Pesticides and children

Prevention and control of damage to health, crops, and property by insects, fungi, and noxious weeds are the major goals of pesticide applications. As with use of any biologically active agent, pesticides have unwanted side-effects. In this review, we will examine the thesis that adverse pesticide effects are more likely to occur in children who are at special developmental and behavioral risk. Children's exposures to pesticides in the rural and urban settings and differences in their exposure patterns are discussed. The relative frequency of pesticide poisoning in children is examined. In this connection, most reported acute pesticide poisonings occur in children younger than age 5. The possible epidemiological relationships between parental pesticide use or exposure and the risk of adverse reproductive outcomes and childhood cancer are discussed. The level of consensus among these studies is examined. Current concerns regarding neurobehavioral toxicity and endocrine disruption in juxtaposition to the relative paucity of toxicant mechanism-based studies of children are explored.     

Pesticide Exposures and Fetal Death: A Review of the Epidemiologic Literature

Despite considerable concern regarding the effects on reproductive outcome of exposures to pesticides, convincing evidence for the developmental toxicity of occupational and environmental pesticide exposure in humans is lacking. In this comprehensive review of the English language epidemiologic literature, we summarize studies that have examined potential associations between fetal deaths (both spontaneous abortions and stillbirths) and specific pesticides, as well as maternal and paternal employment in occupations with potential for exposure. While many of the epidemiologic studies to date suffer from methodologic problems, the data are suggestive of increased risks of fetal deaths associated with pesticides in general and maternal employment in the agricultural industry. There is a clear need for epidemiologic research that focuses on specific pesticide products or chemical families, with improved exposure assessment. The potential role of solvents in developmental toxicity associated with pesticide use by both males and females should also be considered.     

Evidence for a role of paternal exposures in developmental toxicity

Experimental evidence from radiation exposure, antimitotic drugs or chemicals such as pesticides or metals does suggest the possibility of transmission of paternally mediated developmental effects across generations. The mechanistic framework is growing with suggestion of transmission of epigenetic modifications as a mechanism alternative to germ-line mutagenesis. There is also ample experimental evidence for a specific susceptibility of the male embryo to the action of endocrine disrupters. In parallel, interpretation of epidemiological findings regarding effects of well-characterized paternal exposures, such as ionizing radiation or persistent organic pollutants (dioxins), on intrauterine development remains equivocal. Many epidemiological studies have included paternal exposures as an add-on to existing studies and focused mainly on birth defects, sex ratio, childhood cancers or spontaneous abortions. Functional alterations such as neurobehavioural parameters or reproductive dysfunction resulting from paternal exposure have been barely studied. Improved knowledge on possible consequences of paternal exposures in future generations is needed and has strong implication in terms of regulation, in the workplace for instance. One may expect human studies to be conducted with a particular focus on male-mediated developmental toxicity making use of biological markers pertinent to hypothesized mechanisms. Recognition of early determinants of disease onset has led to the setup of a number of mother-child cohorts across the world and careful assessment of paternal exposures should be included in these studies. These cohorts will also have the power to evaluate the specific impact of in utero exposure on a number of endpoints of developmental toxicity in males.     

Animal models of chronic pesticide neurotoxicity

There is a wealth of literature on neurotoxicological outcomes of acute and short-term exposure to pesticides in laboratory animals, but there are relatively few studies of- long-term exposure. Many reports in the literature describing ;chronic' exposures to pesticides are, in fact, as short as five days and rarely longer than three months. Furthermore, routes of administration range from subcutaneous to dietary. Doses used in many of the studies produce signs of acute or overt toxicity. In contrast, human symptoms have been reported following exposures that are prolonged and often without obvious toxic effects. A survey of the literature was conducted to identify rodent studies with neurobehavioral and neurophysiological endpoints of pesticide exposures lasting 30 days or longer. This survey indicated that the majority of studies concentrate on cholinesterase inhibitors (organophosphorus and carbamate insecticides). Various neuromotor, cholinergic, physiological, affective and cognitive disorders were reported at doses producing cholinesterase inhibition; however, there were a fewer effects at non-inhibiting doses. Other classes of pesticides produced similar effects, with the exception of cholinergic signs. In many studies, the changes were subtle, which may correspond to the nonspecific changes in psychomotor and cognitive function reported in humans. It appears, then, that the data from animal and human pesticide exposures are generally comparable, but the specific outcomes are influenced by many experimental differences. Future research should concentrate on analogous exposures and outcomes to facilitate interpretation.     

