Quantitative analysis of children's microactivity patterns: The Minnesota Children's Pesticide Exposure Study

Exposure of Young Children to Permethrin and Cypermethrin Insecticides in the Residential Environment

The aims of this study were to evaluate the exposure to permethrin and cypermethrin of young children aged between 2 and 5 years in Nakhon Pathom and Sing Buri provinces, Thailand. A questionnaire that included general demographic information, household characteristics, insecticide usage and exposure-related behavior in children was used to interview parents or family caregivers. Permethrin and cypermethrin concentrations on floor surfaces and children's hands, as well as their urinary metabolites, were analyzed by gas chromatography coupled with mass spectrometry. The results showed that permethrin and cypermethrin were detected in 62% and 83% of the children's hand wipe samples, with geometric mean (GM) levels of 0.02 µg and 0.04 µg, respectively. Permethrin and cypermethrin were detected in 79% and 93% of floor surface wipe samples, with GM levels of 0.90 µg/m2, and 1.49 µg/m2, respectively. For children's urine, the GM concentrations of cis- and trans-DCCA, 3-PBA, and total pyrethroid metabolites were 0.84, 0.31 and 1.23 nmol/g creatinine, respectively. This study found that household insecticide product usage and having a tile floor were associated with increased permethrin concentrations on the children's hands and floor surfaces. However, cypermethrin concentrations on floor surfaces were significantly higher in families using aerosol insecticide sprays and insecticide products in the living room and bedroom. The predictors of the total pyrethroid, DCCA and 3-PBA metabolites are permethrin on children's hands or floor surfaces and cypermethrin on floor surfaces.

Estimation of indoor soil/dust-skin adherence factors and health risks for adults and children in two typical cities in southern China

Soil/dust (SD) skin adherence is key dermal exposure parameter used for calculating the health risk of dermal exposure to contaminants. However, few studies of this parameter have been conducted in Chinese populations. In this study, forearm SD samples were randomly collected using the wipe method from population in two typical cities in southern China as well as office staff in a fixed indoor environment. SD samples from the corresponding areas were also sampled. The wipes and SD were analyzed for tracer elements (aluminum, barium, manganese, titanium, and vanadium). The SD-skin adherence factors were 14.31 μg/cm² for adults in Changzhou, 7.25 μg/cm² for adults in Shantou, and 9.37 μg/cm² for children in Shantou, respectively. Further, the recommended values for indoor SD-skin adherence factors for adults and children in Southern China were calculated to be 11.50 μg/cm² and 9.37 μg/cm², respectively, which were lower than the U.S. Environmental Protection Agency (USEPA) recommended values. And the SD-skin adherence factor value for the office staff was small (1.79 μg/cm²), but the data were more stable. In addition, PBDEs and PCBs in dust samples from industrial and residential area in Shantou were also determined, and health risks were assessed using the dermal exposure parameters measured in this study. None of the organic pollutants posed a health risk to adults and children via dermal contact. These studies emphasized the importance of localized dermal exposure parameters, and further studies should be conducted in the future.

Sentinel animals for monitoring the environmental lead exposure: combination of traditional review and visualization analysis

In nature, certain animals share a common living environment with humans, thus these animals have become biomonitors of health effects related to various environmental exposures. As one of the most toxic environmental chemicals, lead (Pb) can cause detriment health effects to animals, plants, and even humans through different exposure pathways such as atmosphere, soil, food, water, and dust, etc. Sentinel animals played an "indicative" role in the researches of environmental pollution monitoring and human health. In order to comprehend the usage of sentinel animals in the indication of environmental Pb pollution and human Pb exposure completely, a combination of traditional review and visualization analysis based on CiteSpace literature was used to review earlier researches in this study. In the first instance, present researches on exposure sources and exposure pathways of Pb were summarized briefly, and then the studies using sentinel animals to monitor environmental heavy metal pollution and human health were combed. Finally, visualization software CiteSpace 5.8.R3 was used to explore and analyze the hotspots and frontiers of lead exposure and sentinel animals researches at home and abroad. The results showed that certain mammals were good indicators for human lead exposure. Sentinel animals had been widely used to monitor the ecological environment and human lead exposure. Among them, the blood lead levels of small mammals, particularly for domestic dogs and cats, had a significant correlation with the blood lead levels of human living in the same environment. It indicated that certain biological indicators in animals can be used as surrogates to monitor human body exposure to heavy metals. This study also explored the challenges and perspectives that may be faced in sentinel animal research, in order to provide a certain theoretical basis and train of thought guidance for future research.

Association between lower-level of environmental lead exposure and reactive and proactive aggression in youth: Sex differences

Lead exposure during childhood has been associated with a variety of negative outcomes, including antisocial/aggressive behavior. However, different subtypes of antisocial behavior have been found to have different neurobiological correlates, and it is unclear whether lead exposure is related to specific subtypes of aggressive behavior. The objective of the study was to examine relationships between childhood blood lead levels (BLL) and proactive and reactive aggression. Further, given prior findings of sex differences in the effects of lead exposure, we examine whether there are sex differences in these relationships. In a sample of 818 youth (47.2% girls) ages 10-13 in China, we assessed BLL and administered the Reactive Proactive Aggression Questionnaire. Results show that BLLs were associated with reactive, but not proactive aggression. There was a significant interaction between BLL and sex in predicting aggression; boys with higher BLL scored higher in both proactive and reactive aggression than boys with lower BLL, but these differences were not present for girls. These findings suggest that lead exposure may have broad effects on antisocial behavior, but that boys may be more susceptible than girls. These findings may provide insights to identifying protective factors that could be potential targets for intervention.

A probabilistic assessment of microbial infection risks due to occupational exposure to wastewater in a conventional activated sludge wastewater treatment plant

Exposure to pathogens during wastewater treatment could result in significant health risks. In this paper, a probabilistic approach for assessing the risks of microbial infection for workers in an activated sludge wastewater treatment plant is presented. A number of exposure routes were modelled, including hand-to-mouth and droplet ingestion of untreated wastewater, droplet ingestion and inhalation of aerosols after secondary treatment, and ingestion of sludge during drying. Almost all workers exposed to untreated wastewater could be infected with the three selected potential pathogens of pathogenic E. coli, Norovirus and Cryptosporidium spp. Hand-to-mouth ingestion is the single most significant route of exposure at the head of works. There is also a risk of infections resulting from ingestion of droplets or inhalation of aerosols at the aeration tanks or contaminated hands at the clarifiers during secondary wastewater treatment. For sludge, the risks of infection with Norovirus was found to be the highest due to accidental ingestion (median risks of 2.2 × 10^-2(±3.3 × 10^-3)). Regardless of the point and route of exposure, Norovirus and Cryptosporidium spp. presented the highest risks. The study finds that occupational exposure to wastewater at wastewater treatment plants can result in significant viral and protozoan infections. This risk assessment framework can be used to establish and measure the success of risk reduction measures in wastewater treatment plants. These measures could include the use of personal protective equipment and adherence to strict personal hygiene.

Is hand-to-mouth contact the main pathway of children's soil and dust intake?

Children (n = 240) between the ages of 2 and 17 years were randomly selected from three cities in China. The total amount of soil and dust (SD) on their hands was measured and ranged from 3.50-187.39 mg (median = 19.49 mg). We screened for seven elements (Ce, V, Y, Al, Ba, Sc, and Mn), and Ce levels were used to calculate hand SD by variability and soil elements. The main factors affecting SD amount were location and age group, as identified using a conditional inference tree. Hand SD and the hand SD intake rate were highest in Gansu Province, followed by Guangdong and Hubei provinces, respectively. Hand SD and the hand SD intake rate were highest among children in primary school, followed by kindergarten and secondary school, respectively. The hand SD intake rate of the three typical areas was 11.9 mg/d, which was about 26.6% of the children's soil intake rate (44.8 mg/d), indicating that hand-to-mouth contact is not the main route for children's soil intake in the three areas of China.

