Residential pesticide exposure among a cohort of urban minority mothers and newborns
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Residential pesticide exposure among a cohort of urban minority mothers and newborns
Robin M. Whyatt, Dr.P.H.
Columbia Center for Children’s Environmental Health
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Environmental Exposures Biomarkers Clinical Outcomes
PAH PAH-DNA Adducts Growth ETS Cotinine, 4-ABP
Neurodevelopment
Allergens Immune changes Asthma/Persistent Wheeze
PM 2.5
DEP
NO2
Lead, Mercury
PCBs PCBs, DDT/DDE
Pesticides Contemporary-use pesticides
Susceptibility Factors
Nutritional deficits Vitamins A,C,E
Socioeconomic stressors
Exposure Biomarkers of Exposure OutcomeAssessment Effect/Susceptibility
Pregnancy . . . . . . 2-5 years
Columbia Center for Children’s Environmental Health
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Columbia Center for Children’s Environmental Health
Background on Pesticides
• Residential use widespread in U. S.
• Heaviest applications in New York State in NYC
• Indoor exposures can be substantial
• Link between prenatal organophosphate exposure and adverse neurocognitive development
• Limited data on pesticide use among urban minority women during pregnancy
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Columbia Center for Children’s Environmental Health
Contemporary-use insecticides
OrganophosphatesMechanism: acetylcholinesterase inhibition
Examples: chlorpyrifos, diazinon
CarbamatesMechanism: acetylcholinesterase inhibition
Examples: propoxur, bendiocarb
PyrethroidsMechanism: alters permeability of excited nerves
Examples: permethrin
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Columbia Center for Children’s Environmental Health
Research Goals• To determine the extent of prenatal pesticide use and
exposure
• To evaluate predictors of prenatal pesticide exposure
• To assess effects of prenatal exposure on fetal growth and infant neurocognitive development
• To reduce prenatal pesticide use while controlling pest infestation levels
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Columbia Center for Children’s Environmental Health
Cohort
Number: 459 mother/newborn pairs
Ethnicity: African American and Dominican
Residence: Northern Manhattan & South Bronx
• Non-smokers
• Non-illicit drug users
• No history of HIV, hypertension, diabetes
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Columbia Center for Children’s Environmental Health
Prenatal Interview
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Columbia Center for Children’s Environmental Health
48-hour personal air monitoring
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Columbia Center for Children’s Environmental Health
Samples at delivery
umbilical cord blood
maternal blood
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Columbia Center for Children’s Environmental Health
Demographics
Age 24.6 4.8
Ethnicity Hispanic 61% African American 39%
Marital Status Never married 67%
Education< High School 35%
Annual Household Income < $10,000 42%
Lacked basic necessities shelter, food, clothing, heat, medicine 41%
N=459
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Columbia Center for Children’s Environmental Health
Percent of women reporting indicators of housing disrepair
Paint chips or dust 41%
Holes in ceiling or walls 31%
Leaky pipes 22%
Water damage 22%
Visible mold 17%
60% reported at least 1 indicator of disrepair and 17% reported 3 or more.
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Columbia Center for Children’s Environmental Health
Total with pest sightings85%
• Cockroaches68%
• Rodents53%
• Other insects29%
• insect pests 29%
Proportion of women reporting pest sightings in the home during pregnancy
N=459
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Columbia Center for Children’s Environmental Health
Total using pest control measures84%
• By exterminator34%
• By others50%
90% of women with pest sightings, versus 57% without, reported using pest control measures during pregnancy (2 = 51, p<0.001).
Proportion of women using pest control measures during pregnancy
N=459
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Columbia Center for Children’s Environmental Health
Miscellaneous
Bomb
Boric Acid
Can Sprays
Bait Traps
Spray by Exterminator
Gels
Sticky Traps
Other
Rodents
Cockroaches
Among users, percent using specific pest control measures
52%
44%
40%
29%
27%14%
5%
11%
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Columbia Center for Children’s Environmental Health
Among users, percent using lower versus higher toxicity methods
African Americans used more can sprays (p<0.001) and boric acid (p=0.001) and less baits (p=0.05) and gels (p<0.001) than Dominicans.
