman A, Kogut K, Barr DB, Johnson C, et al. Organophosphate Pesticide Exposure and Attention in Young Mexican-American Children: The CHAMACOS Study. Environmental Health Perspectives. 2010;118:1768-1774.
      Meek ME, Boobis A, Cote I, Dellarco V, Fotakis G, Munn S, Seed J, and Vickers, C.  2014. New developments in the evolution and application of the WHO/IPCS framework on mode of action/species concordance analysis.  J Appl Toxicol.  Jan;34(1):1-18.
      Meek ME, Boobis A, Cote I, Dellarco V, Fotakis G, Munn S, Seed J, Vickers C.  2014. New developments in the evolution and application of the WHO/IPCS framework on mode of action/species concordance analysis.  J Appl Toxicol. 2014 Jan;34(1):1-18.
      Moreno-Banda, G., Blanco-Muñoz, J., Lacasaña, M., Rothenberg, S.J., Aguilar-Garduño, C., Gamboa, R., Pérez-Méndez, O. Maternal exposure to floricultural work during pregnancy, PON1 Q192R polymorphisms and the risk of low birth weight. Science of the Total Environment 407: 5478 - 5485, 2009.
      Muñoz-Quezada MT, Lucero BA, Barr DB, Steenland K, Levy K, Ryan PB, Veronica Iglesiase V, Alvaradoe S, Conchaf C, Rojas E, Catalina Vega C.  Neurodevelopmental effects in children associated with exposure to organophosphate pesticides: A systematic review.  Neurotoxicology 39: 158-168.
      Naksen W, Prapamontol T, Mangklabruks A, Chantara S, Thavornyutikarn P, Srinual N, Panuwet P, Ryan PB, Riederer AM, Barr DB. Associations of maternal organophosphate pesticide exposure and PON1 activity with birth outcomes in SAWASDEE birth cohort, Thailand. Environmental Research142: 288 - 296, 2015.
      Nevison. A comparison of temporal trends in United States autism prevalence to trends in suspected environmental factors. Environmental Health. 2014; 13(73): 16 pp
      Oulhote, Youssef and Bouchard, Maryse F. (2013) Urinary Metabolites of Organophosphate and Pyrethroid Pesticides and Behavioral Problems in Canadian Children. Environmental Health Perspectives. 121:1378-1384
      Petit, Claire, Chevrier, Cécile, Durand, Gaël, Monfort, Christine, Rouget, Florence, Garlantezec, Ronan, Cordier, Sylvaine. Impact on fetal growth of prenatal exposure to pesticides due to agricultural activities: a prospective cohort study in Brittany, France. Environmental Health 9:71-83, 2010.
      Quiros-Alcala L., Alkom A.D., Boyce W.T., Lippert S., et al., (2011). Maternal prenatal and child organophosphate pesticide exposures and children's autonomic function. NeuroToxicology 32 (2011) 646-655.
      Racke J.D. Degradation of organophosphorous insecticidesin environmental matrices. In: Organophosphates Chemistry, Fate and Effects. Academic Press, Inc., San Diego, CA, 1992, pp 47 - 72.
      Raanan R, Harley KG, Balmes JR, Bradman A, Lipsett M, and Eskenazi B. (2015) Early-life Exposure to Organophosphate Pesticides and Pediatric Respiratory Symptoms in the CHAMACOS Cohort. Environmental Health Perspectives: 123(2), 179-185.
      Rauch, Stephen A., Braun, Joe M., Boyd Barr, Dana, Calafat, Antonia M., Khoury, Jane, M., Montesano, Angela, Yolton, Kimberly, and Lanphear, Bruce P. Associations of Prenatal Exposure to Organophosphate Pesticide Metabolites with Gestational Age and Birth Weight. Environmental Health Perspectives. 120:1055 - 1060 (2012).
      Rauh VA, Garfinkel R, Perera FP, Andrews HF, Hoepner L, Barr DB, Whitehead R, Tang D, Whyatt RW. Impact of Prenatal Chlorpyrifos Exposure on Neurodevelopment in the First 3 Years of Life Among Inner-City Children. Pediatrics. 2006;18(6): 1835-1859.
      Rauh V, Arunajadai S, Horton M, Perera F, Hoepner L, Barr DB, et al. 2011. Seven-Year Neurodevelopmental Scores and Prenatal Exposure to Chlorpyrifos, a Common Agricultural Pesticide. Environmental Health Perspectives. 2011;119:1196-1201.
      Rauh, V. A., Perera, F. P., Horton, M. K., Whyatt, R. M., Bansal, R., Hao, X., . . . Peterson, B. S. (2012). Brain anomalies in children exposed prenatally to a common organophosphate pesticide. Proc Natl Acad Sci U S A, 109(20), 7871-7876.
      Rauh VA.; Garcia WE.; Whyatt RM.; et al. (2015) Prenatal exposure to the organophosphate pesticide chlorpyrifos and childhood tremor. Neurotoxicology: 51, 80-86.
      Roegge, C.S., Timofeeva, O.A., Seidler, F.J., Slotkin, T.A., Levin, E.D., 2007. Developmental diazinon neurotoxicity in rats: later effects on emotional response. Brain Res Bull 75, 166-172.
      Rohlman, Diane S., Arcury, Thomas A., Quandt, Sara A., Lasarev, Michael, Rothlein, Joan, Travers, Rachelle, Tamulinas, Alys, Scherer, Jennifer, Early, Julie, Marín, Antonio, Phillips, Jacki, McCauley, Linda. Neurobehavioral performance in preschool children from agricultural and non-agricultural communities in Oregon and North Carolina. Neurotoxicology 26:895-598, 2005.
      Ruckart, et al. Long-Term Neurobehavioral Health Effects of Methyl Parathion Exposure in Children in Mississippi and Ohio. Environmental Health Perspectives. 2004; 112(1):46-51.
      Samarawickrema, Nirma, Pathmeswaran, Arunasalam, Wickremasinghe, Rajitha, Peiris-John, Roshini, Karunaratna, Madawa, Buckley, Nick, Dawson, Andrew, and De Silva, Janaka. Fetal effects of environmental exposure of pregnant women to organophosphorus compounds in a rural farming community in Sri Lanka. Clinical Toxicology 46:489 - 495, 2008.
      Savitz, David A., Arbuckle, Tye, Kaczor, Diane, and Curtis, Kathryn M. Male pesticide exposure and pregnancy outcome. American Journal of Epidemiology 146(12):1025-1036, 1997.
      Schuh RA, Lein PJ, Beckles RA, Jett DA.  2002. Noncholinesterase mechanisms of chlorpyrifos neurotoxicity: altered phosphorylation of Ca2+/cAMP response element binding protein in cultured neurons. Toxicol Appl Pharmacol. 2002 Jul 15;182(2):176-85
      Shelton, Janie F., Geraghty, Estella M., Tancredi, Daniel J., Delwiche, Lora D., Schmidt, Rebecca J., Ritz, Beate, Hansen, Robin L., and Hertz-Picciotto, Irva. Neurodevelopmental disorders and prenatal residential proximity to agricultural pesticides: The CHARGE Study. Environmental Health Perspectives 122:1103 - 1109, 2014.
      Simon TW, Simons SS Jr, Preston RJ, Boobis AR, Cohen SM, Doerrer NG, Fenner-Crisp PA, McMullin TS, McQueen CA, Rowlands JC; RISK21 Dose-Response Subteam.  2014.  The use of mode of action information in risk assessment: Quantitative key events/dose-response framework for modeling the dose-response for key events. Crit Rev Toxicol. 2014 Aug;44 Suppl 3:17-43.
      Slotkin, T.A., Tate, C.A., Ryde, I.T., Levin, E.D., Seidler, F.J. 2006. Organophosphate insecticides target the serotonergic system in developing rat brain regions: Disparate effects of diazinon and parathion at doses spanning the threshold for cholinesterase inhibition.  Environ Health Perspec 114, 1542-1546.
      Sochaski, M.A., McManus, B.M., Struve, M.F., Wallace, D.G., Dorman, D.C.  2007. Inhibition and recovery of maternal and foetal cholinesterase enzymes following fenitrothion administration in CD rats. Xenobiotica 37, 19-29.
      Sonich-Mullin C, Fielder R,  Wiltse J,  et al.  2001.  IPCS conceptual framework for evaluating a mode of action for chemical carcinogenesis.  Regul Toxicol Pharmacol.  34:146-152.
      Spyker, J.M., Avery, D.L., 1977. Neurobehavioral effects of prenatal exposure to the organophosphate Diazinon in mice. J Toxicol Environ Health 3, 989-1002.
      Stamper, C.R., Balduini, W., Murphy, S.D., Costa, L.G., 1988. Behavioral and biochemical effects of postnatal parathion exposure in the rat. Neurotoxicol Teratol 10, 261-266.
      Stein, L. J., Gunier, R. B., Harley, K., Kogut, K., Bradman, A., & Eskenazi, B. (2016). Early childhood adversity potentiates the adverse association between prenatal organophosphate pesticide exposure and child IQ: The CHAMACOS cohort. NeuroToxicology, 56, 180-187.
      Suarez-Lopez J. R., Jacobs D.R., Himes J.H., Alexander B.H., Lazovich D., et al., (2012). Lower acetylcholinesterase activity among children living with flower plantation workers. Environmental Research 114 (2012) 53-59.
      Suarez-Lopez J. R., Jacobs D.R., Himes J.H., Alexander B.H., (2013). Aectylcholinesterase activity and neurodevelopment in boys and girls. PEDIATRICS Volume 132, number 6, December 2013.
      Suarez-Lopez J. R., Jacobs D.R., Himes J.H., Alexander B.H., (2013a). Acetycholinesterase activity, cohabitation with floricultural workers, and blood pressure in Ecuadorian Children. Environmental Health Perspectives, volume 121, number 5, May 2013.
      Timofeeva, O.A., Roegge, C.S., Seidler, F.J., Slotkin, T.A., Levin, E.D., 2008a. Persistent cognitive alterations in rats after early postnatal exposure to low doses of the organophosphate pesticide, diazinon. Neurotoxicol Teratol 30, 38-45.
      Timofeeva, O.A., Sanders, D., Seemann, K., Yang, L., Hermanson, D., Regenbogen, S., Agoos, S., Kallepalli, A., Rastogi, A., Braddy, D., Wells, C., Perraut, C., Seidler, F.J., Slotkin, T.A., Levin, E.D., 2008b. Persistent behavioral alterations in rats neonatally exposed to low doses of the organophosphate pesticide, parathion. Brain Res Bull 77, 404-411.
      Turgeman, G., Pinkas, A., Slotkin, T. A., Tfilin, M., Langford, R., & Yanai, J. (2011). Reversal of chlorpyrifos neurobehavioral teratogenicity in mice by allographic transplantation of adult subventricular zone-derived neural stem cells. J Neurosci Res, 89(8), 1185 - 1193.
      U.S. Environmental Protection Agency. (1999). Guidelines for carcinogen risk assessment. Risk Assessment Forum. SAB review draft. Washington, DC: U.S. Environmental Protection Agency.  www.epa.gov/ncea/raf/crasab.htm.
      U.S. Environmental Protection Agency. (2002).  Determination of The Appropriate FQPA Safety Factor(S) In Tolerance Assessment.  Office of Pesticide Programs, U.S. Environmental Protection Agency, Washington, DC, February 28, 2002.
      U.S. Environmental Protection Agency. (2005). Guidelines for Carcinogen Risk Assessment.  Risk Assessment Forum, U.S. Environmental Protection Agency.  Washington, DC.  EPA/630/P-03/001F.
      U.S. Environmental Protection Agency. (2006). Revised Organophosphorous Pesticide Cumulative Risk Assessment; July 31, 2006. Office of Pesticide Programs, U.S. Environmental Protection Agency. Washington, D.C. Available http://www.epa.gov/pesticides/cumulative/rra-op.
      U.S. Environmental Protection Agency.  (2008). Draft Science Issue Paper: Chlorpyrifos Hazard and Dose Response Characterization. http://www.epa.gov/scipoly/sap/meetings/2008/091608_mtg.htm
      U.S. Environmental Protection Agency. (2010). Draft Framework for Incorporating Human Epidemiologic and Incident Data in Health Risk Assessment, January 7, 2010.
      U.S. Environmental Protection Agency. (2011a). Chlorpyrifos: Preliminary Human Health Risk Assessment for Registration Review. June 30, 2011. D388070.
      U.S. Environmental Protection Agency. (2011b). Chlorpyrifos:  Occupational and Residential Exposure Assessment, EPA Barcode: D388165,. In Office of Pesticide Programs (Ed.). Washington D.C.
      U.S. Environmental Protection Agency.  (2012). Draft Issue Paper: Scientific Issues Concerning Health Effects of Chlorpyrifos. http://www.regulations.gov/#!documentDetail;D=EPA-HQ-OPP-2012-0040-0002
      U.S. Environmental Protection Agency. (2014). Chlorpyrifos: Revised Human Health Risk Assessment for Registration Review. December 29, 2014. D424485.
      U.S. Environmental Protection Agency. (2015) Literature Review on Neurodevelopment Effects & FQPA Safety Factor Determination for the Organophosphate Pesticides. September 15, 2015.
      U.S. Environmental Protection Agency. 2015b. Swe, K. and Holman, E. Summary Reviews from _2015 Epidemiological Literature Review for Organophosphates. September 15, 2015.
      U.S. EPA (U.S. Environmental Protection Agency).  2015c. Preamble to the Integrated Science Assessments.  National Center for Environmental Assessment, RTP Division, Office of Research and Development, USEPA. https://yosemite.epa.gov/sab/sabproduct.nsf/0/33E1AD305287588F85257D20006BE8CC/$File/ISA_PREAMBLE_FINAL2015.PDF
      U.S. Environmental Protection Agency. 2016. Holman, E. and Swe, K. Summary Reviews for Additional Epidemiological Literature Studies from Prospective Birth Cohort Studies. D432184. March 25, 2016
      U.S. Environmental Protection Agency. 2016b. Aldridge, A. Summary Reviews for Additional Epidemiological Literature Studies from Prospective Birth Cohort Studies. D432184. December XXX, 2016
      U.S. Environmental Protection Agency. 2016c. Framework for Incorporating Human Epidemiologic and Incident Data in Health Risk Assessment, December 28, 2016.
      Vatanparast, J., Naseh, M., Baniasadi, M., Haghdoost-Yazdi, H., 2012. Developmental exposure to chlorpyrifos and diazinon differentially affect passive avoidance performance and nitric oxide synthase-containing neurons in the basolateral complex of the amygdala. Brain Res 1494, 17-27.
      Venerosi A, Tait S, Stecca L, Chiarotti F, DeFelice A, Cometa MF, Volpe MT, Calamandrei G, Ricceri L. Effects of maternal chlorpyrifos diet on social investigation and brain neuroendocrine markers in the offspring  -  a mouse study. Environ. Health 14:32-42, 2015
      Wang, Pei, Tian, Ying, Wang, Xiao-Jin, Gao, Yu, Shi, Rong, Wang, Guo-Quan, Hu, Guo-Hua, Shen, Xiao-Ming. Organophosphate pesticide exposure and perinatal outcomes in Shanghai, China. 4 Environment International 2:100 - 104, 2012.
      Whyatt, R. M., Barr, D. B., Camann, D. E., Kinney, P. L., Barr, J. R., Andrews, H. F., . . . Perera, F. P. (2003). Contemporary-use pesticides in personal air samples during pregnancy and blood samples at delivery among urban minority mothers and newborns. Environ Health Perspect, 111(5), 749-756.
      Whyatt RM, Rauh V, Barr DB, Camann DE, Andrews HF, Garfinkel R, Hoepner LA, Diaz D, Dietrich J, Reyes A, Tang D, Kinney PL, Perera FP. Prenatal Insecticide Exposures and Birth Weight and Length among an Urban Minority Cohort. Environmental Health Perspectives. 2004;112:1125 - 1132.
      Whyatt RM, Garfinkel R, Hoepner LA, Holmes D, Borjas M, Williams MK, et al. Within- and Between-Home Variability in Indoor-Air Insecticide Levels during Pregnancy among an Inner-City Cohort from New York City. Environmental Health Perspectives 2007;115:383-389.
      Whyatt RM, Garfinkel R, Hoepner LA, Andrews H, Holmes D, Williams MK, et al. A Biomarker Validation Study of Prenatal Chlorpyrifos Exposure within an Inner-City Cohort during Pregnancy. Environmental Health Perspectives. 2009;117:559-567.
      Wickerham, Erin L., Lozoff, Betsy, Shao, Jie, Kaciroti, Niko, Xia, Yankai, Meeker, John D. Reduced birth weight in relation to pesticide mixtures detected in cord blood of full-term infants. Environment International 47:80 - 85, 2012.
      Win-Shwe, T.T., Nakajima, D., Ahmed, S., Fujimaki, H., 2012. Impairment of novel object recognition in adulthood after neonatal exposure to diazinon. Arch Toxicol 87, 753-762.
      Wolff, MS, Engel, S, Berkowitz, G, Teitelbaum, S, Siskind, J, Barr, DB, Wetmur, J. Prenatal Pesticide and PCB Exposures and Birth Outcomes. 2007. Pediatric Research 61(2):243-250.
      Yang, D., Howard, A., Bruun, D., Ajua-Alemanj, M., Pickart, C., & Lein, P. J. 2008. Chlorpyrifos and chlorpyrifos-oxon inhibit axonal growth by interfering with the morphogenic activity of acetylcholinesterase. Toxicol Appl Pharmacol, 228(1), 32-41.
      Yolton, K., Xu, Y., Sucharew, H., Succop, P., Altaye, M., Popelar, A., ... & Khoury, J. C. (2013). Impact of low-level gestational exposure to organophosphate pesticides on neurobehavior in early infancy: a prospective study. Environmental health, 12(1), 1.
      Young JG, Eskenazi B, Gladstone EA, Bradman A, Pedersen L, Johnson C, Barr DB, Furlong CE, Holland NT. Association Between In Utero Organophosphate Pesticide Exposure and Abnormal Reflexes in Neonates. NeuroToxicology. 2005;26:199 - 209.
      Zhang Y., Han S., Liang D., Shi X., Wang F., et al., (2014). Prenatal exposure to organophosphate pesticides and neurobehavioral development of neonates: A birth cohort study in Shenyang, China. Plos ONE 9(2):e88491. doi:10.1371/journal.pone.0088491.
      Zhang X, Driver JH, Li Y, Ross JH, Krieger RI. (2008) Dialkylphosphates (DAPs) in fruits and vegetables may confound biomonitoring in organophosphorus insecticide exposure and risk assessment.  J Agric Food Chem. 2008 Nov 26;56(22):10638-45. doi: 10.1021/jf8018084.

