A systematic review of neurodevelopmental effects of prenatal and postnatal organophosphate pesticide exposure

Agricultural and residential use of organophosphate (OP) pesticides has increased in recent decades after banning some persistent pesticides. Although there is evidence of the effects of OPs on neurodevelopment and behaviour in adults, limited information is available about their effects in children, who might be more vulnerable to neurotoxic compounds. This paper was aimed at analysing the scientific evidence published to date on potential neurodevelopmental and behavioural effects of prenatal and postnatal exposure to OPs. A systematic review was undertaken to identify original articles published up to December 2012 evaluating prenatal or postnatal exposure to OPs in children and effects on neurodevelopment and/or behaviour. Articles were critically compared, focusing on the methodology used to assess exposure and adverse effects, as well as potential contributing factors that may modify both exposure and outcomes, such as genetic susceptibility to certain enzymes involved in OPs metabolisation (e.g. paraoxonase-1) and gender differences. Twenty articles met the inclusion criteria, 7 of which evaluated prenatal exposure to OPs, 8 postnatal exposure and 5 both pre- and postnatal exposure. Most of the studies evaluating prenatal exposure observed a negative effect on mental development and an increase in attention problems in preschool and school children. The evidence on postnatal exposure is less consistent, although 2 studies found an increase in reaction time in schoolchildren. Some paraoxonase-1 polymorphisms could enhance the association between OPs exposure and mental and psychomotor development. A large variability in epidemiological designs and methodologies used for assessing exposure and outcome was observed across the different studies, which made comparisons difficult. Prenatal and to a lesser extent postnatal exposure to OPs may contribute to neurodevelopmental and behavioural deficits in preschool and school children. Standardised methodologies are needed to allow results to be better compared and to perform a quantitative meta-analysis before drawing any final conclusions.

Maternal and paternal occupational exposure to agricultural work and the risk of anencephaly

AIMS

To evaluate the association between parental occupational exposure to agricultural work and the risk of anencephaly in three Mexican states.

METHODS

A paired case control study (1:1) was done based on records of the Epidemiological Surveillance System of Neural Tube Defects in Mexico; 151 cases of anencephaly of more than 20 weeks' gestation were selected between March 2000 and February 2001. Controls were selected from the same maternity services as those of the cases and were born alive without congenital malformations. Information was obtained from both parents by means of a general questionnaire, a food frequency questionnaire, and a specific questionnaire on occupational exposure to pesticides. Exposures were analysed with emphasis on the three months before and one month after the last menstruation periods (acute risk period (ARP)), as well as exposure prior to the above mentioned period (non-acute risk period (NARP)).

RESULTS

The children of mothers who worked in agriculture in the ARP had a greater risk of anencephaly (OR = 4.57, 95% CI 1.05 to 19.96). The risk of fathers having a child with anencephaly was greater in those who applied pesticides irrespective of whether it was done in the ARP or the NARP (OR = 2.50, 95% CI 0.73 to 8.64; and OR = 2.03, 95% CI 0.58 to 7.08, respectively).

CONCLUSIONS

These results support the hypothesis of the effect of maternal exposure to agricultural work on anencephaly and suggest that exposure of the father to pesticides in the periconceptional period or prior to this can also increase the risk of having an anencephalic child.

Changes in male hormone profile after occupational organophosphate exposure. A longitudinal study

There is a growing concern about the endocrine effects of long-term, low-level exposure to organophosphate (OP) compounds. Studies on experimental animals have found that OP pesticides have an impact on the endocrine system and a few clinical and epidemiological studies have also shown that OPs may affect the male hormone profile, although results are inconsistent. We have evaluated the effect of exposure to OP pesticides, measured through urinary levels of six dialkylphosphate (DAP) metabolites, on male hormone profile in 136 floriculture workers from the State of Mexico and Morelos during two agricultural periods with different degree of pesticide exposure. Generalized estimated equations (GEE) models were developed and adjusted for several potential confounders, including PON1 enzyme activity, as a biomarker of susceptibility, and serum levels of p,p'-DDE, a metabolite of the pesticide DDT widely used in Mexico until 1999 for control of agricultural pests and malaria. Exposure of male floriculture workers to OP pesticides was associated with increased serum levels of follicle-stimulating hormone (FSH) and prolactin and with decreased serum testosterone and inhibin B levels. Among all DAPs tested, only DETP was inversely associated with luteinizing hormone (LH). Estradiol showed a marginally significant positive trend with DEP and DETP derivatives. In conclusion, OP pesticides may have an impact on the endocrine function because of their potential to modify the male hormone profile as a function of the type of pesticide used as well as the magnitude of exposure.

