Table 6.

Characteristics of Latin American and the Caribbean studies on pesticide exposure and thyroid function published between 2007 and 2021 ($n=16$).

Study	Year of publication/country	Population and sample size	Study design	Pesticides assessed	Exposure assessment method	Pesticide or metabolite concentrations	Health effect and assessment method/instrument	Results
Studies on OCs
Studies in children
1. Freire et al.187	2012/Brazil	193 children (0–14 years of age) from an old factory	Cross-sectional	OCs	Questionnaire (occupational and residential history of parents) Serum HCH, HCB, chlordane, trans-nonachlor, heptachlor, DDT, DDE, endosulfan, aldrin, endrin, dieldrin, methoxychlor, mirex	Median (P20–P80) ($\text{ng}/\mathrm{mL}$): $\mathrm{\alpha }\text{-HCH}=7.8(1.1–18.0)$; $\mathrm{\beta }\text{-HCH}=10.2(2.0–27.0)$; $\mathrm{\gamma }\text{-HCH}=2.5(0.5–6.7)$; $\text{HCB}=0.8(0.2–2.0)$; $\mathrm{\alpha }\text{-chlordane}=0.6(<\text{LOD}–1.6)$; $\mathrm{\gamma }\text{-chlordane}=0.5(<\text{LOD}–0.9)$; $trans\text{-nonachlor}=0.9(0.1–1.7)$; $\text{heptachlor}=1.1(<\text{LOD}–2.3)$; $p,p\prime \text{-DDE}=10.2(2.0–35.7)$; $o,p\prime \text{-DDT}=1.2(<\text{LOD}–2.2)$; $p,p\prime \text{-DDT}=6.9(1.1–17.7)$; $p,p\prime \text{-DDD}=1.2(0.3–2.6)$; $\text{endosulfan\hspace{0.17em}}1=0.7(<\text{LOD}–1.0)$; $\text{endosulfan\hspace{0.17em}}2=0.7(<\text{LOD}–1.4)$; $\text{aldrin}=3.4(0.7–19.3)$; $\text{endrin}=1.5(0.3–3.6)$; $\text{dieldrin}=1.1(0.3–2.9)$; $\text{methoxychlor}=0.7(<\text{LOD}–0.5)$; $\text{mirex}=1.0(<\text{LOD}–1.7)$	Serum TSH, total T3, fT4	Higher concentrations of 17 of 19 OC pesticides were associated with increased total T3 levels [$\mathrm{\beta }$ (95% CI)] for highest quintile of exposure compared with lowest quintile of exposure: $\mathrm{\alpha }\text{-HCH}=14.9\left(-2.6,27.2\right)$; $\mathrm{\beta }\text{-HCH}=12.1\left(-0.12,24.4\right)$; $\mathrm{\gamma }\text{-HCH}=13.8\left(1.5,26.2\right)$; $\text{HCB}=14.8\left(2.7,26.9\right)$; $\mathrm{\alpha }\text{-chlordane}=21.4\left(9.7,33.1\right)$; $\mathrm{\gamma }\text{-chlordane}=16.0\left(4.5,27.4\right)$; $trans\text{-nonachlor}=19.6\left(7.5,31.6\right)$; $p,p\prime \text{-DDE}=11.5\left(-0.6,23.6\right)$; $o,p\prime \text{-DDT}=8.8\left(-2.5,20.1\right)$; $p,p\prime \text{-DDT}=-10.6\left(-1.4,22.6\right)$; $p,p\prime \text{-DDD}=14.5\left(2.4,26.6\right)$; $\text{endosulfan\hspace{0.17em}}1=17.3\left(6.4,28.2\right)$; $\text{endosulfan\hspace{0.17em}}2=15.1\left(4.3,25.9\right)$; $\text{aldrin}=13.1\left(0.8,25.3\right)$; $\text{endrin}=13.3\left(1.2,25.4\right)$; $\text{dieldrin}=20.3\left(8.1,32.6\right)$. For mirex, exposure was categorized into quartiles and the highest quartile of exposure was associated with increased total T3 levels compared with the lowest quartile ($\mathrm{\beta }=10.3$; 95% CI: $-0.1$, 20.7). Highest quartile of DDD ($\mathrm{\beta }=0.1$; 95% CI: 0, 0.2), endosulfan 1 ($\mathrm{\beta }=0.1$; 95% CI: 0, 0.1), and dieldrin ($\mathrm{\beta }=0$; 95% CI: $-0.1$, 0.11) were associated with increased fT4 levels. Mostly null associations between OC pesticides and TSH levels.