6.0	Appendices

 Table of In Vivo Developmental Neurotoxicity Studies of OPs.
 Summary of Guideline DNT Studies Submitted to the Agency for OPs other than Chlorpyrifos.
 Low Quality Studies: Summary of Study Design Elements Impacting Study Quality Assignment
 Table of Systematic Review Analysis:  Initial Search Research & Initial Exclusion Criteria
 Table of Systematic Review Analysis:  Second Tier Exclusion Criteria
   6. 	Plausible hypotheses on MOA/AOP for neurodevelopmental outcomes (Extracted from Section 4.4.3. RHHRA for chlorpyrifos)
Appendix 1.	Table of In Vivo Developmental Neurotoxicity Studies of OPs.
(Effects described are only those measured after weaning.  Bold indicates functional domains that were reported to show treatment effects.)

OP
Study
Species & strain
Dose, route, vehicle
Dosing period
ChE inhibition
Domain
Age of testing
Outcomes
NOEL, LOEL
Notes & Study Problems
Chlormephos
Ceh et al., 2012
mouse BALB/c
3.5, 0.35 ug/ml in drinking water of dams
~ 0.6, 0.06 mg/kg/d (@ 5ml/d, 30 g)
7 day premating to weaning
No
Anxiety & Emotion
PND70-80
Increased time in closed arms & decreased time in open arms in elevated plus maze, ~0.6 mg/kg/d, M&F
NOEL=0.35 ug/ml in water, ~0.06 mg/kg/d
Litter not unit of statistical analysis
No pup allocation described but had to have used some littermates
M & F responses appear similar but not statistically compared
Diazinon
Roegge et al., 2008
rat Sprague Dawley
0.5, 2 mg/kg/d sc DMSO
PND1-4
Cites Slotkin et al. (2006): 0.5 mg/kg/d produced <10% brain inhibition on PND5, 2 mg/kg/d produced 25-30% brain inhibition 2 hr after dose on PND4, and 10-20% inhibition on PND5
Anxiety & Emotion
PND52-56
Decreased time in open arms in elevated plus maze, 2 mg/kg/d, M only
No NOEL
LOEL=0.5 mg/kg/d
Pups & dams redistributed daily
No effect in F
Accepts p<0.1 as significant for interactions
No dose-response in feeding or milk preference studies
Abstract misstates sex differences

PND64-67, 78-79
Decreased latency to eat in novelty suppressed but not home-cage feeding, 0.5 & 2 mg/kg/d, M only

PND73-74
Decreased chocolate milk preference, 0.5 mg/kg/d only, M only

PND86-87
No effect on forced swim test

Diazinon
Spyker and Avery, 1977
mouse F2 hybrid (NCTR cross bred)
0.18, 9 mg/kg/d in peanut butter
GD1-birth
No
Sensory

PND38
Increased errors on visual cliff, 0.18 mg/kg/d only, F only
No effect acoustic startle or olfactory responses
No NOEL
LOEL=0.18 mg/kg/d
No pup allocation described but had to have used littermates
Not clear when both sexes tested and/or compared
Statistics not described
Maternal weight gain lowered at both doses
Weight gain of high dose pups decreased
Preweaning testing: decreased contact placing, 0.18 mg/kg/d only
No dose-response for some measures
Twice as many controls as treated
Looks like decreased rotarod endurance PND65, not significant due to high variability

Neuromotor
PND50, 60, 65,75
No effect swimming ability
Increased rod cling endurance, 0.18 & 9 mg/kg/d, sex not specified
Decreased inclined plane performance, 0.18 & 9 mg/kg/d, sex not specified

Activity

PND75-76
No effect open field

Cognition
PND87
No effect errors in Lashley maze

Diazinon
Timofeeva et al., 2008
rat Sprague Dawley
0.5, 2 mg/kg/d sc DMSO
PND1-4
Cites Slotkin et al. (2006): 0.5 mg/kg/d produced <10% brain inhibition on PND5, 2 mg/kg/d produced 25-30% brain inhibition 2 hr after dose on PND4, and 10-20% inhibition on PND5
Activity
PND28-42
No effect in figure-8 chamber, M&F

No NOEL
LOEL=0.5 mg/kg/d
Littermates of those used in Roegge et al. 2008
Pups & dams redistributed daily
Accepts p<0.1 as significant for interactions
No mention of sex effects in T-maze
No dose-response for some measures

Sensory
PND77-84
Decreased prepulse inhibition, 0.5 & 2 mg/kg/d, M only

Cognition
PND28-35, 91-126
No effect on T-maze spontaneous alternation, M&F
Increased working memory errors, 0.5 mg/kg/d only, M&F

Diazinon
Vatanparast et al., 2013
rat Wistar
1 mg/kg/d sc DMSO
GD15-18 or PND1-4
No
Activity
PND60
Gestational: No effect in open field, M&F
Postnatal: No effect in open field, M&F
No NOEL
LOEL=1 mg/kg/d
1 M & 1 F per litter but sex not nested within litter in statistics
F only affected with gestational exposure, both sexes affected with postnatal, looks like M more affected
Large effect sizes
Number of dams not mentioned
Discrepancy in text on pup sample sizes

Cognition
PND60-63
Gestational: Decreased latency to cross and increased time spent in dark side on retention trial, no effect acquisition in passive avoidance, F only
Postnatal: Decreased latency to cross and increased time spent in dark side on retention trial, no effect acquisition in passive avoidance, M&F

Diazinon
Win-Shwe et al., 2013
mouse C3H/HeN
0.5, 5 mg/kg/d sc DMSO
PND8-11
No
Cognition
PND46-49, 81-84
PND46-49: Decreased novel object exploration and discrimination, 0.5 & 5 mg/kg/d
PND81-84: Decreased novel object exploration and discrimination, 5 mg/kg/d only
No NOEL
LOEL=0.5 mg/kg/d
M only tested
Separate mice at two test times
Litter allocation to dose group not described
Assumes that ChE inhibition reported by Slotkin in rats would be same as in mice
Larger sample size at later age
Dichlorvos
Lazarini et al., 2004
rat Wistar
8 mg/kg po (dilution of technical product); vehicle from formulation
GD6-15
No
Activity
PND21, "adult"
PND21: Decreased locomotion open field, M only
"Adult": Decreased locomotion and increased immobility, only M tested
No NOEL
LOEL=8 mg/kg/d
Data analyzed as litter but sex not nested within litter in statistics
No effect on physical and reflex preweaning development
Only M tested as after PND21
Adult age not given

Cognition
"Adult"
Decreased latency to cross on retention trial in passive avoidance

Fenitrothion (sumithionR, 50% ai)
Lehotzky et al., 1989
rat Lati
5, 10, 15 mg/kg/d po
sunflower oil
GD7-15
No
Neuromotor
PND26, 36, 104
Decreased latency to fall off rotarod PND26, 104, not 36, 15 mg/kg/d
NOEL=5 mg/kg/d
LOEL=10 mg/kg/d
Postnatal mortality at all doses (16-17.5%)
No pup allocation described but had to have used some littermates
Only M tested
Statistics not described
Measured startle, righting, contact placing on PND22 but no results given
Shorter latency in cognitive task hard to interpret
Nonsignificant decrease in activity at PND26

Activity
PND26, 36, 104
Decreased activity in open field PND104, 15 mg/kg/d

Cognition
PND42, 104
Shorter escape latency in conditioned response during acquisition, 10 & 15 mg/kg/d

