Pesticides are used extensively throughout the world in agriculture and in pest 
control as well as for community health purposes. Organophosphate (OP) pesticide 
self-poisoning is an important clinical problem in rural regions of the 
developing world that kills an estimated 200,000 people every year. 
Unintentional poisoning kills far fewer people but is an apparent problem in 
places where highly toxic OP pesticides are available. Neurologic dysfunction is 
the best documented health effect of pesticide exposure. High-level exposure has 
both acute and long-term neurologic signs and symptoms, and adverse effects have 
been reported in most type of pesticides, including organophosphate (OP), 
carbamate, organochlorine, and pyrethroid insecticides, herbicides, fungicides, 
and fumigants. Acute OP pesticide exposure can involve in wide range of both 
central and peripheral neurologic symptoms. Increased neurologic symptom 
prevalence may provide early evidence of neurologic dysfunctions, before 
clinically measurable signs are evident.In this study, we analyzed the 
cross-sectional data on neurologic signs and symptoms from 225 rural children, 
both males (n = 132) and females (n = 93) who were occupationally and 
paraoccupationally exposed to methyl OPs (dichlorvos, fenthion, malathion, 
methyl parathion) and ethyl OPs (chlorpyrifos, diazinon, ethyl parathion) as 
they belonged to agricultural families handling, mixing, and spraying the OP 
pesticides. The children completed a specially designed questionnaire (Q16) on 
neurologic symptoms associated with pesticide exposure with their parental help. 
A suitable reference group consisting of rural children (n = 50) never involved 
in pesticide handling (neither outdoor nor indoor) belonging to similar 
socioeconomic strata included in the study to compare the prevalence of various 
neurologic symptoms between the two groups.Among all the neurologic 
self-reported symptoms, headache, watering in eyes, and burning sensation in 
eye/face were the most important clinical manifestations attributed to OP 
pesticide exposure. These symptoms could probably be the consequence of chronic 
effects of most pesticides on the central nervous system. The muscarinic 
symptoms reported the maximum prevalence of salivation (18.22%), whereas 
lacrimation was observed in 17.33% cases, followed by diarrhea in 9.33% cases. 
The nicotinic clinical manifestations of acute OP poisoning revealed excessive 
sweating in 13.78% cases and tremors in 9.3% cases followed by mydriasis in 8.4% 
exposed children. The characteristic cholinergic symptoms, such as insomnia, 
headache, muscle cramps, weakness, and anorexia were also reported by both male 
and female exposed children. The high frequency of neurologic symptoms observed 
in the study may be due to parasympathetic hyperactivity due to the accumulated 
ACh resulting from AChE inhibition.