2. Arrebola et al.188	2016/Boliviaa	200 mother–newborn pairs from agricultural area	Cross-sectional	OCs	Questionnaire (residential exposure history) Cord blood DDT and DDE	Median (P25–P75) ($\text{ng}/\mathrm{g}$ lipid): $p,p\prime \text{-DDE}=196.8(52.8–475.0)$; $o,p\prime \text{-DDT}=39.5(19.3–75.1)$	Serum TSH	Null associations of cord blood DDT and DDE with neonatal TSH levels.
3. Cordier et al.117	2015/Guadeloupeb	111 mother–child (18 months of age) pairs	Prospective cohort	OCs	Cord blood and breast milk chlordecone, cord blood DDE	Median (P25–P75) ($\mathrm{\mu }\mathrm{g}/\mathrm{L}$): $\text{Cord\hspace{0.17em}blood\hspace{0.17em}chlordecone}=0.13(<\text{LOD}–0.31)$; $\text{cord\hspace{0.17em}blood\hspace{0.17em}}p,p\prime \text{-DDE}=0.30(0.09–1.05)$; $\text{breast\hspace{0.17em}milk\hspace{0.17em}chlordecone}=0.60(<\text{LOD}–1.16)$	Serum TSH, fT3, fT4	Cord chlordecone was associated with increased TSH, particularly among boys ($p<0.01$). Postnatal chlordecone was associated with decreased fT3 among boys and decreased fT4 among girls ($p<0.05$).
4. Ayhan et al.189	2021/Guadeloupec,d	285 mother–child (7 years of age) pairs	Prospective cohort	OCs	Cord and child blood chlordecone, cord blood DDE	Median (P25–P75) ($\mathrm{\mu }\mathrm{g}/\mathrm{L}$): Cord blood chlordecone: $\text{boys}=0.25(0.08–0.41)$, $\text{girls}=0.21(0.07–0.37)$; child chlordecone: $\text{boys}=0.06(<\text{LOD}–0.11)$, $\text{girls}=0.05(<\text{LOD}–0.11)$; cord blood DDE: $\text{boys}=0.22(0.09–0.64)$, $\text{girls}=0.31(0.10–0.74)$	Serum TSH, fT3, fT4	Third quartile of cord blood chlordecone associated with elevated TSH levels in girls ($\mathrm{\beta }=0.2$; 95% CI: 0, 0.4), relative to first quartile. Null associations of cord blood chlordecone with fT3 and fT4. No report on associations of child chlordecone and cord blood DDE with thyroid hormones.