Social behavior
PND62
Increased time in social interaction, 10 & 15 mg/kg/d

Methamidophos
deCastro et al., 2000
rat Wistar
1 mg/kg/d po water
GD6-15
Pilot in nonpregnant F dosed for 10 d gives 17% plasma inhibition at 1 mg/kg/d
Activity
PND40
No effect in open field, sex no mentioned
NOEL=1 mg/kg/d
Used 2 pups/litter but no mention of sex, apparently used as independent observations
No effect on preweaning swimming performance
Decreased immobility time PND 14 only
Open field measures with really high variability, not reliable
Methamidophos
Lima et al., 2013
mouse Swiss
1 mg/kg/d sc DMSO
PND3-9
Pilot showed for 1 mg/kg/d: ~19% brain inhibition on PND10; ~36%, 46% brain inhibition 1, 4 hr after dosing on PND3; ~53, 61% brain inhibition 1, 4 hr after dosing on PND9; no brain inhibition in PND60 adults
Activity
PND61
No effect in open field, sex not mentioned
No NOEL
LOEL=1 mg/kg/d
1 M & 1 F per litter
No data for M & F separately or mention of statistical differences
Dosing by litter
High variability especially with passive avoidance

Anxiety & Emotion
PND60-61
Increased immobility time in forced swim, sex not mentioned
No effect on elevated plus maze, sex not mentioned

Cognition
PND63
No effect on passive avoidance, sex not mentioned

Methyl parathion
Crowder et al., 1980
rat Sprague Dawley
1 mg/kg/d po corn oil
GD7-15
No
Activity
PND23, 30, 44, 54, 65
Increased activity in open field, only PND23 and 54, sex not mentioned
to criterion
No NOEL
LOEL=1 mg/kg/d
Preweaning testing: possibly decreased wire cling time (not analyzed), no effect on righting, startle, placement response
Increased postnatal mortality (30%)
Littermates used
Only 3 litters used
Small sample size for maze testing
Statistics not mentioned except for maze transfer test, just used t-test
Sex not mentioned except for maze transfer test, data not given for M & F
Methods & results cursory

Cognition
>PND68
Slower transfer on 1st, 4th direction change in T-maze learning transfer, sex not mentioned

Methyl parathion
Gupta et al., 1985
rat Wistar-Furth F mated with F344 M
1 mg/kg/d in peanut butter, 1.5 mg/kg/d po peanut oil
GD6-20
Dams on GD19 show 20, 60% brain inhibition at 1, 1.5 mg/kg/d
Pups show brain inhibition up to 50% on  PND1, 7, 14, 21, 1 & 1.5 mg/kg/d; on PND28 only 1.5 mg/kg/d
Cognition
PND60
No effect on passive avoidance
No effect on shuttle box avoidance
Slower latency to bar press & increased days to asymptote on operant task (no schedule given), 1 mg/kg/d only, sex not mentioned
No NOEL
LOEL=1 mg/kg/d but no effects at 1.5 mg/kg/d
High dose dams had cholinergic signs, increased resorptions
Pups moved to foster mothers at 24 hr
No effect on preweaning reflexive behaviors
Pup allocation not described
Statistics barely described
M & F apparently tested but data for each not shown or mentioned
Methods cursory
No dose-response for behavior but there is dose-response for ChE inhibition
Only 4/dose for operant testing

Neuromotor
PND60
No effect on rotarod

Activity
PND60
Decreased activity, 1 mg/kg/d only, sex not mentioned

Anxiety & Emotion
PND60
Faster cage emergence, 1 mg/kg/d only, sex not mentioned

Sensory
PND120
No effect on acoustic startle response

Methyl parathion
Johnson et al., 2009
rat Sprague Dawley
Incrementing doses: low 0.2 mg/kg/d throughout; mid 0.2, 0.4, 0.6 mg/kg/d every 5-6 d; high 0.3, 0.6, 0.9 mg/kg/d every 5-6 d
PND1-21
Low dose showed 13-15% brain inhibition and high dose showed 63, 20, 18% brain inhibition on PND20, 30, 40; all doses recovered by PND50
Cognition
PND29-60
Increased working memory errors, mid and high dose, M only
Increased reference memory errors, all doses, M only
No NOEL
LOEL=0.2 mg/kg/d
Split-litter dose design
Included litter as random effect in statistics
No effect on preweaning measures of reflex development
No effect in F

Oxydemeton methyl (metasystoxR, 91% ai)
Clemens et al., 1990
rat CD
0.5, 1.5, 4.5 mg/kg/d water
GD6-15
Dams on GD16 show 30, 54, 72%  plasma inhibition (RBC similar) & 22, 52, 68% brain inhibition at 0.5, 1.5, 4.5 mg/kg/d
Dams on GD20 show 20, 39, 54% brain inhibition at 0.5, 1.5, 4.5 mg/kg/d, 40% RBC inhibition at 4.5 mg/kg/d, and no plasma inhibition
Fetuses on GD20 show no brain inhibition
Cognition
PND25, 26, 35
No effect on M-maze
NOEL=4.5 mg/kg/d
High dose dams had tremors
1 M & 1 F per litter
No data for M & F separately or mention of statistical differences
Statistics barely described
No effect on preweaning reflex or sensory tests

Activity

No effect in open field

Parathion
Al-Hachim & Fink, 1968
mouse CF1
3 mg/kg/d po
Corn oil
3 dosing times: 1st, 2nd, or 3rd trimester
No
Cognition
PND30-37
No effect on conditioned avoidance learning
NOEL=3 mg/kg/d
Very similar experiment as other papers, maybe same study
Pup allocation not clear but littermates probably used
Inadequate statistics
No mention of sex
Parathion
Al-Hachim & Fink, 1968
mouse CF1
3 mg/kg/d po
Corn oil
3 dosing times: 1st, 2nd, or 3rd trimester
No
Activity
PND60-66
No effect in open field
NOEL=3 mg/kg/d
Very similar experiment as other papers, maybe same study
Pup allocation not clear but littermates probably used
Inadequate stats
No mention of sex
Parathion
Levin et al., 2010
rat Sprague Dawley
0.1, 0.2 mg/kg/d sc DMSO
PND1-4
Cites Slotkin et al. 2006: 0.1 mg/kg/d produced 5-15% brain inhibition on PND5, no data for 0.2 mg/kg/d
Cognition
PND420, 510, 570
PND420: Increased working memory errors in radial arm maze, 0.1 mg/kg/d, M only; increased reference memory errors, 0.1 & 0.2 mg/kg/d, M only
PND510: Increased working memory errors in radial arm maze, 0.1 & 0.2 mg/kg/d, M only
PND570: No effect in radial arm maze
No NOEL
LOEL=0.1 mg/kg/d
Littermates of those used in Timofeeva 2008
Pups & dams redistributed daily
5% mortality high dose
No effect in F
Accepts p<0.1 as significant for interactions
No dose-response for several measures
Parathion
Stamper et al., 1988
rat Long Evans
1.3, 1.9 mg/kg/d sc corn oil
PND5-20
35, 68% brn inh PND21; 26, 36% brn in PND28
Activity
PND24
No effect in open field
No NOEL
LOEL=1.3 mg/kg/d
Split-litter dose design
Pup allocation not clear but littermates probably used
High dose produced cholinergic signs, says doses are 33 and 50% of LD50 in PND5 rat
Decreased weight gain with both doses
Preweaning, increased cliff avoidance latency, no effect righting, negative geotaxis, open field
M only tested
No post-hoc comparison of groups when significant, but looks like effects in both doses
No dose-response in working memory errors

Neuromotor
PND24
No effect on rotarod

Cognition
PND24, PND 35-37
Decreased alternation rate in T-maze, 1.3 & 1.9 mg/kg/d, only M tested
Increased working memory errors, 1.3 & 1.9 mg/kg/d, only M tested

Parathion
Timofeeva et al., 2008
rat Sprague Dawley
0.1. 0.2 mg/kg/d sc DMSO
PND1-4
Cites Slotkin et al. 2006: 0.1 mg/kg/d produced 5-15% brain inhibition on PND5, no data for 0.2 mg/kg/d
Activity
PND58-61
No effect in figure-8 chambers
No NOEL
LOEL=0.1 mg/kg/d
Pups & dams redistributed daily
5% mortality high dose
Accepts p<0.1 as significant  for interactions
All radial arm maze effects only in low dose

Cognition
PND35-45
PND112-182
No effect in T-maze spontaneous alternation
Decreased working memory errors in radial arm maze, 0.1 mg/kg/d only, M&F

Anxiety & Emotion
PND50-53
PND64-72
PND81-94
Increased time in open arms in elevated plus maze, 0.2 mg/kg/d, M&F
No effect on novelty suppressed feeding
No effect on chocolate milk preference

Sensory
PND78-81
Decreased tactile startle, 0.2 mg/kg/d, M&F
No effect on prepulse inhibition

Appendix 2.	Summary of Guideline DNT Studies Submitted to the Agency for OPs other than Chlorpyrifos.
(Only changes that were observed after exposure had ended (post weaning, adult) are listed.  `X' indicates no significant changes on tests for each domain.)

Chemicals
Cognition
Motor activity
Acoustic startle
Neuromotor (FOB)
Notes
Acephate
X
X
X
X

Azinphos-methyl
X
X
X
X

Coumaphos
X
X
X
X

Diazinon
Biel maze: increase errors & latency high dose (~33.1 mg/g,/d, dam diet) M, PND24 & PND62; also mid dose (~3.4 mg/kg/d, dam diet) F, PND24
X
X
X

Dichlorvos[1]
 --
 --
 --
 --

Dicrotophos
X
X
X
X

Dimethoate
X
X
X
X

Disulfoton
X
X
X
X

Ethoprop
M maze: increase trials to criterion high dose (~29.3 mg/kg/d, dam diet) M, PND60
X
X
X

Fenamiphos
X
X
X
X

Malathion
X
increased rearing in FOB open field mid dose (50 mg/kg/d to dams & pups), F, significant at PND45 only (maybe also PND60); no change automated motor activity
increased peak amplitude later blocks (perhaps habituation effect) all doses (5, 50, 150 mg/kg/d to dams & pups), F only, PND23; increased peak amplitude without prepulse low dose only, F only, PND60
altered gait mid & high dose (50, 150 mg/kg/d to dams & pups), M & F, PND60 but not earlier

Methamidophos
~X
X
decreased peak amplitude early blocks mid & high dose (~1.65, 5.2 mg/kg/d dam diet), F only, significant at PND38, looks same but not significant at PND60
X
PA PND24: report says decreased latency but nothing significant & table is questionable; M maze PND60: report says increased trials to criterion (M) and increased (M) or decreased (F) errors, but nothing significant and table is questionable
Methyl parathion
X
X
X
X

Naled
X
X
increased peak amplitude & decreased latency middle blocks low dose only (0.4 mg/kg/d to dams & pups), F only, PND60; report says decreased amplitude but not significant all blocks high dose (10 mg/kg/d to dams & pups), M only, PND23 & PND60
X
only swimming time in Y maze reported, varied significances, no mention of errors or other performance measures
Phorate
M maze: decrease number reaching criterion with relearning, low & mid dose (0.03 & 0.1 mg/kg/d to dams & pups), M only significant, PND30; not seen in second study with higher dose
X
decreased peak amplitude all blocks high dose (0.1 mg/kg/d to dams & pups), M only, PND60; not seen in second study with higher dose
X
combined two studies; one with low & mid dose, other with high dose; some data didn't agree
Profenofos
X
X
X
X

Terbufos
X
X
X
X

Tetrachlorvinphos
X
X
X
X

Tribufos
X
X
X
X

Trichlorfon
PA: decreased latency to enter on retention high dose (~205.1 mg/kg/d dam diet), M only, PND29; M maze: increased average errors second trial high dose, F only, PND60
decreased activity middle blocks (maybefaster habituation) mid dose (~76.2 mg/kg/d dam diet) only, F only, PND60
decreased peak amplitude all blocks high dose (~205.1 mg/kg/d dam diet), early blocks mid dose (~76.2 mg/kg/d dam diet), M & F, PND22; decreased amplitude middle blocks (not consistent) all doses (~23.3, 76.2, 205.1 mg/kg/d dam diet), F only, PND38; for M decreased amplitude apparent but not significant high dose PND38 & PND60
X

[1] high pup mortality in all groups, including control, negated any valid neurotoxicity assessments of dichlorvos

Appendix 3.	Low Quality Studies: Summary of Study Design Elements Impacting Study Quality Assignment
                                     Study
                                Study Location
                 Cohort Name / Description of Study Population
                                 Study Design
                              Exposure Assessment
                              Outcome Assessment
                        Confounder /
Covariate Control
                             Statistical Analysis
                             Risk of (other) Bias
Acosta-Maldonado et al. (2009)
Chihuahua, Mexico
Singleton pregnancies
Cross-sectional, small pilot study  -  only 9 women exposed, participant selection and exclusion not detailed
N=54 mothers
(9 exposed, 45 comparison mothers)
Proxy indicator of exposure - Residence in agricultural community were pesticides had been applied; or home located < 5 km from a pesticide application zone; or cohabitating with worker exposed to pesticides or agricultural labor