Gels, baits and traps only 42%
Cans sprays, bombs and exterminator 58%
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Odds Ratio (C.I.)2 p-value
Pests sighted* 2.0 (1.5-2.8) <0.001
Any pest control used 1.4 (1.1-1.8) <0.01
Lower toxicity only 1.3 (1.0-1.7) 0.05
Higher toxicity 1.5 (1.2-1.9) <0.01
Columbia Center for Children’s Environmental Health
Association1 between housing disrepair and whether or not pests were sighted or pest control measures used
1Logistic regression analyses controlling for ethnicity and neighborhood of residence
2For each unit increase in the degree of housing disrepair reported (0-5)
*Rodents, cockroaches, other pests
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Columbia Center for Children’s Environmental Health
Pesticides measured in prenatal maternal 48-hour personal air samples and delivery blood samples
OrganophosphatesChlorpyrifos Diazinon Malathion Methyl parathion
CarbamatesBendiocarbCarbarylCarbofuranPropoxur
Pyrethroidscis-Permethrin trans-Permethrin
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Columbia Center for Children’s Environmental Health
Pesticides in personal air and blood samples
Personal air Maternal blood Cord blood (ng/m3, n=260) (pg/g, n=174) (pg/g, n=186)
%>LOD Mean±SD %>LOD Mean±SD %>LOD Mean±SD
Chlorpyrifos 100% 18.3±36.5 95% 6.0±5.3 96% 6.1±6.6
Diazinon 100% 122±544 47% 1.1±2.3 53% 1.1±1.7
Propoxur2 100% 64.6±148 55% 3.3±2.5 59% 3.6±3.3
Bendiocarb NC NC 68% 5.6±4.1 48% 4.3±2.8
2isopropoxyphenol measured in blood samplesNC = not calculated
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Columbia Center for Children’s Environmental Health
1Spearman’s rank 22-isopropoxyphenol
Chlorpyrifos r = 0.57, p < 0.001
Diazinon r = 0.45, p < 0.001
Propoxur2 r = 0.49, p < 0.001
Bendiocarb r = 0.27, p = 0.001
Correlation1 between maternal and cord blood pesticide levels
N=147 pairs
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Columbia Center for Children’s Environmental Health
30.126.4
31.4
49.9
0
10
20
30
40
50
60
Propoxur (ng/m3)
19.723.8
31.8
92.2
0
10
20
30
40
50
60
Diazinon (ng/m3)
*No pest control methods
Higher toxicity > once per month
Higher toxicity once per month
Lower toxicity methods only
Pesticides in personal air by use of pest control during pregnancy(Geometric mean)
* p<0.01 compared to other groups ** p<0.001 linear trend ANOVA
8.4 7.7 8.412.3
0
10
20
30
40
50
60
Chlorpyrifos (ng/m3)
* **
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Columbia Center for Children’s Environmental Health
Personal air Maternal blood Cord blood
Clorpyrifos NS B=0.3, p=0.08 B=0.4, p=0.009
Diazinon NS B=0.4, p=0.02 B=0.5, p=0.009
Propoxur B=0.7, p<0.001 NSNS
Association between pesticide levels and ethnicity
Multiple linear regression; dependent variable: log-transformed pesticide levels; independent variable: ethnicity (Domincans = 0, African Americans = 1) , housing disrepair and neighborhood of residence. NS = not significant
There was no association between indicators of housing disrepair and pesticide levels in personal air and blood.
(African American versus Dominican)
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Columbia Center for Children’s Environmental Health
9.97.4
6.3
0
10
20
30
40
50
Chlorpyrifos (ng/m3)
1999
2001
2000
Geometric mean pesticide levels by year of personal monitoring (#1) or year of delivery (#2)
* p<0.05 linearity trend test
32.528.5
17.1
0
10
20
30
40
50
Diazinon (ng/m3)
41.7
25.9
13.3
0
10
20
30
40
50
Propoxur (ng/m3)
5.6
3.1
0
2
4
6
8
Chlorpyrifos (pg/g)
3.5
2.1
0
2
4
6
8
Isopropoxyphenol (pg/g)
4.23.4
0
2
4
6
8
Bendiocarb (pg/g)
1. Personal air samples (ng/m3)
2. Cord blood levels (pg/g)
** *
**p<0.01 ANOVA
**
**** **
0.90.4
0
2
4
6
8
Diazionon (pg/g)
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Columbia Center for Children’s Environmental Health
Integrated Pest Management Repairing of holes in walls and ceilingsRepairing of water damageSealing of cracks and crevicesExtensive cleaningTargeted application of pest gels
Intervention study to reduce residential pesticide exposure during pregnancy
Cohort25 African American and Dominican women using higher toxicity pest control methods and match controls
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Columbia Center for Children’s Environmental Health
Intervention study to reduce residential pesticide exposure during pregnancy
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Columbia Center for Children’s Environmental Health
Intervention study to reduce residential pesticide exposure during pregnancy
EducationWritten (all)One-on-one (cases)
Air tight containersFood and trash
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Columbia Center for Children’s Environmental Health
Measures pre and post interventionQuestionnaire dataPest infestation levelsIntegrated indoor air pesticide levels
Measures post interventionBlood pesticide levels(maternal and newborn)
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Columbia Center for Children’s Environmental Health
Conclusions
• Results show widespread use of pest control measures among African American and Dominican women during pregnancy.
• Pest sightings and use of pest control increased significantly with the degreee of housing disrepair reported.
• Chlorpyrifos, diazinon, propoxur and bendiocarb were detected frequently in personal air and/or blood samples. Exposures were to mixtures of pesticides
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Columbia Center for Children’s Environmental Health
Conclusions
• Maternal and newborn blood levels were similar and highly correlated indicating that the pesticides are readily transferred from mother to the developing fetus
• Prenatal chlorpyrifos exposure is inversely associated with fetal growth among African Americans
• Pesticide exposures have decreased significantly between 1999-2001
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Columbia Center for Children’s Environmental Health
F.P. Perera
P.L. Kinney
H.F.Andrews
W.Y. Tsai
D.E.Camann
D.B. Barr
L.L. Needham
R. Jackson
D. Diaz
J. Dietrich
A. Reyes
J. Ramirez
D. Holmes
M. Borjas
Y. Cosme
Co-Investigators Research StaffAcknowlegements
OB/GYN and postpartum staff at NY Presbyterian and Harlem Hospital, Study Participants, U.S. EPA and NIEHS