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Okuzono SS, Wilson J, Slopen N. Resilience in development: Neighborhood context, experiences of discrimination, and children's mental health. Dev Psychopathol 2023; 35:2551-2559. [PMID: 37641977 DOI: 10.1017/s0954579423001025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
An understanding of child psychopathology and resilience requires attention to the nested and interconnected systems and contexts that shape children's experiences and health outcomes. In this study, we draw on data from the National Survey of Children's Health, 2016 to 2021 (n = 182,375 children, ages 3- to 17 years) to examine associations between community social capital and neighborhood resources and children's internalizing and externalizing problems, and whether these associations were moderated by experiences of racial discrimination. Study outcomes were caregiver-report of current internalizing and externalizing problems. Using logistic regression models adjusted for sociodemographic characteristics of the child and household, higher levels of community social capital were associated with a lower risk of children's depression, anxiety, and behaviors. Notably, we observed similar associations between neighborhood resources and child mental health for depression only. In models stratified by the child's experience of racial/ethnic discrimination, the protective benefits of community social capital were specific to those children who did not experience racial discrimination. Our results illustrate heterogeneous associations between community social capital and children's mental health that differ based on interpersonal experiences of racial/ethnic discrimination, illustrating the importance of a multilevel framework to promote child wellbeing.
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Affiliation(s)
- Sakurako S Okuzono
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joseph Wilson
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Center on the Developing Child, Cambridge, MA, USA
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Wallerich L, Fillol A, Rivadeneyra A, Vandentorren S, Wittwer J, Cambon L. Environment and child well-being: A scoping review of reviews to guide policies. Health Promot Perspect 2023; 13:168-182. [PMID: 37808945 PMCID: PMC10558968 DOI: 10.34172/hpp.2023.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 05/18/2023] [Indexed: 10/10/2023] Open
Abstract
Background Acting on social determinants is the most effective, efficient, and fairest strategy to improve population health and health equity. Because of their vulnerability and dependence, children are particularly exposed to the deleterious effects of their living environment. Taking these issues into account in the development of public policies and identifying levers for action are crucial. The objective of this scoping review of reviews is to identify the main environmental determinants on children's health and development, and their mechanisms of effect, to be addressed by public policies. Methods We conducted a scoping review of reviews in accordance with the method developed by Arksey and O'Malley, and Levac and colleagues' methodology advancement and the PRISMA guideline. Inclusion criteria were identified with the PICos (population-phenomena of interest-context-study design) framework. We used the PubMed database and conducted a thematic analyze. Results Forty-seven articles were selected. Their analysis allowed us to identify five categories of interdependent environmental determinants of child health: i) urban design ii) contaminants, iii) parenting environment, iv) social conditions, v) climate change. Together and in a systemic way, they act on the health of the child. Conclusion The review carried out allows us to propose a pragmatic framework for clarifying the effects of the physical, social, and economic environment on children's health and wellbeing.
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Affiliation(s)
- Louise Wallerich
- University of Bordeaux, INSERM, BPH, U1219, Mérisp/PHARES, Equipe Labellisée Ligue Contre le Cancer, CIC 1401, F-33000 Bordeaux, France
| | - Amandine Fillol
- University of Bordeaux, INSERM, BPH, U1219, Mérisp/PHARES, Equipe Labellisée Ligue Contre le Cancer, CIC 1401, F-33000 Bordeaux, France
| | - Ana Rivadeneyra
- Institute of Public Health, Epidemiology and Development, Bordeaux, France
- Equipe PHARes, Bordeaux Population Health, Bordeaux, France
| | - Stéphanie Vandentorren
- French Public Health Agency, F-94415 Saint-Maurice, France
- University of Bordeaux, Centre INSERM U1219 Bordeaux Population Health Research Center, Bordeaux, France
| | - Jérôme Wittwer
- University of Bordeaux, Centre INSERM U1219 Bordeaux Population Health Research Center, Bordeaux, France
