Validity and Reliability of an Assessment Tool for the Screening of Neurotoxic Effects in Agricultural Workers in Chile

Abstract

There is a substantial use of pesticides within the agricultural industry of Chile, with neurotoxic effects through mechanisms of acetylcholinesterase inhibition. These pesticides result in deterioration in health, increasing the risk of diseases such as Parkinson's and Alzheimer's in highly exposed occupational population. To date, there are no brief assessment tools to monitor cognitive impairment in agricultural workers chronically exposed to these pesticides. Method. 234 agricultural workers and 305 nonagricultural workers were assessed two times (test-retest) through a brief tool which comprised three tests (clock-drawing test (CDT); frontal assessment battery (FAB); trail making tests (TMT) A and B). The full scale of WAIS-IV was administered as a gold standard to 18% of the sample of agricultural workers. Factor analysis was used to evaluate the factor structure, and validity and test-retest reliability were assessed concurrently. Results. Cronbach's alpha values were satisfactory or above (>0.60). Test-retest correlations were all significantly correlated (p<0.001). All the tests had a significant correlation with the full scale IQ score of WAIS-IV (p<0.05). The Kaiser-Meyer-Olkin (KMO) measure was 0.74, and the Bartell sphericity test = p<0.001. Three factors explaining 61.62% of the variance were extracted. Two items of the FAB test were dropped of the final factor solution. Normative data transformed into percentile scores and stratified by age and educational level were obtained for Chilean agricultural workers. Conclusion. The brief assessment tool has adequate metric properties as a screening instrument. This allows for a simple administration test (10 to 15 minutes) that can potentially be used for the rapid monitoring of cognitive deterioration in the face of occupational exposure to pesticides in agricultural workers.