Residential Exposure to Pesticide During Childhood and Childhood Cancers: A Meta-Analysis

Carcinogenic health outcomes associated with endocrine disrupting chemicals exposure in humans: A wide-scope analysis

Endocrine-disrupting chemicals (EDCs) are persistent and pervasive compounds that pose serious risks. Numerous studies have explored the effects of EDCs on human health, among which tumors have been the primary focus. However, because of study design flaws, lack of effective exposure levels of EDCs, and inconsistent population data and findings, it is challenging to draw clear conclusions on the effect of these compounds on tumor-related outcomes. Our study is the first to systematically integrate observational studies and randomized controlled trials from over 20 years and summarize over 300 subgroup associations. We found that most EDCs promote tumor development, and that exposure to residential environmental pollutants may be a major source of pesticide exposure. Furthermore, we found that phytoestrogens exhibit antitumor effects. The findings of this study can aid in the development of global EDCs regulatory health policies and alleviate the severe risks associated with EDCs exposure.

Deployment-related toxic exposures are associated with worsening mental and physical health after military service: Results from a self-report screening of veterans deployed after 9/11

Exposure to toxins-such as heavy metals and air pollution-can result in poor health and wellbeing. Recent scientific and media attention has highlighted negative health outcomes associated with toxic exposures for U.S. military personnel deployed overseas. Despite established health risks, less empirical work has examined whether deployment-related toxic exposures are associated with declines in mental and physical health after leaving military service, particularly among the most recent cohort of veterans deployed after September 11, 2001. Using data from 659 U.S. veterans in the VISN 6 MIRECC Post-Deployment Mental Health Study, we tested whether self-reported toxic exposures were associated with poorer mental and physical health. At baseline, veterans who reported more toxic exposures also reported more mental health, β = 0.14, 95% CI [0.04, 0.23], p = 0.004, and physical health symptoms, β = 0.21, 95% CI [0.11, 0.30], p < 0.001. Over the next ten years, veterans reporting more toxic exposures also had greater increases in mental health symptoms, β = 0.23, 95% CI [0.15, 0.31], p < 0.001, physical health symptoms, β = 0.22, 95% CI [0.14, 0.30], p < 0.001, and chronic disease diagnoses, β = 0.15, 95% CI [0.07, 0.23], p < 0.001. These associations accounted for demographic and military covariates, including combat exposure. Our findings suggest that toxic exposures are associated with worsening mental and physical health after military service, and this recent cohort of veterans will have increased need for mental health and medical care as they age into midlife and older age.

Age-period-cohort effects on incidence trends of childhood leukemia from four population-based cancer registries in Colombia

BACKGROUND

Childhood leukemia (CL) is the most prevalent form of pediatric cancer on a global scale. However, there is a limited understanding of the dynamics of CL incidence in South America, with a specific knowledge gap in Colombia. This study aimed to identify trends in CL incidence and to analyze the effects of age, period, and birth cohort on the risk of leukemia incidence in this population.

METHODS

Information on all newly diagnosed leukemia cases (in general and by subtype) among residents aged 0-18 years and living in the serving areas of population-based cancer registries of Cali (2008-2017), Bucaramanga (2000-2017), Manizales (2003-2017), and Pasto (1998-2018). Estimated annual percent changes (EAPC) in incidence over time and potential changes in the slope of these EAPCs were calculated using joinpoint regression models. The effects of age, period, and cohort in CL incidence trends were evaluated using age-period-cohort models addressing the identifiability issue through the application of double differences.

RESULTS

A total of 966 childhood leukemia cases were identified. The average standardized incidence rate (ASIR) of leukemia was calculated and expressed per 100,000 person-years - observing ASIR of 4.46 in Cali, 7.27 in Bucaramanga, 3.89 in Manizales and 4.06 in Pasto. Concerning CL trends there were no statistically significant changes in EAPC throughout the different periods, however, when analyzed by leukemia subtype, statistically significant changes were observed in the EAPC for both ALL and AML. Analysis of age-period-cohort models revealed that age-related factors significantly underpin the incidence trends of childhood leukemia in these four Colombian cities.

CONCLUSIONS

This study offers valuable insights into the incidence trends of childhood leukemia in four major Colombian cities. The analysis revealed stable overall CL incidence rates across varying periods, predominantly influenced by age-related factors and the absence of cohort and period effects. This information is useful for surveillance and planning purposes for CL diagnosis and treatment in Colombia.

Pesticide exposure and asthma morbidity in children residing in urban, multi-family housing

BACKGROUND

Children are potentially more susceptible to the adverse effects of pesticides due to more sensitive organ systems and lower capacity to metabolize and eliminate chemicals compared to adults. The health risks are particularly concerning children with asthma, living in low-income neighborhoods in multi-family housing because of their impaired respiratory health, and factors associated with low-income, multi-family environments.

OBJECTIVE

To assess the association between pesticide exposure and asthma morbidity among children 7-12 years residing in low-income, multi-family housing.

METHODS

The concentrations of seven urinary pesticide biomarkers: 3,5,6-trichloro-2-pyridinol (TCPy), 2-isopropyl-4-methyl-6-hydroxypyrimidine, para-nitrophenol (PNP), 3-phenoxybenzoic acid (3-PBA), 4-fluoro-3-phenoxybenzoic acid, trans-3-(2,2-dichlorovinyl)-2,2-dimethyl-cyclopropane-1-carboxylic acid, and 2,4-dichlorophenoxyacetic acid (2,4-D) were measured. Children (n = 162) were followed for one year with three measures of pesticides biomarkers. Associations between individual biomarkers and asthma attack, asthma related health care utilization, and fraction of exhaled nitric oxide (FeNO), adjusting for demographic and household factors were examined with Generalized Estimating Equations (GEE). Weighted Quantile Sum (WQS) regression was used to examine the effect of pesticide mixture on asthma attacks and asthma-related health care utilization (HCU).

RESULTS

In adjusted GEE models, positive non-significant associations were found between PNP and HCU (adjusted Odds Ratio(aOR):2.05 95% CI:0.76-5.52) and null associations for 3-PBA and HCU (aOR:1.07 95% CI: 0.88-1.29). Higher concentrations of PNP and 2,4-D were associated with significantly lower FeNO levels (PNP: -17.4%; 2,4-D:-19.74%). The mixture was positively associated with HCU in unadjusted (OR: 1.56 97.5% CI: 1.08-2.27) but not significant in adjusted models (aOR: 1.40 97.5% CI: .86-2.29). The non-specific pyrethroid biomarker 3-PBA at baseline contributed the greatest weight to the index (45%).

SIGNIFICANCE

There were non-significant associations between pesticide biomarkers and respiratory outcomes in children with asthma. There was a suggestive association between urinary pesticide biomarkers and HCU. Further studies with larger sample sizes could help to confirm these findings.

IMPACT STATEMENT

Pesticide exposure among children in the urban environment is ubiquitous and there is a dearth of information on the impact of low-level chronic exposure in vulnerable populations. This study suggested that pesticide exposure at concentrations below the national average may not affect asthma morbidity in children. However, different biomarkers of pesticides showed different effects, but the mixture suggested increasing pesticide exposure results in asthma related HCU. The results may show that children with asthma may be at risk for negative health outcomes due to pesticides and the need to further examine this relationship.

Predictors of pesticide levels in carpet dust collected from child care centers in Northern California, USA

BACKGROUND

Young children may be exposed to pesticides in child care centers, but little is known about determinants of pesticide contamination in these environments.

OBJECTIVE

Characterize pesticide contamination in early care and education (ECE) centers and identify predictors of pesticide concentrations and loading in dust collected from classroom carpets.

METHODS

Carpet dust samples were collected from 51 licensed child care centers in Northern California and analyzed for 14 structural and agricultural pesticides. Program characteristics were collected through administration of director interviews and observational surveys, including an integrated pest management (IPM) inspection. Pesticide use information for the prior year was obtained from the California Department of Pesticide Regulation to characterize structural applications and nearby agricultural pesticide use.

RESULTS

The most frequently detected pesticides were cis-permethrin (98%), trans-permethrin (98%), bifenthrin (94%), fipronil (94%), and chlorpyrifos (88%). Higher bifenthrin levels were correlated with agricultural applications within 3 kilometers, and higher fipronil levels were correlated with professional pesticide applications in the prior year. In multivariable models, higher IPM Checklist scores were associated with lower loading of chlorpyrifos and permethrin. Placement of the sampled area carpet was also a predictor of chlorpyrifos loading. The strongest predictor of higher pesticide loading for the most frequently detected pesticides was location in California's San Joaquin Valley.

