Questionnaire assessment of nonoccupational pesticide exposure in epidemiologic studies of cancer

Development of a questionnaire-based insecticide exposure assessment method and comparison with urinary insecticide biomarkers in young Australian children

Environmental and behavioural factors assessed via an online questionnaire were compared to insecticide metabolite concentrations in urine collected from 61 children from South East Queensland, Australia. Metabolite concentrations (μg/L urine) were transformed using the natural logarithm prior to regression analysis and adjusted for age and creatinine. A significant dietary association was reported for vegetable intake and 3-phenoxybenzoic acid (3-PBA) (β: 1.47 for top quartile of intake versus bottom quartile of intake 95% CI: 0.36, 2.57). Intake of vegetables and fruit were also positively associated with sum non-specific organophosphate metabolites (ƩnsOP). ƩnsOP concentrations were lower when fruits and vegetables were always or almost always washed prior to cooking or eating (β: -0.69 95% CI: -1.25, -0.12). In multivariable modelling 3-PBA concentrations were also associated with hand-washing frequency (β: 1.69 95% CI: 0.76, 2.61 for <1 day versus > 3 day), presence of a dog in the home (β: 0.73 95% CI: 0.07, 1.38), frequency of pest-spray use in the summer months (β: 0.88 95% CI: 0.22, 1.54 weekly versus less than weekly) and season (β: 0.88 95% CI: 0.32, 1.44 for spring/summer versus winter/autumn). This is the first study in Australia to report dietary, behavioural and environmental factors associated with biomarkers of insecticide exposure in young children.

Assessing exposure of young children to common endocrine-disrupting chemicals in the home environment: a review and commentary of the questionnaire-based approach

BACKGROUND

Although infants and young children are particularly vulnerable to endocrine disrupting chemical (EDC) exposure, there is an absence of comprehensive exposure data for this age group. As young children spend the majority of their time indoors, improved methods of exposure assessment are needed to characterise the health risks from exposures in the home environment. Biologic assessment, which has been considered the gold standard for exposure assessment in recent years, is difficult to conduct in young children. Questionnaires are an alternative and indirect method of predicting exposure, which may overcome some of the limitations of direct exposure assessment.

RESEARCH PROBLEM

The feasibility of using a questionnaire-based approach to predict exposure of young children to EDCs in the home has yet to be comprehensively reviewed. Moreover, there is no one questionnaire that has been validated for predicting the exposure of infants to common EDCs in the home.

AIMS AND OBJECTIVES

The aim of this review is to discuss the use and validation of the questionnaire-based approach to predict exposure of children to chemicals from three common classes of EDCs in the home, namely, plasticisers, flame retardants, and insecticides. We discuss the strengths and weaknesses of the questionnaire-based approach as well as the important pathways of exposure in the home environment, by which to guide the design and validation of future exposure questionnaires.

RESULTS

The findings from our review indicate that the questionnaire-based approach is a valuable tool in the prediction of exposure to persistent organic pollutants, as well as to toxicants that have consistent patterns of exposure. With improvements to the design and validation process, the questionnaire-based approach may also prove to be a reliable instrument in predicting exposure to EDCs with short-half lives, including bisphenol A, phthalates, and pyrethroid and organophosphate insecticides.

Household and occupational exposure to pesticides and risk of breast cancer

The association between breast cancer in women and the use of household or occupational pesticides was examined in a population-based case-control study. This study was conducted in Western Australia in 2009-2011 and included 1,789 controls and 1,205 cases. Information on household pesticide exposure was collected from questionnaires. For occupational pesticide exposure, job-specific modules (JSMs) were used. To evaluate potential recall bias, we stratified the analysis by belief about whether pesticides contribute to breast cancer. Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Women's exposures to pesticides in households and workplaces were not related to increased risk of breast cancer (OR = 1.10; CI: 0.86-1.37) and (OR = 0.77; CI: 0.45-1.32), respectively. The prevalence of occupational exposure to pesticides among women in our study was low. In the stratified analyses, the odd ratios associated with household pesticide use were similar among participants who believed pesticides increased breast cancer risk and those who did not. The results of our study did not show associations between breast cancer and household or occupational exposure to pesticides.

Characterization of residential pesticide use and chemical formulations through self-report and household inventory: the Northern California Childhood Leukemia study

BACKGROUND

Home and garden pesticide use has been linked to cancer and other health outcomes in numerous epidemiological studies. Exposure has generally been self-reported, so the assessment is potentially limited by recall bias and lack of information on specific chemicals.

