Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Environ Int. 2012 Oct 15;47:80-5. doi: 10.1016/j.envint.2012.06.007. Epub 2012 Jul 13.
Previous research has shown that prenatal exposure to pesticides may be associated with decreased fetal growth. The specific pesticides investigated and results reported across studies have been inconsistent, and there is a mounting need for the consideration of mixtures rather than individual agents in studies of health outcomes in relation to environmental exposures. There are also many individual pesticides that have not been investigated in human health studies to date. We conducted a pilot study in rural Zhejiang province, China, measuring 20 non-persistent pesticides (10 insecticides, 6 herbicides, 3 fungicides, and 1 repellant) in umbilical cord blood of 112 full term (> 37 weeks) infants. The pesticides detected with the greatest frequency were diethyltoluamide (DEET) (73%), a repellant, and vinclozolin (49%), a fungicide. The samples had detectable concentrations for a mean of 4.6 pesticides (SD=1.9) with a maximum of 10. Adjusting for potential confounders, newborn birth weight was inversely associated with the number of pesticides detected in cord blood (p=0.04); birth weight decreased by a mean of 37.1g (95% CI, -72.5 to -1.8) for each detected pesticide. When assessing relationships by pesticide type, detection of fungicides was also associated with decreased birth weight (adjusted β=-116 g [95% CI, -212 to -19.2]). For individual pesticides analyzed as dichotomous (detect vs. non-detect) variables, only vinclozolin (adjusted β=-174 g [95% CI, -312 to -36.3]) and acetochlor (adjusted β=-165 g [95% CI, -325 to -5.7]) were significantly associated with reduced birth weight. No significant associations were seen between birth weight and individual pesticides assessed as continuous or 3-level ordinal variables. Our findings from this pilot investigation suggest that exposure to fungicides may adversely impact fetal growth. Exposure to mixtures of multiple pesticides is also of concern and should be explored in addition to individual pesticides. Additional research is needed to establish causality and to understand the function and impact of fungicides and pesticide mixtures on fetal development.
先前的研究表明，产前接触农药可能与胎儿生长受限有关。研究中调查的具体农药和报告的结果并不一致，因此迫切需要在与环境暴露有关的健康结果研究中考虑混合物而不是单一药剂。到目前为止，还有许多个别农药尚未在人类健康研究中进行调查。我们在中国浙江省农村进行了一项试点研究，测量了 112 名足月（>37 周）婴儿脐带血中的 20 种非持久性农药（10 种杀虫剂、6 种除草剂、3 种杀菌剂和 1 种驱虫剂）。检测到的最常见农药是避蚊胺（DEET）（73%），一种驱虫剂，以及戊唑醇（49%），一种杀菌剂。这些样本的平均检出浓度为 4.6 种农药（标准差=1.9），最高检出浓度为 10 种。调整潜在混杂因素后，新生儿出生体重与脐带血中检出的农药数量呈负相关（p=0.04）；每检出一种农药，出生体重平均下降 37.1g（95%置信区间，-72.5 至 -1.8）。在按农药类型评估关系时，检测到的杀菌剂也与出生体重降低有关（调整后的β=-116g[95%置信区间，-212 至 -19.2]）。对于作为二分类（检出与未检出）变量进行分析的个别农药，只有戊唑醇（调整后的β=-174g[95%置信区间，-312 至 -36.3]）和乙草胺（调整后的β=-165g[95%置信区间，-325 至 -5.7]）与出生体重降低显著相关。出生体重与作为连续或 3 级有序变量评估的个别农药之间没有显著关联。我们从这项试点研究中得出的结论表明，接触杀菌剂可能对胎儿生长产生不利影响。接触多种农药的混合物也令人担忧，除了个别农药外，还应加以探索。需要进一步研究以确定因果关系，并了解杀菌剂和农药混合物对胎儿发育的功能和影响。