SIGNIFICANCE

Our findings contribute to the growing understanding that pesticides are ubiquitous in children's environments. Pesticide levels in carpet dust were associated with some factors that ECE directors may have control over, such as IPM practices, and others that are beyond their control, such as geographic location. IPM is an important tool that has the potential to reduce pesticide exposures in ECE environments, even for pesticides no longer in use.

IMPACT

One million children in California under six years old attend child care programs where they may spend up to 40 h per week. Children are uniquely vulnerable to environmental contaminants; however early care settings are under researched in environmental health studies. Little is known about predictors of pesticide levels found in environmental samples from child care facilities. This study aims to identify behavioral and environmental determinants of pesticide contamination in California child care centers. Findings can empower child care providers and consumers and inform decision makers to reduce children's exposures to pesticides and promote lifelong health.

Crystal structures and Hirshfeld surface analyses of methyl 4-{2,2-di-chloro-1-[(E)-phenyl-diazen-yl]eth-enyl}benzoate, methyl 4-{2,2-di-chloro-1-[(E)-(4-methyl-phen-yl)diazen-yl]ethen-yl}benzoate and methyl 4-{2,2-di-chloro-1-[(E)-(3,4-di-methyl-phen-yl)diazen-yl]ethen-yl}benzoate

The crystal structures and Hirshfeld surface analyses of three similar azo compounds are reported. Methyl 4-{2,2-di-chloro-1-[(E)-phenyl-diazen-yl]ethen-yl}benzoate, C16H12Cl2N2O2, (I), and methyl 4-{2,2-di-chloro-1-[(E)-(4-methyl-phen-yl)diazen-yl]ethen-yl}benzoate, C17H14Cl2N2O2, (II), crystallize in the space group P21/c with Z = 4, and methyl 4-{2,2-di-chloro-1-[(E)-(3,4-di-methyl-phen-yl)diazen-yl]ethen-yl}benzoate, C18H16Cl2N2O2, (III), in the space group P with Z = 2. In the crystal of (I), mol-ecules are linked by C-H⋯N hydrogen bonds, forming chains with C(6) motifs parallel to the b axis. Short inter-molecular Cl⋯O contacts of 2.8421 (16) Å and weak van der Waals inter-actions between these chains stabilize the crystal structure. In (II), mol-ecules are linked by C-H⋯O hydrogen bonds and C-Cl⋯π inter-actions, forming layers parallel to (010). Weak van der Waals inter-actions between these layers consolidate the mol-ecular packing. In (III), mol-ecules are linked by C-H⋯π and C-Cl⋯π inter-actions forming chains parallel to [011]. Furthermore, these chains are connected by C-Cl⋯π inter-actions parallel to the a axis, forming (01) layers. The stability of the mol-ecular packing is ensured by van der Waals forces between these layers.

Metabolite profiling of four Tunisian Eucalyptus essential oils and assessment of their insecticidal and antifungal activities

Aphids (Aphidoidea) and Fusarium spp. are widely recognized as destructive pests that cause significant damage to crops on a global scale. This study aimed to ascertain the chemical composition of essential oils (EOs) of four Tunisian Eucalyptus species and evaluate their toxicity against common aphids and phytopathogenic fungi. The EOs were obtained via hydrodistillation and subsequently analyzed using GC-MS. The chemical composition analysis revealed the presence of five distinct chemical classes in the EOs: monoterpene hydrocarbons (3.8-16.7 %), oxygenated monoterpenes (5.5-86.0 %), sesquiterpene hydrocarbons (0.2-2.2 %), oxygenated sesquiterpenes (4.2-86.7 %), and non-terpene derivatives (0.1-14.1 %).Hierarchical clustering analysis (HCA) and principal component analysis (PCA) of the Eucalyptus leaf EOs highlighted significant differences among them, leading to the generation of distinct HCA clades representing at least twelve major components. The statistical analysis clearly demonstrated a dose-response relationship, indicating the impact of the tested EOs on the growth of insects and fungal mycelium. The observed effects varied due to the variability in the chemical compositions of the EOs. Notably, among the EOs tested, Eucalyptus lesoufii Maiden exhibited particularly potent effects against the targeted insect and fungal species. This research contributes to the ongoing exploration of natural alternatives to chemical pesticides, providing further insights for potential industrial applications. It underscores the versatility of these EOs and their potential as valuable candidates in strategies for pest and disease management.

Pesticides as a potential independent childhood leukemia risk factor and as a potential confounder for electromagnetic fields exposure

BACKGROUND

Both pesticides and high magnetic fields are suspected to be childhood leukemia risk factors. Pesticides are utilized at commercial plant nurseries, which sometimes occupy the areas underneath high-voltage powerlines.

OBJECTIVES

To evaluate whether potential pesticide exposures (intended use, chemical class, active ingredient) utilized at plant nurseries act as an independent childhood leukemia risk factor or as a confounder for proximity to, or magnetic fields exposure from, high-voltage powerlines.

METHODS

We conducted a state-wide records-based case-control study for California with 5788 childhood leukemia cases and 5788 controls that examined specific pesticide use, magnetic field exposures and distances to both powerlines and plant nurseries. Exposure assessment incorporated geographic information systems, aerial satellite images, and other historical information.

RESULTS

Childhood leukemia risk was potentially elevated for several active pesticide ingredients: permethrin (odds ratio (OR) 1.49, 95% confidence interval (CI) (0.83-2.67), chlorpyrifos (OR 1.29, 95% CI 0.89-1.87), dimethoate (OR 1.79, 95% CI 0.85-3.76), mancozeb (OR 1.41, 95% CI 0.85-2.33), oxyfluorfen (OR 1.41, 95% CI 0.75-2.66), oryzalin (OR 1.60, 95% CI 0.97-2.63), and pendimethalin (OR 1.82, 95% CI 0.81-2.25). Rodenticide (OR 1.42, 95% CI 0.78-2.56) and molluscicide (OR 1.22, 95% CI 0.82-1.81) exposure also presented potentially elevated childhood leukemia risks. Childhood leukemia associations with calculated fields or powerline proximity did not materially change after adjusting for pesticide exposure. Childhood leukemia risks with powerline proximity remained similar when pesticide exposures were excluded.

DISCUSSION

Pesticide exposure may be an independent childhood leukemia risk factor. Childhood leukemia risks for powerline proximity and magnetic fields exposure were not explained by pesticide exposure.

Follicular DNA Damage and Pesticide Exposure Among Latinx Children in Rural and Urban Communities

The intersectional risks of children in United States immigrant communities include environmental exposures. Pesticide exposures and their biological outcomes are not well characterized in this population group. We assessed pesticide exposure and related these exposures to DNA double-strand breaks (DSBs) in Latinx children from rural, farmworker families (FW; N = 30) and from urban, non-farmworker families (NFW; N = 15) living in North Carolina. DSBs were quantified in hair follicular cells by immunostaining of 53BP1, and exposure to 72 pesticides and pesticide degradation products were determined using silicone wristbands. Cholinesterase activity was measured in blood samples. DSB frequencies were higher in FW compared to NFW children. Seasonal effects were detected in the FW group, with highest DNA damage levels in April-June and lowest levels in October-November. Acetylcholinesterase depression had the same seasonality and correlated with follicular DNA damage. Organophosphate pesticides were more frequently detected in FW than in NFW children. Participants with organophosphate detections had increased follicular DNA damage compared to participants without organophosphate detection. Follicular DNA damage did not correlate with organochlorine or pyrethroid detections and was not associated with the total number of pesticides detected in the wristbands. These results point to rural disparities in pesticide exposures and their outcomes in children from vulnerable immigrant communities. They suggest that among the different classes of pesticides, organophosphates have the strongest genotoxic effects. Assessing pesticide exposures and their consequences at the individual level is key to environmental surveillance programs. To this end, the minimally invasive combined approach used here is particularly well suited for children.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12403-023-00609-1.

A Two-Pronged Educational Intervention for Caregivers to Prevent Residential Pesticide Exposure Among Thai Young Children Living in Agricultural Area

Background

Residential pesticide exposure can be harmful to the health of young children, particularly in agricultural areas. It is critical to educate their caregivers on pesticide exposure prevention. The purpose of this study was to determine the effectiveness of a two-pronged education intervention for caregivers in preventing pesticide exposure among Thai young children living in agricultural areas.