Pesticides and childhood cancer: an update of Zahm and Ward's 1998 review

Children are exposed to pesticides through a number of sources, including residential and agricultural applications. Parental occupational exposure to pesticides is also a concern because exposures occurring during pregnancy and carry-home residues also contribute to children's cumulative burden. A number of epidemiological studies consistently reported increased risks between pesticide exposures and childhood leukemia, brain cancer, neuroblastoma, non-Hodgkin's lymphoma, Wilms' tumor, and Ewing's sarcoma. An extensive review of these studies was published in 1998 (Zahm & Ward, 1998). Fifteen case-control studies, 4 cohort studies, and 2 ecological studies have been published since this review, and 15 of these 21 studies reported statistically significant increased risks between either childhood pesticide exposure or parental occupational exposure and childhood cancer. Therefore, one can confidently state that there is at least some association between pesticide exposure and childhood cancer. However, an unambiguous mechanistic cause-and-effect relationship between pesticide exposure and childhood cancer was not demonstrated in these studies, and modifying factors such as genetic predisposition, rarely considered in the reviewed studies, likely play an important role. While the time window of exposure may be a crucial determinant for biological effects associated with pesticide exposure on children, studies have not contributed definitive information on the most vulnerable period. Accurate exposure assessment remains a challenge; future epidemiological studies need to assess gene-environment interactions and use improved exposure measures, including separate parental interviews, specific pesticide exposure questions, and semiquantitative exposure measures that can be used to confirm information obtained through questionnaires.     

Environmental hazards: evidence for effects on child health

The human fetus, child, and adult may experience adverse health outcomes from parental or childhood exposures to environmental toxicants. The fetus and infant are especially vulnerable to toxicants that disrupt developmental processes during relatively narrow time windows. This review summarizes knowledge of associations between child health and development outcomes and environmental exposures, including lead, methylmercury, polychlorinated biphenyls (PCBs), dioxins and related polyhalogenated aromatic hydrocarbons (PHAHs), certain pesticides, environmental tobacco smoke (ETS), aeroallergens, ambient air toxicants (especially particulate matter [PM] and ozone), chlorination disinfection by-products (DBPs), sunlight, power-frequency magnetic fields, radiofrequency (RF) radiation, residential proximity to hazardous waste disposal sites, and solvents. The adverse health effects linked to such exposures include fetal death, birth defects, being small for gestational age (SGA), preterm birth, clinically overt cognitive, neurologic, and behavioral abnormalities, subtle neuropsychologic deficits, childhood cancer, asthma, other respiratory diseases, and acute poisoning. Some environmental toxicants, notably lead, ionizing radiation, ETS, and certain ambient air toxicants, produce adverse health effects at relatively low exposure levels during fetal or child developmental time windows. For the many associations supported by limited or inadequate epidemiologic evidence, major sources of uncertainty include the limited number of studies conducted on specific exposure-outcome relationships and methodologic limitations. The latter include (1) crude exposure indices, (2) limited range of exposure levels, (3) small sample sizes, and (4) limited knowledge and control of potential confounders. Important knowledge gaps include the role of preconceptual paternal exposures, a topic much less studied than maternal or childhood exposures. Large longitudinal studies beginning before or during early pregnancy are urgently needed to accurately measure and assess the relative importance of parental and childhood exposures and evaluate relatively subtle health outcomes such as neuropsychologic and other functional deficits. Large case-control studies are also needed to assess the role of environmental exposures and their interactions with genetic factors in relatively uncommon outcomes such as specific types of birth defects and childhood cancers. There is also an urgent need to accelerate development and use of biomarkers of exposure and genetic susceptibility in epidemiologic studies. This review supports the priority assigned by international agencies to relationships between child health and air quality (indoor and outdoor), lead, pesticides, water contaminants, and ETS. To adequately address such priorities, governments and agencies must strengthen environmental health research capacities and adopt policies to reduce parental and childhood exposures to proven and emerging environmental threats.     

