Lead Exposure Can Affect Early Childhood Development and Could Be Aggravated by Stunted Growth: Perspectives from Mexico.

BACKGROUND: Lead can affect early childhood development (ECD) differentially due to nutritional deficiencies that lead to stunted growth, defined as being at least two standard deviations below the average height-for-age. These deficiencies are more frequent among children living in rural locations or with lower socioeconomic status (SES); however, studies at a population level are scarce worldwide. Early childhood development plays a crucial role in influencing a child's health and wellbeing throughout life. Therefore, the aim of this study was to analyze how stunted growth can modify the association between lead exposure and ECD in children from disadvantaged communities. METHODS: Data were analyzed from the 2018 National Health and Nutrition Survey in localities with fewer than 100,000 inhabitants in Mexico (ENSANUT-100K). Capillary blood lead (BPb) levels were measured using a LeadCare II device and dichotomized as detectable (cutoff point ≥ 3.3 µg/dL) and non-detectable. As a measure of ECD, language development was assessed in n = 1394 children, representing 2,415,000 children aged 12-59 months. To assess the association between lead exposure and language z-scores, a linear model was generated adjusted by age, sex, stunted growth, maternal education, socioeconomic status, area, region (north, center, south), and family care characteristics; afterwards, the model was stratified by stunted growth. RESULTS: Fifty percent of children had detectable BPb and 15.3% had stunted growth. BPb showed a marginal inverse association with language z-scores (ß: -0.08, 95% CI: -0.53, 0.36). Children with detectable BPb and stunted growth had significantly lower language z-scores (ß: -0.40, 95% CI: -0.71, -0.10) than those without stunted growth (ß: -0.15, 95% CI: -0.36, 0.06). CONCLUSIONS: Children with stunted growth are more vulnerable to the adverse effects of lead exposure. These results add to previous research calling for action to reduce lead exposure, particularly in children with chronic undernutrition.

Environmental exposures contribute to respiratory and allergic symptoms among women living in the banana growing regions of Costa Rica.

OBJECTIVES: This research evaluates whether environmental exposures (pesticides and smoke) influence respiratory and allergic outcomes in women living in a tropical, agricultural environment. METHODS: We used data from 266 mothers from the Infants' Environmental Health cohort study in Costa Rica. We evaluated environmental exposures in women by measuring seven pesticide and two polycyclic aromatic hydrocarbons metabolites in urine samples. We defined 'high exposure' as having a metabolite value in the top 75th percentile. We collected survey data on respiratory and allergic outcomes in mothers as well as on pesticides and other environmental exposures. Using logistic regression models adjusted for obesity, we assessed the associations of pesticide exposure with multiple outcomes (wheeze, doctor-diagnosed asthma, high (≥2) asthma score based on symptoms, rhinitis, eczema and itchy rash). RESULTS: Current pesticide use in the home was positively associated with diagnosed asthma (OR=1.99 (95% CI=1.05 to 3.87)). High urinary levels of 5-hydroxythiabendazole (thiabendazole metabolite) and living in a neighbourhood with frequent smoke from waste burning were associated with a high asthma score (OR=1.84 (95%CI=1.05 to 3.25) and OR=2.31 (95%CI=1.11 to 5.16), respectively). Women who worked in agriculture had a significantly lower prevalence of rhinitis (0.19 (0.01 to 0.93)), but were more likely to report eczema (OR=2.54 (95%CI=1.33 to 4.89)) and an itchy rash (OR=3.17 (95%CI=1.24 to 7.73)). CONCLUSIONS: While limited by sample size, these findings suggest that environmental exposure to both pesticides and smoke may impact respiratory and skin-related allergic outcomes in women.

Passive monitoring techniques to evaluate environmental pesticide exposure: Results from the Infant's Environmental Health study (ISA).

BACKGROUND: Pesticides used in agriculture may expose populations living nearby. Costa Rica is a major banana-exporting country, its production depends on extensive pesticide use. OBJECTIVES: To evaluate environmental pesticide exposure, we measured levels of current-use pesticides in air and dust from 12 schools in Matina County, Costa Rica, with passive sampling methods. METHODS: We selected ten proximal and two non-proximal schools and placed polyurethane foam passive air samplers outdoors at each school, during four consecutive periods. At three of these schools, we also placed an active air sampler during the first 24 h of each sampling period. We collected passive dust samples by placing a glass Petri Dish at the inside of each school. We subsequently performed a chemical analysis of 18 pesticides, using gas chromatography with mass detector. RESULTS: With passive air samplers we detected ten different pesticides: two insecticides, two nematicides, and six fungicides, of which nine reported to be used on banana plantations. More than half of the samples contained at least five pesticides. Chlorpyrifos was detected most-frequently, in 98% of samples, followed by the nematicides etoprophos and the fungicide pyrimethanil that were both detected in 81% of samples. Chlorpyrifos concentrations were five times higher in proximal as compared to non-proximal schools: mean = 18.2 ng/m3 (range = 6.1-36.1) and mean = 3.5 ng/m3 (range= <0.5-11.4) and varied more between schools than in time (intra-class correlation coefficient = 0.80). In general, results from passive and active samplers showed similar exposure patterns; yet median concentrations tended to be higher in passive samplers. In dust samples, mostly fungicides were detected; chlorothalonil was detected most frequently, in 50% of samples. DISCUSSION: Passive air sampling is a promising technique to characterize environmental exposure to current-use pesticides; more studies are needed to characterize the sampling rates, reproducibility and optimum sampling times for passive samplers. School environments near banana plantations are contaminated with multiple pesticides that include insecticides, nematicides, and fungicides, which is of concern.