Methods

This was an experimental study with 90 primary caregivers of young children aged 6 months to 5 years. Thirty caregivers each were assigned to one of three groups: booklet plus lecture intervention, only booklet intervention, and control. Caregivers in both interventions received a booklet that educated them on residential pesticide exposure and prevention. The caregivers in the booklet plus lecture group also attended a 2-hour lecture with the same content as the booklet. A questionnaire was developed to assess caregivers' knowledge, attitudes, intention, and behaviors regarding residential pesticide exposure and prevention in children. Face-to-face interviews were conducted at their homes three times: baseline, post-intervention, and follow-up (three weeks after the end of the intervention).

Results

Linear mixed models showed that, from baseline to post-intervention, the intervention effect on knowledge and attitude in both intervention groups, as well as intention in the booklet plus lecture group, was significant (p<0.05). From baseline to follow-up, the knowledge, attitude, intention, and behavior scores in both intervention groups increased significantly more than the control group (p<0.01). Only the attitude score increased more in the booklet plus lecture group than in the booklet group at post-intervention (p=0.009) and follow-up (p=0.003).

Conclusion

Both the booklet plus lecture method and the booklet method alone have a positive effect on improving the caregiver's knowledge and behaviors regarding pesticide exposure prevention at home. Thus, providing a booklet to caregivers to reduce children's risk of pesticide exposure is recommended.

Assessment of Preschool Children's Exposure Levels to Organophosphate and Pyrethroid Pesticide: A Human Biomonitoring Study in Two Turkish Provinces

Pesticides are products developed to prevent, destroy, repel or control certain forms of plant or animal life that are considered to be pests. However, now they are one of the critical risk factors threatening the environment, and they create a significant threat to the health of children. Organophosphate (OP) and pyrethroid (PYR) pesticides are widely used in Turkey as well as all over the world. The main focus of this presented study was to analyze the OP and PYR exposure levels in urine samples obtained from 3- to 6-year-old Turkish preschool children who live in the Ankara (n:132) and Mersin (n:54) provinces. In order to measure the concentrations of three nonspecific metabolites of PYR insecticides and four nonspecific and one specific metabolite of OPs, liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyses were performed. The nonspecific PYR metabolite 3-phenoxybenzoic acid (3-PBA) found in 87.1% of samples (n = 162) and the specific OP metabolite 3,5,6-trichloro-2-pyridinol (TCPY) found in 60.2% of samples (n = 112) were the most frequently detected metabolites in all urine samples. The mean concentrations of 3-PBA and TCPY were 0.38 ± 0.8 and 0.11 ± 0.43 ng/g creatinine, respectively. Although due to the large individual variation no statistically significant differences were found between 3-PBA (p = 0.9969) and TCPY (p = 0.6558) urine levels in the two provinces, significant exposure differences were determined both between provinces and within the province in terms of gender. Risk assessment strategies performed in light of our findings do not disclose any proof of a possible health problems related to analyzed pesticide exposure in Turkish children.

Glyphosate in house dust and risk of childhood acute lymphoblastic leukemia in California

BACKGROUND

Residential use of pesticides has been associated with increased risk of childhood acute lymphoblastic leukemia (ALL). We evaluated determinants of glyphosate concentrations in house dust and estimated ALL risk in the California Childhood Leukemia Study (CCLS).

METHODS

The CCLS is a population-based case-control study of childhood leukemia in California. Among those < 8-years (no move since diagnosis/reference date), we collected dust (2001-2007) from the room where the child spent the most time while awake and measured > 40 pesticides. Three-to-eight years later, we collected a second sample from non-movers. We used Ultra-Performance Liquid Chromatography Tandem Mass Spectrometry to measure glyphosate (µg/g dust) for 181 ALL cases and 225 controls and for 45 households with a second dust sample. We used multivariable Tobit regression to evaluate determinants of glyphosate concentrations. Odds ratios (ORs) and 95 % confidence intervals (CI) were calculated for ALL and quartiles of the concentration (first samples) using unconditional logistic regression. We computed the within- and between-home variance and intraclass correlation coefficient (ICC).

RESULTS

Glyphosate was frequently detected (cases: 98 %; controls: 99 %). Higher concentrations were associated with occupational pesticide exposure, nearby agricultural use, treatment for lawn weeds and bees/wasps, and sampling season. Increasing concentrations were not associated with ALL risk (adjusted OR_Q4vsQ1 = 0.8, CI: 0.4-1.4). We observed similar null associations for boys and girls, Hispanics and non-Hispanic whites, and among those who resided in their home since birth (76 cases/117 controls) or age two (130 cases/176 controls). The ICC was 0.32 indicating high within-home temporal variability during the years of our study.

CONCLUSIONS

We observed higher concentrations in homes associated with expected predictors of exposure but no association with childhood ALL risk. Due to continuing use, potential exposure to young children is high. It will be important to evaluate risk in future studies with multiple dust measurements or biomarkers of exposure.

Efficacy and toxicity of cockroach gel bait (imidacloprid 2.5% and fipronil 0.05%) against American cockroach infestation in sewer system

Background

The American cockroach, Periplaneta americana, is the most prevalent domiciliary and invasive urban pest in the sewer and waste water system. It poses a substantial threat to human public health and home allergens. This study was conducted at Universiti Sains Malaysia main campus to highlight and provide information on the control and management of American cockroach infestations in sewage systems by comparing the efficiency of fipronil 0.05% gel bait with imidacloprid 2.5% gel bait. A total number of adult and nymph stages of trapped American cockroaches was recorded using glass jar traps at eight sampling sites. Gel baits were placed beneath the lids of each manhole shaft along the inner wall perimeter.

Results

The use of fipronil and imidacloprid gel baits in the sewer system resulted in a significant difference (P = 0.013). Imidacloprid 2.5% gel bait, compared to fipronil 0.05% gel bait, is the most effective treatment technique for reducing American cockroaches' population in sewer systems, with a high reduction percentage mean for both adult (91.17%) and nymph (85.50%) stages.

Conclusion

As a conclusion, imidacloprid gel bait can effectively control cockroaches in sewer systems up to eight weeks.

Maternal pesticide exposure and its relation to childhood cancer: an umbrella review of meta-analyses

This umbrella review summarizes the available meta-analyses elucidating the effects of maternal pesticide exposure on adverse health outcomes in children particularly the risk of childhood cancer. A literature search was conducted on PubMed and Scopus with 10-years temporal restriction and with search terms of ('pesticides') and ('maternal' or 'pregnancy' or 'gestational' or 'perinatal' or 'children' or 'infants' or 'birth weight' or 'gestational age' or 'cancer' or 'tumor' or 'malignancy' or 'carcinoma') and ('meta-analysis' or 'systematic review'). Using relative risk estimates, e.g., odds ratio (OR), relative risk (RR), ß coefficients, and 95% confidence interval (CI) as a prerequisite for inclusion/exclusion criteria a total of 19 eligible meta-analyses were included. The results showed that maternal domestic/occupational pesticide exposure increases the risk for childhood leukaemia. The overall OR regarding the risk of pesticide exposure and leukaemia was 1.23 to 1.57 with heterogeneity I² values that varied between 12.9% and 73%. Some studies found that exposure to dichlorodiphenyldichloroethylene (p,p´-DDE) and polychlorinated biphenyls (PCB-153) pesticides appears to decrease infant birth weight to some extent [p,p´-DDE (ß = -0.007 to -0.008)] and [PCB-153 (ß = -0.15 to -0.17)]Needing more studies on this relationship, our study found that pesticide exposure is a risk factor for leukaemia in children.

Epigenetic Inheritance: Intergenerational Effects of Pesticides and Other Endocrine Disruptors on Cancer Development

Parental environmental experiences affect disease susceptibility in the progeny through epigenetic inheritance. Pesticides are substances or mixtures of chemicals-some of which are persistent environmental pollutants-that are used to control pests. This review explores the evidence linking parental exposure to pesticides and endocrine disruptors to intergenerational and transgenerational susceptibility of cancer in population studies and animal models. We also discuss the impact of pesticides and other endocrine disruptors on the germline epigenome as well as the emerging evidence for how epigenetic information is transmitted between generations. Finally, we discuss the importance of this mode of inheritance in the context of cancer prevention and the challenges ahead.

A brief review of the current knowledge on environmental toxicants and risk of pediatric cancers

The incidence of pediatric cancers has steadily increased since 1975, which could suggest that other exogenous factors are accounting for an increasing proportion of cases. There has been growing concern over environmental exposures (i.e., toxicants) the on development of pediatric cancers. However, identifying environmental exposures on childhood cancer risk has been challenging because these outcomes are infrequent compared to cancer in adults, and it is difficult to estimate exposure during specific critical periods of development (e.g., pre-conception, in utero, early childhood) that are likely more important for childhood cancer development. Here, we summarize the International Agency for Research on Cancer (IARC) Group 1 agents (toxicants known to be carcinogenic to humans), their routes of exposure, current methods for risk mitigation, and what is known of their associations with pediatric cancer risk. Our review suggests that environmental toxicants are important and potentially modifiable risk factors that need to be more fully explored in children and adolescents.

