Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, California, USA.
Environ Health Perspect. 2018 Jun 14;126(6):067006. doi: 10.1289/EHP2657. eCollection 2018 Jun.
Indoor residual spraying (IRS) of insecticides, conducted in low- and middle-income countries to control malaria, may result in high exposure to dichlorodiphenyltrichloroethane (DDT), its breakdown product dichlorodiphenyldichloroethylene (DDE), or pyrethroids. Animal studies suggest exposure to these chemicals may increase childhood infection frequency.
We investigated associations between maternal DDT/E and pyrethroid metabolite concentration and child infection associations in an IRS setting in which susceptibility factors are common and infections are leading causes of child morbidity and mortality.
Using gas chromatography-mass spectrometry, we measured serum DDT/E and urinary pyrethroid metabolite concentrations in peripartum samples from 674 women participating in the Venda Health Examination of Mother, Babies and their Environment (VHEMBE) study. Counts of persistent child fevers, otitis media, and severe sore throat between 1 and 2 y of age were ascertained from maternal interviews. Associations between DDT/E and pyrethroid metabolite concentrations and infections were estimated using zero-inflated Poisson regression. We estimated relative excess risks due to interaction (RERI) with poverty, maternal energy intake, and maternal HIV status.
Concentrations of DDT/E, particularly -DDE, were associated with higher rates of persistent fevers [IRR=1.21 (95% CI: 1.01, 1.46)], for a 10-fold increase in -DDE). This association was stronger among children from households below versus above the South African food poverty line [IRR=1.31 (95% CI: 1.08, 1.59) vs. IRR=0.93 (95% CI: 0.69, 1.25), respectively] and for children whose mothers had insufficient versus sufficient caloric intake during pregnancy [IRR=1.30 (95% CI: 1.07, 1.58) vs. IRR=0.96 (95% CI: 0.72, 1.28), respectively].
IRS insecticide exposure may increase childhood infection rates. This was particularly apparent among children from poorer households or whose mothers had low energy intake during pregnancy. https://doi.org/10.1289/EHP2657.
在中低收入国家，为控制疟疾而进行的室内滞留喷洒（IRS）可能会导致高水平暴露于滴滴涕（DDT）、其分解产物二氯二苯二氯乙烯（DDE）或拟除虫菊酯。动物研究表明，接触这些化学物质可能会增加儿童感染的频率。
我们在 IRS 环境中调查了母亲 DDT/E 和拟除虫菊酯代谢物浓度与儿童感染之间的关联，在 IRS 环境中，易感因素很常见，感染是儿童发病率和死亡率的主要原因。
使用气相色谱-质谱法，我们测量了参加文达母婴及其环境健康检查（VHEMBE）研究的 674 名围产期妇女的血清 DDT/E 和尿中拟除虫菊酯代谢物浓度。通过母亲访谈确定 1 至 2 岁儿童持续性发热、中耳炎和严重喉咙痛的次数。使用零膨胀泊松回归估计 DDT/E 和拟除虫菊酯代谢物浓度与感染之间的关联。我们估计了相对超额风险比（RERI）与贫困、母亲能量摄入和母亲 HIV 状况之间的交互作用。
DDT/E 的浓度，特别是-DDE，与持续性发热的发生率较高相关[IRR=1.21（95%CI：1.01，1.46）]，对于-DDE 的十倍增加。这种关联在家庭收入低于而非高于南非食物贫困线的儿童中更强[IRR=1.31（95%CI：1.08，1.59）vs.IRR=0.93（95%CI：0.69，1.25）]，并且在母亲怀孕期间能量摄入不足而非充足的儿童中更强[IRR=1.30（95%CI：1.07，1.58）vs.IRR=0.96（95%CI：0.72，1.28）]。
IRS 杀虫剂的暴露可能会增加儿童的感染率。这在来自较贫困家庭或母亲在怀孕期间能量摄入较低的儿童中更为明显。https://doi.org/10.1289/EHP2657.
