RESUMO
BACKGROUND: Multiple epidemiological studies have shown that exposure to pesticides is associated with adverse health outcomes. However, the literature on pesticide-related health effects in the Latin American and the Caribbean (LAC) region, an area of intensive agricultural and residential pesticide use, is sparse. We conducted a scoping review to describe the current state of research on the health effects of pesticide exposure in LAC populations with the goal of identifying knowledge gaps and research capacity building needs. METHODS: We searched PubMed and SciELO for epidemiological studies on pesticide exposure and human health in LAC populations published between January 2007 and December 2021. We identified 233 publications from 16 countries that met our inclusion criteria and grouped them by health outcome (genotoxicity, neurobehavioral outcomes, placental outcomes and teratogenicity, cancer, thyroid function, reproductive outcomes, birth outcomes and child growth, and others). RESULTS: Most published studies were conducted in Brazil (37%, n=88) and Mexico (20%, n=46), were cross-sectional in design (72%, n=167), and focused on farmworkers (45%, n=105) or children (21%, n=48). The most frequently studied health effects included genotoxicity (24%, n=62) and neurobehavioral outcomes (21%, n=54), and organophosphate (OP) pesticides were the most frequently examined (26%, n=81). Forty-seven percent (n=112) of the studies relied only on indirect pesticide exposure assessment methods. Exposure to OP pesticides, carbamates, or to multiple pesticide classes was consistently associated with markers of genotoxicity and adverse neurobehavioral outcomes, particularly among children and farmworkers. DISCUSSION: Our scoping review provides some evidence that exposure to pesticides may adversely impact the health of LAC populations, but methodological limitations and inconsistencies undermine the strength of the conclusions. It is critical to increase capacity building, integrate research initiatives, and conduct more rigorous epidemiological studies in the region to address these limitations, better inform public health surveillance systems, and maximize the impact of research on public policies. https://doi.org/10.1289/EHP9934.
Assuntos
Exposição Ocupacional , Praguicidas , Agricultura , Carbamatos , Região do Caribe , Criança , Exposição Ambiental/análise , Feminino , Humanos , América Latina , Organofosfatos , Praguicidas/análise , Praguicidas/toxicidade , Placenta/química , GravidezRESUMO
Objectives The importance of mother-child interaction in early infancy on child development has been well documented. The purpose of this study was to assess the feasibility of using the Still Face Paradigm to measure mother interactive style, infant affect and emotional regulation in a rural Ecuador setting. Methods Infant's emotional regulation and the quality of mother's interaction were measured with the Still Face Paradigm at 4 months of age (±15 days). Twenty-four infants and their mothers were assessed in their home. Mother interactive style was coded for attention seeking and contingent responding. Emotional regulation was described by change in infant affect between Still Face episodes. Results A significant difference was found for infant affect between the five Still Face episodes (F1,118 = 9.185, p = 0.003). A significant negative correlation was found for infant affect between episode 3 and 2 with attention seeking mother interactive style during episode 3 (rho = -0.44, p = 0.03), indicating that mothers using more contingent-responding interactions had infants with more positive affect. Conversely, a significant positive association was found for infant affect between episode 3 and 2 and contingent responding mother interactive style during episode 3 (rho = 0.46, p = 0.02), indicating that mothers who used more attention seeking play had infants who showed less positive affect. Conclusion for Practice Study results demonstrate feasibility in using the Still Face Paradigm in working populations residing in a rural region in Ecuadorian highlands and may be feasible in other similar populations in Latin America, and as a successful approach to measuring maternal-child interactions within a field-based epidemiological study design.
Assuntos
Adaptação Psicológica , Relações Mãe-Filho/psicologia , Mulheres Trabalhadoras/psicologia , Adulto , Criança , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Equador , Emoções , Feminino , Humanos , Lactente , Comportamento do Lactente/psicologia , Masculino , Mães/psicologia , População Rural , Classe Social , Estresse Psicológico/complicações , Estresse Psicológico/psicologiaRESUMO
Touch between mother and infant plays an important role in development starting from birth. Cross-cultural differences surrounding rearing practices have an influence on parent-infant interaction, including types of touch used and the development of emotional regulation. This study was designed to investigate maternal touch and infant emotional regulation in infant-mother dyads from Ecuador (n=25) and Hispanic dyads from the United States (US) (n=26). Mothers and their 4-month-old full-term infants participated in the Still Face Paradigm. Second-by-second coding of maternal touch and infant affect was completed. Overall the analyses showed that Ecuadorian mothers used more nurturing and accompaniment touch and less attention seeking touch than US Hispanic mothers during the pre-stressor (baseline) episode. Lagged multilevel models were used to investigate the effect of the different types of touch on infant emotional regulation in the groups for the episodes. The data suggest that playful touch had a significant increase in infant affect, whereas accompaniment and attention-seeking touch had a significant decrease in infant affect. Overall, this study provides support for the role of touch in mother-infant synchronicity in relation to infant's emotional regulation. Identifying touch that is more calming is important to foster emotional regulation in infancy, which can have important implications for development.