Quantification and Analysis of Micro-Level Activities Data from Children Aged 1-12 Years Old for Use in the Assessments of Exposure to Recycled Tire on Turf and Playgrounds

Background: There are growing health concerns about exposure to toxicants released from recycled tire rubber, which is commonly used in synthetic turf and playground mats. To better estimate children’s exposure and risk from recycled tire rubber used in synthetic turf and playground mats, there is a need to collect detailed accurate information on mouthing activity and dermal contact behaviors. The objective of this study was to quantify and analyze micro-level activity time series (MLATS) data from children aged 1–12 years old while playing (non-sport-related games) at turf-like locations and playgrounds. Another objective was to estimate the incidental ingestion rate of rubber crumb among children. Methods: Hand and mouth contact frequency, hourly duration, and median contact duration with different objects were calculated for children playing on turf (i.e., parks, lawns, and gardens) (n = 56) and for children playing on playground structures (n = 24). Statistically significant differences between males and females as well as children’s age groups were evaluated. The daily incidental ingestion rate of rubber crumb was calculated. Results: For children playing on turf, there were significant differences between younger (1–6 y) and older (7–12 y) children for the mouthing median duration with non-dietary objects and all objects. For children playing on playground structures, we found significant mouthing frequency differences between younger (1–6 y) and older children (7–12 y) with all objects, and for mouthing median duration with non-dietary objects. There were no significant differences between males and females playing on artificial turf-like surfaces or playground mats. Our estimated mean incidental ingestion rate was 0.08, 0.07, and 0.08 g rubber crumb/day for children <2, 2–6, and 6–11 years old, respectively. Discussion: our results suggest that age and contact duration should be considered in risk assessment models to evaluate mouthing activities when children are playing on artificial turf surfaces or playground mats.

Role of endocrine disrupting chemicals in children's neurodevelopment

Environmental stressors, like endocrine disrupting chemicals (EDC), are considered important contributors to the increased rates of neurodevelopmental dysfunctions. Considering the cumulative research on adverse neurodevelopmental effects associated with prenatal exposure to EDC, the purpose of this study was to review the available limited literature about the effects of postnatal exposure to EDC on child neurodevelopment and behaviour. Despite widespread children's exposure to EDC, there are a limited number of epidemiological studies on the association of this exposure with neurodevelopmental disorders, in particular in the postnatal period. The available research suggests that postnatal EDC exposure is related to adverse neurobehavioral outcomes in children; however the underlying mechanisms of action remain unclear. Timing of exposure is a key factor determining potential neurodevelopmental consequences, hence studying the impact of multiple EDC co-exposure in different vulnerable life periods could guide the identification of sensitive subpopulations. Most of the reviewed studies did not take into account sex differences in the EDC effects on children neurodevelopment. We believe that the inclusion of sex in the study design should be considered as the role of EDC on children neurodevelopment are likely sex-specific and should be taken into consideration when determining susceptibility and potential mechanisms of action.

Exposure parameters and health risk of Cryptosporidium and Giardia in the recreational water activities for urban residents in China

Knowledge gaps in the exposure parameters for recreational water activities make quantitative risk assessment related to water recreation difficult. Therefore, the annual exposure frequency and single exposure duration for the recreational water activities of residents from ten cities in the North and South of China were investigated. Questionnaire interviews were carried on recreational water activities comprising swimming (SW), boating (BA), playing in interactive fountains (PF), and watching fountains (WF). Quantitative microbial risk assessment for the exposure of urban residents to Cryptosporidium and Giardia was also performed. For the four recreational water activities, the participation rates of urban residents in SW and WF were higher than the others. For SW and BA, the mean annual exposure frequency and single exposure duration for males were significantly higher than those for females. PF and WF showed the opposite. The annual exposure frequency for above 35-year-old residents was higher than that for young residents (18-35 years). However, the single exposure duration for young residents was highest in SW, BA, and PF. The mean annual exposure frequency and single exposure duration for North China residents were higher than those for South China residents in all recreational water activities, except for SW. Overall, the annual exposure frequency and single exposure duration in recreational water activities for all urban residents followed a lognormal distribution. In the four recreational water activities, the total annual infection risk of male exposure to Cryptosporidium was 1.0 × 10^-2, with the confidence intervals between 95 and 5% of [4.3 × 10^-4, 3.7 × 10^-2], whereas that for females was 6.8 × 10^-3 and [4.2 × 10^-4, 2.4 × 10^-2]. Also, the annual infection risk of males to Giardia was 8.8 × 10^-3 and [5.1×10^-4, 3.2×10^-2], and that of females was 5.3 × 10^-3 and [4.0 × 10^-4, 1.8 × 10^-2]. These results demonstrated that SW and PF made the highest contribution to the total annual infection risk. Sensitivity analysis highlighted that the characterization of exposure parameters plays a critical role in health risk assessment, which may provide a scientific basis for recreational water quality standards formulation.

Estimation of Soil and Dust Ingestion Rates from the Stochastic Human Exposure and Dose Simulation Soil and Dust Model for Children in Taiwan

This study focuses on estimating the probabilistic soil and dust ingestion rates for children under 3 years old by the Stochastic Human Exposure and Dose Simulation Soil and Dust (SHEDS-S/D) model developed by the U.S. Environmental Protection Agency. The health risk of children's exposure to heavy metals through soil and dust ingestion and dermal absorption was then assessed in three exposure scenarios. In the exposure scenario of direct contact with soil, the average soil and dust ingestion rates for children aged 24 to 36 months were 90.7 and 29.8 mg day^-1 in the sand and clay groups, respectively. Hand-to-mouth soil ingestion was identified as the main contributor to soil and dust ingestion rates, followed by hand-to-mouth dust ingestion and object-to-mouth dust ingestion. The soil-to-skin adherence factor was the most influential factor increasing the soil and dust ingestion rate based on a sensitivity analysis in the SHEDS-S/D model. Furthermore, the modeled soil and dust ingestion rates based on the SHEDS-S/D model were coincident with results calculated by the tracer element method. Our estimates highlight the soil ingestion rate as the key parameter increasing the risk for children, while a higher frequency of hand washing could potentially reduce the risk.

Prevalence and persistence of microcystin in shoreline lake sediments and porewater, and associated potential for human health risk

Midlatitude waterbodies are experiencing increased cyanobacteria blooms that necessitate health advisories to protect waterbody users. Although surface waters may contain cyanotoxins such as microcystin (MC), at concentrations that pose potential public health risks, little is known about MC contamination of shoreline sediments. Based on growing evidence that lake and reservoir sediments can accumulate MCs, we hypothesized that shoreline sediments (i.e., recreational beaches) may accumulate MCs and thereby pose a potential health risk to recreational users even if people stay out of contaminated water. We sampled nearshore surface water, shoreline sediment, and porewater from seven Washington State, USA, lakes/reservoirs recreational beaches to determine MC presence/absence during or immediately following cyanobacteria blooms. We found MCs in shoreline sediments at all waterbodies using ELISA and LC-MS/MS. MC concentrations in shoreline sediments and porewaters persisted for 20 days following dissipation of cyanobacteria blooms when MC concentrations were near analytical reporting limits in corresponding surface waters. A human health risk assessment based on potential MC exposure through incidental ingestion of porewaters and sediments found, even when very high MC concentrations occur in surface waters (i.e., >11,000 μg/L), estimated ingestion doses are below MC World Health Organization tolerable daily intake and U.S. Environmental Protection Agency's risk reference dose. While our findings suggest MCs in Washington State recreational beaches in 2018 did not present a significant human health risk, future blooms with higher MC concentrations could pose human health risks via the shoreline sediment/porewater exposure pathway.

"That's Not His Regular Formula": A Case of Organophosphate Poisoning in an Infant

INTRODUCTION

Organophosphates (OPs) are the basis of many insecticides and herbicides and are also used as nerve agents. Approximately 1 million unintentional and 2 million suicidal poisonings as well as more than 300,000 fatalities that are reportedly due to OPs are reported each year worldwide. The mortality rate from OP toxicity is reported as approximately 20%. We present a rare pediatric exposure to OPs.

CASE

This is an unintentional OP poisoning in an infant who presented to a pediatric emergency department with obtundation, respiratory distress, and copious secretions. The infant was intubated, treated with atropine and pralidoxime after resuscitation, and eventually recovered with no neurologic sequelae.

DISCUSSION

Symptoms from OP toxicity are secondary to effects on muscarinic and nicotinic cholinergic receptors in the autonomic and central nervous systems. Symptoms include diaphoresis, diarrhea, urination, miosis, bradycardia, bronchospasm, bronchorrhea, emesis, lethargy, lacrimation, and salivation. Treatment starts with titrated doses of atropine and oximes (eg, pralidoxime) after resuscitation and decontamination. Severity of toxicity and recovery can be monitored via plasma and whole blood acetylcholinesterase levels, respectively. Once aging has occurred, oximes will not be able to reverse acetylcholinesterase inhibition. Despite early treatment, rare cases may result in delayed neurologic complications associated with sensory and motor axonal degeneration of the peripheral nerves and spinal cord known as OP-induced delayed neuropathy.

CONCLUSIONS

This case highlights the importance of safety education for families. It also demonstrates how to recognize and treat OP toxicity in an infant. It emphasizes starting treatment early to avoid complications secondary to aging.