OBJECTIVES

As part of an integrated assessment of residential pesticide exposure, we identified active ingredients and described patterns of storage and use.

METHODS

During a home interview of 500 residentially stable households enrolled in the Northern California Childhood Leukemia Study during 2001-2006, trained interviewers inventoried residential pesticide products and queried participants about their storage and use. U.S. Environmental Protection Agency registration numbers, recorded from pesticide product labels, and pesticide chemical codes were matched to public databases to obtain information on active ingredients and chemical class. Poisson regression was used to identify independent predictors of pesticide storage. Analyses were restricted to 259 participating control households.

RESULTS

Ninety-five percent (246 of 259) of the control households stored at least one pesticide product (median, 4). Indicators of higher sociodemographic status predicted more products in storage. We identified the most common characteristics: storage areas (garage, 40%; kitchen, 20%), pests treated (ants, 33%; weeds, 20%), pesticide types (insecticides, 46%; herbicides, 24%), chemical classes (pyrethroids, 77%; botanicals, 50%), active ingredients (pyrethrins, 43%) and synergists (piperonyl butoxide, 42%). Products could contain multiple active ingredients.

CONCLUSIONS

Our data on specific active ingredients and patterns of storage and use will inform future etiologic analyses of residential pesticide exposures from self-reported data, particularly among households with young children.

Residential insecticide usage in northern California homes with young children

Residential insecticide usage and actual application details were collected in a population-based sample of 477 households residing within 22 counties in northern California with at least one child of age ≤ 5 years between January 2006 and August 2008. Structured telephone interviews were conducted collecting information on residential use of insecticides, including outdoor sprays, indoor sprays, indoor foggers, applications by professionals, and pet flea/tick control during the previous year. Interviews also covered post-treatment behaviors, which influence post-application exposure levels. Altogether, 80% of the households applied some type of insecticide in the previous year, with half of this population using two or more application methods. Of the households using insecticides, half reported applying insecticides relatively infrequently (<4 times per year), whereas 11-13% reported high frequency of use (>24 times per year). Application frequency was temperature dependent, with significantly more applications during the warmer months from May through October. Spot treatments appeared to be the most prevalent application pattern for sprays. For one out of three of the indoor applications, children played in the treated rooms on the day of the application, and for 40% of the outdoor applications, pets played in the treated area on the day of the application. These findings describing the intensity of insecticide use and accompanying behaviors in families with young children may inform future insecticide exposure modeling efforts, and ultimately, risk assessments.

SMAD4--molecular gladiator of the TGF-beta signaling is trampled upon by mutational insufficiency in colorectal carcinoma of Kashmiri population: an analysis with relation to KRAS proto-oncogene

BACKGROUND

The development and progression of colorectal cancer has been extensively studied and the genes responsible have been well characterized. However the correlation between the SMAD4 gene mutations with KRAS mutant status has not been explored by many studies so far. Here, in this study we aimed to investigate the role of SMAD4 gene aberrations in the pathogenesis of CRC in Kashmir valley and to correlate it with various clinicopathological variables and KRAS mutant genotype.

METHODS

We examined the paired tumor and normal tissue specimens of 86 CRC patients for the occurrence of aberrations in MCR region of SMAD4 and exon 1 of KRAS by PCR-SSCP and/or PCR-Direct sequencing.

RESULTS

The overall mutation rate of mutation cluster region (MCR) region of SMAD4 gene among 86 patients was 18.6% (16 of 86). 68.75% (11/16) of the SMAD4 gene mutants were found to have mutations in KRAS gene as well. The association between the KRAS mutant genotype with SMAD4 mutants was found to be significant (P = or < 0.05). Further more, we found a significant association of tumor location, tumor grade, node status, occupational exposure to pesticides and bleeding PR/Constipation with the mutation status of the SMAD4 gene (P = or < 0.05).

CONCLUSION

Our study suggests that SMAD4 gene aberrations are the common event in CRC development but play a differential role in the progression of CRC in higher tumor grade (C+D) and its association with the KRAS mutant status suggest that these two molecules together are responsible for the progression of the tumor to higher/advanced stage.