Assuntos
Face , Comportamento do Lactente/psicologia , Tato/fisiologia , Adulto , Comparação Transcultural , Equador , Emoções/fisiologia , Feminino , Humanos , Lactente , Masculino , Comportamento Materno/psicologia , Relações Mãe-Filho , Mães/psicologia , Estados UnidosRESUMO
Few studies have detailed the prenatal pesticide exposure levels of women employed in or residing near large-scale agricultural industries. This study reports pesticide metabolite levels during and shortly after pregnancy in a pilot study of workers in Ecuador. Urine samples were collected for 16 rose workers and 10 nonagricultural workers enrolled into the study in early pregnancy. We measured six nonspecific organophosphatedialkylphosphate (DAP) pesticide metabolites, two alkylenebis-dithiocarbamate pesticide metabolites [ethylene thiourea (ETU) and propylene thiourea (PTU)], 3,5,6-trichloro-2-pyridinol (TCPy), malathion dicarboxylic acid, and two pyrethroid metabolites (2,2-dimethylcyclo propanecarboxylic acid and 3-phenooxybenzoic acid). We collected 141 urine samples (mean: 5.4 per woman). We observed high detection frequencies for five DAP metabolites and ETU, PTU, and TCPy. We report elevated levels of ETU in the entire sample (median 4.24 ng/mL, IQR 2.23, 7.18), suggesting other possible non-occupational pathways of exposure. We found no statistical differences in pesticide levels by current employment status, although the highest pesticide levels were among rose workers. We observed within-woman correlation in TCPy and PTU levels, but not in ETU or DAP levels. The present study is the first to characterize prenatal pesticide exposure levels among working women in Ecuador. Limitations include a small sample size and use of a convenience sample. Strengths include a longitudinal design and multiple urine samples per woman. Results provide an initial characterization of prenatal pesticide exposure levels and how these levels vary over pregnancy in a community impacted by agricultural industry and will inform further studies in the region.
Assuntos
Poluentes Ambientais/metabolismo , Exposição Materna/estatística & dados numéricos , Praguicidas/metabolismo , Adulto , Equador , Feminino , Humanos , GravidezRESUMO
Self-reported measures of residential pesticide exposure are commonly used in epidemiological studies, especially when financial and logistical resources are limited. However, self-reporting is prone to misclassification bias. This pilot study assesses the agreement between self-report of residential pesticide exposure with direct observation measures, in an agricultural region of Ecuador, as a cross-validation method in 26 participants (16 rose workers and 10 controls), with percent agreement and kappa statistics calculated. Proximity of homes to nearby flower farms was found to have only fair agreement (kappa =.35). The use of discarded plastics (kappa =.06) and wood (kappa =.13) were found to have little agreement. Results indicate that direct observation or measurement may provide more accurate appraisals of residential exposures, such as proximity to industrial farmland and the use of discarded materials obtained from the flower farms.
