Urinary Concentrations of Insecticide and Herbicide Metabolites among Pregnant Women in Rural Ghana: A Pilot Study

Pregnancy pesticide exposure and child development in low- and middle-income countries: A prospective analysis of a birth cohort in rural Bangladesh and meta-analysis

BACKGROUND

Despite considerable evidence on a negative association between pregnancy pesticide exposure and child development in high-income countries, evidence from low- and middle-income countries (LMICs) is limited. Therefore, we assessed associations between pregnancy pesticide exposure and child development in rural Bangladesh and summarised existing literature in a systematic review and meta-analysis.

METHODS

We used data from 284 mother-child pairs participating in a birth cohort established in 2008. Eight urinary pesticide biomarkers were quantified in early pregnancy (mean gestational age 11.6±2.9 weeks) as an index of pesticide exposure. The Bayley Scales of Infant and Toddler Development, Third Edition were administered at 20-40 months of age. Associations between creatinine-adjusted urinary pesticide biomarker concentrations and child development scores were estimated using multivariable generalised linear models. We searched ten databases up to November 2021 to identify prospective studies on pregnancy pesticide exposure and child development conducted in LMICs. We used a random-effects model to pool similar studies, including our original analysis. The systematic review was pre-registered with PROSPERO: CRD42021292919.

RESULTS

In the Bangladesh cohort, pregnancy 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY) concentrations were inversely associated with motor development (-0.66 points [95% CI -1.23, -0.09]). Pregnancy 3,5,6-trichloro-2-pyridinol (TCPY) concentrations were inversely associated with cognitive development, but the association was small: -0.02 points (-0.04, 0.01). We observed no associations between 4-nitrophenol and 3-phenoxybenzoic acid (3-PBA) concentrations and child development. The systematic review included 13 studies from four LMICs. After pooling our results with one other study, we found consistent evidence that pregnancy 3-PBA concentrations were not associated with cognitive, language, or motor development.

CONCLUSION

Evidence suggests that pregnancy exposure to some organophosphate pesticides is negatively associated with child development. Interventions to reduce in-utero pesticide exposure in LMICs may help protect child development.

Determinants of organophosphorus pesticide urinary metabolite levels in pregnant women from the CHAMACOS cohort

Organophosphosphorus pesticides (OPs) are widely used as insecticides in agriculture. Human exposure to OPs has been linked to adverse effects including poorer child neurodevelopment, reduced birth weight, altered serum hormone levels, and reduced semen quality. We measured six OP dialkyl phosphate (DAP) metabolites [three dimethyl alkylphosphates (DMs) and three diethyl alkylphosphates (DEs)] in urine samples collected two times during pregnancy (~13 and ~26 weeks gestation) from 594 women participating in the CHAMACOS birth cohort study and resided in an agricultural community in the United States (U.S.) between 1999 and 2000. Previous studies have shown these women have higher OP exposures compared with the general U.S. population. We examined bivariate associations between prenatal DAP metabolite levels and exposure determinants such as age, season, years living in the US, housing characteristics, fruit and vegetable consumption, occupation and residential proximity to agricultural fields. Final multivariable models indicated that season of urine collection was significantly associated (p < 0.01) with specific gravity-adjusted DM, DE and total DAP metabolites; samples collected in fall and winter had higher concentrations than those collected in spring-summer. Specific gravity-adjusted levels of DM and total DAP metabolites were significantly higher in women who had resided in the U.S. for 5 years or less (p < 0.05). Levels of DM metabolites also increased with daily fruit and vegetable servings (p < 0.01), and levels of DE metabolites were higher in residences with poorer housekeeping quality (p < 0.01) and in mothers that worked in agriculture (p < 0.05). These findings suggest that there are multiple determinants of OP exposure in pregnant women.