Frequency of hand-to-head, -mouth, -eyes, and -nose contacts for adults and children during eating and non-eating macro-activities

Hand-to-face contacts are important for estimating chemical and microbial exposures. Few studies describe children's hand-to-eye or -nose contacts or adults' hand-to-face contacts. The study objective was to characterize hand-to-head (mouth, eyes, nose, and other) contacts for children in a daycare and adults in multiple locations. Macro-activities and sequences of hand-to-face contacts were recorded for 263 people observed for 30 min each. Statistically significant differences between locations, males and females, adults and children, and during eating and non-eating macro-activities were evaluated. Discrete Markov chains were fit to observed contact sequences and compared among adults and children during eating and non-eating macro-activities. No significant differences in contact frequency were observed between males and females with the exception of hand-to-nose contacts. Children tended to touch the mouth, eyes, and nose more frequently than adults during non-eating macro-activities. Significant differences in contact frequency were observed between locations. Transitional probabilities indicated that children make repetitive mouth, eye, and nose contacts while adults frequently transition to contacts of the head other than the mouth, eyes, or nose. More data are needed to evaluate the effect of age on adults' contact frequencies and to confirm lack of statistically significant differences between adults and children during eating macro-activities.

Addressing uncertainty in mouthing-mediated ingestion of chemicals on indoor surfaces, objects, and dust

In indoor environments, humans ingest chemicals present as surface residues and bound to settled particles (dust), through mouthing hands (hand-to-mouth transfer) and objects (object-to-mouth transfer). Here, we introduce a novel modeling approach in support of systematic investigation into the mouthing-mediated ingestion of chemicals present in indoor environments. This model explicitly considers the indoor dynamics of dust and chemicals, building on mechanistic links with physicochemical properties of chemicals, features of the indoor environment, and human activity patterns. The evaluation of this model demonstrates that it satisfactorily reproduces chemical hand loadings and exposure data reported in the literature. We then use the evaluated model to investigate the response of mouthing-mediated ingestion to chemical partitioning between the gas phase and solid phases, expressed as the octanol-air partition coefficient (K_OA). Assuming a unit emission rate to the indoor environment, we find that low-volatility chemicals (with a K_OA greater than 10⁹) are more efficiently enriched in hand skin, resulting in higher mouthing-mediated ingestion than other compounds. For individuals living in a room with a typical level of dustiness, more than half of the chemical mass found in their hands comes from dust transfer, whereas more than half of the chemical mass ingested is the fraction present as residues on hands. We also use the new model to explore how the mouthing-mediated ingestion of chemicals is dependent on factors describing the indoor environment and human behavior. The model predicts that less frequent cleaning leads to higher accumulation of dust on indoor surfaces, thereby transferring more chemicals to hands and mouth in each contact. Introducing more dust into the room, but maintaining the same cleanup frequency, increases the dustiness of indoor surfaces, which promotes the transfer of relatively volatile chemicals (with a K_OA lower than 10⁹) to hands and mouth but decreases the transfer of chemicals with low volatility. More frequent hand contact with indoor surfaces increases both the hand loading and mouthing-mediated ingestion of chemicals, but the increases are more remarkable for adults than children because the higher surface contact frequency of children "saturates" hand loadings. An increase in handwashing frequency lowers the hand loading and mouthing-mediated ingestion of chemicals and this mitigating process is more prominent for relatively volatile chemicals. The new evaluated modeling approach can facilitate the prediction of mouthing-mediated ingestion for various age groups and the model predictions can be used to aid future fate and (bio)monitoring studies focusing on indoor contamination.

Pyrethroid Insecticides in Households from Urban Areas: An Association of the 3-PBA Metabolite and Hand Wipes

Background

Pyrethroid exposure in the household environment affects children directly via inhalation or dermal exposure. Hand wipes can effectively predict pyrethroid exposure to young children along with the children's activities. The main purpose of this study is to identify the relationship between 3-PBA metabolites, hand wipe sample concentrations and multiple exposure factors, within the population of households with young children in urban Bangkok, Thailand.

Methods

Interviews were conducted with the parents of 80 children (aged 2-3 years). Urine was collected to analyze for 3-PBA metabolites and hand wipe samples were collected to analyze for cypermethrin. Both were analyzed by gas chromatography (GC/MS).

Results

A Spearmen's correlation test of the increase of 3-PBA metabolites was significantly associated with an increase in hand wipe samples (cypermethrin) in children (r_s = 0.226-0.274, p-value < 0.05). The binary logistic regression test presented an association between exposure factors with 3-PBA metabolite concentration. Gender presented a significant association with 3-PBA metabolites (p-value = 0.035, OR = 0.326, 95% CI 0.115-0.926), and frequency of bare feet inside the household presented a significant association with 3-PBA metabolites (p-value < 0.01, OR = 7.072, 95% CI 1.707-29.291). In addition, exposure factors were not significantly associated with wipe sample concentration (cypermethrin) but showed high risk of exposure to young children.

Conclusions

Suggestions to reduce the risk from long-term pyrethroid insecticide exposure to children living in households include increased education, awareness, and management.

Using Life History Calendars to Estimate in Utero and Early Life Pesticide Exposure of Latinx Children in Farmworker Families

(1) Background: Early life exposure to neurotoxic chemicals can have later impacts on child health. Most research designs must assume that current exposure is similar to past. Life history calendar methods can help to provide data on early life exposure. (2) Methods: Life history calendars were completed by mothers of 8-year-old children from Latinx farmworker and non-farmworker families (n = 73 and 65, respectively). Measures were created of months exposure through living adjacent to farm fields and having household members who worked in jobs exposing them to toxic chemicals. Data were divided into time periods of in utero, early childhood (birth-35 months) and later childhood (36-96 months). Cluster analysis compared the measures for children from farmworker and non-farmworker parents. (3) Results: Although, as a group, children from farmworker families have greater lifetime months of probable exposure to pesticides than children in non-farmworker families, cluster analysis reveals groups of children who do not follow that pattern. (4) Conclusions: The life history calendar is a technique for obtaining data on early life toxic chemical exposure that may help assign children to proper exposure groups. Conducting secondary analyses using such information can help to clarify the association of exposures to health outcomes.

Characterizing the Neurodevelopmental Pesticide Exposome in a Children's Agricultural Cohort

The exposome provides a conceptual model for identifying and characterizing lifetime environmental exposures and resultant health effects. In this study, we applied key exposome concepts to look specifically at the neurodevelopmental pesticide exposome, which focuses on exposures to pesticides that have the potential to cause an adverse neurodevelopmental impact. Using household dust samples from a children's agricultural cohort located in the Yakima Valley of Washington state, we identified 87 individual pesticides using liquid chromatography-tandem mass spectrometry. A total of 47 of these have evidence of neurotoxicity included in the Environmental Protection Agency (EPA) (re)registration materials. We used a mixed effects model to model trends in pesticide exposure. Over the two study years (2005 and 2011), we demonstrate a significant decrease in the neurodevelopmental pesticide exposome across the cohort, but particularly among farmworker households. Additional analysis with a non-parametric binomial analysis that weighted the levels of potentially neurotoxic pesticides detected in household dust by their reference doses revealed that the decrease in potentially neurotoxic pesticides was largely a result of decreases in some of the most potent neurotoxicants. Overall, this study provides evidence that the neurodevelopmental pesticide exposome framework is a useful tool in assessing the effectiveness of specific interventions in reducing exposure as well as setting priorities for future targeted actions.

Age-related changes to environmental exposure: variation in the frequency that young children place hands and objects in their mouths

Children are exposed to environmental contaminants through direct ingestion of water, food, soil, and feces, and through indirect ingestion owing to mouthing hands and objects. We quantified ingestion among 30 rural Bangladeshi children < 4 years old, recording every item touched or mouthed during 6-hour video observations that occurred annually for 3 years. We calculated the frequency and duration of mouthing and the prevalence of mouth contacts with soil and feces. We compared the mouthing frequency distributions to those from US children to evaluate the appropriateness of applying the US data to the Bangladeshi context. Median hand-mouthing frequency was 43-72 times/h and object-mouthing frequency 17-34 times/h among the five age groups assessed. For half of the observations, > 75% of all hand mouthing was associated with eating. The frequency of indoor hand mouthing not related to eating was similar to the frequency of all indoor hand mouthing among children in the United States. Object-mouthing frequency was higher among Bangladeshi children compared with US children. There was low intra-child correlation of mouthing frequencies over our longitudinal visits. Our results suggest that children's hand- and object-mouthing vary by geography and culture and that future exposure assessments can be cross-sectional if the goal is to estimate population-level distributions of mouthing frequencies. Of all observations, a child consumed soil in 23% and feces in 1%.

