Introduction: Adolescent females living in agricultural areas where crops are routinely sprayed by pesticides
are expected to be environmentally exposed to pesticidesˊ health hazards partially as those occupationally
exposed. Aim of work: to assess neurobehavioral and menstrual disorders among adolescent females
environmentally exposed to pesticides. Materials and methods: This was a cross-sectional study conducted
on 100 pesticide exposed adolescent females who had one or more of family members are pesticidesˊ seasonal
applicators and 50 non- exposed adolescent females matched for age and education, served as controls at
Menoufia governorate, Egypt; during the period of pesticide application season of cotton crop from the first
of May to the end of September 2017. A self-administered questionnaire and a series of neurobehavioral tests
were administered and serum acetyl cholinesterase (AChE) activity was assessed. Results: A significant lower
AChE activity levels were detected among the exposed group compared to the controls (Mean±SD=238.49±
23.83 vs 303.35±78.54 IU/L; respectively). There were significant higher mean scores of trail making test (parts
1 and 2) and significant lower mean scores of (similarities test, Benton visual retention test, block design test,
Santa Ana dexterity test (dominant and non-dominant hands) and Beery visuo-motor imitation test among the
exposed group compared to the controls (P<0.05). Also, the exposed group reported more prevalent irregular
menstrual cycle (26.8%) and intermenstrual bleeding (28.2%) compared to the control participants (8.1% and
8.1%; respectively). Conclusion and recommendations: Adolescent females living in agricultural areas and
from families whose one or more members are pesticidesˊ applicators had significantly lower neurobehavioral
performance, report more prevalent menstrual irregularities and have lower levels of serum AChE compared to
the control group. The neurobehavioral deficits demonstrated a dose–response relationship with AChE levels among the exposed participants. This necessitates the need for implementation of health education programs toprevent or reduce health effects associated with pesticide exposure to adolescent females.