Perinatal exposure to low doses of cypermethrin induce the puberty-related hormones and decrease the time to puberty in the female offspring

Pyrethroid insecticides are ubiquitously detected in environmental media, food, and urine samples. Our previous epidemiological study reported a correlation between increased pyrethroid exposure and delayed pubertal development in Chinese girls. In this study, we further investigated the effects of perinatal exposure to low doses of cypermethrin (CP) on pubertal onset and hypothalamic-pituitary-ovarian axis in the female mice offspring. The treatment of CP with 60 μg/kg/day from gestation day 6 (GD6) to postnatal day 21 (PND21) significantly decreased the time to puberty in the female offspring. Exposure of CP increased the serum levels of gonadotropin-releasing hormone (GnRH) and the expression of GnRH genes in a dose-dependent manner in the female offspring. CP also induced the serum levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as the expression of gonadotropin subunit genes [LHβ, FSHβ, and chorionic gonadotropin α (Cgα)]. Furthermore, CP induced serum estradiol (E₂) levels and the expression of steroidogenesis-related genes [steroidogenic acute regulatory (StAR) and Cytochrome p 450, family 11, subfamily A, polypeptide 1 (CYP11A1)] in the ovary. In accordance with the in vivo tests, administration of CP (6.7, 20, and 60 μg/L) stimulated a dose-dependent increase in the synthesis and secretion of the puberty-related hormones in the explants of hypothalamus, pituitary, and ovary. The interference with calcium channels in the ovary may be responsible for CP-induced pubertal onset. Our study provided evidence that perinatal exposure to low doses of CP induced puberty-related hormones and decreased the time to puberty in the female offspring.

A systematic review of human biomonitoring studies of 3-phenoxybenzoic acid, a urinary biomarker pyrethroid insecticide exposure, 1997 to 2019

Pyrethroid insecticides are used, for example, in agriculture, indoor environments, and mosquito control programs, resulting in human exposure. Urinary 3-phenoxybenzoic acid (3-PBA) is a nonspecific biomarker for exposure to many pyrethroids. This systematic review identified human biomonitoring studies with 3-PBA that characterize environmental pyrethroid exposures in children and adolescents, pregnant women, and adults or occupational pyrethroid exposures relative to the National Health and Nutrition Examination Survey (NHANES) populations in the United States (US). PubMed, Embase, and SciFinder were searched for "3-phenoxybenzoic acid ", CAS No. 3739-38-6, and urine or urinary or urine level. Duplicate studies and studies meeting the exclusion criteria were removed from the search results based on predetermined exclusion criteria. This screening process identified 57 papers. Twenty-one, thirteen, twenty-two, and eleven manuscripts reported urinary 3-PBA levels in children, pregnant women, environmentally exposed adults, and occupationally exposed adults, respectively. Median 3-PBA levels ranged from 0.2 to 4.7 μg/g creatinine in children (1999-2016), 0.23-1.55 μg/g creatinine in pregnant women (1997-2014), and 0.11-3.34 μg/g creatinine in environmentally exposed adults (1999-2017). 3-PBA levels in occupationally exposed adults were significantly higher than in environmentally exposed populations, ranging from 0.43 to 14 μg/g creatinine (2004-2017). 3-PBA levels in children and adults from the general North American population increased significantly with the sampling year. A decrease in 3-PBA levels was noted in the adult cohorts from PR China and Japan. 3-PBA levels in most studies appeared to be comparable to levels in the NHANES populations; however, some smaller studies had high pyrethroid exposures. Factors contributing to higher 3-PBA levels in the general population included primarily dietary exposures and residential and agricultural pyrethroid applications. These findings demonstrate that pyrethroid exposures are near-ubiquitous worldwide and, in some regions, appear to increase over time. Thus, exposures to pyrethroid insecticides represent a continuing public health concern.