Children Exposure-Related Behavior Patterns and Risk Perception Associated with Recreational Beach Use

Background: Oil spill chemicals (OSCs) result not only from the crude oil components but also from dispersants used in the clean-up activities, where some may result in adverse health effects under certain exposure and dosage conditions. One of the main populations of concern for exposure to OSCs are children, who are frequent beach users. Activities such as ingestion of and digging in sand can increase dermal and ingestion exposure. Longer times spent at the beach can also increase exposures for all routes. Objectives: The Beach Exposure and Child Health Study (BEaCHeS) was initiated to evaluate the risk of exposure to children from oil contaminants. Reported here are results for surveys collected, as a part of the project, to address exposure-related behavior patterns and risk perception for parents or guardians who visit the beach. Methods: Over 400 parental surveys were collected at four beaches, two in Miami and two in Texas, to evaluate children’s exposure related activities. Surveys consisted of three general sections: demographics, exposure, and risk perception. Surveys were analyzed in REDcap and Stata to evaluate demographic and regional differences on activities related to beach behavior and potential exposures to oil contaminants (e.g., how much time spent on beach, cleaning habits following beach activities). The statistical analysis included the mean and standard errors, along with regressions to evaluate associations between parameters. Results: Overall, the data showed high variability in how children play on the beach, influenced more by age and less by gender. Variations were also seen in certain variables by beach region (e.g., hygiene practices). By race, variations were seen in income, distance of travel to beach, and preferred method of communication for beach warning. Other important findings are reflected in the article. Discussion: The data presented here may prove useful for those evaluating children exposures to a variety of contaminants, chemical, or bacterial in origin. In addition, coastal managers may find the risk perception and general behaviors useful for planning and maintenance of beach areas.

Data fitting approach more critical than exposure scenarios and treatment of censored data for quantitative microbial risk assessment

Recreational waters are a source of many diseases caused by human viral pathogens, including norovirus genogroup II (NoV GII) and enterovirus (EV). Water samples from the Arenales river in Salta, Argentina, were concentrated by ultrafiltration and analyzed for the concentrations of NoV GII and EV by quantitative PCR. Out of 65 samples, 61 and 59 were non-detects (below the Sample Limit of Detection limit, SLOD) for EV and NoV GII, respectively. We hypothesized that a finite number of environmental samples would lead to different conclusions regarding human health risks based on how data were treated and fitted to existing distribution functions. A quantitative microbial risk assessment (QMRA) was performed and the risk of infection was calculated using: (a) two methodological approaches to find the distributions that best fit the data sets (methods H and R), (b) four different exposure scenarios (primary contact for children and adults and secondary contact by spray inhalation/ingestion and hand-to-mouth contact), and (c) five alternatives for treating censored data. The risk of infection for NoV GII was much higher (and exceeded in most cases the acceptable value established by the USEPA) than for EV (in almost all the scenarios within the recommended limit), mainly due to the low infectious dose of NoV. The type of methodology used to fit the monitoring data was critical for these datasets with numerous non-detects, leading to very different estimates of risk. Method R resulted in higher projected risks than Method H. Regarding the alternatives for treating censored data, replacing non-detects by a unique value like the average or median SLOD to simplify the calculations led to the loss of information about the particular characteristics of each sample. In addition, the average SLOD was highly impacted by extreme values (due to events such as precipitations or point source contamination). Instead, using the SLOD or half- SLOD captured the uniqueness of each sample since they account for the history of the sample including the concentration procedure and the detection method used. Finally, substitution of non-detects by Zero is not realistic since a negative result would be associated with a SLOD that can change by developing more efficient and sensitive methodology; hence this approach would lead to an underestimation of the health risk. Our findings suggest that in most cases the use of the half-SLOD approach is appropriate for QMRA modeling.

Children Are Exposed to Fecal Contamination via Multiple Interconnected Pathways: A Network Model for Exposure Assessment

In recent decades, quantitative microbial risk assessment (QMRA) has been widely used to assess exposure to fecal microbes and associated health risks. In this study, a multipathway exposure assessment model was developed to evaluate exposure to fecal microbes for children under 5 in highly contaminated urban environments. Children had contact with various environmental compartments. The contamination levels of these compartments were estimated from fecal indicator counts in the environmental samples. Structured observations of child behavior (including activities, locations, and time) were used to model behavioral sequences as a dynamic network. The exposure model combines behavior sequences with environmental contamination, using additional exposure factors when needed, to estimate the number of fecal microbes transferred from environmental sources to human oral ingestion. As fecal exposure in a highly contaminated urban environment consists of contributions from multiple pathways, it is imperative to study their relative importance. The model helps us better understand the characteristics of the exposure pathways that may be driven by variation in contamination and by variable behavior, like hygiene and high-risk activities. Importantly, the model also allows prediction of the quantitative effects of an intervention-the expected reduction in exposure due to infrastructural or behavioral changes-by means of scenario studies. Based on experience with this exposure model, we make specific recommendations for additional studies of child behavior and exposure factors in order to fill critical information gaps and improve the model structure and assumptions.

Introducing relative potency quotient approach associated with probabilistic cumulative risk assessment to derive soil standards for pesticide mixtures

Children can be exposed to organophosphate and carbamate mixtures, which pose additive health effects via soil exposure. However, only 23 countries have soil standard values for organophosphate and carbamate pesticides, and most regulatory jurisdictions do not consider the cumulative exposure. This study derived proposed soil standards for organophosphates and carbamates by introducing the relative potency quotient approach (RPQ). The probabilistic cumulative risk assessment was also applied to evaluate current soil standards of pesticide mixtures. The U.S. Environmental Protection Agency (EPA) have soil standards of 19 organophosphates and five carbamates. However, these standards cannot protect population health via chronic exposure in conservative and semi-conservative scenarios based on the probabilistic risk assessment because the U.S.EPA simplified the regulatory process for the cumulative exposure to pesticide mixtures and omitted the soil allocation factor, which should be set for aggregate exposure. The analysis of proposed soil standards developed by the RPQ approach indicates that some human behavior variables, such as soil intake rate and exposure duration, have stronger impacts on the proposed soil standards than human biometric variables like body weight. This study may be helpful to develop regulatory standards and a framework for pesticide mixtures having additive health effects.

Field Measurements of Inadvertent Ingestion Exposure to Metals

The determinants of inadvertent occupational ingestion exposure are poorly understood, largely due to a lack of available exposure measurement data. In this study, perioral exposure wipes were used as a surrogate for inadvertent ingestion exposure to measure exposure to eight metals (chromium, nickel, aluminium, cobalt, lead, arsenic, manganese, and tin) among 38 workers at 5 work sites in the UK. This work was done alongside a previously reported observational study of hand/object-to-mouth contact frequency. Systematic wipes of the perioral area, and of both hands were taken with proprietary cellulose wipes pre-moistened with deionized water. Measurements were taken at the beginning, middle and end of the shift. Mixed-effect models of exposure measurements were built with area of skin sampled, time during shift, and job group entered as fixed effects and worker identification as a random effect. Linear regression modelling was used to study the effect of hand/object-to-mouth contact frequency on perioral exposure, adjusting for the measured exposure on the hand and observed respirator use. Hand and perioral exposure measurements were correlated with one another (r = 0.79) but mass per unit area exposure was significantly higher on the perioral area than on the hands for seven of the metals (at P < 0.05). There were no significant differences between measurements taken at the middle or the end of the shift for five of the metals suggesting that dermal loading may remain relatively constant for much of the workday. This applies to both hand and perioral measurements. In linear regression modelling there was no relationship between hand/object-to-mouth contact frequency and perioral exposure, but hand exposure was significantly positively related to perioral exposure and workers who used respirators had significantly higher perioral exposure than those who did not. The results suggest the levels of exposure on the hand and respirator use are important determinants of potential inadvertent ingestion exposure. The results did not demonstrate a relationship between perioral exposure and hand-to-mouth contact frequency. Perioral wipe sampling may be a useful surrogate measure for exposure by the inadvertent ingestion route, but further research is required to confirm the link between perioral levels and actual exposure, measured using biological monitoring.