Also, AChE activity  -  Objective biomarker of exposure/altered function
Standardized but partially subjective assessment of placental maturity

Minimal. Adjustment for placental characteristics.
Appropriate multivariate analysis; Corrected hypothesis test results for multiple comparisons.
Selection bias unlikely; Residual confounding likely; substantial potential for differential misclassification of exposure.
Dawbrowski et al. (2003)
Lodz, Poland
Newborn children among Polish farmers
Case-control, large sample size
N=389
Age: newborns
Prenatal pesticide exposure assessed via questionnaire (retrospective self-report). Site visit after delivery to evaluate pesticide exposure
Pregnancy outcomes assessed using birth records
Appropriate. Included maternal demographics, predictors of high-risk pregnancy (duration, maternal weight) and environmental toxicant exposure (ETS). No adjustment for SES indicators
Appropriate multivariate analysis.
Selection bias unlikely; Residual confounding likely small in magnitude; considerable potential for non-differential misclassification of exposure (unlikely to account for non-null findings). Minimal misclassification of outcome.
Cartier et al. (2016)
Brittany, France
PELAGIE study (French population; pregnant women and children)
Longitundinal birth cohort

n = 231

Mother-infant pairs

Metabolite concentrations (total DAP, DM, and DE) of prenatal OP pesticide exposure quantified in two maternal spot urine samples provided at 16 and 26 weeks of gestation

Maternal IQ and the family environment were also assessed using the Wechsler Adult Intelligence Scale and the HOME test
Wechsler Intelligence Scale administered to children to determine IQ

All models were adjusted for HOME score, breastfeeding duration, mothers' IQ, school, maternal education level, psychologist testing the child, and creatinine levels of mother and child
Appropriate: Linear regression and multivariate models
Urine collection methods and storage (urine samples collected at home and mailed back to laboratory); lack of frequent urine spot samling and due to the short half-life of urinary metabolites could have led to exposure misclassification
Fielder et al. (2015)

Bangkok, Thailand area
Thai population (Children aged 6 to 8, who were from two farming regions (aquaculture v. rice)
Cohort, small sample size
n = 54
Age 6- 8 years
Child Exposure  -  Total DEAP, DAP, and DMAP metabolites measured in spot urine samples, collected at three, separate time points (every 6 months)
Parental education was assessed via a vocabulary test; the home environment was scored via the HOME test
BARS examination administered to children to determine neurobehavorial performance.

All models were adjusted for age and the HOME scale
Appropriate: Multivariate linear regression model and mix model linear regression to determine interaction
Small sample size (n = 54); errors in exposure classification methods, specifically, urine collection methods and storage (urine samples collected at home); short half-life of urinary metabolites could have led to exposure misclassification
Grandjean et al.(2006)
Tabacundo, Ecuador
Healthy 2nd and 3rd grade children
Cross-sectional, small sample size
N=72
Age <9 years
Prenatal occupational exposure assessed via questionnaire; Also recent child exposure biomarker assessment (DAP).
Objective anthropometric and other clinical outcomes; Numerous neurobehavioral outcomes evaluated using easy-to-administer screening instruments; Age appropriate. May be insensitive to subtle effects of OP pesticide exposure effects.
Appropriate. Homogenous population limited confounding by design; Included child demographics (age, sex, weight); SES indicators (maternal race, housing, running water, sewage), diet (meals/day), environmental toxicants (maternal alcohol and smoking) and medical history.
Appropriate multivariate analysis; Numerous hypotheses evaluated without correction for multiple comparisons.
Selection bias unlikely; Residual confounding likely small in magnitude; considerable potential for non-differential misclassification of exposure (likely to account for null findings). Potential misclassification of outcome.

                                     Study
                                Study Location
                 Cohort Name / Description of Study Population
                                 Study Design
                              Exposure Assessment
                              Outcome Assessment
                        Confounder /
Covariate Control
                             Statistical Analysis
                             Risk of (other) Bias
Harari et al. (2010)
Tabacundo, Ecuador (Andean plateau north of Quito)
6- to 8-year-old children in the two lowest grades (called second and third) of one of two schools
Cross-sectional, small sample size
n = 81
Age 6- 8 years
Child Current Exposure - DMP metabolites measured in a spot urine samples. A blood sample was analyzed for AChE.

Maternal Exposure  -  Interview by skilled interviewers
Blood pressure and neurophysiologic measures - the instruments used for neurophsychologic measures were validated to avoid cross-cultural influences.

Appropriate: child's sex, age, BMI, number of daily meals (only in current exposure), stunting, hematocrit, school grade, having repeated one grade, maternal education level, family living in a traditional house, drinking water supply, and paternal education and employment
Appropriate: Standard parametric tests and logistic regression
Errors in exposure classification status since it was based on the maternal self-report, mothers likely being aware of the neurobehavioral status of their children, exposure assessment based on a spot urine sample
Kofman et al. (2006)
Israel (Negev region)
Bedouin population (Children aged 6 to 12 at the time of the study, who were victims of poisoning before age three)
Retrospective cohort study, small sample size
N = 52
9-Exposed to OP; 17-Exposed to Kerosene/paint thinner
26-Controls
Aged 6-12 years
OP poisoning was confirmed by low serum butyrylcholinesterase activity based on hospital records
Neuropsychological evaluation and structured interview of parents. Errors in assessment minimized as psychologists were qualified individuals, language and cultural differences taken into consideration, each child tested on same day and in same place as matched control.
Age, sex, background (cultural and demographic)
Difference in means
Errors is outcome classification likely since psychologists who administered the tests knew which children were exposed, small sample size
Koutroulakis et al. (2014)
Crete, Greece
Women with singleton pregnancies, permanent residents for at least two years, referral for amniocentesis to the Fetal-Maternal Unit, Department of Obstetrics and Gynecology, University Hospital of Heraklion
Prospective Cohort Study  -  large sample size, ethical issues
n = 415
Age: newborns
Objective. DAP measurement in a single amniotic fluid samples collected at either 16th or 20th weeks of gestation  -  Novel biomarker. Questionnaire was also used.
Birth weight and head circumference. Unclear how the outcome information was obtained.
Neonatal sex, maternal age, agricultural activities, and gestational age at amniocentesis  -  Rationale for confounder selection not provided
Appropriate: multiple linear regression
Comparing exposure measurements in AF against known biomarker (e.g., OP metabolite levels in urine) for validation of AF not conducted. Smoking status of participants before/during pregnancy, high risk pregnancies, gestational diabetes, PON1 enzyme activity in the fetuses not considered.

Appendix 3.	Low Quality Studies: Summary of Study Design Elements Impacting Study Quality Assignment (continued)
                                     Study
                                Study Location
                 Cohort Name / Description of Study Population
                                 Study Design
                              Exposure Assessment
                              Outcome Assessment
                        Confounder /
Covariate Control
                             Statistical Analysis
                             Risk of (other) Bias
Lizardi et al. (2008)
Yuma County, Arizona, USA
Children's Pesticide Survey (CPS)
Cross-sectional, small sample size
N=48
Age 7 years
Objective Biomarker of prenatal OP pesticide exposure (DAP) quantified in single child spot urine sample provided at the time of the cognitive assessment.
Cognitive assessment using battery of test instruments considered valid and reliable in similar populations. Spanish translation as necessary.
None
Correlation coefficients (type unspecified). Statistically significant confounders were not robust due to influential outliers
Selection bias unlikely; Residual confounding likely; considerable potential for non-differential misclassification of exposure Potential misclassification of outcome.
Lu et al. (2009)
Cota Brus, Costa Rica
4-10 yr. old children whose parents worked in organic coffee farm (La Amistad) and conventional coffee farms (Las Mellizas)
Cross-Sectional (pilot), low sample numbers
N=35:
17 Organic farm
18 Conventional farms
Age 4-10 years old
Good measure (urinary PNP, IMPY, TCPy), but no major differences between exposure groups
Good measure (CBARS) but different SES and demographic characteristics for exposure groups
Limited number (group, age, sex, handedness, grade)
Appropriate: Linear mixed effects for significant test outcomes from paired t-test analyses
Somewhat high - Convenience sample with different recruitment methods; exposure misclassification
Moreno-Banda et al. (2009)
Mexico (Villa Guerrero, Coatepec de Harinas, Tenancingo (Mexico); Cuernavaca, Cuautla, Jiutepec, Temixco, (Morelos)
Newborn children of floricultural workers and families
Cross-sectional, large sample size
N=328
Age: newborns
Proxy indicator of prenatal occupational OP pesticide exposure (self-reported floricultural occupation)
Objectively measured birth outcomes assessed using birth certificate (partial). Self-reported by mother if birth certificate unavailable.
Appropriate, though minimal  -  history of adverse reproductive outcomes, infant sex, maternal smoking and alcohol use during pregnancy.
Appropriate multivariate analysis
Selection bias likely; Residual confounding likely small in magnitude; considerable potential for non-differential misclassification of exposure (likely accounts for null findings). Potential outcome misclassification (self-report in subset of participants).
Nevison (2014)
U.S. National population
Children with birth years 1970 - 2005 in 1) California Department of Developmental Services (CDDS) reports 2) Individuals with Disabilities Education Act (IDEA) reports
Ecological (time trend)
N=NP (national database)
Non-specific, proxy OP exposure measure (lbs/yr)
Two large reporting DBs: CA Department of Developmental Services (CDDS), US Individuals with Disabilities Education Act (IDEA)
Limited: differences in autism definitions, changes in diagnostic criteria
Appropriate: ratio of age-resolved snapshot; tracking trend slopes; correlation coefficient between temporal trend and composite autism prevalence curve
Selection bias unlikely; do not know individual exposure

Appendix 3.	Low Quality Studies: Summary of Study Design Elements Impacting Study Quality Assignment (continued)
                                     Study
                                Study Location
                 Cohort Name / Description of Study Population
                                 Study Design
                              Exposure Assessment
                              Outcome Assessment
                        Confounder /
Covariate Control
                             Statistical Analysis
                             Risk of (other) Bias
Rohlman et al. (2005)
Oregon and North Carolina, USA
Latino children of immigrant parents living in Oregon or North Carolina
Cross-Sectional, small sample size
N= 78
Age 48-71 months
Proxy indicator of chronic OP pesticide exposure - Residence in highly agricultural communities
Battery of neurocognitive development; Screening tools; Some instruments likely not appropriate for use in study population - Not all participants able to complete all evaluations. Poor administration. Tests administered twice; only performance on 2[nd] evaluation considered in analysis.
Self-reported covariate information collected via questionnaire. Adjustment for age, SES indicator (maternal education). No environmental toxicants.
One-sided hypothesis tests. Numerous hypotheses evaluated without correction for multiple comparisons.
Selection bias unlikely; Residual confounding likely; substantial potential for differential misclassification of exposure and outcome. Inadequate presentation of study results. Seemingly post-hoc evaluation of effect modification.
Samarawickrema et al. (2008)
Southern Sri Lanka
Pregnant women delivering at Embilipitiya Base Hospital
Cross-sectional Birth Cohort, small sample size
N=41 end of two pesticide spraying seasons;
N=25 at beginning of spraying season
Proxy indicator of prenatal OP pesticide exposure (delivery during pesticide spray season); Objective pesticide biomarkers assessed (OP pesticide residues), but detected in only two subject's specimens  -  not evaluated
Objective biomarkers of early biological effect outcomes - Maternal and fetal butyrylcholinesterase (BuChE) activity; antioxidant status;
fetal oxidative stress;
fetal DNA fragmentation
No adjustment for potential confounders (though comparison groups were considered to be relatively homogeneous).
Largely appropriate. Assumptions of some statistical tests likely violated.
Selection bias unlikely; Residual confounding likely; substantial potential for differential misclassification of exposure; Seemingly post-hoc evaluation of effect modification.
Savitz et al. (1997)
Ontario, Canada
Newborn children in the Ontario Farm Family Health Study;
Retrospective Birth Cohort, large sample size
N= 1,898 couples; 3,984
Age: newborns
Proxy indicator of pre-conception paternal para-occupational OP pesticide exposure (self-reported male farm activities in 3-month period prior to conception.
Objectively measured birth outcomes assessed by maternal self-report
Appropriate. Included family/child demographics (sex, weight, maternal age, ethnicity); SES indicators (maternal and paternal education and occupation, per capita income) race, housing, running water, sewage), diet (meals/day), pregnancy risks (maternal caffeine, alcohol and smoking) and medical history.
Inappropriate multivariate regression analysis. Likely misspecification of true variance; No adjustment for multiple comparisons.
Selection bias probable; Residual confounding likely; substantial potential for differential misclassification of exposure and outcome.
Wickerham et al. (2012)
Zhejiang Province,
China
Newborn children delivered at the Fuyang Maternal and Children's hospital
Cross-sectional, small pilot study
n=116
Age: Full term infants
Objective biomarker of pesticide exposure (pesticide residues in cord blood)  -  parameterized as number of pesticide residues detected. Methods unlikely suitable for detecting low levels.
Birth weight assessed using birth records and maternal report
Appropriate. Assessed using questionnaire (maternal self-report) and medical records.
Appropriate multivariate analysis.
Selection bias unlikely; Residual confounding likely; substantial potential for differential misclassification of exposure. Some outcome misclassification unlikely .
Naksen et al (2015)
Fang district, Chiang Mai province, Thailand
Pregnant women delivering at Fang Hospital
Prospective Cohort, small pilot study
n=52
Age: newborns
Objective biomarkers of pesticide exposure (DAPs).  Also AChE, BChE, and PON1 genotype expression measurement.  Maternal blood and urinary samples taken, plus cord blood.  Questionnaire to assess other exposures and covariates.
Birth outcomes (Body weight and length, and head circumference) abstracted from medical records.
Appropriate.  Assessed using questionnaire (maternal self-report) and medical records.
Some errors in statistical analysis were identified; e.g., for gestation age, log total DEAP at 32 weeks of pregnancy, a 0.7 beta was reported, but the confidence interval is reported as (-0.1, -1.4)].  No adjustment for multiple comparisons.
Inadequate presentation of study results. Selection bias possible due to loss to follow-up; Residual confounding likely, small in magnitude; potential for non-differential misclassification of exposure.