Studies in adults
5. Freire et al.190	2013/Brazil	608 adolescents and adults ($>14$ years of age) living near an abandoned pesticide factory	Cross-sectional	OCs	Questionnaire (residential exposure history) Serum HCH, HCB, chlordane, trans-nonachlor, heptachlor, DDT, DDE, endosulfan, aldrin, endrin, dieldrin, methoxychlor, mirex	Median (P25–P75) ($\text{ng}/\mathrm{mL}$): Women: $\mathrm{\alpha }\text{-HCH}=2.6(1.0–6.0)$; $\mathrm{\beta }\text{-HCH}=7.0(2.8–17.6)$; $\mathrm{\gamma }\text{-HCH}=1.0(0.4–2.2)$; $\text{HCB}=0.4(0.2–0.7)$; $\mathrm{\alpha }\text{-chlordane}=0.3(<\text{LOD}–0.6)$; $\mathrm{\gamma }\text{-chlordane}=0.2(<\text{LOD}–0.4)$; $trans\text{-nonachlor}=0.4(0.2–0.8)$; $\text{heptachlor}=0.4(<\text{LOD}–0.8)$; $p,p\prime \text{-DDE}=9.6(3.5–28.9)$; $o,p\prime \text{-DDT}=0.4(<\text{LOD}–1.1)$; $p,p\prime \text{-DDT}=3.2(1.0–7.6)$; $p,p\prime \text{-DDD}=0.7(0.2–1.4)$; $\text{endosulfan\hspace{0.17em}}1=0.2(<\text{LOD}–0.4)$; $\text{endosulfan\hspace{0.17em}}2=0.2(<\text{LOD}–0.7)$; $\text{aldrin}=2.4(0.8–14.1)$; $\text{endrin}=0.6(0.3–1.5)$; $\text{dieldrin}=0.6\left(0.2-1.2\right)$; $\text{methoxychlor}=0.4(<\text{LOD}–1.0)$; $\text{mirex}\le \text{LOD\hspace{0.17em}}(<\text{LOD}–0.3)$ Men: $\mathrm{\alpha }\text{-HCH}=2.5(1.0–0.7)$; $\mathrm{\beta }\text{-HCH}=6.0(2.1–15.4)$; $\mathrm{\gamma }\text{-HCH}=1.0(0.4–2.2)$; $\text{HCB}=0.3(0.1–0.6)$; $\mathrm{\alpha }\text{-chlordane}=0.2(<\text{LOD}–0.6)$; $\mathrm{\gamma }\text{-chlordane}=0.2(<\text{LOD}–0.4)$; $trans\text{-nonachlor}=0.3(0.2–0.8)$; $\text{heptachlor}=0.3(<\text{LOD}–0.9)$; $p,p\prime \text{-DDE}=8.3(2.9–21.9)$; $o,p\prime \text{-DDT}=0.3(<\text{LOD}–0.9)$; $p,p\prime \text{-DDT}=3.1(1.0–7.0)$; $p,p\prime \text{-DDD}=0.6(0.2–1.3)$; $\text{endosulfan\hspace{0.17em}}1=0.2(<\text{LOD}–0.5)$; $\text{endosulfan\hspace{0.17em}}2=0.2(<\text{LOD}–0.7)$; $\text{aldrin}=1.9(0.7–11.0)$; $\text{endrin}=0.6(0.2–1.5)$; $\text{dieldrin}=0.6(0.3–1.3)$; $\text{methoxychlor}=0.5(<\text{LOD}–1.0)$; $\text{mirex}\le \text{LOD\hspace{0.17em}}(<\text{LOD}–0.3)$	Serum TSH, total T3, fT4 TPOAb, TGAb	Among men, higher endosulfan 2 was associated with decreased total T3 levels ($\mathrm{\beta }=-2.3$; 95% CI: $-4.6$, $-0.01$); higher $\mathrm{\beta }\text{-HCH}$ was associated with decreased fT4 levels ($\mathrm{\beta }=-0.003$; 95% CI: $-0.006$, $-0.001$) and slightly increased TSH levels ($\mathrm{\beta }=0.003$; 95% CI: 0.001, 0.007); higher $p,p\prime$-DDT was associated with decreased fT4 ($\mathrm{\beta }=-0.003$; 95% CI: $-0.006$, $-0.001$). Men with detected methoxychlor had an increased risk for presence of TPOAb ($\text{OR}=2.2$; 95% CI: 1.3, 3.8). Among women, higher $\mathrm{\alpha }\text{-chlordane}$ ($\mathrm{\beta }=5.7$; 95% CI: 1.1, 10.2), $p,p\prime$-DDT ($\mathrm{\beta }=0.4$; 95% CI: 0.1, 0.7), endosulfan 2 ($\mathrm{\beta }=3.5$; 95% CI: 0.1, 7.0), and methoxychlor ($\mathrm{\beta }=8.5$; 95% CI: 1.7, 15.4) was associated with increased total T3 levels; higher HCB ($\mathrm{\beta }=0.02$; 95% CI: 0.001, 0.04), heptachlor ($\mathrm{\beta }=0.02$; 95% CI: 0.003, 0.03), $o,p\prime$-DDT ($\mathrm{\beta }=0.02$; 95% CI: 0.01, 0.04), and $p,p\prime$-DDT ($\mathrm{\beta }=0.003$; 95% CI: 0.001, 0.01) were associated with increased fT4 among women. Aldrin was associated with the presence of TPOAb ($\text{OR}=1.01$; 95% CI: 1.0, 1.02).