| | - Linda Cambon
- University of Bordeaux, INSERM, BPH, U1219, Mérisp/PHARES, Equipe Labellisée Ligue Contre le Cancer, CIC 1401, F-33000 Bordeaux, France
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Golzarpour M, Santana P, Sajjadi H, Ghaed Amini Harouni G, Costa C, Ziapour A, Azizi SA, Akbari M, Afrashteh S. The influence of home and environmental characteristics on 5-18 years old children's health during the COVID-19 pandemic: A cross-sectional study in Iran. Front Public Health 2023; 11:1134411. [PMID: 37064700 PMCID: PMC10097928 DOI: 10.3389/fpubh.2023.1134411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
Background The coronavirus disease (COVID-19) pandemic has dramatically changed the health and wellbeing of children. Therefore, this study aimed to investigate the relationship between the home environment and the environmental characteristics on 5-18 years old children health in Iran. Method An online survey was conducted among parents of children aged 5 to 18 living in large cities in Iran in 2021. The statistical population of this cross-sectional study was 500 people. In this survey, questionnaires on the quality of the home environment, exterior and interior landscapes of homes, and the Child Health Questionnaire (CHQ) were used to investigate the relationship between the home environment and environmental characteristics on 5-18 years old children health during the COVID-19 pandemic. The t-test and analysis of variance were used in SPSS 24, and the structural equation modeling (SEM) was utilized in AMOS 24 for analyzing the data. Results The average age of respondents was 37.13 ± 7.20, and that of children was 11.57 ± 3.47. 73.02% of the families were covered by insurance, and 74.08% of them lived in the metropolis. In addition, 65.04% of the families complied with the restrictions of the quarantine period. A share of 31% of the families live in villas, and 55% paid more attention to cleaning their homes during the COVID-19 pandemic than before. A positive and significant statistical relationship (β = 0.414, p < 0.001) was observed between the residence environment and child health. Thus, explained 17.5% of variations in child health. Conclusion The results showed that the children who lived in homes with an exterior landscape in nature had better health. In addition, the 5-18 years old children whose home landscape was a garden, compared to the other two groups (yard, balcony), had better health. Gardens are a potential source of health and not necessarily replaced by other natural environments, thus providing them along with green space is one of the crucial issues that should be considered.
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Affiliation(s)
- Majid Golzarpour
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Social Welfare and Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Paula Santana
- Centre of Studies in Geography and Spatial Planning, Department of Geography and Tourism, Humanities Faculty, University of Coimbra, Coimbra, Portugal
| | - Homeira Sajjadi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- *Correspondence: Homeira Sajjadi
| | | | - Claudia Costa
- Centre of Studies in Geography and Spatial Planning, Department of Geography and Tourism, Humanities Faculty, University of Coimbra, Coimbra, Portugal
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Amar Azizi
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Social Welfare and Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Akbari
- Urban Planning, University of Tehran, Tehran, Iran
| | - Sima Afrashteh
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
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Rider CV. Mixture Math: Deciding What to Add in a Cumulative Risk Assessment. CURRENT OPINION IN TOXICOLOGY 2022; 31:100358. [PMID: 35813121 PMCID: PMC9262140 DOI: 10.1016/j.cotox.2022.100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Component-based approaches for cumulative risk assessment provide an important tool for informing public health policy. While current quantitative cumulative risk assessments focus narrowly on pesticides that share a mechanism of action, growing scientific evidence supports expansion of their application to encompass stressors that target a common disease. Case studies have demonstrated dose additive effects of chemicals with different mechanisms of action on liver steatosis, craniofacial malformations, and male reproductive tract developmental disruption. Evidence also suggests that nonchemical stressors such as noise or psychosocial stress can modify effects of chemicals. Focused research attention is required before nonchemical stressors can routinely be included in quantitative cumulative risk assessments.
