Elements to increase translation in pyrethroid epidemiology research: A review

Pyrethroid insecticides have been the subject of numerous epidemiology studies in the past two decades. We examined the pyrethroids epidemiology literature published between 2016 and 2021. Our objective with this exercise was to inform interested readers regarding information on methodological elements that strengthen a study's use for translation (i.e., use in risk assessment) and to describe aspects of future research methods that could improve utility for decision-making. We focused on the following elements: (i) study design that provided evidence that pyrethroid exposure preceded the outcome, (ii) evidence that the method used for exposure characterization was reliable and sufficiently accurate for the intended purpose, and (iii) use of a robust approach for outcome ascertainment. For each of the 74 studies identified via the literature search, we categorized the methodological elements as Acceptable or Supplemental. A study with three Acceptable elements was considered Relevant for risk assessment purposes. Based on our evaluative approach, 18 (24%) of the 74 publications were considered to be Relevant. These publications were categorized as Acceptable for all three elements assessed: confirmed exposure (N = 24), confirmed outcome (N = 64), exposure preceded the outcome (N = 44). Three of these studies were birth cohorts. There were 15 Relevant publications of adults which included 10 Agricultural Health Study cohort publications of self-reported permethrin. Overall, the majority of the reviewed studies used methods that did not permit a determination that pyrethroid exposure preceded the outcome, and/or did not utilize robust methods for exposure assessment and outcome ascertainment. There is an opportunity for investigators and research sponsors to build on the studies reviewed here and to incorporate more translational approaches to studying exposure/outcome associations related to pesticides and other chemicals.

Estimating household exposure to pyrethroids and the relative contribution of inhalation pathway in a sample of Japanese children

Several synthetic pyrethroids are suspected to have carcinogenicity or reproductive toxicity. However, there is little knowledge about indoor air pollution in residences or the extent of intake by the residents of the newly developed pyrethroids, transfluthrin, profluthrin, and metofluthrin, although they have been widely used indoors as mosquito repellents and mothproof repellents in recent years. In the present study, the household exposure to pyrethroids through all exposure pathways and the contribution of inhalation pathway in Japanese children were examined by measuring urinary pyrethroid metabolites in the children and the airborne pyrethroids in their residences. Urine excreted first after waking up was collected from subjects aged 6 to 15 years (n = 132), and airborne pyrethroids were sampled in the subjects' bedrooms for 24 h. Nineteen pyrethroids and their nine urinary metabolites were measured. Their daily intakes estimated were as follows (median, ng/kg b.w./d): bifenthrin, 56; transfluthrin, 22; metofluthrin, 11; profluthrin, 0.86. The contribution rates of the amounts absorbed by inhalation to the amounts absorbed via all of the exposure pathways while at home tended to decrease in the following order: profluthrin (median 15%) ≈ transfluthrin (14%) > metofluthrin (1%) > bifenthrin (0.1%). Transfluthrin was considered to be the most notable pyrethroid as an indoor air pollutant. Our study demonstrated widespread exposure to transfluthrin, metofluthrin, profluthrin, and bifenthrin in a sample of Japanese children.

[Human Biomonitoring as a Useful Approach to Health Risk Assessment Compared with Occupational Exposure Assessment of Insecticide Intake: Fundamental Study Focused on Local Populations and Occupational Fields]

Human biomonitoring (HBM) is a technique to evaluate chemical exposure level by measuring the levels of chemicals or related substances such as their metabolites or adducts in biological samples (e.g., urine or blood). Compared with exposure assessment by an approach to estimate insecticide intake from diet or the environment, HBM can provide information more specific to an individual exposure dose and can reflect the exact body burden condition at the time of measurement. If the analytical sensitivities, completeness and cost-effectiveness of the method are improved further, HBM might be widely applicable to not only research fields such as epidemiological and occupational study but also routine analysis for effective prevention of the exposure of the human body to chemical substances. In this article, we provide an overview of HBM as a determination method for insecticide exposure markers in urine and its applications, and discuss future research perspectives in the field of environmental and occupational health.