Assuntos
Agricultura , Exposição Ocupacional , Praguicidas/análise , Adolescente , Adulto , Equador , Feminino , Flores , Humanos , Estudos Longitudinais , Observação , Projetos Piloto , Gravidez , Inquéritos e Questionários , Adulto JovemRESUMO
PURPOSE: Drug-resistant tuberculosis (DRTB) is steadily increasing in Mexico, but little is known of patient risk factors in the Mexico-United States border region. This preliminary case-control study included 95 patients with active pulmonary TB with drug susceptibility results attending the José E. González University Hospital in the urban hub of Nuevo León-the Monterrey Metropolitan Area. We report potential social and clinical risk factors of DRTB among this hospital-based sample. METHODS: We collected data through face-to-face interviews and medical record reviews from 25 cases with DRTB and 70 drug-sensitive controls. DNA was collected to assess an effect of genetic ancestry on DRTB by using a panel of 291,917 genomic markers. We calculated crude and multivariate logistic regression. RESULTS: After adjusting for potential confounding factors, we found that prior TB treatment (odds ratio, 4.5; 95% confidence interval, 0.9-21.1) and use of crack cocaine (odds ratio, 4.6; 95% confidence interval, 1.1-18.7) were associated with DRTB. No other variables, including genetic ancestry and comorbidities, were predictive. CONCLUSIONS: Health care providers may benefit from recognizing predictors of DRTB in regions where routine drug susceptibility testing is limited. Prior TB treatment and illicit drug use, specifically crack cocaine, may be important risk factors for DRTB in this region.
Assuntos
Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Cocaína Crack/efeitos adversos , Marcadores Genéticos , Mycobacterium/genética , Tuberculose Resistente a Múltiplos Medicamentos/genética , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Estudos de Casos e Controles , Comorbidade , DNA/análise , DNA/genética , Feminino , Hospitais Urbanos/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Modelos Logísticos , Masculino , Prontuários Médicos/estatística & dados numéricos , México/epidemiologia , Pessoa de Meia-Idade , Recidiva , Fatores de Risco , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/genéticaRESUMO
OBJECTIVE: To examine important micronutrient deficiencies related to child health and growth outcomes for all weight statuses to 1) better understand other potential nutritional problems and inequities that may be masked by focusing solely on BMI percentiles and overweight/obesity, and 2) draw attention to the need for more studies focused on the nutritional well-being of children at all weight statuses, including healthy weight. METHODS: A sample of children (ages 2-19 years) old from the National Health and Nutrition Examination Survey (NHANES) 2003-2010 was analyzed. Prevalence of stunting, folate, vitamin D, iron, iodine, and anemia, was considered. Comparisons were conducted between non-Hispanic whites and Hispanics, and within Hispanics, based on socio-demographic and economic characteristics. RESULTS: Hispanic children experienced significantly higher prevalence of stunting (6.1% versus 2.6%), and the prevalence of stunted Hispanic children in the healthy weight category was higher than those in the overweight/obese category. Comparable percentages were observed by ethnicity for most analyzed micronutrients, although girls had consistently higher prevalence of nutritional deficiencies than boys, especially girls reaching reproductive age. CONCLUSIONS: The results of this article draw attention to the need for more specific and differentiated analyses of child obesity and nutritional status among and within ethnic, sex, and age groups. Appropriate public health interventions need to consider the entire range of weight statuses and micronutrient deficiencies to eliminate inequities among minority children, especially girls.
OBJETIVO: Analizar las carencias importantes de micronutrientes relacionadas con la salud del niño, y los resultados de crecimiento para las distintas situaciones en cuanto a peso, con objeto de 1) comprender mejor otros posibles problemas y desigualdades nutricionales que podrían quedar ocultos al adoptar un enfoque exclusivo en los percentiles de índice de masa corporal, y el sobrepeso y la obesidad, y 2) hacer hincapié en la necesidad de llevar a cabo más estudios que se centren en el bienestar nutricional de los niños en las distintas situaciones en cuanto al peso, incluido el peso saludable. MÉTODOS: Se analizó una muestra de niños (de 2 a 19 años) de la Encuesta Nacional de Salud y Nutrición (NHANES) 2003-2010. Se consideraron las prevalencias del retraso en el crecimiento, de las deficiencias de folato, vitamina D, hierro y yodo, y de la anemia. Se establecieron comparaciones entre blancos no hispanos e hispanos, y entre los mismos hispanos, con base en las características sociodemográficas y económicas. RESULTADOS: Los niños hispanos mostraron una prevalencia significativamente mayor de retraso en el crecimiento (6,1 frente a 2,6%), y la prevalencia del retraso en el crecimiento en los niños hispanos clasificados como de peso saludable fue mayor que