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Affiliation(s)
- Cynthia V. Rider
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, 27709, USA
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Disparities in Neighborhood Characteristics among U.S. Children with Secondhand and Thirdhand Tobacco Smoke Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074266. [PMID: 35409946 PMCID: PMC8998580 DOI: 10.3390/ijerph19074266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: Home tobacco smoke exposure (TSE) and negative neighborhood characteristics adversely affect children’s overall health. The objective was to examine the associations of child TSE status and neighborhood characteristics among U.S. school-aged children. (2) Methods: We conducted a secondary analysis of the 2018–2019 National Survey of Children’s Health (NSCH) data including 17,300 U.S. children ages 6–11 years old. We categorized children’s home TSE status into: (a) no TSE: child did not live with a smoker; (b) thirdhand smoke (THS) exposure alone: child lived with a smoker who did not smoke inside the home; and (c) secondhand smoke (SHS) and THS exposure: child lived with a smoker who smoked inside the home. We conducted a series of weighted linear and logistic regression analyses to assess the associations between child TSE status and neighborhood characteristics, adjusting for covariates. (3) Results: Overall, 13.2% and 1.7% of children were exposed to home THS alone and home SHS and THS, respectively. Compared to children with no TSE, children with home THS exposure alone and children with home SHS and THS exposure had a significantly lower total number of neighborhood amenities and children with SHS and THS exposure had a significantly higher total number of detracting neighborhood elements. (4) Conclusions: Children with TSE demonstrate disparities in the characteristics of the neighborhood in which they live compared to children with no TSE. TSE reduction interventions targeted to children with TSE who live in these neighborhoods are warranted.
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Exposome and Social Vulnerability: An Overview of the Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063534. [PMID: 35329217 PMCID: PMC8955941 DOI: 10.3390/ijerph19063534] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/25/2022] [Accepted: 02/27/2022] [Indexed: 02/01/2023]
Abstract
Background—The exposome concept refers to the totality of exposures from internal and external sources, including chemical and biological agents from conception throughout the lifetime. Exposome is also made up of psychosocial components such as socio-economic status (SES), which will focus on in this review. Despite exposures to the same environmental nuisances, individuals and groups are impacted differently. According to the literature, health inequalities exist among different socioeconomic groups, and SES may influence the association between environmental nuisances and health outcomes. However, the variation of this interaction across ages has rarely been studied. There is a need to adopt a life course approach to understand the history of diseases better. Objective—The main objective of this review is to document how SES could modify the association between environmental nuisances and health outcomes, across different ages, as a first crucial step introducing the emerged concept of social exposome. Methods—The PubMed database was searched from January 2010 to August 2021 for systematic reviews published in English addressing the interaction between SES, environmental nuisances, and health outcomes. Socio-economic indicators considered include education, level of income, neighborhood environment. Environmental nuisances considered many environment nuisances, mainly air pollution and noise. Results—Among 242 literature reviews identified, 11 of them address the question of the effect modification. Overall, our work reveals that environmental nuisances were mostly associated with poorer health outcomes and that SES modified this association, increasing the health risk among the poorest. Very interestingly, our work reports the existence of this interaction across different ages, including pregnancy, childhood, and adulthood, and for various environmental nuisances. Conclusion—In conclusion, our work confirms that we are not all equal to face environmental nuisances. The poorest are more vulnerable to the health effect of environmental nuisances. Policy decisions and interventions should target this high-risk population as a priority. Further investigations are needed to formalize the concept of social exposome more precisely and then communicate about it.
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Kane N. Revealing the racial and spatial disparity in pediatric asthma: A Kansas City case study. Soc Sci Med 2021; 292:114543. [PMID: 34802780 DOI: 10.1016/j.socscimed.2021.114543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 07/22/2021] [Accepted: 11/04/2021] [Indexed: 12/24/2022]
Abstract
Black and other socially disadvantaged children are disproportionately burdened by high rates of pediatric asthma. Intraurban variation in environmental risk factors and limited access to high-resolution health data make it difficult to identify vulnerable patients, communities, or the immediate exposures that may contribute to pediatric asthma exacerbation. This article presents a novel, interdisciplinary health disparities research and intervention strategy applied to the problem of pediatric asthma in Kansas City. First, address-level electronic health records from a major children's hospital in the Kansas City region are used to map the distribution of asthma encounters in 2012 at a high spatial resolution. Census tract Environmental Justice Screening Method (EJSM) indicators are then developed to scan for patterns in both the population health risks and vulnerabilities that may contribute to the burden of asthma in different communities. A Bayesian Profile Regression cluster analysis is used to systematically explore the complex relationships between census tract EJSM indicators and pediatric asthma incidence rates, helping to identify population characteristics and risk factors associated with both high and low rates of pediatric asthma throughout the region. The EJSM scanning exercise and BPR analysis demonstrate that each community faces a distinct set of risks and vulnerabilities that can contribute to the rate of acute pediatric asthma acute care encounters, providing targets for research and intervention. It is clear, however, that different forms of social disadvantage are driving high rates of pediatric asthma, which is closely tied to uneven development patterns and racial residential segregation. The results provide a starting point for designing place-based health disparities research and intervention strategies catered to the unique needs of vulnerable patients and communities; disparities-focused research and intervention strategies that leverage local knowledge and resources through community-based practices.