6. Blanco-Muñoz et al.192	2016/Mexico	136 male floriculture workers	Prospective cohort	OCs	Questionnaire (occupational and residential exposure history) Serum $p,p\prime$-DDE, $p,p\prime$-DDT	Median (P25–P75) ($\text{ng}/\mathrm{mL}$) Rainy season $p,p\prime \text{-DDE}=4.9(2.9–11.1)$; dry season $p,p\prime \text{-DDE}=4.7(2.2–11.1)$	Serum TSH, total T3, total T4	Higher $p,p\prime$-DDE was associated with increased total T3 ($\mathrm{\beta }=0.01$; 95% CI: $-0.01$, 0.03) and total T4 ($\mathrm{\beta }=0.01$; 95% CI: 0.0, 0.1) levels. Null association of $p,p\prime$-DDE with TSH levels.
7. Piccoli et al.191	2016/Brazil	275 men and women from farmworker families	Cross-sectional	OCs, OPs	Questionnaire (residential and occupational exposure history) Serum HCH, HCB, chlordane, heptachlor, heptachlor epoxide B, trans-nonachlor, DDT, DDE, DDD, endosulfan, aldrin, endrin, dieldrin, metoxichlor, mirex, pentachloroanisole Blood AChE, BChE	Median (P5–P95) ($\text{ng}/\mathrm{g}$): $\mathrm{\alpha }\text{-HCH}<\text{LOD\hspace{0.17em}}(<\text{LOD}–21.8)$; $\mathrm{\beta }\text{-HCH}<\text{LOD\hspace{0.17em}}(<\text{LOD}–77.9)$; $\mathrm{\gamma }\text{-HCH}<\text{LOD\hspace{0.17em}}(<\text{LOD}–24.4)$; $\text{HCB}<\text{LOD\hspace{0.17em}}(<\text{LOD}–31.9)$; $\text{pentachloroanisole}<\text{LOD\hspace{0.17em}}(<\text{LOD}–20.0)$; $\text{endrin\hspace{0.17em}}(<\text{LOD}–179.7)$; $\text{dieldrin}<\text{LOD\hspace{0.17em}}(<\text{LOD}–21.4)$; $\text{heptachlor\hspace{0.17em}epoxide\hspace{0.17em}}\mathrm{B}<\text{LOD\hspace{0.17em}}(<\text{LOD}–11.6)$; $\mathrm{\gamma }\text{-chlordane}<\text{LOD\hspace{0.17em}}(<\text{LOD}–22.2)$; $\text{heptachlor}<\text{LOD\hspace{0.17em}}(<\text{LOD}–39.9)$; $o,p\prime \text{-DDT}<\text{LOD\hspace{0.17em}}(<\text{LOD}–53.4)$; $p,p\prime \text{-DDT}<\text{LOD\hspace{0.17em}}(<\text{LOD}–84.9)$; $o,p\prime \text{-DDE}<\text{LOD\hspace{0.17em}}(<\text{LOD}–66.3)$; $p,p\prime \text{-DDE}<\text{LOD\hspace{0.17em}}(<\text{LOD}–112.3)$; $p,p\prime \text{-DDD}<\text{LOD\hspace{0.17em}}(<\text{LOD}–40.4)$; $\text{endosulfan\hspace{0.17em}}1<\text{LOD\hspace{0.17em}}(<\text{LOD}–58.5)$	Serum TSH, total T3, fT4	Farmworkers had higher total T3 ($\mathrm{\beta }=1.1$; 95% CI: 1.01, 1.1) than non-farmworkers. Higher $\mathrm{\gamma }\text{-chlordane}$ was associated with increased TSH levels ($\mathrm{\beta }=1.3$; 95% CI: 1.01, 1.5), whereas higher dieldrin was associated with increased fT4 ($\mathrm{\beta }=0.9$; 95% CI: 0.9, 1.0). Higher $\mathrm{\gamma }\text{-chlordane}$ ($\mathrm{\beta }=1.1$; 95% CI: 1.0, 1.1), $\mathrm{\beta }\text{-HCH}$ ($\mathrm{\beta }=1.1$; 95% CI: 1.0, 1.1), heptachlor epoxide B ($\mathrm{\beta }=1.1$; 95% CI: 1.0, 1.2), trans-nonachlor ($\mathrm{\beta }=1.1$; 95% CI: 1.0, 1.2), $p,p\prime$-DDE ($\mathrm{\beta }=1.03$; 95% CI: 1.0, 1.1), and endosulfan 2 ($\mathrm{\beta }=1.1$; 95% CI: 1.0, 1.3) were associated with increased total T3. AChE and BChE inhibitions were not associated with thyroid hormones.
8. Hernández-Mariano et al.193	2017/Mexico	430 pregnant women living in a floriculture area	Prospective cohort	OCs	Serum DDE during pregnancy	$\text{Mean}\pm \text{SD}$ ($\text{ng}/\mathrm{g}$ lipid) $p,p\prime \text{-DDE}=111.75\pm 140.20$	Serum TSH, total T3, fT3, total T4, fT4	Women with $>\text{LOQ}$ DDE concentrations had higher total T3 levels ($\mathrm{\beta }=0.2$; 95% CI: 0.06, 0.3) than those with $<\text{LOQ}$. Mostly null associations of serum DDE with total and free T4 and TSH levels.
9. Londoño et al.194	2018/Colombia	819 farmworkers and their partners from plantain and coffee farms	Cross-sectional	OCs, OPs	Serum chlorpyrifos, DDT, DDE, endosulfan, HCB, aldrin, endrin, heptachlor, methoxychlor, chlordane	Median (range) ($\text{ng}/\mathrm{mL}$): $\text{Heptachlor}=1.31(0.11–9.48)$; $p,p\prime \text{-DDE}=8.3\left(\text{NA}\right)$	Serum TSH, fT4 TPOAb	Higher $p,p\prime$-DDE ($\text{OR}=3.8$; 95% CI: 1.6, 9.2), heptachlor ($\text{OR}=1.7$; 95% CI: 1.0, 3.2), endosulfan 1 ($\text{OR}=6.2$; 95% CI: 1.6, 24.8), and $\ge 3$ OCs in blood ( $\text{OR}=1.8$; 95% CI:1.1, 3.3) were associated with increased odds of subclinical hypothyroidism. Null associations of chlorpyrifos concentrations and hypothyroidism.
Studies on OPs or CBs
Studies in children
10. Phillips et al.195	2021/Ecuador	80 adolescents (12–17 years of age) living in agricultural areas	Cross-sectional	OPs	Questionnaire Blood AChE	Not applicable	Serum TSH, fT4	Lower AChE activity was marginally associated with increased fT4 levels ($\mathrm{\beta }$ per SD decrease in AChE $\text{activity}=0.03$, 90% CI: 0.00, 0.06), but not with TSH ($\mathrm{\beta }=-0.01$, 90% CI: $-0.38$, 0.36). In girls, lower AChE activity was associated with increased fT4 levels ($\mathrm{\beta }=0.05$, 90% CI: 0.01, 0.10) and decreased TSH levels ($\mathrm{\beta }=-0.51$, 90% CI: $-1.00$, $-0.02$). Null associations were observed in boys.