Appendix 4.	Table of Systematic Review Analysis:  Initial Search Research & Initial Exclusion Criteria.

Initial search yielded 299 studies.  Removing duplicates (56), there were 243 articles, and 79 were determined to be epidemiological investigations of potential relevance.  The 164 studies excluded from the analysis comprised 57 exposure only studies; 51 review articles; 33 reports of acute OP intoxication; 20 studies in non-human systems; and 3 were otherwise not relevant).

                                    Number
                                   Citations
Category (EPI-epi only; EXPO- exposure only; ACR - acute case report or case series; TOX-animal study; REV - review or commentary, no original data; OTH - other, non-English
                                       1
Abdallah, M. A. E., & Covaci, A. (2014). Organophosphate flame retardants in indoor dust from Egypt: implications for human exposure. [Journal article]. Environmental Science & Technology, 48, 4782-4789.
                                     EXPO
                                       2
Acosta-Maldonado, B., Sanchez-Ramirez, B., Reza-Lopez, S., & Levario-Carrillo, M. (2009). Effects of exposure to pesticides during pregnancy on placental maturity and weight of newborns: a cross-sectional pilot study in women from the Chihuahua State, Mexico. Hum Exp Toxicol, 28(8), 451-459.
                                      EPI
                                       3
Ali, P., Anwer, A., Bashir, B., Jabeen, R., Haroon, H., & Makki, K. (2012). Clinical pattern and outcome of organophosphorus poisoning. [Article]. Journal of the Liaquat University of Medical and Health Sciences, 11, 15-18.
                                      ACR
                                       4
Alizadeh, A. M., Hassanian-Moghaddam, H., Shadnia, S., Zamani, N., & Mehrpour, O. (2014). Simplified acute physiology score II/Acute physiology and chronic health evaluation ii and prediction of the mortality and later development of complications in poisoned patients admitted to intensive care unit. [Article]. Basic and Clinical Pharmacology and Toxicology, 115, 297-300.
                                      ACR
                                       5
Andersen, H. R., Debes, F., Wohlfahrt-Veje, C., Murata, K., & Grandjean, P. (2015). Occupational pesticide exposure in early pregnancy associated with sex-specific neurobehavioral deficits in the children at school age. Neurotoxicology and Teratology, 47, 1-9.
                                      EPI
                                       6
Attfield, K. R., Hughes, M. D., Spengler, J. D., & Lu, C. (2014). Within- and between-child variation in repeated urinary pesticide metabolite measurements over a 1-year period. [Article]. Environmental Health Perspectives, 122, 201-206.
                                     EXPO
                                       7
Attfield, K. R., Hughes, M. D., Spengler, J. D., & Lu, C. S. (2014). Within- and between-child variation in repeated urinary pesticide metabolite measurements over a 1-year period. [Journal article]. Environmental Health Perspectives, 122, 201-206.
                                   DUPLICATE
                                       8
Babina, K., Dollard, M., Pilotto, L., & Edwards, J. W. (2012). Environmental exposure to organophosphorus and pyrethroid pesticides in South Australian preschool children: A cross sectional study. [Article]. Environment International, 48, 109-120.
                                   DUPLICATE
                                       9
Babina, K., Dollard, M., Pilotto, L., & Edwards, J. W. (2012). Environmental exposure to organophosphorus and pyrethroid pesticides in South Australian preschool children: A cross sectional study. [Article]. Environment International, 48, 109-120.
                                     EXPO
                                      10
Balakumar, K., Misha, K., & Milind, K. (2013). Increased fetal endocardial echogenicity mimicking endocardial fibroelastosis following maternal organophosphorus poisoning and its complete regression in utero. [Article]. Indian Journal of Radiology and Imaging, 23, 262-265.
                                      ACR
                                      11
Baltazar, M. T., Dinis-Oliveira, R. J., de Lourdes Bastos, M., Tsatsakis, A. M., Duarte, J. A., & Carvalho, F. (2014). Pesticides exposure as etiological factors of Parkinson's disease and other neurodegenerative diseases -- A mechanistic approach. Toxicology Letters, 230, 85-103.
                                      REV
                                      12
Barr, D. B., Ananth, C. V., Yan, X., Lashley, S., Smulian, J. C., Ledoux, T. A., et al. (2010). Pesticide concentrations in maternal and umbilical cord sera and their relation to birth outcomes in a population of pregnant women and newborns in New Jersey. Sci Total Environ, 408(4), 790-795.
                                      EPI
                                      13
Béchaux, C., Zetlaoui, M. l., Tressou, J., Leblanc, J.-C., Héraud, F., & Crépet, A. l. (2013). Identification of pesticide mixtures and connection between combined exposure and diet. [Article]. Food and Chemical Toxicology, 59, 191-198.
                                     EXPO
                                      14
Bedi, J. S., Gill, J. P. S., Aulakh, R. S., Kaur, P., Sharma, A., & Pooni, P. A. (2013). Pesticide residues in human breast milk: Risk assessment for infants from Punjab, India. Science of The Total Environment, 463 - 464, 720-726.
                                     EXPO
                                      15
Bellinger, D. C. (2012a). A strategy for comparing the contributions of environmental chemicals and other risk factors to neurodevelopment of children. [Article]. Environmental Health Perspectives, 120, 501-507.
                                      REV
                                      16
Bellinger, D. C. (2012b). Comparing the population neurodevelopmental burdens associated with children's exposures to environmental chemicals and other risk factors. [Article]. NeuroToxicology, 33, 641-643.
                                      REV
                                      17
Berkowitz, G. S., Wetmur, J. G., Birman-Deych, E., Obel, J., Lapinski, R. H., Godbold, J. H., et al. (2004). In utero pesticide exposure, maternal paraoxonase activity, and head circumference. Environ Health Perspect, 112(3), 388-391.
                                      EPI
                                      18
Berton, T., Mayhoub, F., Chardon, K., Duca, R.-C., Lestremau, F., Bach, V., et al. (2014a). Development of an analytical strategy based on LC-MS/MS for the measurement of different classes of pesticides and theirs metabolites in meconium: Application and characterisation of foetal exposure in France. Environmental Research, 132, 311-320.
                                     EXPO
                                      19
Berton, T., Mayhoub, F., Chardon, K., Duca, R.-C., Lestremau, F., Bach, V., et al. (2014a). Development of an analytical strategy based on LC - MS/MS for the measurement of different classes of pesticides and theirs metabolites in meconium: Application and characterisation of foetal exposure in France. Environmental Research, 132, 311-320.
                                   DUPLICATE
                                      20
Berton, T., Mayhoub, F., Chardon, K., Duca, R.-C., Lestremau, F., Bach, V., et al. (2014b). Development of an analytical strategy based on LC - MS/MS for the measurement of different classes of pesticides and theirs metabolites in meconium: Application and characterisation of foetal exposure in France. Environmental Research, 132, 311-320.
                                   DUPLICATE
                                      21
Berton, T., Mayhoub, F., Chardon, K., Duca, R.-C., Lestremau, F., Bach, V., et al. (2014b). Development of an analytical strategy based on LC--MS/MS for the measurement of different classes of pesticides and theirs metabolites in meconium: Application and characterisation of foetal exposure in France. [article]. Environmental research (New York, N.Y. : Print), 132, 311-320.
                                   DUPLICATE
                                      22
Bettegowda, C. (2012). Pesticides perturb prenatal brain. [Note]. Science Translational Medicine, 4.
                                      REV
                                      23
Betts, K. S. (2013). Lasting impacts: Pre- and postnatal PBDE exposures linked to IQ deficits. [Note]. Environmental Health Perspectives, 121.
                                      REV
                                      24
Bhagavath, P., Monteiro, F. N. P., & Gnanadev, N. C. (2012). Epidemiology of intentional self poisoning. [Article]. Medico-Legal Update, 12, 52-54.
                                      ACR
                                      25
Bhaskar, R., & Mohanty, B. (2014). Pesticides in mixture disrupt metabolic regulation: In silico and in vivo analysis of cumulative toxicity of mancozeb and imidacloprid on body weight of mice. General and Comparative Endocrinology, 205, 226-234.
                                      TOX
                                      26
Bhatnagar, S., Das, U. M., & Bhatnagar, G. (2012). Comparison of oral midazolam with oral tramadol, triclofos and zolpidem in the sedation of pediatric dental patients: An in vivo study. [Article]. Journal of Indian Society of Pedodontics and Preventive Dentistry, 30, 109-114.
                                      OTH
                                      27
Biello, D. (2012). Bad for bugs and brains? A common pesticide may interfere with a child's brain development. [Article]. Scientific American, 307, 22.
                                      REV
                                      28
Bouchard, M. F., Bellinger, D. C., Wright, R. O., & Weisskopf, M. G. (2010). Attention-deficit/hyperactivity disorder and urinary metabolites of organophosphate pesticides. [Research Support, N.I.H., Extramural]. Pediatrics, 125(6), e1270-1277.
                                      EPI
                                      29
Bouchard, M. F., Chevrier, J., Harley, K. G., Kogut, K., Vedar, M., Calderon, N., et al. (2011). Prenatal exposure to organophosphate pesticides and IQ in 7-year-old children. Environ Health Perspect, 119(8), 1189-1195.
                                      EPI
                                      30
Bradman, A., Kogut, K., Eisen, E. A., Jewell, N. P., Quirós-Alcalá, L., Castorina, R., et al. (2013). Variability of organophosphorous pesticide metabolite levels in spot and 24-hr urine samples collected from young children during 1 week. [Article]. Environmental Health Perspectives, 121, 118-124.
                                     EXPO
                                      31
Brown, J. S., Jr. (2013). Psychiatric Effects of Organic Chemical Exposure: BLACKWELL SCIENCE PUBL, OSNEY MEAD, OXFORD OX2 0EL, UK.
                                      REV
                                      32
Bulgaroni, V., Lombardo, P., Rivero-Osimani, V., Vera, B., Dulgerian, L., Cerban, F., et al. (2013). Environmental pesticide exposure modulates cytokines, arginase and ornithine decarboxylase expression in human placenta. [Article]. Reproductive Toxicology, 39, 23-32.
                                      TOX
                                      33
Burdorf, A., Brand, T., Jaddoe, V. W., Hofman, A., Mackenbach, J. P., & Steegers, E. A. (2011). The effects of work-related maternal risk factors on time to pregnancy, preterm birth and birth weight: the Generation R Study. Occup Environ Med, 68(3), 197-204.
                                      EPI
                                      34
Burns, C. J., McIntosh, L. J., Mink, P. J., Jurek, A. M., & Li, A. A. (2013). Pesticide exposure and neurodevelopmental outcomes: Review of the epidemiologic and animal studies. [Article]. Journal of Toxicology and Environmental Health - Part B: Critical Reviews, 16, 127-183.
                                      REV
                                      35
Butt, C. M., Congleton, J., Hoffman, K., Fang, M. L., & Stapleton, H. M. (2014). Metabolites of organophosphate flame retardants and 2-ethylhexyl tetrabromobenzoate in urine from paired mothers and toddlers. [Journal article]. Environmental Science & Technology, 48, 10432-10438.
                                     EXPO
                                      36
Butt, C. M., Congleton, J., Hoffman, K., Fang, M., & Stapleton, H. M. (2014). Metabolites of organophosphate flame retardants and 2-ethylhexyl tetrabromobenzoate in urine from paired mothers and toddlers. Environ Sci Technol, 48, 10432-10438.
                                   DUPLICATE
                                      37
Camann, D. E., Schultz, S. T., Yau, A. Y., Heilbrun, L. P., Zuniga, M. M., Palmer, R. F., et al. (2013). Acetaminophen, pesticide, and diethylhexyl phthalate metabolites, anandamide, and fatty acids in deciduous molars: Potential biomarkers of perinatal exposure. [Article]. Journal of Exposure Science and Environmental Epidemiology, 23, 190-196.
                                     EXPO
                                      38
Cappiello, A., Famiglini, G., Palma, P., Termopoli, V., Lavezzi, A. M., & Matturri, L. (2014). Determination of selected endocrine disrupting compounds in human fetal and newborn tissues by GC-MS. [Article]. Analytical and Bioanalytical Chemistry, 406, 2779-2788.
                                     EXPO
                                      39
Carmichael, S. L., Yang, W., Roberts, E. M., Kegley, S. E., Wolff, C., Guo, L., et al. (2013). Hypospadias and residential proximity to pesticide applications. [Article]. Pediatrics, 132, e1216-e1226.
                                      EPI
                                      40
