Beyond the Fields: Unlocking the Predictive Power of Neutrophil/Lymphocyte Ratio and Hepatic Markers in Chronic Pesticide Toxicity

Abstract

Objectives: To investigate predictive role of N/L ratio coupled with hepatic markers in agricultural workers that are chronically exposed to pesticides.

Methodology: This case control study was carried out at Al Tibri Medical College, Karachi. Data was collected using purposive sampling from agricultural workers between ages 18-75 years working for minimum of 2 years in agricultural farms of Gadap town, Sindh, Pakistan involved in spraying pesticides were included. Duration of study was six months from July 2024 to December 2024. Liver function tests and neutrophil to lymphocyte ratio were analyzed and compared between cases and controls through SPSS by applying independent t-test between them keeping p<0.05 as statistically significant.

Results: From total of 386 workers included, 193 were included in exposed and non-exposed group. The mean N/L ratio in the exposed group was significantly higher (3.96 ± 1.41) compared to the non-exposed group (1.78 ± 0.86, p<0.001). In addition, exposed participants had significantly elevated AST and ALP levels compared to non-exposed participants (p<0.001 for both), while ALT and GGT did not differ significantly. Hematological indices including hemoglobin, RBC count, hematocrit, MCH, MCHC, and platelet counts were significantly lower in the exposed group.

Conclusion:  Chronic pesticide exposure is associated with increased inflammatory and hepatic stress, as evidenced by raised N/L ratio and hepatic markers dysfunction.