Assessment of Pediatric Cancer and Its Relationship to Environmental Contaminants: An Ecological Study in Idaho

The primary aim of this study was to determine the degree to which a multivariable principal component model based on several potentially carcinogenic metals and pesticides could explain the county-level pediatric cancer rates across Idaho. We contend that human exposure to environmental contaminants is one of the reasons for increased pediatric cancer incidence in the United States. Although several studies have been conducted to determine the relationship between environmental contaminants and carcinogenesis among children, research gaps exist in developing a meaningful association between them. For this study, pediatric cancer data was provided by the Cancer Data Registry of Idaho, concentrations of metals and metalloids in groundwater were collected from the Idaho Department of Water Resources, and pesticide use data were collected from the United States Geological Survey. Most environmental variables were significantly intercorrelated at an adjusted P-value <0.01 (97 out of 153 comparisons). Hence, a principal component analysis was employed to summarize those variables to a smaller number of components. An environmental burden index (EBI) was constructed using these principal components, which categorized the environmental burden profiles of counties into low, medium, and high. EBI was significantly associated with pediatric cancer incidence (P-value <0.05). The rate ratio of high EBI profile to low EBI profile for pediatric cancer incidence was estimated as 1.196, with lower and upper confidence intervals of 1.061 and 1.348, respectively. A model was also developed in the study using EBI to estimate the county-level pediatric cancer incidence in Idaho (Nash-Sutcliffe Efficiency = 0.97).

Environmental Risk Factors for Childhood Acute Lymphoblastic Leukemia: An Umbrella Review

Leukemia is the most common type of cancer among children and adolescents worldwide. The aim of this umbrella review was (1) to provide a synthesis of the environmental risk factors for the onset of childhood acute lymphoblastic leukemia (ALL) by exposure window, (2) evaluate their strength of evidence and magnitude of risk, and as an example (3) estimate the prevalence in the German population, which determines the relevance at the population level. Relevant systematic reviews and pooled analyses were identified and retrieved through PubMed, Web of Science databases and lists of references. Only two risk factors (low doses of ionizing radiation in early childhood and general pesticide exposure during maternal preconception/pregnancy) were convincingly associated with childhood ALL. Other risk factors including extremely low frequency electromagnetic field (ELF-MF), living in proximity to nuclear facilities, petroleum, benzene, solvent, and domestic paint exposure during early childhood, all showed some level of evidence of association. Maternal consumption of coffee (high consumption/>2 cups/day) and cola (high consumption) during pregnancy, paternal smoking during the pregnancy of the index child, maternal intake of fertility treatment, high birth weight (≥4000 g) and caesarean delivery were also found to have some level of evidence of association. Maternal folic acid and vitamins intake, breastfeeding (≥6 months) and day-care attendance, were inversely associated with childhood ALL with some evidence. The results of this umbrella review should be interpreted with caution; as the evidence stems almost exclusively from case-control studies, where selection and recall bias are potential concerns, and whether the empirically observed association reflect causal relationships remains an open question. Hence, improved exposure assessment methods including accurate and reliable measurement, probing questions and better interview techniques are required to establish causative risk factors of childhood leukemia, which is needed for the ultimate goal of primary prevention.

Geographical Distribution and Pattern of Pesticides in Danish Drinking Water 2002-2018: Reducing Data Complexity

Pesticides are a large and heterogenous group of chemicals with a complex geographic distribution in the environment. The purpose of this study was to explore the geographic distribution of pesticides in Danish drinking water and identify potential patterns in the grouping of pesticides. Our data included 899,169 analyses of 167 pesticides and metabolites, of which 55 were identified above the detection limit. Pesticide patterns were defined by (1) pesticide groups based on chemical structure and pesticide-metabolite relations and (2) an exploratory factor analysis identifying underlying patterns of related pesticides within waterworks. The geographic distribution was evaluated by mapping the pesticide categories for groups and factor components, namely those detected, quantified, above quality standards, and not analysed. We identified five and seven factor components for the periods 2002-2011 and 2012-2018, respectively. In total, 16 pesticide groups were identified, of which six were representative in space and time with regards to the number of waterworks and analyses, namely benzothiazinone, benzonitriles, organophosphates, phenoxy herbicides, triazines, and triazinones. Pesticide mapping identified areas where multiple pesticides were detected, indicating areas with a higher pesticide burden. The results contribute to a better understanding of the pesticide pattern in Danish drinking water and may contribute to exposure assessments for future epidemiological studies.

Multiple neonicotinoids in children's cerebro-spinal fluid, plasma, and urine

BACKGROUND

Neonicotinoids (NN) are selective neurotoxic pesticides that bind to insect but also mammal nicotinic acetycholine receptors (nAChRs). As the most widely used class of insecticides worldwide, they are ubiquitously found in the environment, wildlife, and foods, and thus of special concern for their impacts on the environment and human health. nAChRs are vital to proper brain organization during the prenatal period and play important roles in various motor, emotional, and cognitive functions. Little is known on children's contamination by NN. In a pilot study we tested the hypothesis that children's cerebro-spinal fluid (CSF) can be contaminated by NN.

METHODS

NN were analysed in leftover CSF, blood, and urine samples from children treated for leukaemias and lymphomas and undergoing therapeutic lumbar punctions. We monitored all neonicotinoids approved on the global market and some of their most common metabolites by ultra-high performance liquid chromatography-tandem mass spectrometry.

RESULTS

From August to December 2020, 14 children were consecutively included in the study. Median age was 8 years (range 3-18). All CSF and plasma samples were positive for at least one NN. Nine (64%) CSF samples and 13 (93%) plasma samples contained more than one NN. Thirteen (93%) CSF samples had N-desmethyl-acetamiprid (median concentration 0.0123, range 0.0024-0.1068 ng/mL), the major metabolite of acetamiprid. All but one urine samples were positive for ≥ one NN. A statistically significant linear relationship was found between plasma/urine and CSF N-desmethyl-acetamiprid concentrations.

CONCLUSIONS

We have developed a reliable analytical method that revealed multiple NN and/or their metabolites in children's CSF, plasma, and urine. Our data suggest that contamination by multiple NN is not only an environmental hazard for non-target insects such as bees but also potentially for children.

Pediatric Chemical Exposure: Opportunities for Prevention

Over the past 50 years, the use of artificial chemicals in products has increased exponentially. Most of these chemicals were not tested for safety before widespread use, and the impacts of exposures are just now being realized. Children are especially vulnerable to the health impacts of chemical exposures, and these exposures are now known to be an important component of rising rates of diseases such as asthma, some cancers, and neurodevelopmental disorders in children. This article reviews the impacts of chemical exposures on children's health, common chemicals children may be exposed to and their health impacts, and how advanced practice registered nurses can assess for exposures, provide anticipatory guidance, and engage in advocacy in support of a healthier environment.

Environmental Risk Factors for Childhood Cancer in an Era of Global Climate Change: A Scoping Review

INTRODUCTION

Contemporary research about environmental risk factors in an era of global climate change to inform childhood cancer prevention efforts is disjointed. Planetary pediatric providers need to establish a better understanding of how the postnatal environment influences childhood cancer. Authors conducted a scoping review of recent scientific literature with the aim of understanding the environmental risk factors for childhood cancer.

METHOD

Ovid Medline, CINAHL, and Scopus databases were searched with results limited to the English language with publication years 2010-2021. Two independent reviewers screened 771 abstracts and excluded 659 abstracts and 65 full-text articles on the basis of predefinedcriteria.

RESULTS

The scoping review identified 47 studies about environmental risk factors for childhood cancer with mixed results and limited consensus in four main categories, including air pollution, chemical exposures, radiation, and residential location.

DISCUSSION

Research by collaborative international groups of planetary health researchers about environmental risk factors is needed to inform global health policy for childhood cancer prevention efforts.

Preschool-Age Children's Pesticide Exposures in Child Care Centers and at Home in Northern California

INTRODUCTION

Young children may be exposed to pesticides used in child care centers and their family homes. We examined pesticide use and environmental and behavioral factors potentially associated with child exposures in these settings.

METHOD

Preschool-age children (n = 125) wore silicone wristbands to assess pesticide exposures in their child care centers and home environments. Information about environmental and behavioral exposure determinants was collected using parent surveys, child care director interviews, and observations.

