Figures
- FIGURE 1
Flow chart of identification and selection of original articles finally included in the review of environmental exposure to pesticides and respiratory health.
Tables
- TABLE 1
Effects of pesticide exposure in children on respiratory health: prenatal exposure
First author [ref.] Location Study design Summary of method Results Population characteristics Pesticides of interest Exposure assessment Health outcomes Sunyer [30] Menorca, Spain Prospective cohort 468 mother–infant pairs, with complete outcome data at 4 years Organochlorine insecticides DDT and its metabolite DDE and fungicide HCB Cord serum: DDE (median 1.03 ng·mL−1); HCB (median 0.68 ng·mL−1) Face-to-face maternal questionnaire: report of persistent wheezing and/or doctor-diagnosed asthma at 4 years of age Wheezing at 4 years of age increased when DDE concentration >1.90 ng·mL−1 (RR 2.63, 95% CI 1.19–4.69) and persistent wheezing (RR 1.26, 95% CI 1.04–1.54) Sunyer [31] Menorca, Spain Prospective cohort 462 mother–infant pairs, with complete outcome data at 6.5 years Organochlorines DDE/DDT Cord serum: DDE (median 1.03 ng·mL−1); DDT (median 0.08 ng·mL−1) Children's blood (at 4 years): DDE (median 0.08 ng·mL−1); DDT (median 0.05 ng·mL−1) Face-to-face maternal questionnaire: report of persistent wheezing and/or doctor-diagnosed asthma at 6.5 years of age DDE concentration at birth associated with diagnosis of asthma at age 6.5 years (OR 1.18, 95% CI 1.01–1.39) and wheeze at age 4 years (OR 1.14, 95% CI 1.02–1.28) Sunyer [32] Spain Birth cohort of Infancia y Medico Ambiente (INMA) 520 mother–infant pairs, age: 14 months DDE, HCH Maternal serum (first trimester of pregnancy): pp′DDE (mean 112.3 ng·g−1); HCB (mean 43.7 ng·g−1) Face-to-face maternal questionnaire to report doctor-diagnosed LRTIs including bronchitis, bronchiolitis or pneumonia Significant association of DDE concentration during the first trimester of pregnancy with recurrent LRTI at 6 months (RR 1.68, 95% CI 0.06–2.66), and 14 months (RR 1.52, 95% CI 1.05–2.21) Gascon [33] Spain Birth cohort of INMA 1455 mother–infant pairs, age: 14 months DDE, HCH Maternal serum (7–26th week of pregnancy): DDE (mean 116.3 ng·g−1); HCB (mean 46.4 ng·g−1) Face-to-face maternal questionnaire to report doctor-diagnosed of LRTIs based on ISAAC questionnaire DDE concentrations (third quartile) associated with LRTI risk (RR 1.33, 95% CI 1.08–1.62) and wheeze (RR 1.30, 95% CI 1.06–1.59) Weselak [34] Canada Retrospective cohort of Ontario Farm Family Health Study(OFFHS) 3405 children of farm families Agricultural herbicides, insecticides and fungicides Questionnaire on pesticide exposure in farm activities of the father and mother during pregnancy, the year and month of pesticide use being matched with year and month of each pregnancy No pesticides measured Parental self-report of doctor-diagnosed health problems: chronic bronchitis or cough, asthma in their child No significant association between any reported parental pesticide use during pregnancy and the development of persistent cough, bronchitis and asthma among the offspring of farm families Glynn [35] Uppsala, Sweden Prospective cohort 190 primiparous women living and seeking prenatal care in Uppsala, age: 3 months DDE Maternal serum (32–34th week of pregnancy): pp′DDE (mean 88 ng·g−1) Mother's breast milk: pp′DDE (mean 311 ng·g−1) Face-to-face questionnaire report of respiratory symptoms in infant, or doctor diagnosis of respiratory infection No association between prenatal serum levels DDE and respiratory infections in the infants Liu [36] USA Birth cohort of the Columbia Center for Children's Environmental Health (CCCEH) 224 children, age: 5–6 years, 50.0% male Pesticides: permethrins and PBO (a synergist for residential pyrethroid insecticides) Residential air samples in the third trimester of pregnancy: PBO (mean 1.1 ng·m−3); Cis-permethrin (not calculated); Trans-permethrin (mean 0.8 ng·m−3) Residential air samples at 5–6 years: PBO (LODs 0.06 ng·m−3); Cis-permethrin (LOD 0.1 ng·m−3) Trans-permethrin (LOD 0.2 ng·m−3) Face-to-face questionnaire report of doctor-diagnosed of asthma based on ISAAC questionnaire Significant association between prenatal exposure to PBO and non-infectious cough in children aged 5–6 years (OR 1.27, 95% CI 1.09–1.48) DDT: dichlorodiphenyl trichloroethane; DDE: dichlorodiphenyldichloroethylene; HCB: hexachlorobenzene; RR: relative risk; HCH: hexachlorocyclohexane; pp′DDE: pp'-dichlorodiphenyldichloroethylene; LRTI: lower respiratory tract infection; ISAAC: International Study of Asthma and Allergies in Childhood; PBO: piperonyl butoxide; LOD: limit of detection.