Maternal exposure to floricultural work during pregnancy, PON1 Q192R polymorphisms and the risk of low birth weight

BACKGROUND

Although there is evidence from animal studies of impaired reproductive function by exposure to organophosphates (OP), the effects on birth weight have not been sufficiently evaluated in epidemiological studies. Paraoxonase (PON1) detoxifies organophosphates by cleavage of active oxons. Some PON1 gene polymorphisms could reduce the enzyme activity and increase susceptibility to OP toxicity.

OBJECTIVE

To assess the association between maternal exposure to floriculture during pregnancy and the risk of low birth weight (<2500 g) in their offspring, as well as to evaluate the interaction between this exposure and maternal genotype for PON1 Q192R polymorphisms.

MATERIALS AND METHODS

A cross sectional study was carried out in two Mexican states (States of Mexico and Morelos) with high frequencies of greenhouse activity. We interviewed and collected blood samples from 264 females (floriculturists or partners of floricultural workers) who became pregnant during the 10 years prior to the interview. The questionnaire measured socioeconomic characteristics, tobacco and alcohol consumption, diseases and occupational and reproductive history. We also applied a food frequency questionnaire. Information was obtained pertaining to 467 pregnancies. DNA was extracted from white cells, and PON1 genotype was determined by Restriction Fragment Length Polymorphism for Q192R polymorphisms. Results were analyzed with generalized estimating equations models.

RESULTS

After adjusting for potential confounders, we detected a statistically significant interaction between maternal exposure to flower growing work during pregnancy and PON1 Q192R polymorphisms on risk of low birth weight. The risk of having a baby with LBW is nearly six times higher if a mother is a floriculture worker during pregnancy and has PON1 192RR genotype (OR 5.93, 95% CI 1.28, 27.5).

CONCLUSION

These results suggest that the interaction between maternal floriculture work during pregnancy and 192RR PON1 genotype increases the probability of having children with LBW.

Biomonitoring of 45 inorganic elements measured in plasma from Spanish subjects: A cross-sectional study in Andalusian population

Heavy metals and other toxic elements are frequently detected in humans. Rare earth elements (REE) have arisen as a novel group of substances considered as emerging pollutants due to its dependence for high tech industry. We designed a study aimed to conduct the biomonitoring a total of 45 inorganic elements in the population of Andalusia (Spain). A total of 419 participants were recruited and their plasma samples analyzed. Concentration of elements, including elements in the ATSDR's priority pollutant list and REE were measured by ICP-MS in the blood plasma of participants. Arsenic, copper, lead, selenium, antimony, strontium, and bismuth were detected in ˃98% of subjects. Median values of arsenic, mercury and lead were 1.49, 1.46, and 5.86 ng/mL, respectively. These concentrations did not exceed reference values published by international agencies. We observed a positive correlation between age and plasma concentrations of arsenic, mercury, antimony and strontium. Sum of elements was lower in the group of subjects younger than 45 years old (P = 0.002). Positive correlations were observed between body mass index (BMI) and plasma concentrations of barium, cerium, osmium, tin, and ytterbium. 7 out of 26 REEs showed a percentage of detection ≥ 90%. Bismuth, yttrium, and cerium were quantified at the highest concentrations (median value = 7.7, 0.19, and 0.16 ng/mL, respectively). We found that plasma levels of 6 REEs were higher among males, and a positive correlation between REEs and age was detected. The present results suggest a potential interaction with the human physiology that deserves additional research. Given the high persistence of these elements in the environment, and the significant technological dependence on them, future studies are needed to elucidate the potential sources of exposure and possible adverse effects on health, especially in the most vulnerable populations.

Parental occupational exposure to organic solvents and anencephaly in Mexico

OBJECTIVE

To assess the relationship between parental occupational exposure to organic solvents, and the risk of anencephaly in Mexico.

METHODS

A case-control study was conducted based on the registers of the Epidemiological Surveillance System for Neural Tube Defects in Mexico; 151 cases of anencephaly of > or =20 weeks' gestation were included. A control, born alive and without any apparent congenital malformations at birth, was selected for each case in the same maternity service in which the case was born. Information on occupational exposures, lifestyle habits, reproductive history, use of medicines, supplementation with multivitamins and folic acid, was obtained by a general questionnaire; a food frequency questionnaire was also applied to obtain information of daily intake of folate and other B vitamins. Occupational exposure to organic solvents was based on job title as a proxy for exposure and analysed considering two critical periods around conception.