Studies in adults
11. Lacasaña et al.196	2010/Mexico	136 male floriculture workers	Prospective cohort	OPs	Questionnaire (occupational and residential exposure history) Urinary DAPs	$\text{Mean}\pm \text{SD}$ ($\mathrm{\mu }\mathrm{g}/\mathrm{g}$ creatinine): Rainy season: $\mathrm{\Sigma }\text{DMP}=1.5\pm 29.0$; $\mathrm{\Sigma }\text{DEP}=0.3\pm 0.9$; $\mathrm{\Sigma }\text{DAP}=2.0\pm 29.1$; $\text{DDE}=6.2\pm 18.2\text{\hspace{0.17em}ng}/\mathrm{mL}$ Dry season: $\mathrm{\Sigma }\text{DMP}=0.3\pm 0.9$; $\mathrm{\Sigma }\text{DEP}=0.1\pm 0.4$; $\mathrm{\Sigma }\text{DAP}=0.5\pm 1.0$; $\text{DDE}=4.7\pm 20.4\text{\hspace{0.17em}ng}/\mathrm{mL}$	Serum TSH, total T3, total T4	Higher $\mathrm{\Sigma }\text{DMP}$ ($\mathrm{\beta }=0.2$; 95% CI: 0.1, 0.3), $\mathrm{\Sigma }\text{DEP}$ ($\mathrm{\beta }=0.3$; 95% CI: 0.1, 0.4), and $\mathrm{\Sigma }\text{DAP}$ ($\mathrm{\beta }=0.3$; 95% CI: 0.1, 0.4) were associated with increased TSH levels. Higher $\mathrm{\Sigma }\text{DMP}$ ($\mathrm{\beta }=0.2$; 95% CI: 0.1, 0.3) and $\mathrm{\Sigma }\text{DAP}$ ($\mathrm{\beta }=0.2$; 95% CI: 0.1, 0.3) were associated with increased total T4 levels. Null associations were observed for total T3.
12. Lacasaña et al.197	2010/Mexico	136 male floriculture workers	Prospective cohort	OPs	Questionnaire (occupational and residential exposure history) Urinary DAPs	$\text{Mean}\pm \text{SD}$ ($\mathrm{\mu }\mathrm{g}/\mathrm{g}$ creatinine): Rainy season: $\mathrm{\Sigma }\text{DMP}=1.5\pm 29.0$; $\mathrm{\Sigma }\text{DEP}=0.3\pm 0.9$; $\mathrm{\Sigma }\text{DAP}=2.0\pm 29.1$; $\text{DDE}=6.2\pm 18.2\text{\hspace{0.17em}ng}/\mathrm{mL}$ Dry season: $\mathrm{\Sigma }\text{DMP}=0.3\pm 0.9$; $\mathrm{\Sigma }\text{DEP}=0.1\pm 0.4$; $\mathrm{\Sigma }\text{DAP}=0.5\pm 1.0$; $\text{DDE}=4.7\pm 20.4\text{\hspace{0.17em}ng}/\mathrm{mL}$	Serum TSH, total T3, total T4	Interaction between PON1192RR and $\mathrm{\Sigma }\text{DAP}$ on TSH ($\mathrm{\beta }=0.3$; 95% CI: 0.05, 0.6) and total T3 ($\mathrm{\beta }=0.1$; 95% CI: 0.0, 0.2) levels, and between PON1192RR and $\mathrm{\Sigma }\text{DMP}$ on TSH ($\mathrm{\beta }=0.3$; 95% CI: 0.02, 0.5). No interaction between PON155 polymorphism and DAP metabolite concentrations on hormone levels.