RESULTS

Commonly detected pesticides were bifenthrin, chlorpyrifos, cypermethrin, fipronil, and cis- and trans-permethrin. Pesticide chemical storage onsite, cracks in the walls, using doormats, observed pests, or evidence of pests were associated with child exposures. Exposures were higher in counties with higher agricultural or commercial pesticide use or when children lived in homes near agricultural fields.

DISCUSSION

Young children are being exposed to harmful pesticides, and interventions are needed to lower their risk of health problems later in life.

Genotoxicity evaluation of 2,4-D, dicamba and glyphosate alone or in combination with cell reporter assays for DNA damage, oxidative stress and unfolded protein response

The current generation of carcinogenicity tests is often insufficient to predict cancer outcomes from pesticide exposures. In order to facilitate health risk assessment, The International Agency for Research on Cancer identified 10 key characteristics which are commonly exhibited by human carcinogens. The ToxTracker panel of six validated GFP-based mouse embryonic stem reporter cell lines is designed to measure a number of these carcinogenic properties namely DNA damage, oxidative stress and the unfolded protein response. Here we present an evaluation of the carcinogenic potential of the herbicides glyphosate, 2,4-D and dicamba either alone or in combination, using the ToxTracker assay system. The pesticide 2,4-D was found to be a strong inducer of oxidative stress and an unfolded protein response. Dicamba induced a mild oxidative stress response, whilst glyphosate did not elicit a positive outcome in any of the assays. The results from a mixture of the three herbicides was primarily an oxidative stress response, which was most likely due to 2,4-D with dicamba or glyphosate only playing a minor role. These findings provide initial information regarding the risk assessment of carcinogenic effects arising from exposure to a mixture of these herbicides.

Exposure to pesticides and childhood leukemia risk: A systematic review and meta-analysis

Despite the abundance of epidemiological evidence concerning the association between pesticide exposure and adverse health outcomes including acute childhood leukemia (AL), evidence remains inconclusive, and is inherently limited by heterogeneous exposure assessment and multiple statistical testing. We performed a literature search of peer-reviewed studies, published until January 2021, without language restrictions. Summary odds ratios (OR) and 95% confidence intervals (CI) were derived from stratified random-effects meta-analyses by type of exposure and outcome, exposed populations and window of exposure to address the large heterogeneity of existing literature. Heterogeneity and small-study effects were also assessed. We identified 55 eligible studies (n = 48 case-control and n = 7 cohorts) from over 30 countries assessing >200 different exposures of pesticides (n = 160,924 participants). The summary OR for maternal environmental exposure to pesticides (broad term) during pregnancy and AL was 1.88 (95%CI: 1.15-3.08), reaching 2.51 for acute lymphoblastic leukemia (ALL; 95%CI: 1.39-4.55). Analysis by pesticide subtype yielded an increased risk for maternal herbicide (OR: 1.41, 95%CI: 1.00-1.99) and insecticide (OR: 1.60, 95%CI: 1.11-2.29) exposure during pregnancy and AL without heterogeneity (p = 0.12-0.34). Meta-analyses of infant leukemia were only feasible for maternal exposure to pesticides during pregnancy. Higher magnitude risks were observed for maternal pesticide exposure and infant ALL (OR: 2.18, 95%CI: 1.44-3.29), and the highest for infant acute myeloid leukemia (OR: 3.42, 95%CI: 1.98-5.91). Overall, the associations were stronger for maternal exposure during pregnancy compared to childhood exposure. For occupational or mixed exposures, parental, and specifically paternal, pesticide exposure was significantly associated with increased risk of AL (ORparental: 1.75, 95%CI: 1.08-2.85; ORpaternal: 1.20, 95%CI: 1.07-1.35). The epidemiological evidence, supported by mechanistic studies, suggests that pesticide exposure, mainly during pregnancy, increases the risk of childhood leukemia, particularly among infants. Sufficiently powered studies using repeated biomarker analyses are needed to confirm whether there is public health merit in reducing prenatal pesticide exposure.

Commentary: Novel strategies and new tools to curtail the health effects of pesticides

BACKGROUND

Flaws in the science supporting pesticide risk assessment and regulation stand in the way of progress in mitigating the human health impacts of pesticides. Critical problems include the scope of regulatory testing protocols, the near-total focus on pure active ingredients rather than formulated products, lack of publicly accessible information on co-formulants, excessive reliance on industry-supported studies coupled with reticence to incorporate published results in the risk assessment process, and failure to take advantage of new scientific opportunities and advances, e.g. biomonitoring and "omics" technologies.

RECOMMENDED ACTIONS

Problems in pesticide risk assessment are identified and linked to study design, data, and methodological shortcomings. Steps and strategies are presented that have potential to deepen scientific knowledge of pesticide toxicity, exposures, and risks. We propose four solutions: (1) End near-sole reliance in regulatory decision-making on industry-supported studies by supporting and relying more heavily on independent science, especially for core toxicology studies. The cost of conducting core toxicology studies at labs not affiliated with or funded directly by pesticide registrants should be covered via fees paid by manufacturers to public agencies. (2) Regulators should place more weight on mechanistic data and low-dose studies within the range of contemporary exposures. (3) Regulators, public health agencies, and funders should increase the share of exposure-assessment resources that produce direct measures of concentrations in bodily fluids and tissues. Human biomonitoring is vital in order to quickly identify rising exposures among vulnerable populations including applicators, pregnant women, and children. (4) Scientific tools across disciplines can accelerate progress in risk assessments if integrated more effectively. New genetic and metabolomic markers of adverse health impacts and heritable epigenetic impacts are emerging and should be included more routinely in risk assessment to effectively prevent disease.

CONCLUSIONS

Preventing adverse public health outcomes triggered or made worse by exposure to pesticides will require changes in policy and risk assessment procedures, more science free of industry influence, and innovative strategies that blend traditional methods with new tools and mechanistic insights.

Personal exposure assessment of pesticides in residents: The association between hand wipes and urinary biomarkers

BACKGROUND

Residential exposure to pesticides may occur via inhalation of airborne pesticides, direct skin contacts with pesticide-contaminated surfaces, and consumption of food containing pesticide residues. The aim was to study the association of dermal exposure to pesticides between the use and non-use periods, between farmer and non-farmer families and between dermal exposure and the excretion of metabolites from urine in residents living close to treated agricultural fields.

METHODS

In total, 112 hand wipes and 206 spot urine samples were collected from 16 farmer and 38 non-farmer participants living within 50 m from an agricultural field in the Netherlands. The study took place from May 2016 to December 2017 during the use as well as the non-use periods of pesticides. Hand wipes were analysed for the parent compound and urines samples for the corresponding urinary metabolite of five applied pesticides: asulam, carbendazim (applied as thiophanate-methyl), chlorpropham, prochloraz and tebuconazole. Questionnaire data was used to study potential determinants of occurrence and levels of pesticides in hand wipes according to univariate and multivariate analysis.

RESULTS

Carbendazim and tebuconazole concentrations in hand wipes were statistically significantly higher in the pesticide-use period compared to the non-use period. In addition, especially during the use periods, concentrations were statistically significantly higher in farmer families compared to non-farmer families. For asulam, chlorpropham and prochloraz, the frequency of non-detects was too high (57-85%) to be included in this analysis. The carbendazim contents in urine samples and hand wipes were correlated on the first and second day after taking the hand wipe, whereas chlorpropham was only observed to be related on the second day following the spray event.

CONCLUSIONS

Concentrations in hand wipes were overall higher in pesticide use periods compared to non-use periods and higher in farmer families compared to non-farmer families. Only for carbendazim a strong correlation between concentrations in hand wipes and its main metabolite in urine was observed, indicating dermal exposure via contaminated indoor surfaces. We expect this to be related to the lower vapour pressure and longer environmental lifetime of carbendazim compared to the other pesticides studies.

Passive environmental residential exposure to agricultural pesticides and hematological malignancies in the general population: a systematic review

Incidence rates of hematological malignancies have been constantly increasing over the past 40 years. In parallel, an expanding use of agricultural pesticides has been observed. Only a limited number of studies investigated the link between hematological malignancies risk and passive environmental residential exposure to agricultural pesticides in the general population. The purpose of our review was to summarize the current state of knowledge on that question. A systematic literature search was conducted using PubMed and Scopus databases. We built a scoring scale to appraise relevance of each selected articles. We included 23 publications: 13 ecological studies, 9 case-control studies and a cohort study. Positive associations were reported between hematological malignancies and individual pesticides, pesticide groups, all pesticides without distinction, or some crop types. Relevance score was highly various across studies regardless of their design. Children studies were the majority and had overall higher relevance scores. The effect of passive environmental residential exposure to agricultural pesticides on hematological malignancies risk is suggested by the literature. The main limitation of the literature available is the high heterogeneity across studies, especially in terms of exposure assessment approach. Further studies with high methodological relevance should be conducted.

