Pesticide Metabolites, Anti-Thyroid Peroxidase and Thyroid Stimulating Hormone Status in School Children: A Preliminary Study in Agriculture Areas in Indonesia

Pesticides, which commonly use in agriculture areas, are classified as endocrine disrupting chemicals (EDCs). The study aimed to analyze status of pesticide metabolites, anti-thyroid peroxidase (anti-TPO) antibodies and thyroid stimulating hormone (TSH) status in school children of agriculture areas. Thiswasa cross sectional study. Study subject consisted of 48 elementary school students in Brebes District. Examination of pesticide metabolites used urine sample to detect diethylthiophosphate (DETP) and  dimethyl dithiophosphate (DMDTP),using LC MS-MS. Both TSH and anti-TPO used serum sample and were examined by ELISA. Data was analyzed using chi square test (α 0.05). Mean level of urine DETP was 0.00423 ppm (ranged 0.000-0.043 ppm, SD 0.0099), while urine DMDTP was 0.00953 ppm (ranged 0.00-0.064 ppm, SD 0.019). Anti-TPO ranged 59.29-491.47 IU/ml, with mean level of 167.48 IU/ml (SD 14.19 IU/ml). TSH ranged 1.23-31.56 ml U/L and mean level of 6 ml U/L (SD 5.35 ml U/L). Pesticide metabolites detected in 31.25% of subjects, while positive anti-TPO (>200 IU/ml) found in 25% of subjects. Subclinical hypothyroidism (TSH ≥4.5 mI U/L) was detected in 47.9% of subjects, while 52.1% was euthyroid. Mean levels of urinary iodine excretion (UIE) was 607.27 µg/L, which above requirements UIE level (≥200 µg/L). Proportion of school children who have subclinical hypothyroidism and pesticide metabolites were 66.7%; subclinical hypothyroidism and anti-TPO were 41.7%; while pesticide metabolite and anti-TPO were 20%. There was no significant association between pesticide metabolites and subclinical hypothyroid incident (p-value 0.08, PR 1.69, 95% CI: 0.97-2.9). There was also no significant association between pesticide metabolites and anti-TPO (p-value 0.61, PR 0.83, 95% CI 0.39-1.75). Proportion of school children with positive pesticide metabolites who suffer from subclinical hypothyroidism were higher (66.7%) than negative subclinical hypothyroidism (33.3%). Iodine above requirements may serve as a risk factor of hypothyroidism and autoimmune thyroid disease.