Carmichael, S. L., Yang, W., Roberts, E., Kegley, S. E., Padula, A. M., English, P. B., et al. (2014). Residential agricultural pesticide exposures and risk of selected congenital heart defects among offspring in the San Joaquin Valley of California. [Article]. Environmental Research, 135, 133-138.
                                      EPI
                                      41
Carpenter, D. O. (2013). Intellectual Developmental Disability Syndromes and Organic Chemicals: BLACKWELL SCIENCE PUBL, OSNEY MEAD, OXFORD OX2 0EL, UK.
                                      REV
                                      42
Castorina, R., Bradman, A., McKone, T. E., Barr, D. B., Harnly, M. E., & Eskenazi, B. (2003). Cumulative organophosphate pesticide exposure and risk assessment among pregnant women living in an agricultural community: a case study from the CHAMACOS cohort. Environ Health Perspect, 111(13), 1640-1648.
                                     EXPO
                                      43
Cecchi, A., Rovedatti, M. G., Sabino, G., & Magnarelli, G. G. (2012a). Environmental exposure to organophosphate pesticides: Assessment of endocrine disruption and hepatotoxicity in pregnant women. [Article]. Ecotoxicology and Environmental Safety, 80, 280-287.
                                      EPI
                                      44
Cecchi, A., Rovedatti, M. G., Sabino, G., & Magnarelli, G. G. (2012b). Environmental exposure to organophosphate pesticides: Assessment of endocrine disruption and hepatotoxicity in pregnant women. Ecotoxicology and Environmental Safety, 80, 280-287.
                                   DUPLICATE
                                      45
Cequier, E., Ionas, A. C., Covaci, A., Marcé, R. M., Becher, G., & Thomsen, C. (2014). Occurrence of a broad range of legacy and emerging flame retardants in indoor environments in Norway. [Journal article]. Environmental Science & Technology, 48, 6827-6835.
                                     EXPO
                                      46
Cequier, E., Marcé, R. M., Becher, G., & Thomsen, C. (2014). A high-throughput method for determination of metabolites of organophosphate flame retardants in urine by ultra performance liquid chromatography-high resolution mass spectrometry. [Article]. Analytica Chimica Acta, 845, 98-104.
                                     EXPO
                                      47
Chen, W.-Q., Zhang, Y.-Z., Yuan, L., Li, Y.-F., & Li, J. (2014). Neurobehavioral evaluation of adolescent male rats following repeated exposure to chlorpyrifos. [Article]. Neuroscience Letters, 570, 76-80.
                                      TOX
                                      48
Chen, Y., Garcia, G. E., Huang, W., & Constantini, S. (2014). The involvement of secondary neuronal damage in the development of neuropsychiatric disorders following brain insults. [Article]. Frontiers in Neurology, 5 MAR.
                                   DUPLICATE
                                      49
Chen, Y., Garcia, G. E., Huang, W., & Constantini, S. (2014). The involvement of secondary neuronal damage in the development of neuropsychiatric disorders following brain insults. [Article]. Frontiers in Neurology, 5 MAR.
                                      REV
                                      50
Cole, T. B., Li, W.-F., Co, A. L., Hay, A. M., MacDonald, J. W., Bammler, T. K., et al. (2014). Repeated Gestational Exposure of Mice to Chlorpyrifos Oxon Is Associated with Paraoxonase 1 (PON1) Modulated Effects in Maternal and Fetal Tissues. [Article]. Toxicological Sciences, 141, 409-422.
                                      TOX
                                      51
Crane, A. L., Abdel Rasoul, G., Ismail, A. A., Hendy, O., Bonner, M. R., Lasarev, M. R., et al. (2013). Longitudinal assessment of chlorpyrifos exposure and effect biomarkers in adolescent Egyptian agricultural workers. [Article]. Journal of Exposure Science and Environmental Epidemiology, 23, 356-362.
                                     EXPO
                                      52
Dabrowski, S., Hanke, W., Polanska, K., Makowiec-Dabrowska, T., & Sobala, W. (2003). Pesticide exposure and birthweight: an epidemiological study in Central Poland. Int J Occup Med Environ Health, 16(1), 31-39.
                                      EPI
                                      53
Dahlgren, J. G., Takhar, H. S., Ruffalo, C. A., & Zwass, M. (2004). Health effects of diazinon on a family. J Toxicol Clin Toxicol, 42(5), 579-591.
                                      ACR
                                      54
Das, S., Chatterjee, K., Sarkar, N., Aich, B., & Dolui, S. (2013). Cholinergic crisis, intermediate syndrome and delayed polyneuropathy following malathion poisoning. [Article]. Journal of Pediatric Intensive Care, 2, 137-141.
                                      ACR
                                      55
De Cock, M., Maas, Y. G. H., & De Bor, M. V. (2012). Does perinatal exposure to endocrine disruptors induce autism spectrum and attention deficit hyperactivity disorders? Review. [article]. Acta paediatrica (Oslo), 101, 811-818.
                                      REV
                                      56
de Joode, B. V., Barraza, D., Ruepert, C., Mora, A. M., Cordoba, L., Oberg, M., et al. (2012). Indigenous children living nearby plantations with chlorpyrifos-treated bags have elevated 3,5,6-trichloro-2-pyridinol (TCPy) urinary concentrations. [Article]. Environmental Research, 117, 17-26.
                                     EXPO
                                      57
Detweiler, M. B. (2014). Organophosphate intermediate syndrome with neurological complications of extrapyramidal symptoms in clinical practice. [Article]. Journal of Neurosciences in Rural Practice, 5, 298-301.
                                      REV
                                      58
Deziel, N. C., Ward, M. H., Bell, E. M., Whitehead, T. P., Gunier, R. B., Friesen, M. C., et al. (2013). Temporal variability of pesticide concentrations in homes and implications for attenuation bias in epidemiologic studies. [Article]. Environmental Health Perspectives, 121, 565-571.
                                     EXPO
                                      59
Dhakal, A. K., Shrestha, D., Shakya, A., Shah, S. C., & Shakya, H. (2014). Clinical profile of acute poisoning in children at a teaching hospital in lalitpur. [Article]. Journal of Nepal Paediatric Society, 34, 100-103.
                                      ACR
                                      60
Ding, G. D., Wang, P., Tian, Y., Zhang, J., Gao, Y., Wang, X. J., et al. (2012). Organophosphate Pesticide Exposure and Neurodevelopment in Young Shanghai Children. [Article]. Environmental Science & Technology, 46(5), 2911-2917.
                                      EPI
                                      61
Ding, G., & Tian, Y. (2014). Organophosphate pesticide exposure and child health in China. [Article]. Environmental Science and Pollution Research, 21, 759-760.
                                      REV
                                      62
Ding, G., Han, S., Wang, P., Gao, Y., Shi, R., Wang, G., et al. (2012). Increased levels of 8-hydroxy-2′-deoxyguanosine are attributable to organophosphate pesticide exposure among young children. [Article]. Environmental Pollution, 167, 110-114.
                                     EXPO
                                      63
Dulaurent, S., Gaulier, J. M., Blanc-Lapierre, A., Imbert, L., & Lachâtre, G. (2013). Urinary determination of 2-isopropyl-4-methyl-6-hydroxypyrimidine in case of non fatal poisoning with diazinon. [Article]. Forensic Science International, 228, e20-e24.
                                      ACR
                                      64
Engel, S. M., Berkowitz, G. S., Barr, D. B., Teitelbaum, S. L., Siskind, J., Meisel, S. J., et al. (2007). Prenatal organophosphate metabolite and organochlorine levels and performance on the Brazelton Neonatal Behavioral Assessment Scale in a multiethnic pregnancy cohort. Am J Epidemiol, 165(12), 1397-1404.
                                      EPI
                                      65
Engel, S. M., Wetmur, J., Chen, J., Zhu, C., Barr, D. B., Canfield, R. L., et al. (2011). Prenatal exposure to organophosphates, paraoxonase 1, and cognitive development in childhood. Environ Health Perspect, 119(8), 1182-1188.
                                      EPI
                                      66
Eskenazi, B., Chevrier, J., Rauch, S. A., Kogut, K., Harley, K. G., Johnson, C., et al. (2013). In Utero and Childhood Polybrominated Diphenyl Ether (PBDE) Exposures and Neurodevelopment in the CHAMACOS Study. [Article]. Environmental Health Perspectives, 121(2), 257-262.
                                      EPI
                                      67
Eskenazi, B., Chevrier, J., Rauch, S. A., Kogut, K., Harley, K. G., Johnson, C., et al. (2013). In utero and childhood polybrominated diphenyl ether (PBDE) exposures and neurodevelopment in the CHAMACOS study. [Note]. Environmental Health Perspectives, 121, 257-262.
                                   DUPLICATE
                                      68
Eskenazi, B., Harley, K., Bradman, A., Weltzien, E., Jewell, N. P., Barr, D. B., et al. (2004). Association of in utero organophosphate pesticide exposure and fetal growth and length of gestation in an agricultural population. Environ Health Perspect, 112(10), 1116-1124.
                                      EPI
                                      69
Eskenazi, B., Huen, K., Marks, A., Harley, K. G., Bradman, A., Barr, D. B., et al. (2010). PON1 and neurodevelopment in children from the CHAMACOS study exposed to organophosphate pesticides in utero. Environ Health Perspect, 118(12), 1775-1781.
                                      EPI
                                      70
Eskenazi, B., Kogut, K., Huen, K., Harley, K. G., Bouchard, M., Bradman, A., et al. (2014a). Organophosphate pesticide exposure, PON1, and neurodevelopment in school-age children from the CHAMACOS study. Environmental Research, 134, 149-157.
                                      EPI
                                      71
Eskenazi, B., Kogut, K., Huen, K., Harley, K. G., Bouchard, M., Bradman, A., et al. (2014b). Organophosphate pesticide exposure, PON1, and neurodevelopment in school-age children from the CHAMACOS study. [Article]. Environmental Research, 134, 149-157.
                                   DUPLICATE
                                      72
Eskenazi, B., Marks, A. R., Bradman, A., Harley, K., Barr, D. B., Johnson, C., et al. (2007). Organophosphate pesticide exposure and neurodevelopment in young Mexican-American children. Environ Health Perspect, 115(5), 792-798.
                                      EPI
                                      73
Eskenazi, B., Rosas, L. G., Marks, A. R., Bradman, A., Harley, K., Holland, N., et al. (2008). Pesticide toxicity and the developing brain. Basic Clin Pharmacol Toxicol, 102(2), 228-236.
                                      REV
                                      74
Estevan, C., Fuster, E., Del Río, E., Pamies, D., Vilanova, E., & Sogorb, M. A. (2014). Organophosphorus pesticide chlorpyrifos and its metabolites alter the expression of biomarker genes of differentiation in D3 mouse embryonic stem cells in a comparable way to other model neurodevelopmental toxicants. [Article]. Chemical Research in Toxicology, 27, 1487-1495.
                                      TOX
                                      75
Fenske, R. A., Lu, C., Negrete, M., & Galvin, K. (2013). Breaking the take home pesticide exposure pathway for agricultural families: Workplace predictors of residential contamination. [Article]. American Journal of Industrial Medicine, 56, 1063-1071.
                                     EXPO
                                      76
Ferreira, J. D., Couto, A. C. z., Pombo-de-Oliveira, M. S., & Koifman, S. (2013). In utero pesticide exposure and leukemia in Brazilian children < 2 years of age. [Note]. Environmental Health Perspectives, 121, 269-275.
                                      EPI
                                      77
Feyzİoğlu, B. r., Özdemİr, M., Kutlu, N. O., Baykan, M., & Baysal, B. (2014). Pulmonary infection caused by chryseobacterium indologenes in a patient with a diagnosis of organophosphate poisoning. [Article]. Anatolian Journal of Clinical Investigation, 8, 137-139.
                                      ACR
                                      78
Fortenberry, G. Z., Meeker, J. D., Sanchez, B. N., Barr, D. B., Panuwet, P., Bellinger, D., et al. (2014). Urinary 3,5,6-trichloro-2-pyridinol (TCPY) in pregnant women from Mexico City: Distribution, temporal variability, and relationship with child attention and hyperactivity. [article]. International journal of hygiene and environmental health, 217, 405-412.
                                   DUPLICATE
                                      79
Fortenberry, G. Z., Meeker, J. D., Sanchez, B. N., Barr, D. B., Panuwet, P., Bellinger, D., et al. (2014). Urinary 3,5,6-trichloro-2-pyridinol (TCPY) in pregnant women from Mexico City: distribution, temporal variability, and relationship with child attention and hyperactivity. Int J Hyg Environ Health, 217(2-3), 405-412.
                                      EPI
                                      80
Fortenberry, G. Z., Meeker, J. D., Sánchez, B. N., Barr, D. B., Panuwet, P., Bellinger, D., et al. (2014). Urinary 3,5,6-trichloro-2-pyridinol (TCPY) in pregnant women from Mexico City: Distribution, temporal variability, and relationship with child attention and hyperactivity. International Journal of Hygiene and Environmental Health, 217, 405-412.
                                   DUPLICATE
                                      81