Household pesticide exposure: an online survey and shelf research in the Metropolitan Region of Rio de Janeiro, Brazil

This study aimed to estimate household pesticide exposure in adult individuals in the Metropolitan Region of Rio de Janeiro, Brazil, and to verify the accessibility of these products in local and online businesses. The data were collected by an online questionnaire (1,015 responses) and a shelf survey in physical and online stores. Among the responses analyzed, 87.5% used pesticides in the previous year, most of which against mosquitoes (64.7%). The most common application method was aerosol spray (38.1%), and the most frequent places of use were bedrooms (29.7%) and living rooms (22.1%). About 30% of respondents reported invasion of pests, and the most common pests were ants (79.1%) and cockroaches (40.4%). Service area (71.6%) and kitchen (17.5%) were the most common storage locations. Approximately 91% of those who lived with children aged under 18 used pesticides. The use of chemical group of pyrethroids prevailed (81.6%), and 90.8% of the reportedly used products are class II [55.7% (highly toxic)] or class III [35.1% (medium toxic)]. The most significant amount of purchased products was in the pest category, followed by mosquitoes. More variety of products were available in online stores than in physical stores. The high exposure of the population to pesticides at household is a public health issue and confirms the need for studies that better assess the risks and consequences of chronic and low-dose exposure to these substances. It is essential to inform the population about the uncertainties and potential risks of indiscriminate use so that they can choose whether to use pesticides in their households.

Using primary teeth and archived dried spots for exposomic studies in children: Exploring new paths in the environmental epidemiology of pediatric cancer

It is estimated that 300,000 children 0-14 years of age are diagnosed with cancer worldwide each year. While the absolute risk of cancer in children is low, it is the leading cause of death due to disease in children in high-income countries. In spite of this, the etiologies of pediatric cancer are largely unknown. Environmental exposures have long been thought to play an etiologic role. However, to date, there are few well-established environmental risk factors for pediatric malignancies, likely due to technical barriers in collecting biological samples prospectively in pediatric populations for direct measurements. In this review, we propose the use of novel or underutilized biospecimens (dried blood spots and teeth) and molecular approaches for exposure assessment (epigenetics, metabolomics, and somatic mutational profiles). Future epidemiologic studies of pediatric cancer should incorporate novel exposure assessment methodologies, data on molecular features of tumors, and a more complete assessment of gene-environment interactions.

Why We Will Continue to Lose Our Battle with Cancers If We Do Not Stop Their Triggers from Environmental Pollution

Besides our current health concerns due to COVID-19, cancer is a longer-lasting and even more dramatic pandemic that affects almost a third of the human population worldwide. Most of the emphasis on its causes has been posed on genetic predisposition, chance, and wrong lifestyles (mainly, obesity and smoking). Moreover, our medical weapons against cancers have not improved too much during the last century, although research is in progress. Once diagnosed with a malignant tumour, we still rely on surgery, radiotherapy, and chemotherapy. The main problem is that we have focused on fighting a difficult battle instead of preventing it by controlling its triggers. Quite the opposite, our knowledge of the links between environmental pollution and cancer has surged from the 1980s. Carcinogens in water, air, and soil have continued to accumulate disproportionally and grow in number and dose, bringing us to today's carnage. Here, a synthesis and critical review of the state of the knowledge of the links between cancer and environmental pollution in the three environmental compartments is provided, research gaps are briefly discussed, and some future directions are indicated. New evidence suggests that it is relevant to take into account not only the dose but also the time when we are exposed to carcinogens. The review ends by stressing that more dedication should be put into studying the environmental causes of cancers to prevent and avoid curing them, that the precautionary approach towards environmental pollutants must be much more reactionary, and that there is an urgent need to leave behind the outdated petrochemical-based industry and goods production.

Residential proximity to pesticide application as a risk factor for childhood central nervous system tumors

BACKGROUND

Pesticide exposures have been examined previously as risk factors for childhood brain cancers, but few studies were able to assess risk from specific agents.

OBJECTIVE

To evaluate risks for childhood central nervous system tumors associated with residential proximity to agricultural pesticide applications.

METHODS

Using the California Cancer Registry, we identified cancer cases less than 6 years of age and frequency matched them by year of birth to 20 cancer-free controls identified from birth certificates. We restricted analyses to mothers living in rural areas and births occurring between 1998 and 2011, resulting in 667 cases of childhood central nervous system tumors and 123,158 controls. Possible carcinogens were selected per the Environmental Protection Agency's (US. EPA) classifications, and prenatal exposure was assessed according to pesticides reported by the California Department of Pesticide Regulation's (CDPR) Pesticide Use Reporting (PUR) system as being applied within 4000m of the maternal residence at birth. We computed odds ratios for individual pesticide associations using unconditional logistic and hierarchical regression models.

RESULTS

We observed elevated risks in the hierarchical models for diffuse astrocytoma with exposure to bromacil (OR: 2.12, 95% CI: 1.13-3.97), thiophanate-methyl (OR: 1.64, 95% CI: 1.02-2.66), triforine (OR: 2.38, 95% CI: 1.44-3.92), and kresoxim methyl (OR: 2.09, 95% CI: 1.03-4.21); elevated risks for medulloblastoma with exposure to chlorothalonil (OR: 1.78, 95% CI: 1.15-2.76), propiconazole (OR: 1.60, 95% CI: 1.02, 2.53), dimethoate (OR: 1.60, 95% CI: 1.06, 2.43), and linuron (OR: 2.52, 95% CI: 1.25, 5.11); and elevated risk for ependymoma with exposure to thiophanate-methyl (OR: 1.72, 95% CI: 1.10-2.68).

CONCLUSION

Our study suggests that exposure to certain pesticides through residential proximity to agricultural applications during pregnancy may increase the risk of childhood central nervous system tumors.

Misuse, perceived risk, and safety issues of household insecticides: Qualitative findings from focus groups in Arequipa, Peru

BACKGROUND

The current body of research on insecticide use in Peru deals primarily with application of insecticides offered through Ministry of Health-led campaigns against vector-borne disease. However, there is a gap in the literature regarding the individual use, choice and perceptions of insecticides which may influence uptake of public health-based vector control initiatives and contribute to the thousands of deaths annually from acute pesticide poisoning in Peru.

METHODS

Residents (n = 49) of the Alto Selva Alegre and CC districts of peri-urban Arequipa participated in seven focus group discussions (FGD). Using a FGD guide, two facilitators led the discussion and conducted a role-playing activity. this activity, participants insecticides (represented by printed photos of insecticides available locally) and pretended to "sell" the insecticides to other participants, including describing their qualities as though they were advertising the insecticide. The exercise was designed to elicit perceptions of currently available insecticides. The focus groups also included questions about participants' preferences, use and experiences related to insecticides outside the context of this activity. Focus group content was transcribed, and qualitative data were analyzed with Atlas.ti and coded using an inductive process to generate major themes related to use and choice of insecticides, and perceived risks associated with insecticide use.

RESULTS

The perceived risks associated with insecticides included both short- and long-term health impacts, and safety for children emerged as a priority. However, in some cases insecticides were reportedly applied in high-risk ways including application of insecticides directly to children and bedding. Some participants attempted to reduce the risk of insecticide use with informal, potentially ineffective personal protective equipment and by timing application when household members were away. Valued insecticide characteristics, such as strength and effectiveness, were often associated with negative characteristics such as odor and health impacts. "Agropecuarios" (agricultural supply stores) were considered a trusted source of information about insecticides and their health risks.

CONCLUSIONS

It is crucial to characterize misuse and perceptions of health impacts and risks of insecticides at the local level, as well as to find common themes and patterns across populations to inform national and regional programs to prevent acute insecticide poisoning and increase community participation in insecticide-based vector control campaigns. We detected risky practices and beliefs about personal protective equipment, risk indicators, and safety levels that could inform such preventive campaigns, as well as trusted information sources such as agricultural stores for partnerships in disseminating information.