Urinary 2,4-dichlorophenoxyacetic acid in Chinese pregnant women at three trimesters: Variability, exposure characteristics, and association with oxidative stress biomarkers

Widespread exposure to herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) could have potential adverse health effects on pregnant women. However, related data are scarce. This study aimed to characterize 2,4-D exposure among three trimesters of pregnancy and to explore the relationship of 2,4-D with oxidative stress biomarkers [i.e., 8-hydroxy-2'-deoxyguanosine (8-OHdG), 8-hydroxy guanosine (8-OHG), and 4-hydroxy nonenal mercapturic acid (HNEMA)] in urine. The present study analyzed 3675 urine samples of 1225 women (across the three trimesters of pregnancy) in Wuhan, central China. 2,4-D was detectable in 97.4% of the urine samples. The median unadjusted concentration of 2,4-D was 0.12 ng/mL, and the corresponding concentration adjusted by urinary specific gravity (SG-adjusted) was 0.13 ng/mL. The intraclass correlation coefficient of 2,4-D (SG-adjusted concentrations) was 0.07 across the three trimesters. Significantly higher urinary levels of 2,4-D were found in samples from younger pregnant women/samples collected during winter. In addition, significantly positive association between urinary concentrations of oxidative stress biomarkers and 2,4-D were found in repeated analysis; an interquartile range increase in 2,4-D was significantly (p < 0.001) associated with a 20.8% increase in 8-OHG, a 26.7% increase in 8-OHdG, and a 30.7% increase in HNEMA, respectively. Such associations were also found in trimester-specific analyses. This is the first time to quantify the urinary 2,4-D of pregnant women in China, and this study found significantly positive associations of 2,4-D with oxidative stress biomarkers. Further studies are needed to verify such associations and explore other potential adverse effects of 2,4-D exposure.

Household insecticide use and urinary 3-phenoxybenzoic acid levels in an elder population: a repeated measures data

BACKGROUND

Pyrethroids are associated with adverse health consequences, even at low-dose exposures. However, there is limited evidence on pyrethroids exposure levels among vulnerable elder population and on their exposure sources.

OBJECTIVE

We tried to determine pyrethroids exposure levels among Korean elders and their exposure sources.

METHODS

We measured levels of 3-phenoxybenzoic acid (3-PBA), a pyrethroids metabolite, in urines repeatedly collected from 1239 Korean rural and urban elders; we also explored exposure sources for pyrethroids using questionnaire data.

RESULTS

Our participants had high levels of 3-PBA with 446 (36.0%) of elders with 3-PBA level over 2 ng/mL of 95th percentile of the German representative populations. After adjustment for sex, age, smoking status, visit episode, and surveyed season using linear mixed effect models, household insecticide spray use was significantly associated with 3-PBA level (β = 0.03 and p = 0.02) and the association was apparent only for females (β = 0.03 and p = 0.03). In the analyses for nonlinear relationships using generalized additive mixed models, there was a J-shape change in 3-PBA level by insecticide spray use (p < 0.01 both in total population and in females).

SIGNIFICANCE

Household insecticide spray was a predominant exposure source for pyrethroids at community level among Korean elders, warning more stringent control for frequently exposed environmental factors for pyrethroids including insecticide spray.

Association of prenatal pesticide exposures with adverse pregnancy outcomes and stunting in rural Bangladesh

BACKGROUND

Pesticide exposure during pregnancy is thought to adversely affect fetal growth, which in turn may impact child growth, but results have been inconsistent across studies and few have explored these effects in developing countries.

OBJECTIVES

To quantify urinary concentrations of pesticide biomarkers in early pregnancy (<16 weeks' gestation), and to estimate the association of these concentrations with preterm birth, low birth weight, small for gestational age, and stunting at ~1 and 2 years of age.

METHODS

Eight pesticide biomarkers were quantified in urine collected from 289 pregnant women (aged 18-40 years) participating in a birth cohort study in Bangladesh. Anthropometry measurements were conducted on the index child at birth and approximately 1 and 2 years of age. A directed acyclic graph was used to identify minimal sufficient adjustment sets. Log-binomial regression was used to estimate the relative risk (RR) with 95% confidence intervals (CI).