A review of adverse pregnancy outcomes and formaldehyde exposure in human and animal studies

We examine the potential for reproductive and developmental effects from formaldehyde exposure. Formaldehyde is unlikely to reach the reproductive system in humans in concentrations sufficient to cause damage since it is rapidly metabolized and detoxified upon contact with the respiratory tract. While there are effects seen in in vitro studies or after injection, there is little evidence of reproductive or developmental toxicity in animal studies under exposure levels and routes relevant to humans. Most of the epidemiology studies examined spontaneous abortion and showed some evidence of increased risk (meta-relative risk=1.4, 95% CI 0.9-2.1). We found evidence of reporting biases and publication biases among the epidemiology studies and when these biases were taken into account, we found no evidence of increased risk of spontaneous abortion among workers exposed to formaldehyde (meta-relative risk=0.7, 95% CI 0.5-1.0). The small number of studies on birth defects, low birth weight, and infertility among formaldehyde workers; the limitations in the design of these studies; and the inconsistent findings across these studies make it difficult to draw conclusions from the epidemiology data alone. However, information from experimental studies and studies of metabolism indicate reproductive impacts are unlikely at formaldehyde exposures levels observed in the epidemiology studies.     

Addressing the Linkage between Exposure to Pesticides and Human Health Effects—Research Trends and Priorities for Research

In recent years, there has been escalating concern over the possible association between exposure to pesticides and adverse human health effects by a number of non-governmental organizations, professional and public interest groups. Recognizing the need to document the scientific basis of these concerns as a foundation for initiating a research theme devoted to linkages between exposures to pesticides and human health effects, the Canadian Institutes of Health Research (CIHR) requested a summary of recent research trends that address these linkages. Experts across Canada in the field of pesticide regulation and research were invited to participate in the review. The review summarizes the limitations of past and current studies related to pesticides and human health effects research and makes suggestions for future research priorities and proposed study designs that will improve the assessment of pesticide exposure, the associated health risks, and improved methodology for regulatory decision making.     

Addressing the linkage between exposure to pesticides and human health effects--research trends and priorities for research

In recent years, there has been escalating concern over the possible association between exposure to pesticides and adverse human health effects by a number of non-governmental organizations, professional and public interest groups. Recognizing the need to document the scientific basis of these concerns as a foundation for initiating a research theme devoted to linkages between exposures to pesticides and human health effects, the Canadian Institutes of Health Research (CIHR) requested a summary of recent research trends that address these linkages. Experts across Canada in the field of pesticide regulation and research were invited to participate in the review. The review summarizes the limitations of past and current studies related to pesticides and human health effects research and makes suggestions for future research priorities and proposed study designs that will improve the assessment of pesticide exposure, the associated health risks, and improved methodology for regulatory decision making.     

Review of genotoxicity biomonitoring studies of glyphosate-based formulations

Abstract

Human and environmental genotoxicity biomonitoring studies involving exposure to glyphosate-based formulations (GBFs) were reviewed to complement an earlier review of experimental genotoxicity studies of glyphosate and GBFs. The environmental and most of the human biomonitoring studies were not informative because there was either a very low frequency of GBF exposure or exposure to a large number of pesticides without analysis of specific pesticide effects. One pesticide sprayer biomonitoring study indicated there was not a statistically significant relationship between frequency of GBF exposure reported for the last spraying season and oxidative DNA damage. There were three studies of human populations in regions of GBF aerial spraying. One study found increases for the cytokinesis-block micronucleus endpoint but these increases did not show statistically significant associations with self-reported spray exposure and were not consistent with application rates. A second study found increases for the blood cell comet endpoint at high exposures causing toxicity. However, a follow-up to this study 2 years after spraying did not indicate chromosomal effects. The results of the biomonitoring studies do not contradict an earlier conclusion derived from experimental genotoxicity studies that typical GBFs do not appear to present significant genotoxic risk under normal conditions of human or environmental exposures.     