Mouthing activity data for children age 3 to <6 years old and fraction of hand area mouthed for children age <6 years old in Taiwan

Non-dietary ingestion is an important exposure pathway for children owing to their frequent hand-to-mouth and object-to-mouth activities involving soil and dust contacts. We used videotaping and the computer-based translating methods to quantify the mouthing activity information for 24 children ages 3 to <6 years old living in Taiwan. We also reviewed the entire mouthing activity data collected during the project to determine the lesser studied information on hand surface areas mouthed by children ages <6 years old. The median indoor hand-to-mouth and object-to-mouth frequencies were found to be 10 and 4.3 contacts/h, respectively. Hand-to-mouth and object-to-mouth contact frequencies used in exposure assessments for children ages 3 to <6 years old in this study were similar to the recommended values reported in United States. Exposure Factors Handbook for comparable age US children. The average fractions of the hand area mouthed for children 6 to <12 months, 1 to <2 years, 2 to <3 years, and 3 to <6 years old were 0.12, 0.12, 0.13, and 0.09, respectively. The fraction of hand area mouthed by children was found to be significantly and negatively correlated with their age. About half of the total hand-to-mouth contact events involved immersion of part of a hand or a finger into the mouth. The findings from this study extend the available mouthing activity information for 3 to <6 years old children and also provide new data for an Asian country, allowing comparison of results with western values collected mostly in the United States.

Risk Assessment for Children Exposed to Arsenic on Baseball Fields with Contaminated Fill Material

Children can be exposed to arsenic through play areas which may have contaminated fill material from historic land use. The objective of the current study was to evaluate the risk to children who play and/or spend time at baseball fields with soils shown to have arsenic above background levels. Arsenic in soils at the study sites located in Miami, FL, USA showed distinct distributions between infield, outfield, and areas adjacent to the fields. Using best estimates of exposure factors for children baseball scenarios, results show that non-cancer risks depend most heavily upon the age of the person and the arsenic exposure level. For extreme exposure scenarios evaluated in this study, children from 1 to 2 years were at highest risk for non-cancer effects (Hazard Quotient, HQ > 2.4), and risks were higher for children exhibiting pica (HQ > 9.7) which shows the importance of testing fill for land use where children may play. At the study sites, concentration levels of arsenic resulted in a range of computed cancer risks that differed by a factor of 10. In these sites, the child’s play position also affected risk. Outfield players, with a lifetime exposure to these arsenic levels, could have 10 times more increased chance of experiencing cancers associated with arsenic (i.e., lung, bladder, skin) in comparison to infielders. The distinct concentration distributions observed between these portions of the baseball fields emphasize the need to delineate contaminated areas in public property where citizens may spend more free time. This study also showed a need for more tools to improve the risk estimates for child play activities. For instance, more refined measurements of exposure factors for intake (e.g., inhalation rates under rigorous play activities, hand to mouth rates), exposure frequency (i.e., time spent in various activities) and other exposure factors (e.g., soil particulate emission rates at baseball play fields) can help pinpoint risk on baseball fields where arsenic levels may be a concern.

Brominated and organophosphorus flame retardants in body wipes and house dust, and an estimation of house dust hand-loadings in Dutch toddlers

Children generally have higher Flame Retardant (FR) concentrations in serum compared to other age groups. Toddler behavior enhances direct contact with house dust since their frequent presence proximate to the floor, and their mouthing behavior. This study aimed to thoroughly investigate FR levels in body wipes of toddlers 8-18 months old) and in indoor dust using a noninvasive sampling technique. In this cross-sectional study, body wipes from hands, mouth and back, and indoor household dust samples were collected in twenty-one families and analyzed for one brominated- and seven organophosphorus FRs (polybrominated diphenyl ether 209 (BDE209), tris(2-chloroisopropyl) phosphate (TCIPP), tris(chloroethyl) phosphate (TCEP), tris(1,3-dichloroisopropyl) phosphate (TDCIPP), tris(phenyl) phosphate (TPHP), tris(methylphenyl) phosphate (TMPP), resorcinol bis(diphenyl phosphate) and bisphenol A bis(diphenyl phosphate)). Accelerated solvent extraction was used for extraction and the extract was measured with liquid chromatography combined with mass spectrometry. Non-parametric correlation analyses were performed to assess associations. All FRs were detected in body- and indoor dust samples (median range: 1.0ng/hand wipe (BDE209) to 65ng/hand wipe (TCIPP)) and were mostly correlated with each other. We estimated that approximately 260mg dust (range 50-880mg) accumulated on toddler's hands per day. Hand-to-mouth frequency was negatively associated with FR levels in wipes (τ = -0.38, p = 0.04). With increasing age FR concentrations (BDE209, TCEP, TDCIPP, TPHP and TMPP) on hands decreased significantly (p = 0.01-0.03). Girls had significantly less FRs (TCEP, TCIPP, TPHP and TMPP) on the hands (p = 0.01-0.03) than boys. This is to the best of the authors' knowledge the first study in Europe that measured brominated- as well as organophosphorus FRs in several types of body wipes from toddlers and that estimated the amount of house dust that accumulates on toddler's hands.

Review of take-home pesticide exposure pathway in children living in agricultural areas

BACKGROUND

Children of farmworkers may be chronically exposed to pesticides via the take-home exposure pathway.

OBJECTIVE

The goal of this review was to analyze scientific literature evaluating the role of the take-home pesticide exposure pathway in children of agricultural workers.

METHODS

A systematic review was undertaken and inclusion criteria were applied to identify original articles of interest. Of the 30 articles included in this review, some belonged to the same studies, resulting in a total of 23 studies. Eight studies assessed environmental samples, nine collected biological samples, and the remaining six analyzed both. Eleven studies compared pesticide levels between farm and non-farm families.

RESULTS

There is convincing evidence that children of farmworkers are exposed to pesticides at higher levels than "non-agricultural" children, even when residing in the same agricultural communities. These levels were shown to depend on the season, occupation, number of farmworkers per home, and type of crops. Other factors such as age, gender and, sex seem to also influence this pathway. Some studies have shown that pesticides used solely in agriculture are found only in households of farmworkers spraying these pesticides. Moreover, intervention studies have shown that behaviors among farmworkers can significantly lower exposure of people living in the same households as farmworkers.

DISCUSSION AND CONCLUSION

The evidence presented here raises concerns regarding health effects associated with exposure to pesticides in children living in agricultural communities, and indicates that strategies should be developed to reduce exposures in these populations.

A review of models for near-field exposure pathways of chemicals in consumer products

Exposure to chemicals in consumer products has been gaining increasing attention, with multiple studies showing that near-field exposures from products is high compared to far-field exposures. Regarding the numerous chemical-product combinations, there is a need for an overarching review of models able to quantify the multiple transfers of chemicals from products used near-field to humans. The present review therefore aims at an in-depth overview of modeling approaches for near-field chemical release and human exposure pathways associated with consumer products. It focuses on lower-tier, mechanistic models suitable for life cycle assessments (LCA), chemical alternative assessment (CAA) and high-throughput screening risk assessment (HTS). Chemicals in a product enter the near-field via a defined "compartment of entry", are transformed or transferred to adjacent compartments, and eventually end in a "human receptor compartment". We first focus on models of physical mass transfers from the product to 'near-field' compartments. For transfers of chemicals from article interior, adequate modeling of in-article diffusion and of partitioning between article surface and air/skin/food is key. Modeling volatilization and subsequent transfer to the outdoor is crucial for transfers of chemicals used in the inner space of appliances, on object surfaces or directly emitted to indoor air. For transfers from skin surface, models need to reflect the competition between dermal permeation, volatilization and fraction washed-off. We then focus on transfers from the 'near-field' to 'human' compartments, defined as respiratory tract, gastrointestinal tract and epidermis, for which good estimates of air concentrations, non-dietary ingestion parameters and skin permeation are essential, respectively. We critically characterize for each exposure pathway the ability of models to estimate near-field transfers and to best inform LCA, CAA and HTS, summarizing the main characteristics of the potentially best-suited models. This review identifies large knowledge gaps for several near-field pathways and suggests research needs and future directions.