- TABLE 2
Effects of pesticide exposure in children on respiratory health: post-natal exposure
First author [ref.] Location Study design Summary of method Results Population characteristics Pesticides of interest Exposure assessment Health outcomes Karmaus [37] Germany Cross-sectional 343 second-grade school children in Hamburg, age: 7–10 years DDE, HCH Children's blood (at 7–10 years): DDE (mean 0.32 µg·L−1); HCB (mean 0.22 µg·L−1) Parental self-report of doctor-diagnosed asthma (from ISAAC questionnaire) Exposure to DDE significantly associated with doctor-diagnosed asthma (OR 3.71, 95% CI 1.10–12.56) Karmaus [38] Germany Cross-sectional 338 second-grade school children in South Hesse, age: 7–10 years DDE, HCH Children's blood (at 7–8 years): DDE (mean 0.29 µg·L−1) Parental self-report of doctor-diagnosed asthma (ISAAC questionnaire) No association between DDE and child's respiratory and allergic symptoms Salameh [39] Lebanon Cross-sectional 3291 children in public school, age: 5–16 years Not specified Four questions on pesticides exposure: households (at work, at home or garden treatment) and children (living in a heavily treated region, living in the proximity of a heavily treated field) No pesticides measured Parental self-report of doctor-diagnosed of asthma from ATS questionnaire Any type of exposure significantly associated with respiratory disease (OR 1.71, 95% CI 1.20–2.43) Para-occupational exposure associated with risk of asthma (OR 4.61, 95% CI 2.06–10.29) Residential exposure associated with wheezing (OR 2.73, 95% CI 1.85–4.05) Salam [40] USA Case–control of Children's Health Study (CHS) 691 children from public school, including 279 cases and 412 controls Not specified Questions on children's herbicides and pesticides exposure: farm crops or dust No pesticides measured Telephone questionnaire self-report of asthma at 5 years of age Higher risk of asthma at 5 years of age in children exposed to herbicides (OR 4.58, 95% CI 1.58–5.56) and pesticide (OR 2.39, 95% CI 1.17–4.89) in the first year of life Duramad [41] USA Birth cohort of the Center for the Health Assessment of Mothers and Children of Salinas 412 mother–infant pairs, age: 2 years Organophosphate and pyrethroid insecticides Home inspection during pregnancy, shortly after delivery and at 6, 12, and 24 months Information collected on agricultural work of mother and father and other household members, and home pesticide use No pesticides measured Face-to-face questionnaire of asthma symptoms Medical records from 24 months: diagnosis of asthma, eczema, bronchitis, bronchiolitis, or pneumonia Significantly higher Th2 cytokine level (biomarker of allergic asthma) in children of women who worked in the fields (p=0.001) Maternal agricultural work associated with higher Th2 cytokine levels in children (p=0.04) Tagiyeva [42] UK Prospective cohort 13 971 children surviving to 1 year, age: 7.5 years (91 months) Biocides and fungicides Children's exposure determined by parental job-exposure matrix No pesticides measured Parental report of children's wheeze at age 6, 18, 30, 42, 54, 69 and 81 months At 91 months: question on ever doctor-diagnosed asthma in children Maternal post-natal exposure associated with: wheeze at 81 months of age (OR 1.22, 95% CI 1.02–2.05); doctor-diagnosed asthma at 91 months (OR 1.47, 95% CI 1.14–1.88) Xu [43] USA Cross-sectional of National Health and Nutrition Examination Survey 14 065 children, age: 0–17 years Not specified Questions on children's pesticides exposure at home and/or yard No pesticides measured Parental face-to-face questionnaire report of doctor-diagnosed asthma, and information about acute respiratory problems (wheezing, dry cough and chronic symptoms) reported by parents Pesticide use in the kitchen or dining room and wheezing (OR 1.39, 95% CI 1.08–1.78) and dry cough (OR 2.38, 95% CI 1.40–4.06) DDE: dichlorodiphenyldichloroethylene; HCH: hexachlorocyclohexane; HCB: hexachlorobenzene; ISAAC: International Study of Asthma and Allergies in Childhood; ATS: American Thoracic Society; Th2: T-helper cell type 2.
