residential pesticide exposure among a cohort of urban minority mothers and newborns

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

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



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


Contemporary-use insecticides

OrganophosphatesMechanism: acetylcholinesterase inhibition

Examples: chlorpyrifos, diazinon

CarbamatesMechanism: acetylcholinesterase inhibition

Examples: propoxur, bendiocarb

PyrethroidsMechanism: alters permeability of excited nerves

Examples: permethrin


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


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


Prenatal Interview


48-hour personal air monitoring


Samples at delivery

umbilical cord blood

maternal blood


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


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.


Total with pest sightings85%

• Cockroaches68%

• Rodents53%

• Other insects29%

• insect pests 29%

Proportion of women reporting pest sightings in the home during pregnancy

N=459


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


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%


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%

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


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


Pesticides measured in prenatal maternal 48-hour personal air samples and delivery blood samples

OrganophosphatesChlorpyrifos Diazinon Malathion Methyl parathion

CarbamatesBendiocarbCarbarylCarbofuranPropoxur

Pyrethroidscis-Permethrin trans-Permethrin


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


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


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)

* **


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)


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)


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



EducationWritten (all)One-on-one (cases)

Air tight containersFood and trash


Measures pre and post interventionQuestionnaire dataPest infestation levelsIntegrated indoor air pesticide levels

Measures post interventionBlood pesticide levels(maternal and newborn)


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


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


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

residential pesticide exposure among a cohort of urban minority mothers and newborns

Documents

permethrincolumbia center

diabetescolumbia center

pregnancycolumbia center

pcolumbia center

yearscolumbia center

pesticide use

pest sightings85

extent of prenatal pesticide