RESULTS

In logistic regression analysis, the odds of having a child with anencephaly was higher if the mother or the father was occupationally exposed to organic solvents during the periconceptional period, or when both parents or at least one of them were occupationally exposed during this period with an adjusted odds ratio of 2.97 (95% CI 1.36 to 6.52).

CONCLUSIONS

The results support the hypothesis that both maternal and paternal occupational exposure to organic solvents can increase the probability of having a child with anencephaly.

Urinary levels of organophosphate pesticides and predictors of exposure in pre-school and school children living in agricultural and urban communities from south Spain

BACKGROUND

Despite the widespread use of organophosphate (OP) pesticides, information on predictors of children's exposure to such pesticides is scarce.

OBJECTIVE

To assess exposure to OP pesticides in children 3-11 year-old living in agricultural communities and urban areas from Andalusia (Southern Spain), and to identify the main determinants of exposure.

METHODS

A longitudinal study was conducted in children 3-11-year-old children living in agricultural communities and urban areas from the provinces of Almeria, Granada and Huelva (Andalusia, Spain) between 2010 and 2011. Urinary levels of six dialkylphosphate (DAP) metabolites were measured by UHPLC-QqQ-MS/MS at the periods of low and high pesticide use in the agriculture (LPU and HPU, respectively). Information on sociodemographic characteristics, parental occupation, residential history, lifestyle and diet, among other relevant factors, was obtained from questionnaires administered to the mothers.

RESULTS

A total of 559 and 597 children participated in LPU and HPU periods, respectively. The proportion of urine samples below LOD was 67.4% for ΣDMs (sum of dimethyl metabolites), 77% for ΣDEs (sum of diethyl metabolites) and 58.5% for ΣDAPs (sum of total dialkylphosphate metabolites) in LPU period, and 50.4% for ΣDMs, 65.3% for ΣDEs and 43.9% for ΣDAPs in HPU period. Significantly greater urinary ΣDAP, ΣDM and ΣDE levels were observed in HPU relative to LPU period. Maternal schooling years, proximity of the house to crops or greenhouses, use of insecticides at home, spraying the garden with pesticides, storage of pesticides at home, house cleaning frequency, as well as child's frequency of bath/shower, were found to be the major predictors of urinary levels of ΣDAP. Likewise, not washing fruit and vegetables before consumption and banana consumption were also identified as determinants of the exposure levels.

CONCLUSIONS

Urinary levels of metabolites of OP pesticides found in this study were relatively lower compared to similar studies. DAP levels were significantly increased in HPU period. Maternal schooling years and variables related to residential environment and home exposures were identified as the most relevant determinants of DAP metabolites. Regarding diet, banana consumption and not washing fruit before consumption were also identified as determinants of the exposure levels. This study contributes to improve our knowledge on the main sources and determinants of children exposure to OPS, and given that children are more vulnerable than adults this information is essential to reduce children exposure and protect their health.

Blood lead levels and calcium intake in Mexico City children under five years of age

OBJECTIVE

The relationship between daily calcium intake and blood lead levels was evaluated among children under five years of age living in Mexico City.

METHODS

A random sample of 200 children under five years of age, resident in two neighborhoods of Mexico City was selected: Xalostoc, an industrial neighborhood, and Tlalpan, a residential neighborhood (100 from each area). The mothers of these children filled out a questionnaire on predictors of blood lead levels including daily calcium intake. Lead levels were determined from the venous blood samples. Calcium intake was assessed using a short Food Frequency Questionnaire including 11 food items that accounted for 95% of calcium intake in Mexico.

RESULTS

The average blood lead level was 9.93 microg dl(-1) (range 1-31 microg dl(-1)). An inverse relationship was observed between blood lead levels and daily calcium intake. This relationship was statistically significant among children aged 13 months-5 years.

CONCLUSION

The results suggest that calcium provided a protective effect against lead accumulation in the body among children. Further studies should be undertaken to evaluate this hypothesis through experimental design.

Indirect lead exposure among children of radiator repair workers

BACKGROUND

Secondary exposure to lead has been identified as a public health problem since the late 1940s; we investigate the risk of lead exposure among families of radiator repair workers.