Pesticide toxicity and the developing brain

Organochlorine pesticides are used in some countries for malaria control and organophosphate pesticides are widely used in agriculture and in homes. Previous literature documents children's exposure to these chemicals both in utero and during development. Animal studies suggest that many of these chemicals are neurodevelopmental toxicants even in moderate doses, but there are few studies in human beings. Associations of children's pesticide exposure with neurodevelopment from studies being conducted worldwide are summarized. In addition, we present the work of the CHAMACOS study, a longitudinal birth cohort study of Mexican-American children living in the Salinas Valley of California. In this study, we investigated the relationship of children's neurodevelopment with maternal dichlorodiphenyltrichloroethane and dichlorodiphenyldichloroethylene serum levels, as well as prenatal and child organophosphate urinary metabolite levels. We have examined the association with children's performance on the Brazelton Neonatal Assessment Scales and at 6, 12 and 24 months on the Bayley Scales of Infant Development (mental development and psychomotor development) and mothers report on the Child Behaviour Checklist. We observed a negative association of prenatal dichlorodiphenyltrichloroethane exposure and child mental development. We also observed adverse associations of prenatal but not postnatal organophosphate pesticide exposure with mental development and pervasive developmental disorder at 24 months.     

A review of epidemiologic studies of low-level exposures to organophosphorus insecticides in non-occupational populations

Abstract

This paper systematically reviews epidemiologic studies related to low-level non-occupational exposures to organophosphorus (OP) insecticides. Many of the studies evaluate levels of maternal OP metabolites and subsequent health outcomes in offspring. The studies focused primarily on birth outcomes (e.g., infant body weight or head circumference) and neurodevelopmental (e.g., mental and psychomotor) testing results. The evidence from these studies was reviewed under the Bradford Hill guidelines. Most of the studies assessing exposure based on urinary levels of OP insecticide metabolites used only one or two measurements during pregnancy. The potential for exposure misclassification with this method is largely due to (1) preformed metabolites that are ingested with food, (2) the short elimination half-life of OP insecticides, and (3) lack of specificity to particular OP insecticides for many of the metabolites. For birth outcomes, the majority of reported results are not statistically significant, and the associations are inconsistent within and across studies. There is more within-study consistency for some of the neurodevelopmental testing results, although few associations were examined across several studies. These associations are generally weak, have been replicated only to a limited extent, and require further confirmation before they can be considered established. The OP insecticide levels measured in the epidemiologic studies are too low to cause biologically meaningful acetylcholinesterase inhibition, the most widely used metric for OP insecticide toxicity. Overall, the available evidence does not establish that low-level exposures to OP insecticides cause adverse birth outcomes or neurodevelopmental problems in humans.     

Pesticide Exposure and Neurodevelopmental Outcomes: Review of the Epidemiologic and Animal Studies

Assessment of whether pesticide exposure is associated with neurodevelopmental outcomes in children can best be addressed with a systematic review of both the human and animal peer-reviewed literature. This review analyzed epidemiologic studies testing the hypothesis that exposure to pesticides during pregnancy and/or early childhood is associated with neurodevelopmental outcomes in children. Studies that directly queried pesticide exposure (e.g., via questionnaire or interview) or measured pesticide or metabolite levels in biological specimens from study participants (e.g., blood, urine, etc.) or their immediate environment (e.g., personal air monitoring, home dust samples, etc.) were eligible for inclusion. Consistency, strength of association, and dose response were key elements of the framework utilized for evaluating epidemiologic studies. As a whole, the epidemiologic studies did not strongly implicate any particular pesticide as being causally related to adverse neurodevelopmental outcomes in infants and children. A few associations were unique for a health outcome and specific pesticide, and alternative hypotheses could not be ruled out. Our survey of the in vivo peer-reviewed published mammalian literature focused on effects of the specific active ingredient of pesticides on functional neurodevelopmental endpoints (i.e., behavior, neuropharmacology and neuropathology). In most cases, effects were noted at dose levels within the same order of magnitude or higher compared to the point of departure used for chronic risk assessments in the United States. Thus, although the published animal studies may have characterized potential neurodevelopmental outcomes using endpoints not required by guideline studies, the effects were generally observed at or above effect levels measured in repeated-dose toxicology studies submitted to the U.S. Environmental Protection Agency (EPA). Suggestions for improved exposure assessment in epidemiology studies and more effective and tiered approaches in animal testing are discussed.     