Soil ingestion rates for children under 3 years old in Taiwan

Soil and dust ingestion rates by children are among the most critical exposure factors in determining risks to children from exposures to environmental contaminants in soil and dust. We believe this is the first published soil ingestion study for children in Taiwan using tracer element methodology. In this study, 66 children under 3 years of age were enrolled from Taiwan. Three days of fecal samples and a 24-h duplicate food sample were collected. The soil and household dust samples were also collected from children's homes. Soil ingestion rates were estimated based on silicon (Si) and titanium (Ti). The average soil ingestion rates were 9.6±19.2 mg/day based on Si as a tracer. The estimated soil ingestion rates based on Si did not have statistically significant differences by children's age and gender, although the average soil ingestion rates clearly increased as a function of children's age category. The estimated soil ingestion rates based on Si was significantly and positively correlated with the sum of indoor and outdoor hand-to-mouth frequency rates. The average soil ingestion rates based on Si were generally lower than the results from previous studies for the US children. Ti may not be a suitable tracer for estimating soil ingestion rates in Taiwan because the Ti dioxide is a common additive in food. To the best of our knowledge, this is the first study that investigated the correlations between soil ingestion rates and mouthing behaviors in Taiwan or other parts of Asia. It is also the first study that could compare available soil ingestion data from different countries and/or different cultures. The hand-to-mouth frequency and health habits are important to estimate the soil ingestion exposure for children. The results in this study are particularly important when assessing children's exposure and potential health risk from nearby contaminated soils in Taiwan.

Surveillance of childhood blood lead levels in Chengdu, China in 2010-2011

INTRODUCTION

Lead poisoning has been receiving great attention around the world. The Child Hygiene Cooperation Center of the World Health Organization in China has been conducting investigations to monitor blood lead levels (BLLs) from as early as 2004. However, only several lead poisoning studies have been conducted in China since August 2009. The aim of the present study was to investigate the BLLs in children aged < 7 years and to analyse the risk factors of high BLLs in Chengdu, China.

METHODS

Questionnaires were distributed to children in Chengdu from 2010 to 2011. A total of 2,271 children were included in this study - 1,157 received BLL tests in 2010 and the remaining received the tests in 2011. BLL was measured using a tungsten atomiser absorption spectrophotometer.

RESULTS

The mean BLL of the 2,271 children was 6.2 µg/dL and 2.03% of the children had BLLs ≥ 10 µg/dL. Mean BLL seemed to increase with age. Unhygienic habits (e.g. not washing hands frequently, biting of toys and pencils), history of pica, use of coal and residence in an industrial zone were found to be the main risk factors contributing to high BLL (p < 0.05). Children with high BLLs have a higher risk of manifesting anorexia and/or abdominal pain as compared to those with low BLLs (p < 0.05).

CONCLUSION

The mean BLL of children in Chengdu (i.e. 6.2 µg/dL) was found to be higher than that of children in developed countries. Childhood lead poisoning remains a public health problem.

Risk Assessment for Children Exposed to Beach Sands Impacted by Oil Spill Chemicals

Due to changes in the drilling industry, oil spills are impacting large expanses of coastlines, thereby increasing the potential for people to come in contact with oil spill chemicals. The objective of this manuscript was to evaluate the health risk to children who potentially contact beach sands impacted by oil spill chemicals from the Deepwater Horizon disaster. To identify chemicals of concern, the U.S. Environmental Protection Agency’s (EPA’s) monitoring data collected during and immediately after the spill were evaluated. This dataset was supplemented with measurements from beach sands and tar balls collected five years after the spill. Of interest is that metals in the sediments were observed at similar levels between the two sampling periods; some differences were observed for metals levels in tar balls. Although PAHs were not observed five years later, there is evidence of weathered-oil oxidative by-products. Comparing chemical concentration data to baseline soil risk levels, three metals (As, Ba, and V) and four PAHs (benzo[a]pyrene, benz[a]anthracene, benzo[b]fluoranthene, and dibenz[a,h]anthracene) were found to exceed guideline levels prompting a risk assessment. For acute or sub-chronic exposures, hazard quotients, computed by estimating average expected contact behavior, showed no adverse potential health effects. For cancer, computations using 95% upper confidence limits for contaminant concentrations showed extremely low increased risk in the 10⁻⁶ range for oral and dermal exposure from arsenic in sediments and from dermal exposure from benzo[a]pyrene and benz[a]anthracene in weathered oil. Overall, results suggest that health risks are extremely low, given the limitations of available data. Limitations of this study are associated with the lack of toxicological data for dispersants and oil-spill degradation products. We also recommend studies to collect quantitative information about children’s beach play habits, which are necessary to more accurately assess exposure scenarios and health risks.

Hand- and Object-Mouthing of Rural Bangladeshi Children 3-18 Months Old

Children are exposed to environmental contaminants by placing contaminated hands or objects in their mouths. We quantified hand- and object-mouthing frequencies of Bangladeshi children and determined if they differ from those of U.S. children to evaluate the appropriateness of applying U.S. exposure models in other socio-cultural contexts. We conducted a five-hour structured observation of the mouthing behaviors of 148 rural Bangladeshi children aged 3-18 months. We modeled mouthing frequencies using 2-parameter Weibull distributions to compare the modeled medians with those of U.S. children. In Bangladesh the median frequency of hand-mouthing was 37.3 contacts/h for children 3-6 months old, 34.4 contacts/h for children 6-12 months old, and 29.7 contacts/h for children 12-18 months old. The median frequency of object-mouthing was 23.1 contacts/h for children 3-6 months old, 29.6 contacts/h for children 6-12 months old, and 15.2 contacts/h for children 12-18 months old. At all ages both hand- and object-mouthing frequencies were higher than those of U.S. children. Mouthing frequencies were not associated with child location (indoor/outdoor). Using hand- and object-mouthing exposure models from U.S. and other high-income countries might not accurately estimate children's exposure to environmental contaminants via mouthing in low- and middle-income countries.

Organophosphorus pesticide exposure and neurobehavioral performance in Latino children living in an orchard community

Children living in agricultural communities have a greater risk from pesticides due to para-occupational pathways. The goal of this study was to assess the impact of exposure to organophosphorus pesticides on the neurobehavioral performance of school-aged Latino children over time. Two exposure measures were used to estimate children's pesticide exposure: parent's occupation (agricultural or non-agricultural) and organophosphate residues in home carpet dust samples. During 2008-2011, 206 school-aged children completed a battery of neurobehavioral tests two times, approximately one year apart. The associations between both exposure measures and neurobehavioral performance were examined. Pesticide residues were detected in dust samples from both agricultural and non-agricultural homes, however, pesticides were detected more frequently and in higher concentrations in agricultural homes compared to non-agricultural homes. Although few differences were found between agricultural and non-agricultural children at both visits, deficits in learning from the first visit to the second visit, or less improvement, was found in agricultural children relative to non-agricultural children. These differences were significant for the Divided Attention and Purdue Pegboard tests. These findings are consistent with previous research showing deficits in motor function. A summary measure of organophosphate residues was not associated with neurobehavioral performance. Results from this study indicate that children in agricultural communities are at increased risk from pesticides as a result of a parent working in agricultural. Our findings suggest that organophosphate exposure may be associated with deficits in learning on neurobehavioral performance, particularly in tests of with motor function. In spite of regulatory phasing out of organophosphates in the U.S., we still see elevated levels and higher detection rates of several organophosphates in agricultural households than non-agricultural households, albeit lower levels than prior studies.

Mouthing activity data for children aged 7 to 35 months in Taiwan

Young children's mouthing activities thought to be among the most important exposure pathways. Unfortunately, mouthing activity studies have only been conducted in a few countries. In the current study, we used videotaping and computer-based translating method to obtain mouthing activity data for 66 children aged 7-35 months in Taiwan. The median indoor hand-to-mouth and object-to-mouth frequencies were 8.91 and 11.39 contacts/h, respectively. The median indoor hand-to-mouth and object-to-mouth hourly contact durations were 0.34 and 0.46 min/h, respectively. The indoor object-to-mouth activities were significantly and negatively correlated with age. Children aged 12 to <24 months in the current study had lower indoor hand-to-mouth and object-to-mouth frequencies than children of same age group in the United States. We also found that indoor mouthing duration with pacifier was significantly and negatively correlated with indoor mouthing duration with other non-dietary objects. The results of the current study indicate that the mouthing behaviors may be different between different countries or populations with different ethnic or lifestyle characteristics. We conclude that using hand-to-mouth frequency values from the current literature may not be most reliable for estimating non-dietary exposures of young children living in Taiwan or even in other similar Asian countries.

Blood lead levels in children aged 0-6 years old in Hunan Province, China from 2009-2013

Objectives

The aim of this study is to describe blood lead levels (BLLs) and the prevalence of elevated blood lead levels (EBLLs) in children aged 0–6 years old and to analyze the BLL trend in children from 2009 to 2013 in China.

Methods

A total of 124,376 children aged 0–6 years old were recruited for this study from January 1^st 2009 to December 31^st 2013. Their blood lead levels were analyzed using atomic absorption spectrometry.