Clustering of childhood cancer in Colombia: a nationwide study

Background: Childhood cancer is considered one the most important causes of death in children and adolescents, despite having a low incidence in this population. Spatial analysis has been previously used for the study of childhood cancer to study the geographical distribution of leukemias. This study aimed to identify the presence of space-time clusters of childhood of cancer excluding leukemia in Colombia between 2014 and 2017. Methods: All incident cancer cases (excluding leukemia) in children under the age of 15 years that had been confirmed by the National Surveillance System of Childhood Cancer between 2014 and 2017 were included. Kulldorf's circular scan test was used to identify clusters using the municipality of residence as the spatial unit of analysis and the year of diagnosis as the temporal unit of analysis. A sensitivity analysis was conducted with different upper limit parameters for the at-risk population. Results: A total of 2006 cases of non-leukemia childhood cancer were analyzed, distributed in 432 municipalities with a mean annual incidence rate of 44 cases per million children under the age of 15. Central nervous system (CNS) tumors were the most frequent type. Four spatial clusters and two space-time clusters were identified in the central and southwest regions of the country. In the analysis for CNS tumors, a spatial cluster was identified in the central region of the country.  Conclusions: The distribution of non-leukemia childhood cancer seems to have a clustered distribution in some Colombian regions that may suggest infectious or environmental factors associated with its incidence.

Clustering of non-leukemia childhood cancer in Colombia: a nationwide study

Background: Childhood cancer is considered one the most important causes of death in children and adolescents, despite having a low incidence in this population. Spatial analysis has been previously used for the study of childhood cancer to study the geographical distribution of leukemias. This study aimed to identify the presence of space-time clusters of childhood of cancer excluding leukemia in Colombia between 2014 and 2017. Methods: All incident cancer cases (excluding leukemia) in children under the age of 15 years that had been confirmed by the National Surveillance System of Childhood Cancer between 2014 and 2017 were included. Kulldorf's circular scan test was used to identify clusters using the municipality of residence as the spatial unit of analysis and the year of diagnosis as the temporal unit of analysis. A sensitivity analysis was conducted with different upper limit parameters for the at-risk population in the clusters. Results: A total of 2006 cases of non-leukemia childhood cancer were analyzed, distributed in 432 out of 1,122 municipalities with a mean annual incidence rate of 44 cases per million children under the age of 15. Central nervous system (CNS) tumors were the most frequent type. Two space-time clusters were identified in the central and southwest regions of the country. In the analysis for CNS tumors, a spatial cluster was identified in the central region of the country.  Conclusions: The distribution of non-leukemia childhood cancer seems to have a clustered distribution in some Colombian regions that may suggest infectious or environmental factors associated with its incidence although heterogeneity in access to diagnosis cannot be discarded.

Integrated modeling of extended agro-food supply chains: A systems approach

The current intense food production-consumption is one of the main sources of environmental pollution and contributes to anthropogenic greenhouse gas emissions. Organic farming is a potential way to reduce environmental impacts by excluding synthetic pesticides and fertilizers from the process. Despite ecological benefits, it is unlikely that conversion to organic can be financially viable for farmers, without additional support and incentives from consumers. This study models the interplay between consumer preferences and socio-environmental issues related to agriculture and food production. We operationalize the novel concept of extended agro-food supply chain and simulate adaptive behavior of farmers, food processors, retailers, and customers. Not only the operational factors (e.g., price, quantity, and lead time), but also the behavioral factors (e.g., attitude, perceived control, social norms, habits, and personal goals) of the food suppliers and consumers are considered in order to foster organic farming. We propose an integrated approach combining agent-based, discrete-event, and system dynamics modeling for a case of wine supply chain. Findings demonstrate the feasibility and superiority of the proposed model over the traditional sustainable supply chain models in incorporating the feedback between consumers and producers and analyzing management scenarios that can urge farmers to expand organic agriculture. Results further indicate that demand-side participation in transition pathways towards sustainable agriculture can become a time-consuming effort if not accompanied by the middle actors between consumers and farmers. In practice, our proposed model may serve as a decision-support tool to guide evidence-based policymaking in the food and agriculture sector.

Statistical methods for spatial cluster detection in childhood cancer incidence: A simulation study

BACKGROUND AND OBJECTIVE

The potential existence of spatial clusters in childhood cancer incidence is a debated topic. Identification of such clusters may help to better understand etiology and develop preventive strategies. We evaluated widely used statistical approaches to cluster detection in this context.

METHODS

Incidence of newly diagnosed childhood cancer (140/1,000,000 children under 15 years) and nephroblastoma (7/1,000,000) was simulated. Clusters of defined size (1-50) were randomly assembled on the district level in Germany. Each cluster was simulated with different relative risk levels (1-100). For each combination 2000 iterations were done. Simulated data was then analyzed by three local clustering tests: Besag-Newell method, spatial scan statistic and Bayesian Besag-York-Mollié with Integrated Nested Laplace Approximation approach. The operating characteristics (sensitivity, specificity, predictive values, power and correct classification) of all three methods were systematically described.

RESULTS

Performance varied considerably within and between methods, depending on the simulated setting. Sensitivity of all methods was positively associated with increasing size, incidence and RR of the high-risk area. Besag-York-Mollié showed highest specificity for minimally increased RR in most scenarios. The performance of all methods was lower in the nephroblastoma scenario compared with the scenario including all cancer cases.

CONCLUSION

This study illustrates the challenge to make reliable inferences on the existence of spatial clusters based on single statistical approaches in childhood cancer. Application of multiple methods, ideally with known operating characteristics, and a critical discussion of the joint evidence seems recommendable when aiming to identify high-risk clusters.

Risikofaktoren für Krebserkrankungen im Kindes- und Jugendalter

Die Ursachen von Krebs im Kindes- und Jugendalter sind weitestgehend unbekannt. Beispiele für konsistent beobachtete Risikofaktoren, die in umfangreichen epidemiologischen Untersuchungen identifiziert wurden, sind Strahlenexposition, Chemotherapie, niedriges und hohes Geburtsgewicht, höheres Alter der Mutter, Geschlecht und das Vorhandensein angeborener Anomalien. Diese Faktoren erklären jedoch nur einen geringen Anteil aller inzidenten Fälle. Die derzeit vielversprechendsten Ansätze zur Verbesserung des Verständnisses über die Ursachen von Krebserkrankungen im Kindes- und Jugendalter stammen von genetischen Analysen. Abgesehen von den durch genomweite Assoziationsstudien identifizierten Allelen mit geringem Krebsrisiko wurde festgestellt, dass seltene Keimbahnvarianten, die Krebsprädispositionsyndrome verursachen, mit einem erhöhten Risiko für die Entwicklung von Krebs im Kindes- und Jugendalter verbunden sind. Dieser Beitrag fasst das aktuelle Wissen über die exogenen und endogenen Ursachen von Krebserkrankungen in den frühen Lebensjahren zusammen und gibt einen Ausblick darauf, wie stetig wachsendes Wissen in diesem Bereich zukünftige präventive, diagnostische und therapeutische Strategien beeinflussen könnte.

Childhood Leukemia in Small Geographical Areas and Proximity to Industrial Sources of Air Pollutants in Three Colombian Cities

Acute leukemia is the most common childhood cancer and has been associated with exposure to environmental carcinogens. This study aimed to identify clusters of acute childhood leukemia (ACL) cases and analyze their relationship with proximity to industrial sources of air pollution in three capital cities in Colombia during 2000-2015. Incident ACL cases were obtained from the population cancer registries for the cities of Bucaramanga, Cali, and Medellín. The inventory of industrial sources of emissions to the air was obtained from the regional environmental authorities and industrial conglomerates were identified. The Kulldorf's circular scan test was used to detect city clusters and to identify clusters around industrial conglomerates. Multivariable spatial modeling assessed the effect of distance and direction from the industrial conglomerates controlling for socioeconomic status. We identified industrials sectors within a buffer of 1 km around industrial conglomerates related to the ACL clusters. Incidence rates showed geographical heterogeneity with low spatial autocorrelation within cities. The spatio-temporal tests identified one cluster in each city. The industries located within 1 km around the ACL clusters identified in the three cities represent different sectors. Exposure to air pollution from industrial sources might be contributing to the incidence of ACL cases in urban settings in Colombia.