Fortenberry, G. Z., Meeker, J. D., Sánchez, B. N., Barr, D. B., Panuwet, P., Bellinger, D., et al. (2014). Urinary 3,5,6-trichloro-2-pyridinol (TCPY) in pregnant women from Mexico City: distribution, temporal variability, and relationship with child attention and hyperactivity. [Journal article]. International Journal of Hygiene and Environmental Health, 217, 405-412.
                                   DUPLICATE
                                      82
Fortenberry, G. Z., Meeker, J. D., Sánchez, B. N., Bellinger, D., Peterson, K., Schnaas, L., et al. (2014). Paraoxonase I polymorphisms and attention/hyperactivity in school-age children from Mexico City, Mexico. [Article]. Environmental Research, 132, 342-349.
                                      EPI
                                      83
Fortenberry, G. Z., Meeker, J. D., Sanchez, B. N., Bellinger, D., Peterson, K., Schnaas, L., et al. (2014). Paraoxonase I polymorphisms and attention/hyperactivity in school-age children from Mexico City, Mexico. Environ Res, 132, 342-349.
                                   DUPLICATE
                                      84
Fortenberry, G. Z., Meeker, J. D., Sanchez, B. N., Bellinger, D., Peterson, K., Schnaas, L., et al. (2014). Paraoxonase I polymorphisms and attention/hyperactivity in school-age children from Mexico City, Mexico. Environmental Research, 132, 342-349.
                                   DUPLICATE
                                      85
Fortenberry, G. Z., Meeker, J. D., Sánchez, B. N., Bellinger, D., Peterson, K., Schnaas, L., et al. (2014). Paraoxonase I polymorphisms and attention/hyperactivity in school-age children from Mexico City, Mexico. Environmental Research, 132, 342-349.
                                   DUPLICATE
                                      86
Fortenberry, G. Z., Meeker, J. D., Sánchez, B. N., Bellinger, D., Peterson, K., Schnaas, L., et al. (2014). Paraoxonase I polymorphisms and attention/hyperactivity in school-age children from Mexico City, Mexico. Environmental Research, 132, 342-349.
                                   DUPLICATE
                                      87
Fromme, H., Lahrz, T., Kraft, M., Fembacher, L., Mach, C., Dietrich, S., et al. (2014). Organophosphate flame retardants and plasticizers in the air and dust in German daycare centers and human biomonitoring in visiting children (LUPE 3). [Article]. Environment International, 71, 158-163.
                                     EXPO
                                      88
Furlong, M. A., Engel, S. M., Barr, D. B., & Wolff, M. S. (2014). Prenatal exposure to organophosphate pesticides and reciprocal social behavior in childhood. Environ Int, 70, 125-131.
                                      EPI
                                      89
Furlong, M. A., Engel, S. M., Barr, D. B., & Wolff, M. S. (2014a). Prenatal exposure to organophosphate pesticides and reciprocal social behavior in childhood. Environment International, 70, 125-131.
                                   DUPLICATE
                                      90
Furlong, M. A., Engel, S. M., Barr, D. B., & Wolff, M. S. (2014b). Prenatal exposure to organophosphate pesticides and reciprocal social behavior in childhood. [article]. Environment international, 70, 125-131.
                                   DUPLICATE
                                      91
Gonza'lez-Alzaga, B., Lacasan, tild, a, M., Aguilar, G., o, C., et al. (2014). A systematic review of neurodevelopmental effects of prenatal and postnatal organophosphate pesticide exposure. [Article]. Toxicology Letters, 230, 104-121.
                                      REV
                                      92
Gonzalez, V., Huen, K., Venkat, S., Pratt, K., Xiang, P., Harley, K. G., et al. (2012). Cholinesterase and paraoxonase (PON1) enzyme activities in MexicanAmerican mothers and children from an agricultural community. [Article]. Journal of Exposure Science and Environmental Epidemiology, 22, 641-648.
                                     EXPO
                                      93
Gonzalez-Alzaga, B., Lacasana, M., Aguilar-Garduno, C., Rodriguez-Barranco, M., Ballester, F., Rebagliato, M., et al. (2013). A systematic review of neurodevelopmental effects of prenatal and postnatal organophosphate pesticide exposure. Toxicol Lett, 230, 104-121.
                                   DUPLICATE
                                      94
González-Alzaga, B., Lacasaña, M., Aguilar-Garduño, C., Rodríguez-Barranco, M., Ballester, F., Rebagliato, M., et al. (2014). A systematic review of neurodevelopmental effects of prenatal and postnatal organophosphate pesticide exposure. Toxicology Letters, 230, 104-121.
                                   DUPLICATE
                                      95
Goodman, J. E., Prueitt, R. L., & Rhomberg, L. R. (2013). INCORPORATING LOW-DOSE EPIDEMIOLOGY DATA IN A CHLORPYRIFOS RISK ASSESSMENT. [Article]. Dose-Response, 11(2), 207-219.
                                      REV
                                      96
Goodman, J. E., Prueitt, R. L., & Rhomberg, L. R. (2013). Incorporating low-dose epidemiology data in a chlorpyrifos risk assessment. [Article]. Dose-Response, 11, 207-219.
                                   DUPLICATE
                                      97
Gowda, V. K. N., Bannigidad, N. B., Kumar, P., Srikanteswara, P.-K., Shivananda, Govindraj, et al. (2014). Predictors of non-traumatic coma in a pediatric cohort from a South Indian tertiary care center: Results of a multivariate analysis. [Article]. Journal of Pediatric Neurology, 12, 35-43.
                                      ACR
                                      98
Grandjean, P., Harari, R., Barr, D. B., & Debes, F. (2006). Pesticide exposure and stunting as independent predictors of neurobehavioral deficits in Ecuadorian school children. [Research Support, Non-U.S. Gov't]. Pediatrics, 117(3), e546-556.
                                      EPI
                                      99
Guha, N., Ward, M. H., Gunier, R., Colt, J. S., Suzanne Lea, C., Buffer, P. A., et al. (2013). Characterization of residential pesticide use and chemical formulations through self-report and household inventory: The northern California childhood leukemia study. [Note]. Environmental Health Perspectives, 121, 276-282.
                                     EXPO
                                      100
Guiñazú, N., Rena, V., Genti-Raimondi, S., Rivero, V., & Magnarelli, G. (2012). Effects of the organophosphate insecticides phosmet and chlorpyrifos on trophoblast JEG-3 cell death, proliferation and inflammatory molecule production. [Article]. Toxicology in Vitro, 26, 406-413.
                                      TOX
                                      101
Guodong, D., & Yixiao, B. A. O. (2014). Revisiting pesticide exposure and children's health: Focus on China. [article]. Science of the total environment, 472, 289-295.
                                      REV
                                      102
Guodong, D., Pei, W., Ying, T., Jun, Z., Yu, G., Xiaojin, W., et al. (2012). Organophosphate pesticide exposure and neurodevelopment in young Shanghai children. [Article]. Environmental Science and Technology, 46, 2911-2917.
                                   DUPLICATE
                                      103
Guodong, D., Pei, W., Ying, T., Jun, Z., Yu, G., Xiaojin, W., et al. (2012). Organophosphate pesticide exposure and neurodevelopment in young Shanghai children. Environ Sci Technol.
                                      EPI
                                      104
Handal, A. J., Harlow, S. D., Breilh, J., & Lozoff, B. (2008). Occupational exposure to pesticides during pregnancy and neurobehavioral development of infants and toddlers. Epidemiology, 19(6), 851-859.
                                      EPI
                                      105
Handal, A. J., Lozoff, B., Breilh, J., & Harlow, S. D. (2007a). Effect of community of residence on neurobehavioral development in infants and young children in a flower-growing region of Ecuador. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't]. Environ Health Perspect, 115(1), 128-133.
                                      EPI
                                      106
Handal, A. J., Lozoff, B., Breilh, J., & Harlow, S. D. (2007b). Neurobehavioral development in children with potential exposure to pesticides. Epidemiology, 18(3), 312-320.
                                      EPI
                                      107
Harari, R., Julvez, J., Murata, K., Barr, D., Bellinger, D. C., Debes, F., et al. (2010). Neurobehavioral deficits and increased blood pressure in school-age children prenatally exposed to pesticides. Environ Health Perspect, 118(6), 890-896.
                                      EPI
                                      108
Harley, K. G., Huen, K., Schall, R. A., Holland, N. T., Bradman, A., Barr, D. B., et al. (2011). Association of organophosphate pesticide exposure and paraoxonase with birth outcome in Mexican-American women. PLoS One, 6(8), e23923.
                                      EPI
                                      109
Hoffman, K., Daniels, J. L., & Stapleton, H. M. (2014). Urinary metabolites of organophosphate flame retardants and their variability in pregnant women. [Article]. Environment International, 63, 169-172.
                                     EXPO
                                      110
Hoffman, K., Daniels, J. L., & Stapleton, H. M. (2014). Urinary metabolites of organophosphate flame retardants and their variability in pregnant women. [Journal article]. Environment International, 63, 169-172.
                                   DUPLICATE
                                      111
Hore, P., Robson, M., Freeman, N., Zhang, J., Wartenberg, D., Ozkaynak, H., et al. (2005). Chlorpyrifos accumulation patterns for child-accessible surfaces and objects and urinary metabolite excretion by children for 2 weeks after crack-and-crevice application. Environ Health Perspect, 113(2), 211-219.
                                     EXPO
                                      112
Hore, P., Zartarian, V., Xue, J., Oezkaynak, H., Wang, S.-W., Yang, Y.-C., et al. (2006). Childrens residential exposure to chlorpyrifos: Application of CPPAES field measurements of chlorpyrifos and TCPy within MENTOR/SHEDS-Pesticides model. Science of the Total Environment, 366(2-3), 525-537.
                                     EXPO
                                      113
Horton, M. K., Kahn, L. G., Perera, F., Barr, D. B., & Rauh, V. (2012). Does the home environment and the sex of the child modify the adverse effects of prenatal exposure to chlorpyrifos on child working memory? Neurotoxicol Teratol, 34(5), 534-541.
                                      EPI
                                      114
Horton, M. K., Kahn, L. G., Perera, F., Barr, D. B., & Rauh, V. (2012). Does the home environment and the sex of the child modify the adverse effects of prenatal exposure to chlorpyrifos on child working memory? Neurotoxicology and Teratology, 34, 534-541.
                                   DUPLICATE
                                      115
Horton, M. K., Kahn, L. G., Perera, F., Boyd Barr, D., & Rauh, V. (2012). Does the home environment and the sex of the child modify the adverse effects of prenatal exposure to chlorpyrifos on child working memory? [article]. Neurotoxicology and teratology, 34, 534-541.
                                   DUPLICATE
                                      116
How, V., Hashim, Z., Ismail, P., Said, S. M., Dzolkhifli, O., & Shamsul Bahri, M. T. (2014). Exploring cancer development in adulthood: cholinesterase depression and genotoxic effect from chronic exposure to organophosphate pesticides among rural farm children. [Journal article]. Journal of Agromedicine, 19, 35-43.
                                      EPI
                                      117
Huen, K., Bradman, A., Harley, K., Yousefi, P., Barr, D. B., Eskenazi, B., et al. (2012). Organophosphate pesticide levels in blood and urine of women and newborns living in an agricultural community. [Article]. Environmental Research, 117, 8-16.
                                     EXPO
                                      118
Huen, K., Bradman, A., Harley, K., Yousefi, P., Boyd Barr, D., Eskenazi, B., et al. (2012). Organophosphate pesticide levels in blood and urine of women and newborns living in an agricultural community. [Article]. Environmental Research, 117, 8-16.
                                   DUPLICATE
                                      119
Huen, K., Harley, K., Beckman, K., Eskenazi, B., & Holland, N. (2013). Associations of PON1 and Genetic Ancestry with Obesity in Early Childhood. [Article]. PLoS ONE, 8.
                                      EPI
                                      120
Iftikhar, B., Siddiqui, S., & Rehman, S. (2014). Assessment of the dietary transfer of pesticides to dairy milk and its effect on human health. [Journal article]. African Journal of Biotechnology, 13, 476-485.
                                     EXPO
                                      121
Jafarzadeh, M., Nasri Nasrabadi, Z., Sheikhazadi, A., Abbaspour, A., Vasigh, S., Yousefinejad, V., et al. (2013). Is there a role for progesterone in the management of acute organophosphate poisoning during pregnancy? [Article]. Medical Hypotheses, 80, 804-805.
                                      REV
                                      122
Jamkhande, P. G., Chintawar, K. D., & Chandak, P. G. (2014a). Teratogenicity: a mechanism based short review on common teratogenic agents. Asian Pacific Journal of Tropical Disease, 4, 421-432.
                                      REV
                                      123
