{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:32:00Z","timestamp":1788363120248,"version":"build-2803163510"},"reference-count":40,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swiss Network for International Studies (SNIS)","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Studies suggest that acute pesticide poisonings (APP) may be linked with long-term neurological effects. To examine long-term neurological and psychological distress symptoms associated with having experienced an APP, we conducted a cross-sectional study of 300 conventional and organic smallholder farmers from Zarcero County, Costa Rica, May\u2013August 2016. We collected self-reported data on sociodemographic characteristics, occupational history, pesticide exposure, APPs, neurological and psychological distress symptoms (using the Brief Symptom Inventory (BSI)). Adjusted logistic regression models were fit. A total of 14% of the farmers (98% male) reported experiencing at least one APP during their lifetime. Self-reported APP was associated with neurological symptoms during the 12 months prior to interview (e.g., fainting (Odds Ratio: 7.48, 95% Confidence Interval: 1.83, 30.74), shaking hands (3.50; 1.60, 7.60), numbness\/tingling in hands or feet (3.23; 1.66, 6.32), insomnia (2.53; 1.34, 4.79), accelerated heartrate (2.42; 1.03, 5.47), dizziness (2.38; 1.19, 4.72), increased irritability\/anger (2.37; 1.23, 4.55), low energy (2.33; 1.23, 4.46), and difficulty concentrating (2.01; 1.05, 3.85)). Farmers who reported an APP in the ten years prior to interview experienced increased odds of abnormal BSI scores for hostility (4.51; 1.16, 17.70) and paranoid ideation (3.76; 0.99, 18.18). Having experienced an APP may be associated with long-term neurological and psychological distress symptoms.<\/jats:p>","DOI":"10.3390\/ijerph18179021","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T09:53:23Z","timestamp":1630058003000},"page":"9021","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Long-Term Neurological and Psychological Distress Symptoms among Smallholder Farmers in Costa Rica with a History of Acute Pesticide Poisoning"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0830-0927","authenticated-orcid":false,"given":"Andrea","family":"Farnham","sequence":"first","affiliation":[{"name":"Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland"},{"name":"Swiss TPH, University of Basel, Petersplatz 1, 4001 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Fuhrimann","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland"},{"name":"Swiss TPH, University of Basel, Petersplatz 1, 4001 Basel, Switzerland"},{"name":"Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80177, 3508 TD Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8314-1519","authenticated-orcid":false,"given":"Philipp","family":"Staudacher","sequence":"additional","affiliation":[{"name":"Swiss Federal Institute of Aquatic Science and Technology (Eawag), Ueberlandstrasse 133, 8600 D\u00fcbendorf, Switzerland"},{"name":"Institute of Biogeochemistry and Pollutant Dynamics, Department of Environmental Systems Science, ETH Z\u00fcrich, Universit\u00e4tstrasse 16, 8092 Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Quir\u00f3s-L\u00e9piz","sequence":"additional","affiliation":[{"name":"Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia 83-3000, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6840-2351","authenticated-orcid":false,"given":"Carly","family":"Hyland","sequence":"additional","affiliation":[{"name":"Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia 83-3000, Costa Rica"},{"name":"Center for Environmental Research and Children\u2019s Health (CERCH), School of Public Health, University of California at Berkeley, 1995 University Avenue, Suite 265, Berkeley, CA 94720-7392, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7387-3863","authenticated-orcid":false,"given":"Mirko S.","family":"Winkler","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland"},{"name":"Swiss TPH, University of Basel, Petersplatz 1, 4001 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2008-9714","authenticated-orcid":false,"given":"Ana M.","family":"Mora","sequence":"additional","affiliation":[{"name":"Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia 83-3000, Costa Rica"},{"name":"Center for Environmental Research and Children\u2019s Health (CERCH), School of Public Health, University of California at Berkeley, 1995 University Avenue, Suite 265, Berkeley, CA 94720-7392, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1007\/s42452-019-1485-1","article-title":"Worldwide pesticide usage and its impacts on ecosystem","volume":"1","author":"Sharma","year":"2019","journal-title":"Sn Appl. 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