Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica; Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, United States.
Department of Biological Sciences and Center for Human Health and the Environment, North Carolina State University, United States.
Int J Hyg Environ Health. 2020 Apr;225:113474. doi: 10.1016/j.ijheh.2020.113474. Epub 2020 Feb 15.
Growing evidence suggests that pesticide exposure may influence respiratory health, but data in young children are very limited. We examined the association of prenatal pesticide exposure with lower respiratory tract infections (LRTIs) and wheeze at one year of age in children from the Infants' Environmental Health (ISA) study in Costa Rica.
We measured seven pesticide metabolites, including ethylenethiourea (ETU, metabolite of mancozeb), in maternal urine samples collected repeatedly during pregnancy. For each woman, we averaged pesticide concentrations during each half of pregnancy (≤20 and >20 weeks of gestation) and across repeated samples collected over the course of pregnancy. We collected information about LRTIs (n = 355) and wheezing (n = 272) during the first year of life from mothers when their children were 11-19 months old. We fit multivariable logistic regression models using high (quartile 4) vs. low (quartiles 1-3) urinary pesticide concentrations as exposures and adjusted models for maternal age, education, parity, gestational age at birth, and child sex.
Ten percent of the children had at least one LRTI and 39% had at least one episode of wheezing during their first year of life. Median (25-75th percentile) specific gravity-corrected urinary ETU concentrations during the first half, second half, and over the course of pregnancy were 3.4 (2.1-5.0), 3.3 (2.2-4.7), and 3.4 (2.4-5.0) ng/mL, respectively. We observed that high urinary ETU concentrations during the first half of pregnancy were associated with increased odds of LRTI (OR = 2.45; 95% CI: 0.96, 6.26), whereas high urinary ETU concentrations during the second half of pregnancy were associated with decreased odds of wheezing (OR = 0.50; 95% CI: 0.26, 0.96). We found that the association between high urinary ETU concentrations during the first half of pregnancy and LRTIs persisted among mother-child pairs with either high or low ETU concentrations during the second half. In contrast, the association of high urinary ETU concentrations during the second half of pregnancy with wheezing was attenuated when we simultaneously adjusted for urinary ETU concentrations during the first half. We observed null associations between other pesticide metabolites measured during pregnancy and respiratory outcomes.
Our data indicate that exposure to mancozeb/ETU during the first half of pregnancy may be associated with respiratory outcomes in the first year of life.
越来越多的证据表明，农药暴露可能会影响呼吸道健康，但在幼儿中的数据非常有限。我们研究了哥斯达黎加婴儿环境健康（ISA）研究中儿童在怀孕期间接触农药与一岁时下呼吸道感染（LRTI）和喘息的关系。
我们测量了孕妇尿液样本中 7 种农药代谢物，包括乙撑硫脲（ETU，代森锰锌的代谢物）。对于每个女性，我们在妊娠前半段（妊娠≤20 周和>20 周）和整个妊娠过程中重复收集的样本中平均农药浓度。当孩子 11-19 个月大时，我们从母亲那里收集了第一年生命中 LRTI（n=355）和喘息（n=272）的信息。我们使用高（四分位数 4）与低（四分位数 1-3）尿液农药浓度作为暴露因素，使用多变量逻辑回归模型进行拟合，并调整了母亲年龄、教育程度、产次、出生时的胎龄和孩子性别。
10%的儿童在生命的第一年至少有一次 LRTI，39%的儿童至少有一次喘息发作。妊娠前半段、后半段和整个妊娠过程中，特定比重校正后的 ETU 尿液浓度中位数（25-75 百分位）分别为 3.4（2.1-5.0）、3.3（2.2-4.7）和 3.4（2.4-5.0）ng/ml。我们观察到，妊娠前半段高 ETU 尿液浓度与 LRTI 的几率增加有关（OR=2.45；95%CI：0.96，6.26），而妊娠后半段高 ETU 尿液浓度与喘息几率降低有关（OR=0.50；95%CI：0.26，0.96）。我们发现，在妊娠后半段 ETU 浓度高或低的母婴对子中，妊娠前半段高 ETU 尿液浓度与 LRTI 之间的关联仍然存在。相比之下，当我们同时调整妊娠前半段 ETU 尿液浓度时，妊娠后半段 ETU 尿液浓度与喘息之间的关联减弱。我们观察到在怀孕期间测量的其他农药代谢物与呼吸结果之间没有关联。
我们的数据表明，在妊娠前半段接触代森锰锌/ETU 可能与生命第一年的呼吸道结局有关。
