Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Harvard, T.H. Chan School of Public Health, Boston, MA, USA.
J Expo Sci Environ Epidemiol. 2024 Mar;34(2):241-250. doi: 10.1038/s41370-023-00524-2. Epub 2023 Feb 10.
Children are potentially more susceptible to the adverse effects of pesticides due to more sensitive organ systems and lower capacity to metabolize and eliminate chemicals compared to adults. The health risks are particularly concerning children with asthma, living in low-income neighborhoods in multi-family housing because of their impaired respiratory health, and factors associated with low-income, multi-family environments.
To assess the association between pesticide exposure and asthma morbidity among children 7-12 years residing in low-income, multi-family housing.
The concentrations of seven urinary pesticide biomarkers: 3,5,6-trichloro-2-pyridinol (TCPy), 2-isopropyl-4-methyl-6-hydroxypyrimidine, para-nitrophenol (PNP), 3-phenoxybenzoic acid (3-PBA), 4-fluoro-3-phenoxybenzoic acid, trans-3-(2,2-dichlorovinyl)-2,2-dimethyl-cyclopropane-1-carboxylic acid, and 2,4-dichlorophenoxyacetic acid (2,4-D) were measured. Children (n = 162) were followed for one year with three measures of pesticides biomarkers. Associations between individual biomarkers and asthma attack, asthma related health care utilization, and fraction of exhaled nitric oxide (FeNO), adjusting for demographic and household factors were examined with Generalized Estimating Equations (GEE). Weighted Quantile Sum (WQS) regression was used to examine the effect of pesticide mixture on asthma attacks and asthma-related health care utilization (HCU).
In adjusted GEE models, positive non-significant associations were found between PNP and HCU (adjusted Odds Ratio(aOR):2.05 95% CI:0.76-5.52) and null associations for 3-PBA and HCU (aOR:1.07 95% CI: 0.88-1.29). Higher concentrations of PNP and 2,4-D were associated with significantly lower FeNO levels (PNP: -17.4%; 2,4-D:-19.74%). The mixture was positively associated with HCU in unadjusted (OR: 1.56 97.5% CI: 1.08-2.27) but not significant in adjusted models (aOR: 1.40 97.5% CI: .86-2.29). The non-specific pyrethroid biomarker 3-PBA at baseline contributed the greatest weight to the index (45%).
There were non-significant associations between pesticide biomarkers and respiratory outcomes in children with asthma. There was a suggestive association between urinary pesticide biomarkers and HCU. Further studies with larger sample sizes could help to confirm these findings.
Pesticide exposure among children in the urban environment is ubiquitous and there is a dearth of information on the impact of low-level chronic exposure in vulnerable populations. This study suggested that pesticide exposure at concentrations below the national average may not affect asthma morbidity in children. However, different biomarkers of pesticides showed different effects, but the mixture suggested increasing pesticide exposure results in asthma related HCU. The results may show that children with asthma may be at risk for negative health outcomes due to pesticides and the need to further examine this relationship.
儿童的器官系统更为敏感，代谢和消除化学物质的能力也低于成人，因此他们可能更容易受到农药的不良影响。对于居住在多户低收入住房中的哮喘儿童来说，健康风险尤其令人担忧，因为他们的呼吸健康受损，而且与低收入、多户环境相关的因素也会增加他们的患病风险。
评估居住在低收入多户住房中的 7-12 岁儿童中农药暴露与哮喘发病之间的关联。
测量了七种尿中农药生物标志物的浓度：3,5,6-三氯-2-吡啶醇（TCPy）、2-异丙基-4-甲基-6-羟基嘧啶、对硝基酚（PNP）、3-苯氧基苯甲酸（3-PBA）、4-氟-3-苯氧基苯甲酸、反式-3-（2,2-二氯乙烯基）-2,2-二甲基环丙烷-1-羧酸和 2,4-二氯苯氧乙酸（2,4-D）。162 名儿童在一年的时间里进行了三次农药生物标志物检测。使用广义估计方程（GEE），在调整人口统计学和家庭因素后，研究了个体生物标志物与哮喘发作、哮喘相关医疗保健利用和呼出气一氧化氮分数（FeNO）之间的关系。加权分位数总和（WQS）回归用于研究农药混合物对哮喘发作和哮喘相关医疗保健利用（HCU）的影响。
在调整后的 GEE 模型中，PNP 与 HCU 之间存在正的非显著关联（调整后的优势比[aOR]：2.05，95%置信区间[CI]：0.76-5.52），而 3-PBA 与 HCU 之间存在零关联（aOR：1.07，95% CI：0.88-1.29）。较高浓度的 PNP 和 2,4-D 与显著较低的 FeNO 水平相关（PNP：-17.4%；2,4-D：-19.74%）。在未调整模型中，混合物与 HCU 呈正相关（OR：1.56，97.5% CI：1.08-2.27），但在调整模型中不显著（aOR：1.40，97.5% CI：0.86-2.29）。基线时非特异性拟除虫菊酯生物标志物 3-PBA 对指数的贡献最大（45%）。
在哮喘儿童中，农药生物标志物与呼吸结局之间存在非显著关联。尿中农药生物标志物与 HCU 之间存在提示性关联。更大样本量的进一步研究可能有助于证实这些发现。
城市环境中儿童的农药暴露是普遍存在的，但关于弱势人群中低水平慢性暴露的影响的信息却很少。本研究表明，在全国平均水平以下的浓度下暴露于农药可能不会影响儿童的哮喘发病率。然而，不同的农药生物标志物显示出不同的影响，但混合物表明，随着农药暴露的增加，与哮喘相关的 HCU 也会增加。结果可能表明，哮喘儿童可能因农药而面临负面健康后果的风险，需要进一步研究这种关系。