Growth from birth onwards of children prenatally exposed to drugs: a literature review

Reductions in birth weight and length have been independently attributed to prenatal exposure to alcohol, cigarettes and cocaine. While pregnant women often use multiple substances, studies have not consistently controlled for exposure to other agents or other important differences in maternal lifestyle associated with the use of these substances. Despite these difficulties, the preponderance of evidence suggests that prenatal alcohol and cocaine independently reduce birth measurements. This review synthesizes the scientific literature focusing on prenatal exposures and the relationship to child growth. First examined are studies that investigated the link between prenatal exposures and birth weight and length, followed by the effects of these substances on childhood growth. Studies vary in the number of subjects, cohort characteristics, measurement of exposure and control for potential confounders. Differences in sample characteristics and size, as well as degree of statistical control for potential confounders and the examination of moderating characteristics, have led to differing conclusions regarding the long-term effect of prenatal substance exposure on growth. Large-scale, well-designed studies are needed to clearly examine the unique contribution of both varying prenatal exposures and the magnitude and timing of these exposures on childhood growth deficits.     

Systematic review of biomonitoring studies to determine the association between exposure to organophosphorus and pyrethroid insecticides and human health outcomes

For the appropriate protection of human health it is necessary to accurately estimate the health effects of human exposure to toxic compounds. In the present review, epidemiological studies on the health effects of human exposure to organophosphorus (OP) and pyrethroid (PYR) insecticides have been critically assessed. This review is focused on studies where the exposure assessment was based on quantification of specific biomarkers in urine or plasma. The 49 studies reviewed used different epidemiological approaches and analytical methods as well as different exposure assessment methodologies. With regard to OP pesticides, the studies reviewed suggested negative effects of prenatal exposure to these pesticides on neurodevelopment and male reproduction. Neurologic effects on adults, DNA damage and adverse birth outcomes were also associated with exposure to OP pesticides. With regard to exposure to PYR pesticides, there are currently few studies investigating the adverse health outcomes due to these pesticides. The effects studied in relation to PYR exposure were mainly male reproductive effects (sperm quality, sperm DNA damage and reproductive hormone disorders). Studies' findings provided evidence to support the hypothesis that PYR exposure is adversely associated with effects on the male reproductive system. The validity of these epidemiological studies is strongly enhanced by exposure assessment based on biomarker quantification. However, for valid and reliable results and conclusions, attention should also be focused on the validity of the analytical methods used, study designs and the measured toxicants characteristics.     

Prioritization of pesticides based on daily dietary exposure potential as determined from the SHEDS model

A major pathway for exposure to many pesticides is through diet. The objectives were to rank pesticides by comparing their calculated daily dietary exposure as determined by EPA's Stochastic Human Exposure and Dose Simulation (SHEDS) to single pesticides for different age groups to acceptable daily intakes (ADI), characterize pesticide trends in exposures over different time periods, and determine commodities contributing to pesticide exposures. SHEDS was applied, using Pesticide Data Program (PDP) (1991–2011) and pesticide usage data on crops from USDA combined with NHANES dietary consumption data, to generate exposure estimates by age group. ADI data collected from EPA, WHO, and other sources were used to rank pesticides based on relativeness of the dietary exposure potential to ADI by age groups. Sensitivity analysis provided trends in pesticide exposures. Within SHEDS, commodities contributing the majority of pesticides with greatest exposure potential were determined. The results indicated that the highest ranking pesticides were methamidophos and diazinon which exceeded 100% of the ADI. Sensitivity analysis indicated that exposure to methamidophos, diazinon, malathion, ethion and formetanate hydrochloride had a marked decrease from 1991–1999 to 2000–2011. Contributions analysis indicated that apples, mushroom, carrots, and lettuce contributed to diazinon exposure. Beans and pepper contributed to methamidophos exposure.     