RESULTS

3,5,6-trichloro-2-pyridinol (TCPY), a metabolite of chlorpyrifos and chlorpyrifos methyl, and 4-nitrophenol, a metabolite of parathion and methyl parathion, were detected in nearly all women with geometric mean (95% CI) values of 3.17 (2.82-3.56) and 18.66 (17.03-20.46) µg/g creatinine, respectively. 3-phenoxybenzoic acid (3-PBA), a non-specific metabolite of several pyrethroids, and 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY), a diazinon metabolite, were detected in 19.8% and 16.1% of women, respectively. The remaining four pesticide biomarkers were detected in <10% of women. Women in the highest quartile of 4-nitrophenol were more than 3 times more likely to deliver preterm than women in the lowest quartile: unadjusted RR (95% CI), 3.57 (1.65, 7.73). Women in the highest quartile of 4-nitrophenol were also at increased risk of having a child born small for gestational age: RR (95% CI) adjusted for household income, maternal education, and maternal total energy and meat intake, 3.81 (1.10, 13.21). Women with detectable concentrations of IMPY were at increased risk of having a child born with low birth weight compared to women with non-detectable concentrations: adjusted RR (95% CI), 2.13 (1.12, 4.08). We observed no association between any of the pesticide biomarkers and stunting at 1 or 2 years of age.

DISCUSSION

Exposure to the insecticides parathion and diazinon during early pregnancy may increase the risk of adverse birth outcomes.

Review of the analysis of insecticide residues and their levels in different matrices in Ghana

This review reports on how Ghanaian scientists analyse insecticide residues in various matrices in their laboratories as well as the levels of insecticides found in Ghana. It covers different sample preparation methods such as solid-liquid and liquid-liquid extraction. The main technique used for this analysis was gas chromatography (GC) with various detectors such as electron capture, flame photometric, nitrogen phosphorus, and mass spectrometric detection. Liquid chromatography (LC) with mass spectrometric detection was sometimes used to determine the levels of very polar insecticide residues. From the articles reviewed 74% of the insecticides detected were organochlorines with DDTs, lindanes, and endosulfans as most abundant ones. Levels of the insecticides of interest analysed, varied from below the detection limits to clearly above the safety limits. The lowest detected concentration of insecticide residues reported in fruits and vegetables was δ-lindane in pawpaw (0.06 mg/kg) while the highest was fenvalerate (25.6 mg/kg). Insecticide residues reported in sediment were predominantly organochlorines with concentrations ranging from 9.68 ng/kg to 10.98 µg/kg. Endosulfan and its metabolites were the main insecticides found in water bodies with concentrations ranging from 0.036 µg/L to 62.3 µg/L. DDT and its metabolites were the dominant insecticides found in human fluids.

Pyrethroid Pesticide Exposure and Risk of Primary Ovarian Insufficiency in Chinese Women

Pyrethroids are a class of widely used insecticides. Female animal studies suggested that pyrethroid exposure impaired ovarian function, which resulted in similar symptoms of primary ovarian insufficiency (POI). However, it is still unknown whether this association applies to women. In this case-control study, a total of 172 POI patients and 247 control women were recruited in Zhejiang, China. The urinary concentrations of metabolites of pyrethroids, 3-phenoxybenzoic acid (3-PBA) and 4-fluoro-3-phenoxybenzoic acid (4-F-3-PBA), as well as the serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and anti-Mullerian hormone (AMH) were determined. The associations of pyrethroid metabolites with POI and POI-related hormones were accessed using unconditional logistic regression. Higher urinary levels of 3-PBA were significantly associated with increased risk of POI [adjusted odds ratio (OR) = 2.344, 95% CI: 1.193-4.607 for the highest vs lowest quartile of 3-PBA, p = 0.013]. Stratified analyses showed that each log increase in urinary 3-PBA concentration was significantly associated with an induction in odds of 51.0% being in the highest quartile of FSH and 28.6% being in the highest quartile of LH levels, whereas a 25.9% reduction in odds of being in the highest quartile of AMH levels (All p for trend <0.05). To our knowledge, this is the first case-control study to report an association of pyrethroid exposure with increased risk of POI in women.