en los incluidos en las categorías de sobrepeso u obesidad. Se observaron porcentajes comparables por grupos étnicos en cuanto a los micronutrientes más analizados, aunque las niñas mostraron sistemáticamente una mayor prevalencia de carencias nutricionales que los niños, especialmente las que se acercaban a la edad fecunda. CONCLUSIONES: Los resultados hacen hincapié en la necesidad de llevar a cabo estudios más específicos y diferenciados sobre la obesidad y el estado nutricional de los niños entre y dentro de los distintos grupos étnicos, de sexo y de edad. Las intervenciones de salud pública, para que resulten apropiadas, deben considerar las distintas situaciones en cuanto a peso y las carencias de micronutrientes, con objeto de eliminar las desigualdades en niños de grupos minoritarios, especialmente en niñas.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Efeitos Psicossociais da Doença , Disparidades nos Níveis de Saúde , Hispânico ou Latino , Desnutrição/epidemiologia , Obesidade/epidemiologia , Estados Unidos/epidemiologiaAssuntos
Desigualdades de Saúde , Desnutrição , Hispânico ou Latino , Obesidade , Proteção da Criança , Estados Unidos , Disparidades nos Níveis de Saúde , Desnutrição , Hispânico ou Latino , Obesidade , Saúde da Criança , Estados Unidos , Hispânico ou Latino , Efeitos Psicossociais da Doença , Disparidades nos Níveis de Saúde , Desnutrição , ObesidadeRESUMO
BACKGROUND: Few studies have examined the effects of in utero exposure to organophosphate and carbamate pesticides on neurobehavioral development in infants and young children. This study considers the potential effects of maternal occupation in the cut-flower industry during pregnancy on neurobehavioral development in Ecuadorian children. METHODS: Data were collected during 2003-2004 for 121 children aged 3-23 months and living in the rural highland region of Cayambe, Ecuador. Children were administered the Ages and Stages Questionnaire and were given specific developmental tests including prehension (reach-and-grasp) and visual skills. Information was gathered on maternal health and work characteristics, the home environment, and child health status. Growth measurements and a hemoglobin finger-prick blood test were obtained. We conducted multiple linear and logistic regression analyses. RESULTS: Children whose mothers worked in the flower industry during pregnancy scored lower on communication (8% decrease in score, 95% confidence interval [CI]: -16% to 0.5%) and fine motor skills (13% decrease, 95% CI: -22% to -5), and had a higher odds of having poor visual acuity (odds ratio = 4.7 [CI =1.1-20]), compared with children whose mothers did not work in the flower industry during pregnancy, after adjusting for potential confounders. CONCLUSIONS: Maternal occupation in the cut-flower industry during pregnancy may be associated with delayed neurobehavioral development of children aged 3-23 months. Possible hazards associated with working in the flower industry during pregnancy include pesticide exposure, exhaustion, and job stress.
Assuntos
Deficiências do Desenvolvimento/etiologia , Exposição Ocupacional/efeitos adversos , Praguicidas/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal , Transtornos da Visão/etiologia , Adulto , Agricultura , Estudos de Casos e Controles , Pré-Escolar , Equador , Feminino , Humanos , Lactente , Masculino , Razão de Chances , Gravidez , Adulto JovemRESUMO
OBJECTIVE: To identify and describe the sociodemographic and nutritional characteristics associated with neurobehavioral development among young children living in three communities in the northeastern Andean region of Cayambe-Tabacundo, Ecuador. METHODS: Women in the study communities who had a child 3 to 61 months of age completed a questionnaire about maternal and child health and sociodemographic characteristics. The Ages and Stages Questionnaire (ASQ) was directly administered to 283 children by two trained interviewers. Growth measurements and a hemoglobin finger-prick blood test were obtained in 2003-2004. Prevalence of developmental delay was calculated, and associations between child development and maternal, child, and household characteristics were explored. RESULTS: High frequencies of developmental delay were observed. Children 3 to 23 months old displayed delay in gross motor skills (30.1%), and children 48 to 61 months old displayed delay in problem-solving skills (73.4%) and fine motor skills (28.1%). A high frequency of both anemia (60.4%) and stunting (53.4%) was observed for all age groups. Maternal educational level was positively associated with communication and problem-solving skills, and monthly household income was positively associated with communication, gross motor, and problem-solving skills. CONCLUSIONS: The results suggest a high prevalence of developmental delay and poor child health in this population. Child health status and the child's environment may contribute to developmental delay in this region of Ecuador, but sociodemographic factors affecting opportunities for stimulation may also play a role. Research is needed to identify what is causing high percentages of neurobehavioral developmental delay in this region of Ecuador.