- TABLE 3
Effects on respiratory health and exposure to pesticides in the general population
First author [ref.] Location Study design Summary of method Results Population characteristics Pesticides of interest Exposure assessment Health outcomes Balluz [44] USA Cross-sectional 117 employees of a health centre in Georgia, 94% women, aged: 21–68 years Malathion, Organochlorines including DDT: stored, handled and used in the fight against mosquitoes Environmental sampling of pesticides in the building: Malathion (110 µg·g−1); DDT (24 µg·g−1) Measures of 17 chlorinated pesticides in serum and urine of employees (concentrations below 95% limit for the reference range for the US population) Self-reported occurrence and severity of respiratory illnesses and symptoms Duration of employment (at least 3 years) significantly associated with bronchitis (OR 4.3, 95% CI 1.7–11.0) and sinusitis (OR 3.7, 95% CI 1.5–8.7) No association between health complaint and pesticide levels in serum and urine Ames [45] USA Retrospective study 39 subjects who were residents living near farms where paraquat was applied and 172 controls living in areas remote from spraying Paraquat Living near farms where paraquat was applied (an area of ∼0.5 miles) Self-reported perception of odour during the 2 weeks of study period Self-reported symptoms during the 2-week study period Significant increased risk for cough (RR 2.60; p<0.001) and wheezing (RR 3.04; p<0.01, Chi-squared) in the paraquat-exposed group Karpati [46] USA Retrospective study after a mosquito eradication programme 62 827 visits for asthma in the ED of hospitals in New York, study period, mean age: 34 years Pyrethroid insecticides sprayed in New York City during July–September 2000 to control mosquito vectors of West Nile virus None Data obtained from the New York City Health and Hospitals Corporation for ED visits for asthma during pesticide spraying period No significant association between pesticide spraying days and daily rates of asthma visits (RR 0.92, 95% CI 0.80–1.07) O'Sullivan [47] USA Retrospective study after a mosquito eradication programme 1 318 patients with a diagnosis of asthma in the ED of Lincoln hospital (South Bronx, NY) during 1997, 1998 and 1999 Malathion (organophosphate insecticide) and andresmethrin (pyrethroid insecticide) sprayed during the mosquito eradication programme in South Bronx in September 1999 None Adult and paediatric asthma ED admissions during the 4 days (September 1999) of the mosquito eradication programme No significant differences in patient ED asthma admissions between spraying and non-spraying days in September 1999 No significant difference between the number of ED asthma admissions in September 1999 compared with 1997 and 1998 Zhang [48] China Cross-sectional 22 528 rural adults, 48.7% men, age ≥15 years Insecticides Face-to-face questionnaire to obtain information on regular occupational and environmental exposure to chemicals (insecticides) Face-to-face questionnaire (IUATLD questionnaire) about respiratory symptoms during the past 12 months Exposure to insecticides associated with higher prevalence of chronic cough (OR 2.2, 95% CI 1.4–3.3), asthma attack (OR 1.9, 95% CI 1.3–2.9) and wheeze (OR 1.8, 95% CI 1.2–2.6) LeVan [49] Singapore Prospctive cohort (Singapore Chinese Health Study, SCHS) 52 325 subjects, 42.6% men, age: 45–75 years Vapour exposure including pesticides None Follow-up phone questionnaire based on ATS-DLD: respiratory symptoms, self-report of physician-diagnosed adult-onset asthma and respiratory outcomes in general Occupational pesticide exposure associated with adult-onset asthma (OR 1.69, 95% CI 1.13–2.52) DDT: dichlorodiphenyl trichloroethane; RR: relative risk; ED: emergency department; IUATLD: International Union Against Tuberculosis and Lung Disease; ATS-DLD: American Thoracic Society Division of Lung Disease.
Vol 24 Issue 137
Table of Contents
Environmental exposure to pesticides and respiratory health