Jamkhande, P. G., Chintawar, K. D., & Chandak, P. G. (2014b). Teratogenicity: A mechanism based short review on common teratogenic agents. [Article]. Asian Pacific Journal of Tropical Disease, 4, 421-432.
                                   DUPLICATE
                                      124
Jones, K., Everard, M., & Harding, A. H. (2014). Investigation of gastrointestinal effects of organophosphate and carbamate pesticide residues on young children. [Journal article]. International Journal of Hygiene and Environmental Health, 217, 392-398.
                                      EPI
                                      125
Kajta, M., & Wojtowicz, A. K. (2013). Impact of endocrine-disrupting chemicals on neural development and the onset of neurological disorders. [Literature Review]. Pharmacological Reports, 65, 1632-1639.
                                      REV
                                      126
Karki, R. K., & Risal, A. (2012). Study of poisoning cases in a tertiary care hospital. [Article]. Kathmandu University Medical Journal, 10, 70-73.
                                      ACR
                                      127
Kauffman, R., Marcus, M., Wold, J. L., & Lu, C. (2009). Pesticide exposure and neurodevelopment in migrant farmworker children of South Georgia. International Journal of Child and Adolescent Health. Special Issue: Break the cycle of adverse health and developmental disparities for children, 2(3), 303-312.
                                      REV
                                      128
Kezios, K. L., Liu, X. H., Cirillo, P. M., Cohn, B. A., Kalantzi, O. I., Wang, Y. Z., et al. (2013). Dichlorodiphenyltrichloroethane (DDT), DDT metabolites and pregnancy outcomes. [Article]. Reproductive Toxicology, 35, 156-164.
                                      EPI
                                      129
Khan, H. A. A., & Waseem, A. (2014). The effect of temperature on the toxicity of insecticides against Musca domestica L.: implications for the effective management of diarrhea. [Journal article]. PLoS ONE, 9, e95636.
                                      TOX
                                      130
Khan, K., Ismail, A. A., Abdel Rasoul, G., Bonner, M. R., Lasarev, M. R., Hendy, O., et al. (2014). Longitudinal assessment of chlorpyrifos exposure and self-reported neurological symptoms in adolescent pesticide applicators. [Article]. BMJ Open, 4.
                                   DUPLICATE
                                      131
Khan, K., Ismail, A. A., Abdel Rasoul, G., Bonner, M. R., Lasarev, M. R., Hendy, O., et al. (2014). Longitudinal assessment of chlorpyrifos exposure and self-reported neurological symptoms in adolescent pesticide applicators. [Article]. BMJ Open, 4.
                                      EPI
                                      132
Kicinski, M., Vrijens, J., Vermier, G., Hond, E. D., Schoeters, G., Nelen, V., et al. (2015). Neurobehavioral function and low-level metal exposure in adolescents. International Journal of Hygiene and Environmental Health, 218, 139-146.
                                      EPI
                                      133
Kim, H.-H., Lim, Y.-W., Yang, J.-Y., Shin, D.-C., Ham, H.-S., Choi, B.-S., et al. (2013a). Health risk assessment of exposure to chlorpyrifos and dichlorvos in children at childcare facilities. [Article]. Science of the Total Environment, 444, 441-450.
                                     EXPO
                                      134
Kim, H.-H., Lim, Y.-W., Yang, J.-Y., Shin, D.-C., Ham, H.-S., Choi, B.-S., et al. (2013b). Health risk assessment of exposure to chlorpyrifos and dichlorvos in children at childcare facilities. Science of The Total Environment, 444, 441-450.
                                   DUPLICATE
                                      135
Kofman, O., Berger, A., Massarwa, A., Friedman, A., & Jaffar, A. A. (2006). Motor inhibition and learning impairments in school-aged children following exposure to organophosphate pesticides in infancy. Pediatr Res, 60(1), 88-92.
                                      EPI
                                      136
Koirala, D. P., Rao, K. S., Malla, K. K., & Malla, T. (2013). A study of clinical features, management and outcome of organophosphate and carbamate poisoning in children. [Article]. Journal of Nepal Paediatric Society, 33, 85-90.
                                      ACR
                                      137
Koureas, M., Tsakalof, A., Tsatsakis, A., & Hadjichristodoulou, C. (2012). Systematic review of biomonitoring studies to determine the association between exposure to organophosphorus and pyrethroid insecticides and human health outcomes. [article]. Toxicology letters, 210, 155-168.
                                      REV
                                      138
Koutroulakis, D., Sifakis, S., Tzatzarakis, M. N., Alegakis, A. K., Theodoropoulou, E., Kavvalakis, M. P., et al. (2014). Dialkyl phosphates in amniotic fluid as a biomarker of fetal exposure to organophosphates in Crete, Greece; association with fetal growth. [Article]. Reproductive Toxicology, 46, 98-105.
                                      EPI
                                      139
Kr, M. Z., Öztürk, G. l., Gürler, M., Karaarslan, B., Erden, G. n. l., Karapirli, M., et al. (2013). Pesticide poisoning cases in Ankara and nearby cities in Turkey: An 11-year retrospective analysis. [Article]. Journal of Forensic and Legal Medicine, 20, 274-277.
                                      ACR
                                      140
Krishnamurthy, L., Rohini, K., & Shashikala, P. (2012). Socio-demographic profile of organophosphorous poisoning in a tertiary care hospital. [Article]. Indian Journal of Public Health Research and Development, 3, 169-171.
                                      ACR
                                      141
Kristensen, P., Irgens, L. M., Andersen, A., Bye, A. S., & Sundheim, L. (1997). Gestational age, birth weight, and perinatal death among births to Norwegian farmers, 1967-1991. Am J Epidemiol, 146(4), 329-338.
                                      EPI
                                      142
Kumar, M., Vignan Kumar, G., Babu, P., Kumar, S., Subrahmanyam, B., Veeraprasad, M., et al. (2014). A retrospective analysis of acute organophosphorus poisoning cases admitted to the tertiary care teaching hospital in South India. [Article]. Annals of African Medicine, 13, 71-75.
                                      ACR
                                      143
Kumar, M., Vignan Kumar, G., Babu, P., Kumar, S., Subrahmanyam, B., Veeraprasad, M., et al. (2014). A retrospective analysis of acute organophosphorus poisoning cases admitted to the tertiary care teaching hospital in South India. [Article]. Annals of African Medicine, 13, 71-75.
                                   DUPLICATE
                                      144
Kumar, N., Gupta, A. K., Najotra, D. K., Digra, S. K., Gupta, S., Gupta, P. K., et al. (2013). Incidence and pattern of acute poisoning among children aged 1 month to 18 years: An experience from Jammu. [Article]. Indian Journal of Forensic Medicine and Toxicology, 7, 135-138.
                                      ACR
                                      145
Lee, D., Jung, K., Choi, Y., & Cheon, Y. (2014). Body mass index as a prognostic factor in organophosphate-poisoned patients. [Journal article]. American Journal of Emergency Medicine, 32, 693-696.
                                      ACR
                                      146
Lee, J., & Freeman, J. L. (2014). Zebrafish as a model for investigating developmental lead (Pb) neurotoxicity as a risk factor in adult neurodegenerative disease: A mini-review. Neurotoxicology, 43, 57-64.
                                      TOX
                                      147
Lee, W. J., Ko, Y., & Cha, E. S. (2014). Acute pesticide poisoning among children in south korea: Findings from national health insurance claims data, 2006-2009. [Article]. Journal of Tropical Pediatrics, 60, 4-9.
                                      ACR
                                      148
Li, A. A., Levine, T. E., Burns, C. J., & Kent Anger, W. (2012). Integration of epidemiology and animal neurotoxicity data for risk assessment. [Article]. NeuroToxicology, 33, 823-832.
                                      REV
                                      149
Li, A. A., Lowe, K. A., McIntosh, L. J., & Mink, P. J. (2012). EVALUATION OF EPIDEMIOLOGY AND ANIMAL DATA FOR RISK ASSESSMENT: CHLORPYRIFOS DEVELOPMENTAL NEUROBEHAVIORAL OUTCOMES. [Literature Review]. Journal of Toxicology and Environmental Health Part B Critical Reviews, 15, 109-184.
                                   DUPLICATE
                                      150
Li, A. A., Lowe, K. A., McIntosh, L. J., & Mink, P. J. (2012). Evaluation of epidemiology and animal data for risk assessment: chlorpyrifos developmental neurobehavioral outcomes. J Toxicol Environ Health B Crit Rev, 15(2), 109-184.
                                      REV
                                      151
Li, J., Yu, N., Zhang, B., Jin, L., Li, M., Hu, M., et al. (2014). Occurrence of organophosphate flame retardants in drinking water from China. [Article]. Water Research, 54, 53-61.
                                   DUPLICATE
                                      152
Li, J., Yu, N., Zhang, B., Jin, L., Li, M., Hu, M., et al. (2014). Occurrence of organophosphate flame retardants in drinking water from China. [Article]. Water Research, 54, 53-61.
                                     EXPO
                                      153
Liu, P., Wu, C., Chang, X., Qi, X., Zheng, M., & Zhou, Z. (2014). Assessment of chlorpyrifos exposure and absorbed daily doses among infants living in an agricultural area of the Province of Jiangsu, China. [Journal article]. International Archives of Occupational and Environmental Health, 87, 753-762.
                                     EXPO
                                      154
Lizardi, P. S., O'Rourke, M. K., & Morris, R. J. (2008). The effects of organophosphate pesticide exposure on Hispanic children's cognitive and behavioral functioning. J Pediatr Psychol, 33(1), 91-101.
                                      EPI
                                      155
Llop, S., Julvez, J., Fernandez-Somoano, A., Santa Marina, L., Vizcaino, E., Iñiguez, C., et al. (2013). Prenatal and postnatal insecticide use and infant neuropsychological development in a multicenter birth cohort study. Environment International, 59, 175-182.
                                      EPI
                                      156
London, L., Beseler, C., Bouchard, M. F., Bellinger, D. C., Colosio, C., Grandjean, P., et al. (2012). Neurobehavioral and neurodevelopmental effects of pesticide exposures. [Article]. NeuroToxicology, 33, 887-896.
                                      REV
                                      157
Lopez-Carrillo, L., & Cebrian, M. E. (2013). Cognitive Function: BLACKWELL SCIENCE PUBL, OSNEY MEAD, OXFORD OX2 0EL, UK.
                                      REV
                                      158
Lovasi, G. S., Quinn, J. W., Rauh, V. A., Perera, F. P., Andrews, H. F., Garfinkel, R., et al. (2011). Chlorpyrifos exposure and urban residential environment characteristics as determinants of early childhood neurodevelopment. Am J Public Health, 101(1), 63-70.
                                      EPI
                                      159
Lozowicka, B. (2015). Health risk for children and adults consuming apples with pesticide residue. [Journal article]. Science of the Total Environment, 502, 184-198.
                                      REV
                                      160
Lu, C., & Andres, L. (2012). Reconstructing organophosphorus pesticide doses using the reversed dosimetry approach in a simple physiologically-based pharmacokinetic model. [Article]. Journal of Toxicology, 2012.
                                     EXPO
                                      161
Lu, C., Essig, C., Root, C., Rohlman, D. S., McDonald, T., & Sulzbacher, S. (2009). Assessing the association between pesticide exposure and cognitive development in rural Costa Rican children living in organic and conventional coffee farms. Int J Adolesc Med Health, 21(4), 609-621.
                                      EPI
                                      162
Marks, A. R., Harley, K., Bradman, A., Kogut, K., Barr, D. B., Johnson, C., et al. (2010). Organophosphate pesticide exposure and attention in young Mexican-American children: the CHAMACOS study. Environ Health Perspect, 118(12), 1768-1774.
                                      EPI
                                      163
Marri, M. Z., Mirza, F. H., & Hasan, Q. (2012). Pattern, incidence and mortality rate of acute poisonings at Karachi- one year study. [Article]. Medical Forum Monthly, 23, 6-10.
                                      ACR
                                      164
Martin, I. G., Thottempudi, S. R. K., & Frattarelli, D. A. C. (2013). Changes to Prescription Drug Pediatric Labeling: Awareness by Practicing Pediatricians. [Article]. Drug Information Journal, 47, 214-218.
                                      OTH
                                      165
Mascarelli, A. (2013). Growing up with pesticides. [Note]. Science, 341, 740-741.
                                      REV
                                      166
McGinnis, W. R., Audhya, T., & Edelson, S. M. (2013). Proposed toxic and hypoxic impairment of a brainstem locus in autism. [Article]. International Journal of Environmental Research and Public Health, 10, 6955-7000.
                                      REV
                                      167
Memon, A., Shaikh, J. M., Kazi, S. A. F., & Kazi, A. (2012). Changing trends in deliberate self poisoning at Hyderabad. [Article]. Journal of the Liaquat University of Medical and Health Sciences, 11, 124-126.