Results

The median BLL was 64.3 μg/L (IQR: 49.6–81.0), and the range was 4.3–799.0 μg/L. Blood lead levels were significantly higher in boys (66.0 μg/L) than in girls (61.9 μg/L) (P<0.001). The overall prevalence of BLLs≥100 μg/L was 10.54% in children aged 0–6 years in Hunan Province. Between 2009 and 2013, the prevalence of EBLLs (≥100 μg/L) decreased from 18.31% to 4.26% in children aged 0–6 years and increased with age. The prevalence of EBLLs has dramatically decreased in two stages (2009–2010 and 2012–2013), with a slight fluctuation in 2010 and 2011.

Conclusions

Both BLLs and the prevalence of EBLLs in children aged 0–6 years old declined substantially from 2009 to 2013 in Hunan Province; however, both remain at unacceptably high levels compared to developed countries. Comprehensive strategies are required to further reduce blood lead levels in children.

Macro-activity patterns of farmworker and non-farmworker children living in an agricultural community

BACKGROUND

Children of farmworkers have significantly higher exposure to pesticides than do other children living in the same agricultural communities, but there is limited information about how and where older farmworker children (>6) spend their time and how their activities might influence the risk of pesticide exposure.

OBJECTIVES

Using data from the Community Based Participatory Research Study for Healthy Kids, we compared activity patterns recorded over 7 days during two agricultural seasons (pre thinning and thinning) between farmworker and non-farmworker children aged 6-12 years old living in Eastern Washington State.

METHODS

Parents completed a 7-day activity diary recording the activity patterns of their children. Mean differences in individual-level activity patterns across season were analyzed using paired t-tests and the Signed Rank Test. Differences in mean activity patterns comparing farmworker and non-farmworker children were analyzed using the Wilcoxon Sum Rank Test to assess differences in distributions across independent samples.

RESULTS

We observed substantial differences in child activity patterns between the two seasons. The children in this sample spent more time outdoors (p<0.001) and were more likely to engage in behaviors, such as playing in the fields (p=0.01) and accompanying their parents to work in the fields (p=0.001) during the high-spray thinning season. There were some differences in activities and behaviors between farmworker and non-farmworker children during the thinning season.

CONCLUSION

This study demonstrates that multiple factors, including agricultural season and parental occupation, may be associated with differences in activity patterns that could influence risk of pesticide exposure among children living in agricultural communities. As such, these factors may influence variation in exposure risks and should be considered when analyzing pesticide exposure measurements in these groups.

Health risk assessment for splash parks that use rainwater as source water

In the Netherlands, rainwater becomes more and more popular as an economic and environmentally sustainable water source for splash parks, however, the associated public health risk and underlying risk factors are unknown. Since splash parks have been associated with outbreaks of infectious diseases, a quantitative microbial risk assessment was performed using Legionella pneumophila as a target pathogen to quantify the risk of infection for exposure due to inhalation and Campylobacter jejuni for ingestion. Data for L. pneumophila and C. jejuni concentrations in rainfall generated surface runoff from streets were extracted from literature. Data for exposure were obtained by observing 604 people at splash parks, of whom 259 were children. Exposure volumes were estimated using data from literature to determine the volume of exposure through inhalation at 0.394 μL/min (95% CI-range 0.0446-1.27 μL/min), hand-to-mouth contact at 22.6 μL/min, (95% CI-range 2.02-81.0 μL/min), ingestion of water droplets at 94.4 μL/min (95% CI-range 5.1-279 μL/min) and ingestion of mouthfuls of water at 21.5·10(3) μL/min (95% CI-range 1.17 ·10(3)-67.0·10(3) μL/min). The corresponding risk of infection for the mean exposure duration of 3.5 min was 9.3·10(-5) (95% CI-range 0-2.4·10(-4)) for inhalation of L. pneumophila and 3.6·10(-2) (95% CI-range 0-5.3·10(-1)) for ingestion of C. jejuni. This study provided a methodology to quantify exposure volumes using observations on site. We estimated that using rainwater as source water for splash parks may pose a health risk, however, further detailed quantitative microbial analysis is required to confirm this finding. Furthermore we give insight into the effect of water quality standards, which may limit infection risks from exposure at splash parks.

Neurobehavioral evaluation of adolescent male rats following repeated exposure to chlorpyrifos

Chlorpyrifos (CPF), a highly effective organophosphate pesticide (OP), is extensively used worldwide. However, its agricultural use was extensively reduced in 2001. Several studies have suggested an association between mood disorders and CPF exposure in humans, especially in children, a subgroup that is highly susceptible to xenobiotics. We investigated the hypothesis that repeated CPF exposure in animals would elicit depressive-like behavioral alterations that reflected depression-related symptoms. Adolescent male rats were subcutaneously injected with either olive oil or 2.5, 5, 10, or 20mg/kg CPF from postnatal day 27 to 36, then were followed by a series of neurobehavioral evaluation. Our studies revealed depressive-like alterations that were manifested by increased despair behavior in the forced swimming test, increased escape failure in the learned helplessness test, and altered approach-avoidance conflict in the novelty-suppressed feeding test. There was no effect on locomotor activity in the open-field activity test. This study indicates that repeated exposure to CPF elicits depressive-like behavioral alterations in adolescent male rats.

Quantitative assessment of infection risk from exposure to waterborne pathogens in urban floodwater

Flooding and heavy rainfall have been associated with waterborne infectious disease outbreaks, however, it is unclear to which extent they pose a risk for public health. Here, risks of infection from exposure to urban floodwater were assessed using quantitative microbial risk assessment (QMRA). To that aim, urban floodwaters were sampled in the Netherlands during 23 events in 2011 and 2012. The water contained Campylobacter jejuni (prevalence 61%, range 14- >10(3) MPN/l), Giardia spp. (35%, 0.1-142 cysts/l), Cryptosporidium (30%, 0.1-9.8 oocysts/l), noroviruses (29%, 10(2)-10(4) pdu/l) and enteroviruses (35%, 10(3)-10(4) pdu/l). Exposure data collected by questionnaire, revealed that children swallowed 1.7 ml (mean, 95% Confidence Interval 0-4.6 ml) per exposure event and adults swallowed 0.016 ml (mean, 95% CI 0-0.068 ml) due to hand-mouth contact. The mean risk of infection per event for children, who were exposed to floodwater originating from combined sewers, storm sewers and rainfall generated surface runoff was 33%, 23% and 3.5%, respectively, and for adults it was 3.9%, 0.58% and 0.039%. The annual risk of infection was calculated to compare flooding from different urban drainage systems. An exposure frequency of once every 10 years to flooding originating from combined sewers resulted in an annual risk of infection of 8%, which was equal to the risk of infection of flooding originating from rainfall generated surface runoff 2.3 times per year. However, these annual infection risks will increase with a higher frequency of urban flooding due to heavy rainfall as foreseen in climate change projections.

Modeling exposures to organophosphates and pyrethroids for children living in an urban low-income environment

Pesticide exposure in urban low-income residential environments may be elevated as a result of persistent application due to severe pest infestation. Children living in this environment may be a sensitive subpopulation for these non-dietary exposures, due to their physiological and behavioral differences. In this study, we provide an exposure modeling framework to simulate exposures for children in this environment and assess dominant exposure routes and sources of exposure variability, in order to characterize factors that influence risk. We use a dataset of pesticide measurements collected in 42 low-income dwellings, including vacuum dust and floor wipe samples from kitchens and living rooms. We fit distributions to the concentration measurements for the organophosphates measured, chlorpyrifos and diazinon, and the most prevalent pyrethroids (permethrin, cypermethrin, and cyfluthrin), and simulated 1000 homes from the distributions. Concentration measurements were then connected with activity pattern data, short-term dermal and ingestion exposures and absorbed doses were simulated for children ages 1-5 years. For both pesticide groups, exposure values ranged widely, with concentration values contributing most significantly to exposure variability, although approximately 20-fold variability was attributable to exposure factors alone. In addition, upper percentile exposed children usually had both higher concentrations as well as greater influences from exposure and dose factors. Differences were also seen across pesticide groups in dominant exposure pathways. Our analyses indicate a profile of factors that describe individuals likely to receive high doses of one or multiple pesticides and could allow for more targeted intervention strategies. More generally, this work provides a standard framework to evaluate and describe exposures to prevalent residential pesticides via multiple pathways.