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Affiliation(s)
- Natalie Kane
- Children's Mercy Hospital, Kansas City, MO, USA.
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Suarez-Lopez JR, Cairns MR, Sripada K, Quiros-Alcala L, Mielke HW, Eskenazi B, Etzel RA, Kordas K. COVID-19 and children's health in the United States: Consideration of physical and social environments during the pandemic. ENVIRONMENTAL RESEARCH 2021; 197:111160. [PMID: 33852915 PMCID: PMC8542993 DOI: 10.1016/j.envres.2021.111160] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/12/2021] [Accepted: 04/07/2021] [Indexed: 05/08/2023]
Abstract
Public health measures necessary to counteract the coronavirus disease 2019 (COVID-19) pandemic have resulted in dramatic changes in the physical and social environments within which children grow and develop. As our understanding of the pathways for viral exposure and associated health outcomes in children evolves, it is critical to consider how changes in the social, cultural, economic, and physical environments resulting from the pandemic could affect the development of children. This review article considers the environments and settings that create the backdrop for children's health in the United States during the COVID-19 pandemic, including current threats to child development that stem from: A) change in exposures to environmental contaminants such as heavy metals, pesticides, disinfectants, air pollution and the built environment; B) changes in food environments resulting from adverse economic repercussion of the pandemic and limited reach of existing safety nets; C) limited access to children's educational and developmental resources; D) changes in the social environments at the individual and household levels, and their interplay with family stressors and mental health; E) social injustice and racism. The environmental changes due to COVID-19 are overlaid onto existing environmental and social disparities. This results in disproportionate effects among children in low-income settings and among populations experiencing the effects of structural racism. This article draws attention to many environments that should be considered in current and future policy responses to protect children's health amid pandemics.
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Affiliation(s)
- Jose R Suarez-Lopez
- Department of Family Medicine and Public Health, and Herbert Wertheim School of Public Health and Human Longevity, University of California San Diego, La Jolla, CA, USA.
| | - Maryann R Cairns
- Department of Anthropology, Dedman College of Humanities and Sciences, Southern Methodist University, Dallas, TX, USA
| | - Kam Sripada
- Centre for Global Health Inequalities Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lesliam Quiros-Alcala
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Howard W Mielke
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, LA, 70112, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, CA, USA
| | - Ruth A Etzel
- Milken Institute School of Public Health, The George Washington University, Washington, DC, 20052, USA
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, 14214, USA
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Kane NJ, Wang X, Gerkovich MM, Breitkreutz M, Rivera B, Kunchithapatham H, Hoffman MA. The Envirome Web Service: Patient context at the point of care. J Biomed Inform 2021; 119:103817. [PMID: 34020026 DOI: 10.1016/j.jbi.2021.103817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 11/27/2022]
Abstract
Patient context - the "envirome" - can have a significant impact on patient health. While envirome indicators are available through large scale public data sources, they are not provided in a format that can be easily accessed and interpreted at the point of care by healthcare providers with limited time during a patient encounter. We developed a clinical decision support tool to bring envirome indicators to the point of care in a large pediatric hospital system in the Kansas City region. The Envirome Web Service (EWS) securely geocodes patient addresses in real time to link their records with publicly available context data. End-users guided the design of the EWS, which presents summaries of patient context data in the electronic health record (EHR) without disrupting the provider workflow. Through surveys, focus groups, and a formal review by hospital staff, the EWS was deployed into production use, integrating publicly available data on food access with the hospital EHR. Evaluation of EWS usage during the 2020 calendar year shows that 1,034 providers viewed the EWS, with a total of 29,165 sessions. This suggests that the EWS was successfully integrated with the EHR and is highly visible. The results also indicate that 63 (6.1%) of the providers are regular users that opt to maintain the EWS in their custom workflows, logging more than 100 EWS sessions during the year. The vendor agnostic design of the EWS supports interoperability and makes it accessible to health systems with disparate EHR vendors.
