Université de Montréal Public Health Research Institute (IRSPUM), Montreal, QC, Canada; Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, Montreal, QC, Canada.
Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.
Environ Int. 2018 Oct;119:478-484. doi: 10.1016/j.envint.2018.07.010. Epub 2018 Jul 23.
The World Health Organization recommends indoor residual spraying (IRS) of insecticides (including dichlorodiphenyltrichloroethane [DDT]) to fight malaria vectors in endemic countries. There is limited information on children's exposure to DDT in sprayed areas, and tools to estimate early-life exposure have not been thoroughly evaluated in this context.
To document serum p,p'-DDT/E levels in 47 mothers and children participating in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), a study conducted in an area where IRS insecticides are used annually, and to evaluate the precision and accuracy of a published pharmacokinetic model for the estimation of children's p,p'-DDT/E levels.
p,p'-DDT/E levels were measured in maternal serum at delivery, and in children's serum at 12 and 24 months of age. A pharmacokinetic model of gestational and lactational exposure was used to estimate children's p,p'-DDT/E levels during pregnancy and the first two years of life, and estimated levels were compared to measured levels.
The geometric means of children's serum p,p'-DDT/E levels at 12 and 24 months were higher than those of maternal serum levels. Regression models of measured children's p,p'-DDT/E levels vs. levels estimated with the pharmacokinetic model (which only accounted for children's exposure through placental transfer and breastfeeding) had coefficients of determination (R) ranging from 0.75 to 0.82. Estimated p,p'-DDE levels were not significantly different from measured levels, whereas p,p'-DDT levels were overestimated by 36% at 12 months, and 51% at 24 months.
Results indicate that children living in a sprayed area have serum p,p'-DDT/E levels exceeding their mothers' during the first two years of life. The pharmacokinetic model may be useful to estimate children's levels in the VHEMBE population.
世界卫生组织建议在流行疟疾的国家使用室内滞留喷洒（IRS）杀虫剂（包括滴滴涕[DDT]）来消灭疟疾病媒。关于儿童在喷洒地区接触滴滴涕的信息有限，并且在这种情况下，尚未对用于估计生命早期接触的工具进行彻底评估。
记录参与文达母婴及其环境健康检查（VHEMBE）的 47 位母亲和儿童的血清 p,p'-DDT/E 水平，该研究在一个每年使用 IRS 杀虫剂的地区进行，并评估用于估计儿童 p,p'-DDT/E 水平的已发表药代动力学模型的精度和准确性。
在分娩时测量母亲血清中的 p,p'-DDT/E 水平，在儿童 12 个月和 24 个月时测量其血清中的 p,p'-DDT/E 水平。使用妊娠期和哺乳期接触的药代动力学模型来估计儿童在妊娠和生命的前两年期间的 p,p'-DDT/E 水平，并将估计水平与实测水平进行比较。
儿童血清中 p,p'-DDT/E 水平在 12 个月和 24 个月时的几何平均值均高于母体血清中的水平。实测儿童 p,p'-DDT/E 水平与药代动力学模型估计水平的回归模型（仅考虑儿童通过胎盘转移和母乳喂养的暴露）的决定系数（R）范围为 0.75 至 0.82。估计的 p,p'-DDE 水平与实测水平无显著差异，而 p,p'-DDT 水平在 12 个月时高估了 36%，在 24 个月时高估了 51%。
结果表明，生活在喷洒地区的儿童在生命的前两年血清中 p,p'-DDT/E 水平超过其母亲。药代动力学模型可能有助于估计 VHEMBE 人群中儿童的水平。
