Association between urinary dialkylphosphate metabolites and dyslexia among children from three cities of China: The READ program

Exposure to organophosphate (OP) insecticides has been found to be related to neurodevelopmental disorders in children. However, no study has examined the association between OP insecticide exposure and the risk of dyslexia among children. We aimed to explore the association between OP insecticide exposure, indicated by urinary dialkylphosphate metabolites (DAPs), and the risk of dyslexia among Chinese Han children from three cities. A total of 845 children (422 dyslexics and 423 non-dyslexics) from Tongji Reading Environment and Dyslexia research program were included in the current case-control study. We measured six DAPs in urine samples, collected from November 2017 to December 2020. Logistic regression models were used to estimate odds ratios (ORs) for the association between DAPs and dyslexia risk, adjusting for potential confounders. The detection frequencies of DAPs were above 97.5%, except for diethyldithiophosphate and dimethyldithiophosphate. Diethyl phosphate metabolites (DEs) were significantly associated with the risk of dyslexia. Compared with the lowest quartile, the adjusted ORs of dyslexia risk for the highest quartile of urinary diethylthiophosphate (DETP) and diethylphosphate (DEP) were 1.82 (1.04, 3.20) and 1.85 (1.08, 3.17), respectively. In addition, the adjusted ORs for dyslexia per 10-fold of urinary DEP, DETP, and ∑DEs concentration were 1.87 (1.12, 3.13), 1.55 (1.03, 2.35), and 1.91 (1.13, 3.21), respectively. Analyses stratified by gender indicated that such associations were more significant among boys. This study suggested that exposure to OP insecticides may be related to dyslexia among Chinese Han children from the three studied cities. However, our results should be interpreted with caution because of the case-control design and the fact that only one-spot urine sample was collected from the children. More studies with children living in China are necessary concerning the relatively high levels of urinary OP metabolites in our study.