Perceptions, Knowledge, and Practices Concerning Indoor Environmental Pollution of Parents or Future Parents

Indoor pollutants can have short- and long-term health effects, especially if exposure occurs during prenatal life or early childhood. This study describe the perceptions, knowledge, and practices of adults concerning indoor environmental pollution. Adults of 18 to 45 years of age were recruited in the department of Ille-et-Vilaine (Brittany-France) in 2019 through a stratified random draw in the waiting rooms of general practitioners (GPs) (n = 554) who completed a self-questionnaire. The 71% who had already heard of this type of pollution were older (p = 0.001), predominantly women (p = 0.007), not expecting a baby (p = 0.005), and had a higher knowledge score (p < 0.001). The average knowledge score was 6.6 ± 6.6 out of 11, which was higher for participants living in a couple and with a higher level of education (p < 0.001). Some practices were well implemented (>80% of participants) (aeration during renovation) whereas others were insufficiently practiced (<60% of participants) (paying attention to the composition of cosmetic products). Factors associated differed depending on the frequency of integration: living in a couple and having a child for well implemented practices and educational level, knowledge level, and perception for those under implemented. Knowledge must be improved to modify perceptions and certain practices, making sure not to increase social inequalities in health.

Risk of genotoxic damage in schoolchildren exposed to organochloride pesticides

This study identified and determined organochloride pesticide (OCs) concentrations in hair samples from children at two elementary schools: one exposed to fumigations in agricultural fields, the other unexposed. Three concentrations of OCs levels in the hair were compared (high, medium, low), and total nuclear abnormalities in buccal cells were determined: micronuclei (MNi), condensed chromatin, karyorrhexis, pyknosis, binucleate cells, karyolysis, lobed nuclei, and apoptosis. No significant differences were found for the presence of MNi between the schoolchildren from the exposed and unexposed schools, but the prevalence of OCs in both schools was over 50%, as well as the frequencies of MNi in the children were over 58%. Findings show a significant difference between the frequency of MNi in the total sample of schoolchildren (exposed school + unexposed school) in relation to the concentration of OCs detected in their hair. The children from exposed school that showed the higher concentrations of OCs in hair had higher levels of genotoxic damage in the buccal cells; compared against children with lower concentrations of OCs. The most frequent nuclear abnormalities in the exposed children were lobed nuclei (79.4%), binucleate cells (66.66%), apoptosis (65.07), and MNi (58.7%). We determined the prevalence ratio (PR) and prevalence odds ratio (POR) for the presence of MNi in buccal cells in relation to the OCs concentrations in the hair samples. Both ratios were high for MNi [PR 3.93, 95% confidence interval (CI) 1.97–7.84, p = 0.0003; and POR 7.97, 95% CI 2.62–24.28, p = 0.0003], indicating a 7.97 times greater risk that the exposed children will present > 0.2% of MNi when OCs concentrations exceed 0.447 μg/g. These indicators may be useful biomarkers of genotoxic damage in children exposed to persistent, highly-toxic compounds. Results suggest the potential risk to which those schoolchildren are exposed on a daily basis due to fumigations in nearby agricultural fields.

Impact of pesticide exposure in childhood

Pesticides represent a wide variety of chemicals presented as different formulations and concentrations and used in different settings: agriculture, animal sanitary bath, domestic use, and vector control. Lack of awareness, poor agricultural practices, and inappropriate disposal of containers will increase the exposure and risk of health effects during childhood. The concern about children's exposure to pesticides is based on their toxic properties and the special vulnerability to the exposure, which may occur in different stages, from the prenatal period to infancy. Pesticide related diseases may manifest during the infancy, adolescence, or adulthood. Children may be exposed by multiple routes of exposure, in different scenarios. In domestic settings, insecticides and rodenticides are usually stored within the reach of children, or may be transferred to non-original containers, leading to acute non intentional ingestion. Exploratory behavior increases the risk for exposure to pesticides present on the ground. Gardens and playgrounds may have pesticides residues. Children may be in contact with domestic animals that have been treated with pesticides. In rural settings, children can be exposed to pesticide residues in areas where they have been applied, or by contamination of work equipment and parents clothing. Families dedicated to rural activity have higher levels of exposure, through ingesting contaminated fruits, vegetables, milk, eggs, and water. Several studies confirmed pesticide exposure in children by biomonitoring. Higher levels of organophosphate metabolites have been reported in children compared to adult populations. Toxic effects of pesticides depend on their intrinsic toxic properties as well as on the dose, duration, and life period of exposure. Acute poisonings are related to high doses exposure, while chronic, subtle and delayed effects are often related to low levels/doses exposure. Epidemiologic, animal, and clinical studies suggest an association between chronic, low-level exposures and alterations in growth and development (particularly impaired neurobehavioral development), cancer and increased susceptibility to infections. New research presents evidence that some pesticides are a risk factor of a wide range of acute and chronic diseases. Better practices and public health policies are needed to prevent and protect children from pesticides exposure.

Occupational livestock or animal dust exposure and offspring cancer risk in Denmark, 1968-2016

OBJECTIVE

To examine associations with occupational livestock or other animal dust exposure and offspring cancer risk.

METHODS

In this population-based case-control study of Danish children aged < 17 years old, 5078 childhood cancer cases diagnosed 1968-2016 were matched to cancer-free controls by birth year and sex (n = 123,228). Occupational livestock or animal dust exposure was identified using a job-exposure matrix. We employed multivariable conditional logistic regression models to estimate associations with offspring cancer for births 1968-2016 and 1989-2016, with the latter timeframe reflecting a period of presumed higher exposure due to changes in Danish farming practices. Sensitivity analyses considered place of birth (urban areas vs. rural areas and small towns).

RESULTS

For births 1968-2016, paternal exposure from offspring birth to cancer diagnosis was associated with central nervous system tumors (adjusted odds ratio [OR] = 1.30, 95% confidence interval [CI] 1.04-1.63) and germ cell tumors (OR = 1.82, 95% CI 1.05-3.27), while maternal pregnancy exposure was associated with astrocytoma (OR = 1.89, 95% CI 1.00-3.57). For births 1989-2016, paternal exposure from offspring birth to cancer diagnosis was negatively associated with acute lymphoid leukemia (OR = 0.58, 95% CI 0.33-1.00). For births in rural areas only, maternal exposure from offspring birth to cancer diagnosis was positively associated with acute myeloid leukemia (OR = 2.16, 95% CI 1.09-4.29).

CONCLUSIONS

This study suggests that paternal occupational animal exposure is associated with offspring germ cell tumors, and maternal pregnancy exposure with astrocytomas. Our results are mixed with respect to leukemia subtypes.

Space-time clustering of childhood leukemia in Colombia: a nationwide study

BACKGROUND

Leukemia is the most common cancer in childhood. The estimated incidence rate of childhood leukemia in Colombia is one of the highest in America and little is known about its spatial distribution.

PURPOSE

To explore the presence of space-time clustering of childhood leukemia in Colombia.

METHODS

We included children less than 15 years of age with confirmed diagnosis of acute leukemia reported to the national surveillance system for cancer between 2009 and 2017. Kulldorff's spatio-temporal scan statistics were used with municipality and year of diagnosis as units for spatial and temporal analysis.

RESULTS

There were 3846 cases of childhood leukemia between 2009 and 2017 with a specific mean incidence rate of 33 cases per million person-years in children aged 0-14 years. We identified five spatial clusters of childhood leukemia in different regions of the country and specific time clustering during the study period.

CONCLUSION

Childhood leukemia seems to cluster in space and time in some regions of Colombia suggesting a common etiologic factor or conditions to be studied.

Practice towards pesticide handling, storage and its associated factors among farmers working in irrigations in Gondar town, Ethiopia, 2019

OBJECTIVES

The main objective of this study was to assess pesticide handling and storage practice, and its associated factors among farmers engaged in irrigation in Gondar town, Ethiopia, 2019. Community-based cross-sectional study was used to assess pesticide handling and storage practice, and its associated factors among farmers. Simple random sampling technique was used to select study subjects. Semi-structured questionnaires were used to collect data. Data were entered using Epi Info 7.0 and exported to SPSS 20. Descriptive statistics were used for some variables. Univariate and multivariable binary logistic regression was used to test the factors associated with the outcome. Adjusted odd ratio (AOR) and 95% confidence interval (CI) with P value less than 0.05 were used to report association.

RESULTS

About 409 study subjects completed the semi-structured questionnaires. Among the studies subjects, 261 (63.8%) of them had poor pesticide handling and storage practice. Knowledge [AOR = 3.23 (95% CI 1.91, 5.46)], attitude [AOR = 1.77 (95% CI 1.11, 2.81) and educational status (informal education [AOR = 3.05 (95% CI 1.72, 5.42)], elementary education [AOR = 5.38 (95% CI 2.62, 11.06)], secondary education [AOR = 9.51 (95% CI 4.24, 21.32)] and certificate and above [AOR = 6.00 (95% CI 1.58, 22.78)]) were factors significantly associated with pesticide handling and storage practice. To improve the pesticide handling and storage practice, it is imperative to enhance the level of the farmer's knowledge through training, and information dissemination in workshops.