Evaluation of predictive algorithms used for estimating potential postapplication, nondietary ingestion exposures to pesticides associated with children's hand-to-mouth behavior

Postapplication exposure assessment related to indoor residential application of pesticide products requires consideration of product use information, application methods, chemical-specific deposition, time-dependent availability and transferability of surface residues, reentry time, and temporal location and macro- and microactivity/behavior patterns ( Baker et al., 2000 ). Children's mouthing behavior results in potential postapplication exposure to available pesticides in treated microenvironments through the nondietary ingestion route, in addition to the dermal or inhalation routes. Children's activities and associated behaviors may result in multiple or repeat contact of dermal areas (clothed and unclothed body areas and hands) with treated surfaces, or surfaces that may have indirect sources of residues. Further, some surfaces contacted may have transferable pesticide residues and others may not. Transfer of residues from the indoor residential environment to the dermal surface (e.g., hands) of an individual has been assumed to be linear as a function of time and number of contacts. However, studies suggest that this transfer process to the hands and other body areas may be rapidly saturable. In the most recent U.S. Environmental Protection Agency (EPA), Office of Pesticide Programs (OPP) "Residential Exposure Assessment Standard Operating Procedures" (U.S. EPA, 2012), the input variable for the number of dermal contacts (with treated surfaces) is an exponent, making the relationship nonlinear. Further, removal processes such as hand washing and transfer to untreated surfaces are important to consider. Predictive algorithms for estimating children's hand-to-mouth-related incidental ingestion exposures post pesticide application have been developed by the EPA/OPP and incorporated into probabilistic models. A review of literature addressing variables used to estimate potential incidental ingestion exposure is presented. Data relevant to input variables for predictive algorithms are discussed, including the results of a multiyear, pesticide transferable residue measurement program conducted by the Non-Dietary Exposure Task Force (NDETF) and the associated distributional characterization for this key variable. Sources of conservative bias in current hand-to-mouth, incidental ingestion exposure estimation and the role of biomonitoring to evaluate predicted exposures are discussed.

Pesticide exposure in children

Pesticides are a collective term for a wide array of chemicals intended to kill unwanted insects, plants, molds, and rodents. Food, water, and treatment in the home, yard, and school are all potential sources of children's exposure. Exposures to pesticides may be overt or subacute, and effects range from acute to chronic toxicity. In 2008, pesticides were the ninth most common substance reported to poison control centers, and approximately 45% of all reports of pesticide poisoning were for children. Organophosphate and carbamate poisoning are perhaps the most widely known acute poisoning syndromes, can be diagnosed by depressed red blood cell cholinesterase levels, and have available antidotal therapy. However, numerous other pesticides that may cause acute toxicity, such as pyrethroid and neonicotinoid insecticides, herbicides, fungicides, and rodenticides, also have specific toxic effects; recognition of these effects may help identify acute exposures. Evidence is increasingly emerging about chronic health implications from both acute and chronic exposure. A growing body of epidemiological evidence demonstrates associations between parental use of pesticides, particularly insecticides, with acute lymphocytic leukemia and brain tumors. Prenatal, household, and occupational exposures (maternal and paternal) appear to be the largest risks. Prospective cohort studies link early-life exposure to organophosphates and organochlorine pesticides (primarily DDT) with adverse effects on neurodevelopment and behavior. Among the findings associated with increased pesticide levels are poorer mental development by using the Bayley index and increased scores on measures assessing pervasive developmental disorder, inattention, and attention-deficit/hyperactivity disorder. Related animal toxicology studies provide supportive biological plausibility for these findings. Additional data suggest that there may also be an association between parental pesticide use and adverse birth outcomes including physical birth defects, low birth weight, and fetal death, although the data are less robust than for cancer and neurodevelopmental effects. Children's exposures to pesticides should be limited as much as possible.

Children's environmental health in agricultural settings

Children residing in rural settings may encounter environmental hazards derived from agricultural production activities. Health consequences of organic dusts, farm chemicals including pesticides, machinery noise, excess sun exposure, and zoonotic infectious agents have been clearly described among farm-working adults. The author reviews the related evidence base on child health with a life-stage perspective on their differential exposure and vulnerabilities. Methemoglobinemia among infants consuming nitrate-contaminated well water, neurodevelopmental health impacts associated with early life exposure to organophosphate pesticides, and diarrheal disease due to zoonotic infectious agents are well-described pediatric concerns. There is suggestive but more limited evidence for respiratory health consequences from air contaminants associated with confined animal feeding operations and hearing deficits for children exposed to machinery-related noise. Many contaminants of concern for children in these environments remain largely understudied-diesel exhaust, biomass burning, solvents, veterinary antibiotics, and silica-containing particulate matter. Overall, the state of knowledge and programmatic activities on agriculturally derived environmental contaminants and child health is immature and much less complete than for working adults. This overview provides a context for research, policy, and programmatic needs.

Intake fraction for the indoor environment: a tool for prioritizing indoor chemical sources

Reliable exposure-based chemical characterization tools are needed to evaluate and prioritize in a rapid and efficient manner the more than tens of thousands of chemicals in current use. This study applies intake fraction (iF), the integrated incremental intake of a chemical per unit of emission, for a suite of indoor released compounds. A fugacity-based indoor mass-balance model was used to simulate the fate and transport of chemicals for three release scenarios: direct emissions to room air and surface applications to carpet and vinyl. Exposure through inhalation, dermal uptake, and nondietary ingestion was estimated. To compute iF, cumulative intake was summed from all exposure pathways for 20 years based on a scenario with two adults and a 1-year-old child who ages through the simulation. Overall iFs vary by application modes: air release (3.1 × 10(-3) to 6.3 × 10(-3)), carpet application (3.8 × 10(-5) to 6.2 × 10(-3)), and vinyl application (9.0 × 10(-5) to 1.8 × 10(-2)). These iF values serve as initial estimates that offer important insights on variations among chemicals and the potential relative contribution of each pathway over a suite of compounds. The approach from this study is intended for exposure-based prioritization of chemicals released inside homes.

Quantified outdoor micro-activity data for children aged 7-12-years old

Estimation of aggregate exposure and risk requires detailed information regarding dermal contact and mouthing activity. We analyzed micro-level activity time series (MLATS) of children aged 7-12 years to quantify these contact behaviors and evaluate differences by age and gender. In all, 18 children, aged 7-12 years, were videotaped while playing outdoors. Video footage was transcribed via Virtual Timing Device (VTD) software. We calculated the hand and mouth contact frequency, hourly duration and median duration of contact with 16 object categories. Median mouthing frequencies were 12.6 events/h and 2.6 events/h for hands and non-dietary objects, respectively. Median hourly mouthing duration was 0.4 min/h and 0.1 min/h with hands and objects. Median mouthing contact duration was 1 s and 1.5 s with hands and objects, respectively. The median object contact frequency for both the hands combined was 537.3 events/h with an hourly contact duration of 81.8 min/h and a median contact duration of 3 s. There were no significant differences in the mouthing activity between genders or age groups. Female children had longer and more frequent hand contacts with several surface types. Age was negatively correlated with hand contacts of floor and wood surfaces. Contact frequencies in this study are higher than current regulatory recommendations for this age group.

Blood lead levels and associated sociodemographic factors among preschool children in the South Eastern region of China

Children are especially vulnerable to lead toxicity, and exposure to lead has been linked to poor school performance and delinquency in children and adolescents. Even low-level lead exposure [blood lead level (BLL) <10 µg/dL] can cause intellectual deficit. In China, BLLs in children decreased slightly after the phasing out of lead in gasoline, but few studies have examined the sociodemographic factors associated with BLL above 10 µg/dL. In this study, we sought to examine the hypothesis that sociodemographic factors predict BLLs. We measured BLLs of 1344 preschool children (3-5 years old) from the China Jintan Child Cohort Study. Children's sociodemographic and health statuses, as well as parental sociodemographic data, were collected using questionnaires. Regression models were used to explore the association between sociodemographic factors and log-transformed BLLs as well as the relationship between sociodemographic factors and the risk of BLL ≥10 µg/dL. We found the median BLL to be 6.2 µg/dL (range: 1.8-32.0 µg/dL); 8% of children had BLLs ≥10 µg/dL. Boys had a higher median BLL (6.4 µg/dL) than girls and were more likely to have BLL ≥10 µg/dL [odds ratio = 1.77, 95% confidence interval 1.14, 2.74]. BLLs increased as children aged, with a median BLL of 6.6 µg/dL among 5-year-old children. Children with siblings had a higher average BLL and greater prevalence of a BLL ≥10 µg/dL than those without siblings. Living in a crowded neighbourhood was also associated with increased BLLs. Mother's lower education, father's occupation (as professional worker) and parental smoking at home were associated with increased BLLs. This study shows that children in this area still have relatively high BLLs even after the phasing out of leaded gasoline. Both children's and parental factors and community condition are associated with increased BLLs. Future efforts are needed to identify other sources of exposure and develop targeted prevention strategies.