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Affiliation(s)
- N J Kane
- Children's Mercy Hospital, Kansas City, MO, United States
| | - X Wang
- University of Missouri-Kansas City, United States
| | | | - M Breitkreutz
- Children's Mercy Hospital, Kansas City, MO, United States
| | - B Rivera
- Children's Mercy Hospital, Kansas City, MO, United States
| | | | - M A Hoffman
- Children's Mercy Hospital, Kansas City, MO, United States; University of Missouri-Kansas City, United States.
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Arcury TA, Chen H, Quandt SA, Talton JW, Anderson KA, Scott RP, Jensen A, Laurienti PJ. Pesticide exposure among Latinx children: Comparison of children in rural, farmworker and urban, non-farmworker communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 763:144233. [PMID: 33385842 PMCID: PMC7855950 DOI: 10.1016/j.scitotenv.2020.144233] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 05/05/2023]
Abstract
Personal pesticide exposure is not well characterized among children in vulnerable, immigrant communities. We used silicone wristbands in 2018-2019 to assess pesticide exposure in 8 year old Latinx boys and girls in rural, farmworker families (n = 73) and urban, non-farmworker families (n = 60) living in North Carolina who were enrolled in the PACE5 Study, a community-based participatory research study. We determined the detection and concentrations (ng/g) of 75 pesticides and pesticide degradation products in the silicone wristbands worn for one week using gas chromatography electron capture detection and employed gas chromatography mass spectrometry. Differences by personal and family characteristics were tested using analysis of variance or Wilcoxon Rank Sum tests when necessary. Pesticide concentrations above the limit of detection were analyzed, and reported as geometric means and 95% confidence intervals (CI). The most frequently detected pesticide classes were organochlorines (85.7%), pyrethroids (65.4%), and organophosphates (59.4%), with the most frequently detected specific pesticides being alpha-chlordane (69.2%), trans-nonachlor (67.7%), gamma-chlordane (66.2%), chlorpyrifos (54.9%), cypermethrin (49.6%), and trans-permethrin (39.1%). More of those children in urban, non-farmworker families had detections of organochlorines (93.3% vs. 79.5, p = 0.0228) and pyrethroids (75.0% vs. 57.5%, p = 0.0351) than did those in rural, farmworker families; more children in rural, farmworker families had detections for organophosphates (71.2% vs. 45.0%, p= 0.0022). Children in urban, non-farmworker families had greater concentrations of alpha-chlordane (geometric mean (GM) 18.98, 95% CI 14.14, 25.47 vs. 10.25, 95% CI 7.49, 14.03; p= 0.0055) and dieldrin (GM 17.38, 95% CI 12.78 23.62 vs. 8.10, 95% CI 5.47, 12.00; p= 0.0034) than did children in rural, farmworker families. These results support the position that pesticides are ubiquitous in the living environment for children in vulnerable, immigrant communities, and argue for greater effort in documenting the widespread nature of pesticide exposure among children, with greater effort to reduce pesticide exposure.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Haiying Chen
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Sara A Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Jennifer W Talton
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Kim A Anderson
- Department of Environmental and Molecular Toxicology, Oregon State University, 2750 SW Campus Way, Corvallis, OR 97331, USA.
| | - Richard P Scott
- Department of Environmental and Molecular Toxicology, Oregon State University, 2750 SW Campus Way, Corvallis, OR 97331, USA.
| | - Anna Jensen
- North Carolina Farmworkers Project, 1238 NC Highway 50 S, Benson, NC 27504, USA.
| | - Paul J Laurienti
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
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Clougherty JE, Rider CV. Integration of psychosocial and chemical stressors in risk assessment. CURRENT OPINION IN TOXICOLOGY 2020. [DOI: 10.1016/j.cotox.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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