Department of Toxicology, School of Medicine, University of the Republic, Montevideo, Uruguay.
Rev Environ Health. 2020 Sep 25;35(3):221-227. doi: 10.1515/reveh-2020-0011.
Pesticides represent a wide variety of chemicals presented as different formulations and concentrations and used in different settings: agriculture, animal sanitary bath, domestic use, and vector control. Lack of awareness, poor agricultural practices, and inappropriate disposal of containers will increase the exposure and risk of health effects during childhood. The concern about children's exposure to pesticides is based on their toxic properties and the special vulnerability to the exposure, which may occur in different stages, from the prenatal period to infancy. Pesticide related diseases may manifest during the infancy, adolescence, or adulthood. Children may be exposed by multiple routes of exposure, in different scenarios. In domestic settings, insecticides and rodenticides are usually stored within the reach of children, or may be transferred to non-original containers, leading to acute non intentional ingestion. Exploratory behavior increases the risk for exposure to pesticides present on the ground. Gardens and playgrounds may have pesticides residues. Children may be in contact with domestic animals that have been treated with pesticides. In rural settings, children can be exposed to pesticide residues in areas where they have been applied, or by contamination of work equipment and parents clothing. Families dedicated to rural activity have higher levels of exposure, through ingesting contaminated fruits, vegetables, milk, eggs, and water. Several studies confirmed pesticide exposure in children by biomonitoring. Higher levels of organophosphate metabolites have been reported in children compared to adult populations. Toxic effects of pesticides depend on their intrinsic toxic properties as well as on the dose, duration, and life period of exposure. Acute poisonings are related to high doses exposure, while chronic, subtle and delayed effects are often related to low levels/doses exposure. Epidemiologic, animal, and clinical studies suggest an association between chronic, low-level exposures and alterations in growth and development (particularly impaired neurobehavioral development), cancer and increased susceptibility to infections. New research presents evidence that some pesticides are a risk factor of a wide range of acute and chronic diseases. Better practices and public health policies are needed to prevent and protect children from pesticides exposure.
农药代表了多种不同配方和浓度的化学物质，用于农业、动物卫生浴、家庭使用和病媒控制等不同领域。缺乏意识、不良的农业实践和不当处理容器会增加儿童在童年时期接触和健康风险的可能性。对儿童接触农药的关注基于其毒性特性和对接触的特殊易感性，这种接触可能发生在从产前到婴儿期的不同阶段。与农药相关的疾病可能在婴儿期、青春期或成年期表现出来。儿童可能通过多种接触途径，在不同场景下接触农药。在家庭环境中，杀虫剂和灭鼠剂通常存放在儿童触手可及的地方，或者可能被转移到非原始容器中，导致非故意急性摄入。探索性行为会增加接触地面上存在的农药的风险。花园和操场可能有农药残留。儿童可能会接触到已用农药处理过的家养动物。在农村地区，儿童可能会接触到已施用农药的区域中的农药残留，或者通过工作设备和父母衣物的污染而接触到农药残留。从事农村活动的家庭通过摄入受污染的水果、蔬菜、牛奶、鸡蛋和水，接触农药的风险更高。几项研究通过生物监测证实了儿童接触农药的情况。与成人人群相比，儿童体内有机磷代谢物的水平更高。农药的毒性效应取决于其内在毒性特性以及剂量、持续时间和暴露的生命期。急性中毒与高剂量暴露有关，而慢性、细微和延迟的效应通常与低水平/剂量暴露有关。流行病学、动物和临床研究表明，慢性、低水平暴露与生长和发育（特别是神经行为发育受损）改变、癌症和感染易感性增加之间存在关联。新的研究提供了证据表明，一些农药是一系列急性和慢性疾病的危险因素。需要更好的实践和公共卫生政策来预防和保护儿童免受农药接触。