Pesticide mixtures potentiate the toxicity in murine thymocytes

The immunotoxic risks of multiple pesticide exposure were evaluated. C57BL/6 mouse thymocytes were exposed to lindane, malathion, and permethrin, either separately or in mixtures of two pesticides, in vitro. These pesticide exposures caused both apoptotic and necrotic cell death in thymocytes as evaluated by flow cytometric analysis in combination with 7-aminoactinomycin-D (7-AAD), Annexin-V/propidium iodide (PI) staining assays and lactate dehydrogenase release assays. When cells exposed to mixtures of two pesticides, a significantly greater than additive interaction was observed in both apoptotic and necrotic populations of cells. The gel electrophoresis of DNA of cells showed DNA ladder formation with limited genomic DNA and increased laddering in mixture exposures. Based on these findings, it is suggested that these pesticides are potent immunotoxicants, in vitro, and that the mechanism of cytotoxicity observed upon exposure to these pesticides may, at least in part, be due to induction of apoptosis. We also provided evidence that induction of drug metabolizing mixed function oxidase system with lindane may, in part, be responsible for the potentiation of cytotoxicity in the combined exposures. As more information is obtained on the potential immunotoxic effects of pesticides, further insights will be gained for the risk assessment of these environmental pollutants.     

The presence of dialkylphosphates in fresh fruit juices: implication for organophosphorus pesticide exposure and risk assessments

This study was designed to determine whether dialkylphosphates (DAPs) are present in fresh fruit juices, as a result of organophosphorus (OP) pesticides degradation. Fresh conventional and organic fruit (apple and orange) juices were purchased from local grocery stores. DAPs were found in both conventional and organic juices, and the original levels were higher, for both apple and orange juices, in conventional than in organic juices. Additional DAPs were found in OP pesticide fortified juices after 72 h of storage at 4 degrees C, suggesting a degradation of OP pesticides in juices. Overall, 12% and 36.2% of fortified azinphosmethyl, a dimethyl OP pesticide, and the combination of fortified diazinon and chlorpyrifos, both diethyl OP pesticides, were degraded to dimethyl and diethyl DAPs, respectively. Although the exact mechanism of the degradation is unknown, hydrolysis is likely the cause of OP pesticide degradation in juice. The presence of DAPs in fresh fruit juices clouds the validity of using urinary DAP measurements for estimating OP pesticide exposures in humans, particularly in children. The overestimated OP pesticide exposures based on urinary DAPs reported in other studies is likely due to the coexistence of preformed DAPs and DAPs resulting from OP pesticide exposures. Thus, before urinary DAP concentrations can be reliably used in exposure and risk assessment, the proportion of the concentration attributable to environmental DAP exposure, particularly through the diet, must be ascertained. In conclusion, urinary DAPs have many limitations when being used as biomarkers for OP pesticides in exposure and risk assessment, and caution should be exercised when interpreting DAPs results.     

A study of the impact of agricultural pesticide use on the prevalence of birth defects in northeast Italy

Pesticides are probably the most frequently deliberately released toxic chemicals into the environment. However, although the results of experimental studies indicate developmental toxicity hazards for several groups of chemicals used, the studies in humans are contradictory. There are specific regulations in the European Union (EU) regarding the use of pesticides and there is also considerable awareness about possible related health problems. In order to investigate whether, in the current EU situation, the use of certain pesticides could be associated with adverse health effects in the outcome of pregnancies, we have performed a 6-year study in an agricultural area in the Veneto Region of, northeastern Italy, where we have been able to define the exact quantity and type of pesticides as well as the exposed population, in order to quantify the risk of congenital malformations related to the use of pesticides. Data on congenital malformations were obtained from the northeast Italy Congenital malformation Registry, using several sources of ascertainment, while pesticide use were obtained through interviews with users and sellers. The municipalities of three contiguous provinces were divided into those with a high, low or intermediate use of pesticides. In the study period there was a total of 146,239 consecutive pregnancies terminating in birth or induced abortion because of congenital malformation. No significant differences in the prevalence of congenital malformations were observed between the three different areas (high, low, intermediate risk). Our study confirms that in countries such as Italy, where there is close control of the use of pesticides, there is no epidemiological evidence that pesticides have any effect on the prevalence of congenital malformations.