Inferring past pesticide exposures: a matrix of individual active ingredients in home and garden pesticides used in past decades

BACKGROUND

In retrospective studies of the health effects of home and garden pesticides, self-reported information typically forms the basis for exposure assessment. Study participants generally find it easier to remember the types of pests treated than the specific pesticides used. However, if the goal of the study is to assess disease risk from specific chemicals, the investigator must be able to link the pest type treated with specific chemicals or products.

OBJECTIVES

Our goal was to develop a "pesticide-exposure matrix" that would list active ingredients on the market for treating different types of pests in past years, and provide an estimate of the probability that each active ingredient was used.

METHODS

We used several different methods for deriving the active ingredient lists and estimating the probabilities. These methods are described in this article, along with a sample calculation and data sources for each.

RESULTS

The pesticide-exposure matrix lists active ingredients and their probabilities of use for 96 distinct scenarios defined by year (1976, 1980, 1990, 2000), applicator type (consumer, professional), and pest type (12 categories). Calculations and data sources for all 96 scenarios are provided online.

CONCLUSIONS

Although we are confident that the active ingredient lists are reasonably accurate for most scenarios, we acknowledge possible sources of error in the probability estimates. Despite these limitations, the pesticide-exposure matrix should provide valuable information to researchers interested in the chronic health effects of residential pesticide exposure.

Use and storage of domestic pesticides in the UK

Several epidemiological studies, particularly from the United States, have suggested health concerns may arise from the chronic exposure of young children to pesticides in their home environment. Most of these studies are retrospective and the available pesticide exposure information is either subject to the problem of recall or derived from surrogate information. Currently, little is known about the extent of pesticide use in homes and gardens in the UK. This was investigated in this study using a sample of parents from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort in and around Bristol. The level and extent of pesticide use by parents was explored through interviews that took place at the homes of the participants during August to November 2001, followed by an inventory of products stored in the home. From the results, 93% of parents had used at least one pesticide over the preceding year with the highest use being in the garden, second inside the home, followed by treating pets and head lice. Most households reported using one to five different products over the past year, with a mean of 3.5. The frequency of pesticide use showed that a minority of parents are using pesticides in the high frequency range. Over 85 different pesticide products were found to be stored in 76% of homes, with 76 different types of pesticide active ingredients. Insecticides were the most commonly used and stored pesticide.

Validation of self-reported proximity to agricultural crops in a case-control study of neural tube defects

Self-reported perinatal exposures to chemicals or pollutant sources in case-control studies of birth defects may be inaccurate due to misreporting among mothers. In a case-control study of neural tube defects delivered in California in 1987-1988, mothers of case and control infants were asked whether they lived within 0.25 mile (400 m) of agricultural crops. Responses were compared against a gold standard derived from historical agricultural land-use survey maps. The odds ratio for self-reported proximity to any crops (1.62, 95% confidence interval: 1.08, 2.43) appeared to be positively biased compared with the estimate for map-based proximity (1.17, 95% confidence interval: 0.79, 1.71). This pattern was also observed for proximity to specific crops such as nonpermanent and orchard crops. For vineyards, however, we observed an increased risk associated with map-based proximity (odds ratio=2.45, 95% confidence interval: 1.08, 5.58) but not with self-reported proximity (1.09, 95% confidence interval: 0.51, 2.34). The sensitivity of self-reported proximity to any crops was greater for case (65.7%) than control mothers (50.0%) while specificity was about the same for case and control mothers (87.5 vs. 89.3%), suggesting that control mothers under-reported proximity to crops. Differential reporting was also observed between geographic regions, urban and rural residents, and across levels of maternal employment and education. These results suggest differential reporting between case and control mothers as well as an influence from maternal demographic characteristics on reporting accuracy.

Pesticides and Parkinson's disease--is there a link?

Parkinson's disease (PD) is an idiopathic disease of the nervous system characterized by progressive tremor, bradykinesia, rigidity, and postural instability. It has been postulated that exogenous toxicants, including pesticides, might be involved in the etiology of PD. In this article we present a comprehensive review of the published epidemiologic and toxicologic literature and critically evaluate whether a relationship exists between pesticide exposure and PD. From the epidemiologic literature, there does appear to be a relatively consistent relationship between pesticide exposure and PD. This relationship appears strongest for exposure to herbicides and insecticides, and after long durations of exposure. Toxicologic data suggest that paraquat and rotenone may have neurotoxic actions that potentially play a role in the development of PD, with limited data for other pesticides. However, both the epidemiology and toxicology studies were limited by methodologic weaknesses. Particular issues of current and future interest include multiple exposures (both pesticides and other exogenous toxicants), developmental exposures, and gene-environment interactions. At present, the weight of evidence is sufficient to conclude that a generic association between pesticide exposure and PD exists but is insufficient for concluding that this is a causal relationship or that such a relationship exists for any particular pesticide compound or combined pesticide and other exogenous toxicant exposure.

