A cross-sectional analysis of medical conditions and environmental factors associated with fractional exhaled nitric oxide (FeNO) in women and children from the ISA birth cohort, Costa Rica.

BACKGROUND: Fractional exhaled nitric oxide (FeNO) is a marker of airway inflammation. Elevated FeNO has been associated with environmental exposures, however, studies from tropical countries are limited. Using data from the Infants' Environmental Health Study (ISA) birth cohort, we evaluated medical conditions and environmental exposures' association with elevated FeNO. METHODS: We performed a cross-sectional analysis of 277 women and 293 8-year old children who participated in the 8-year post-partum visit in 2019. We measured FeNO and collected information on medical conditions and environmental exposures including smoke from waste burning, work in banana plantations, and home pesticide use. We defined elevated FeNO as >25 ppb for women and >20 ppb for children. To evaluate factors associated with elevated FeNO, we used logistic regression models adjusted for obesity in women and unadjusted in children. RESULTS: Overall elevated FeNO was common (20% of women, 13% of children). Rhinitis diagnosis was significantly associated with elevated FeNO in both women (odds ratio (OR): 3.67 95% Confidence Interval (CI): 1.81,7.35) and children (OR: 8.18 95%CI: 3.15, 21.22); wheeze was associated with elevated FeNO in women (OR: 4.50 95% CI: 2.25, 8.99). Environmental exposures were associated with elevated FeNO, but not significantly. Waste burning was associated with elevated FeNO in both women (OR: 1.58 95%CI 0.68, 4.15) and children (OR: 2.49 95%CI:0.82, 10.79). Para-occupational pesticide exposures were associated with elevated FeNO in women and children. For women, having a partner working in agriculture was associated with elevated FeNO (OR: 1.61 95%CI:0.77, 3.58) and for children, maternal work in agriculture was associated with elevated FeNO. (OR 2.08 95%CI 0.86, 4.67) CONCLUSION: Rhinitis and wheeze were associated with elevated FeNO in this rural, agricultural population. Smoke from waste burning as well as para-occupational pesticide exposure may contribute to elevated FeNO in rural communities.

[Playful Learning: a tool for Environmental Education]. / Aprendizaje a través de estrategias lúdicas: una herramienta para la Educación Ambiental.

Introduction: Playful learning for environmental education represents a participatory pedagogical mediation that considers the socio-environmental realities in which persons are immersed. Objective: To promote environmental education, through playful, participatory, and flexible methods, to prevent pesticide exposure. Methodology: Using geographic information systems, the distances between schools and bananas plantations were calculated. A playful and constructivism methodology was designed for primary school students (6 - 8.5 years), and their legal guardians. Subsequently, 148 workshops were developed in 37 rural Costa Rican schools, in which 2757 children and 387 adults participated. Results: Thirty-eight percent (38 %) (n=14) of the schools were located at less than 100 meters from banana plantations. Playful communication generated a participatory environment, in which local needs were identified and collective knowledge was built about the effects of pesticide exposure on the environment and human health. Participants were able to identify the main preventive actions to reduce pesticide exposure. Conclusions: Playful, participatory, and flexible methodologies in environmental education facilitate the process of sensitizing first cycle primary school students and their parents from rural communities about the risks of exposure to pesticides. The methodology used can be easily adapted for application in other environmental science studies.