Gaspar Fraser W, Chevrier Jonathan, Quirós-Alcalá Lesliam, Lipsitt Jonah M, Barr Dana Boyd, Holland Nina, Bornman Riana, Eskenazi Brenda
Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, California, USA
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
Environ Health Perspect. 2017 Jul 7;125(7):077006. doi: 10.1289/EHP353.
Although indoor residual spraying (IRS) is an effective tool for malaria control, its use contributes to high insecticide exposure in sprayed communities and raises concerns about possible unintended health effects.
The Venda Health Examination of Mothers, Babies and their Environment (VHEMBE) is a birth cohort study initiated in 2012 to characterize prenatal exposure to IRS insecticides and exposures' impacts on child health and development in rural South Africa.
In this report, we describe the VHEMBE cohort and dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenyldichloroethylene (DDE) serum concentrations measured in VHEMBE mothers when they presented for delivery. In addition, we applied a causal inference framework to estimate the potential reduction in population-level ,-DDT and ,-DDE serum concentrations under five hypothetical interventions. A total of 751 mothers were enrolled.
Serum concentrations of , isomers of DDT and DDE were above the limit of detection (LOD) in ≥98% of the samples, whereas the , isomers were above the LOD in at least 80% of the samples. Median (interquartile range) ,-DDT and ,-DDE serum concentrations for VHEMBE cohort participants were 55.3 (19.0-259.3) and 242.2 (91.8-878.7) ng/g-lipid, respectively. Mothers reporting to have lived in a home sprayed with DDT for malaria control had ~5-7 times higher ,-DDT and ,-DDE serum concentrations than those who never lived in a home sprayed with DDT. Of the five potential interventions tested, we found increasing access to water significantly reduced ,-DDT exposure and increasing the frequency of household wet mopping significantly reduced ,-DDT and ,-DDE exposure.
Our findings suggest that several intervention approaches may reduce DDT/DDE exposure in pregnant women living in IRS communities. https://doi.org/10.1289/EHP353.
尽管室内残留喷洒（IRS）是控制疟疾的有效手段，但其使用导致喷洒社区的人群接触大量杀虫剂，并引发了对可能产生的意外健康影响的担忧。
万德母婴及其环境健康检查（VHEMBE）是一项始于2012年的出生队列研究，旨在描述南非农村地区产前接触IRS杀虫剂的情况以及这种接触对儿童健康和发育的影响。
在本报告中，我们描述了VHEMBE队列以及VHEMBE母亲分娩时所测的血清中滴滴涕（DDT）和二氯二苯二氯乙烯（DDE）的浓度。此外，我们应用因果推断框架来估计在五种假设干预措施下人群水平的β-DDT和β-DDE血清浓度的潜在降低情况。总共招募了751名母亲。
在≥98%的样本中，DDT和DDE的β异构体血清浓度高于检测限（LOD），而γ异构体在至少80%的样本中高于LOD。VHEMBE队列参与者的β-DDT和β-DDE血清浓度中位数（四分位间距）分别为55.3（19.0 - 259.3）和242.2（91.8 - 878.7）ng/g脂质。报告曾居住在为控制疟疾而喷洒DDT房屋中的母亲，其β-DDT和β-DDE血清浓度比从未居住在喷洒DDT房屋中的母亲高约5 - 7倍。在测试的五种潜在干预措施中，我们发现增加供水可显著降低β-DDT暴露，增加家庭湿式拖地频率可显著降低β-DDT和β-DDE暴露。
我们的研究结果表明，几种干预方法可能会降低居住在实施IRS社区的孕妇的DDT/DDE暴露。https://doi.org/10.1289/EHP353