Science and society: the Long Island Breast Cancer Study Project

In the early 1990s, breast cancer advocates petitioned the United States Congress to investigate the high rates of breast cancer on Long Island in the state of New York. The resulting law led to the Long Island Breast Cancer Study Project (LIBCSP)--more than ten research projects designed to study the possible causes of this increased incidence of cancer. This project reported that there was no evidence that environmental exposures were responsible. Controversial from its start, the LIBCSP has had an important role in efforts to understand the reasons for the high rates of breast cancer in some regions of the United States.

The use and disposal of household pesticides

Most pesticides are synthetic chemicals manufactured specifically for their toxic properties to the target species, and widely used globally. Several epidemiological studies in the United States have suggested health concerns arising from the chronic exposure of young children to pesticides in the domestic environment. In the UK very little is currently known about how nonoccupational pesticides are being used or disposed of. Any use of pesticides is a potential risk factor for children's exposure, and any potential exposure is likely to be reduced by the parents' adopting precautionary behaviour when using these pesticide products. This was investigated using a sample of 147 parents from the Avon Longitudinal Study of Parents and Children cohort in and around Bristol, through an in-depth interview between August and November 2001. The results of this study add to the understanding of the underlying behaviour of parents applying pesticide products in the home environment in the UK. Pesticides are readily available, and are normally purchased in do-it-yourself shops and supermarkets and mostly disposed of in domestic waste. Safety was stated by 45% of parents to be the most important factor to consider when buying a pesticide. When buying pesticide products, labels were stated to be the most important source of information about pesticides. However, a third of parents stated they would not follow the product label exactly when using a product, just under half felt labels were both inadequate and hard to understand, and about 10% of parents would not take notice of warnings on the pesticide label. Less than half of parents would use gloves when applying a pesticide, although the use of protective equipment such as gloves during the application of pesticides could greatly reduce the exposure. It is a public health concern that the instructions on the labels of products may not always be understood or followed, and further understanding of user behaviour is needed.

Pesticide product use and risk of non-Hodgkin lymphoma in women

A population-based, incidence case-control study was conducted among women in upstate New York to determine whether pesticide exposure is associated with an increase in risk of non-Hodgkin lymphoma (NHL) among women. The study involved 376 cases of NHL identified through the State Cancer Registry and 463 controls selected from the Medicare beneficiary files and state driver's license records. Information about history of farm work, history of other jobs associated with pesticide exposure, use of common household pesticide products, and potential confounding variables was obtained by telephone interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using an unconditional logistic regression model. The risk of NHL was doubled (OR = 2.12; 95% CI, 1.21-3.71) among women who worked for at least 10 years at a farm where pesticides were reportedly used. When both farming and other types of jobs associated with pesticide exposure were combined, there was a progressive increase in risk of NHL with increasing duration of such work (p = 0.005). Overall cumulative frequency of use of household pesticide products was positively associated with risk of NHL (p = 0.004), which was most pronounced when they were applied by subjects themselves. When exposure was analyzed by type of products used, a significant association was observed for mothballs. The associations with both occupational and household pesticides were particularly elevated if exposure started in 1950-1969 and for high-grade NHL. Although the results of this case-control study suggest that exposure to pesticide products may be associated with an increased risk of NHL among women, methodologic limitations related to selection and recall bias suggest caution in inferring causation.

Health Effects of Chronic Pesticide Exposure: Cancer and Neurotoxicity

Pesticides are widely used in agricultural and other settings, resulting in continuing human exposure. Epidemiologic studies indicate that, despite premarket animal testing, current exposures are associated with risks to human health. In this review, we describe the routes of pesticide exposures occurring today, and summarize and evaluate the epidemiologic studies of pesticide-related carcinogenicity and neurotoxicity in adults. Better understanding of the patterns of exposure, the underlying variability within the human population, and the links between the animal toxicology data and human health effects will improve the evaluation of the risks to human health posed by pesticides. Improving epidemiology studies and integrating this information with toxicology data will allow the human health risks of pesticide exposure to be more accurately judged by public health policy makers.