Akyeampong Enoch, Bend John R, Luginaah Isaac, Oscar Yawson David, Jerry Cobbina Samuel, Ato Armah Frederick, Osei Adu Michael, Kofi Essumang David, Iddi Samuel, Botwe Paul K, Quansah Reginald
Biological, Environmental & Occupational Health Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana.
Department of Pathology & Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Environ Health Insights. 2022 Apr 30;16:11786302221094418. doi: 10.1177/11786302221094418. eCollection 2022.
Several environmental factors are associated with the risk of acute lower respiratory infections (ALRIs) and upper respiratory infections (URIs) in children under 5 years of age (YOA). Evidence implicating chemical pesticides remains equivocal. There are also no data on this subject in these children in Ghana. This study investigated the association between urinary pesticide residual levels and the risk for ALRIs/URIs in children under 5 YOA.
The participants for this study were from the Offinso North Farm Health Study, a population-based cross-sectional study. Two hundred and fifty four parents/guardians who had answered affirmatively to the question "Has your child ever accompanied you to the farm?" were interviewed on household socio-demographic and environmental factors, being breastfed, child education, age, gender, and respiratory infection. One hundred fifty children were randomly selected to provide the first void urine.
The proportion of children with ALRI was 22.1% and those with URI was 35.8%. We observed a statistically significant exposure-response relation of p,p'-DDE (tertile) with ALRI (1.7-3.2 µg/L urine: prevalence ratio [PR] = 1.22 [1.05-1.70], ⩾3.2 µg/L urine: 1.50 [1.07-3.53] [-for trend = .0297]). This observation was in children older than two YOA (-for trend = .0404). Delta-HCH and beta-HCH (2-levels) were significantly associated with ALRI but not URI. The risk of ALRI increased with deltamethrin levels in an exposure-response manner (2.5-9.5 µg/L urine: 2.10 [1.37-3.24], ⩾9.5 µg/L urine: 4.38 [1.87-10.32] [-for trend = .0011]) and this was also observed in children older than two YOA. Similar observation was noted for URI. Bifenthrin (>0.5 µg/L urine) was positively associated with ALRI and URI whereas permethrin (⩾1.2 µg/L urine) was not associated only with URI.
The present study supports the hypothesis that exposure to chemical pesticides is associated with respiratory infections in children under 5 YOA.
多种环境因素与5岁以下儿童急性下呼吸道感染（ALRIs）及上呼吸道感染（URIs）的风险相关。关于化学农药与这些感染之间关系的证据仍不明确。加纳的这些儿童中也没有关于这一主题的数据。本研究调查了5岁以下儿童尿中农药残留水平与ALRIs/URIs风险之间的关联。
本研究的参与者来自奥芬索北农场健康研究，这是一项基于人群的横断面研究。对“您的孩子是否曾陪您去过农场？”这一问题回答为肯定的254名家长/监护人就家庭社会人口统计学和环境因素、是否母乳喂养、孩子的教育情况、年龄、性别以及呼吸道感染情况进行了访谈。随机选择150名儿童提供晨尿。
患ALRI的儿童比例为22.1%，患URI的儿童比例为35.8%。我们观察到p,p'-滴滴伊（三分位数）与ALRI之间存在统计学显著的暴露-反应关系（尿中1.7 - 3.2μg/L：患病率比值[PR]=1.22[1.05 - 1.70]，尿中≥3.2μg/L：1.50[1.07 - 3.53][-趋势p值=.0297]）。这一观察结果在2岁以上儿童中也存在（-趋势p值=.0404）。δ-六六六和β-六六六（两个水平）与ALRI显著相关，但与URI无关。随着溴氰菊酯水平升高，ALRI风险呈暴露-反应关系增加（尿中2.5 - 9.5μg/L：2.10[1.37 - 3.24]，尿中≥9.5μg/L：4.38[1.87 - 10.32][-趋势p值=.0011]），2岁以上儿童中也观察到类似情况。URI也有类似观察结果。联苯菊酯（尿中>0.5μg/L）与ALRI和URI呈正相关，而氯菊酯（尿中≥1.2μg/L）仅与URI无关。
本研究支持以下假设：接触化学农药与5岁以下儿童的呼吸道感染有关。