13. Miranda-Contreras et al.200	2013/Venezuelac	64 male farmworkers/35 controls	Cross-sectional	OPs, CBs	Questionnaire (occupational exposure history) Blood AChE, BChE	Not applicable	Serum TSH, fT4	Null associations of serum hormones with cholinesterase levels.
14. Torres-Sanchez et al.199	2019/Mexico	381 pregnant women living in a floricultural area	Cross-sectional	OPs	Questionnaire (para-occupational exposure history) Urinary DAPs in a subsample	Median total DAPs ($\mathrm{\mu }\text{mol}/\mathrm{g}$ creatinine): Para-occupationally $\text{exposed}=1.16$; non–para-occupationally $\text{exposed}=0.83$ (data not shown in tables)	Serum TSH, fT4	Null associations of para-occupational exposure to OP pesticides and urinary DAPs with hypothyroxinemia. No interaction was observed between pesticides para-occupational exposure and PON1 polymorphisms.
15. Bernieri et al.198	2019/Brazil	46 rural farmworkers/27 controls	Cross-sectional	OPs, CBs	Questionnaire (occupational exposure history) Blood BChEe	Not applicable	Serum fT4, total T3, TSH	Farmworkers had lower TSH ($p<0.10$) but higher total T3 and fT4 ($p<0.01$ for each) than controls.
Studies on other pesticides or multiple pesticide classes
Studies in adults
16. Santos et al.201	2019/Brazilc	122 individuals living in small farms	Cross-sectional	Multiple pesticide classes	Questionnaire (occupational, residential, and seasonal exposure history)	Not applicable	Serum TSH, total T3, fT3, total T4, fT4	Use of dithiocarbamate fungicides in the past week ($-34\%$; 95% CI: $-54$, $-6$) and no use of full PPE during the last pesticide application ($-34\%$; 95% CI: $-55$, $-2$) was associated with decreased TSH levels. Use of cyhalothrin in the past week was associated with decreased fT4 ($-11\%$; 95% CI: $-19$, $-1$) and total T4 ($-7\%$; 95% CI: $-20$, $-9$), whereas use of paraquat in the past week was associated with decreased fT3 ($-9\%$; 95% CI: $-16$, $-1$). Lifetime use ($>20$ y) of OP pesticides was associated with decreased fT4 ($-11\%$; 95% CI: $-20$, $-1$) and total T4 ( $-11\%$; 95% CI: $-19$, $-3$). Lifetime use (1–20 y) of mancozeb was associated with decreased total T4 ($-9\%$; 95% CI: $-16$, $-1$) and fT3 ($-7\%$; 95% CI: $-12$, $-2$).

Note: AChE, acetylcholinesterase; BChE, butyrylcholinesterase; CBs, carbamate pesticides; CI, confidence interval; CPO, chlorpyrifos; DAP, dialkylphosphate; DDD, dichlorodiphenyldichloroethane; DDE, dichlorodiphenyldichloroethylene; DDT, dichlorodiphenyltrichloroethane; DEP, diethylphosphate; DETP, diethylthiophosphate; DM, dimethyl; DMDTP, dimethyldithiophosphate; DMP, dimethylphosphate; HCB, hexa-chlorobenzene; fT3, free triiodothyronine; fT4; free thyroxine; HCH, hexa-chlorocyclohexane; LOD, limit of detection; OC, organochlorine; OP, organophosphate; OR, odds ratio; P, percentile; PON1, paraoxonase-1; PPE, personal protective equipment; T3, triiodothyronine; T4, thyroxine; TGAb, thyroglobulin antibodies; TPOAb, thyroid peroxidase antibodies; TSH, thyroid-stimulating hormone.

^a Also included in Table 8 (birth outcomes and child growth).

^b Also included in Table 3 (neurobehavioral outcomes).

^c Also included in Table 7 (reproductive outcomes).

^d Also included in Table 9 (other health effects).

^e Investigators did not use exposure biomarker concentrations in multivariate analyses.