METHODS

A sample of the wives and children, aged 6 months to 6 years (exposed children) (n = 19), of radiator repair workers and a sample of children whose parents were not occupationally exposed to lead (non-exposed children) (n = 29) were matched for age and residence; their geometric mean blood lead levels are compared. Blood samples were obtained by the finger stick method and environmental dust samples by the wipe method; both were analyzed using a portable anodic stripping voltameter.

RESULTS

Dust lead levels were significantly higher in the houses of exposed children (143.8 vs. 3.9 microg/g; P < 0.01). In crude analyses, the highest lead levels were observed among children whose fathers worked in home-based workshops (22.4 microg/dl)(n = 6). Children whose fathers worked in an external workshop (n = 13) also had high levels (14.2 microg/dl) (P < 0.01), while blood lead levels in non-exposed children were significantly lower (5.6 microg/dl)(P < 0.01). The observed differences remained significant after adjustment for age and gender.

CONCLUSIONS

This study confirms that children of radiator repair workers are at increased risk of lead exposure and public health interventions are needed to protect them.

[Pesticide application practices in agricultural workers]

OBJECTIVE

We describe the sociodemographic characteristics and determinants of pesticide exposure in agricultural workers applying pesticides.

METHODS

The workers selected were included in a case-control study carried out in the Autonomous Community of Valencia in Spain. Contact was made by telephone and individuals who had been involved in agricultural work during the relevant period of exposure were interviewed face-to-face to gain information on the following determinants of pesticide exposure: crops and periods worked, mixing of products, treatment equipment, participation in the washing of equipment, use of personal protection during the treatments and knowledge of the risks of pesticide exposure.

RESULTS

Eighty-nine workers, aged between 16 and 46 years old, were included. Most of the interviewees had primary education or less. Pesticide treatments were mostly applied on high crops (82%), with manual equipment (61%) and throughout the year (45%). Workers frequently performed tasks involving additional exposure to pesticides (mixing chemicals, 66%, or washing equipment, 60%). Sixty-five percent of the workers used no personal protection or used it defectively. No differences were found in personal protection use according to age, family income or education. Most of the workers (90%) reported knowledge of the health risks of pesticide exposure and 21% of them rated the risk as null.

CONCLUSIONS

Workers involved in pesticide application use personal protection measures very defectively. There is a clear need to develop specific prevention programs for these workers. The determinants of pesticide exposure in agricultural workers described in this study should be properly assessed in epidemiological studies of the health effects of pesticides on agricultural workers.

Serum concentrations of organochlorine compounds and predictors of exposure in children living in agricultural communities from South-Eastern Spain

BACKGROUND

Information on exposure levels to organochlorine compounds (OCs) in child population is limited, despite their greater vulnerability to the adverse health effects of these chemicals.

OBJECTIVE

To determine serum concentrations of 10 OCs (including organochlorine pesticides and polychlorinated biphenyls -PCBs-) in children living in agricultural communities from Almería (South-Eastern Spain), and to identify the main predictors of exposure related to socio-economic characteristics, diet and lifestyle.

METHODS

A cross-sectional study was conducted on 133 children aged 6-11 years selected from public schools of the study area. OCs compounds were determined in serum samples by GC/ECD. Anthropometric measures were obtained during sample collection. Information on sociodemographic characteristics, parental occupation, residential history, lifestyle and frequency of food consumption, among other relevant factors, was obtained by questionnaires administered to the mothers.

RESULTS

Geometric means of serum concentrations (ng/ml) were 0.11 for β-hexachloro-cyclohexane (β-HCH), 0.09 for endosulfan, 0.20 for endosulfan-ether, 0.51 for hexachorobenzene (HCB), 0.08 for mirex, 0.06 for oxychlordane, 0.36 for p,p'-DDE, 0.20 for PCB 138, 0.36 for PCB 153, and 0.45 for PCB 180. Percentage of samples above the limit of detection (0.05 ppb) ranged from 32 (β-HCH) to 100 (HCB). A high variability in OC levels depending on the compound was observed between our results and others found in similar studies carried out in children. Variables related to fish consumption were found to be the major dietary determinant of PCB 138, p,p´-DDE, endosulfan-α, β-HCH, mirex and oxychlordane levels.

CONCLUSIONS

Children participating in this study showed detectable levels of many OC, despite these compounds are no longer used. Their presence in children serum can be explained by their high lipophilicity and environmental persistence, leading to contamination of fatty food. In this line, fish consumption seemed to be the most relevant determinant of OC levels found in our study.