Pesticide Health Effects Medical Education Database (PHEMED) 2010 Helen Murphy – FNP, MHS Pacific Northwest Agricultural Safety and Health Center (PNASH) School of Public Health University of Washington Age Considerations: Impacts on Pesticide Exposure and Health Outcomes S.Holland

Pesticide Health Effects Medical Education Database (PHEMED) 2010 How would behavioral and biological attributes associated to each of these age groups impact pesticide exposure and its short or long term health effects? ToddlersYoung children & adolescents Young Male Adults Women of Childbearing Years Prenatal S.Holland

Pesticide Health Effects Medical Education Database (PHEMED) 2010 Pre-Natal Exposures Prenatal exposure to chlorpyrifos an organophosphate is associated to neurodevelopmental effects in the child Increased odds of abnormal reflexes in neonates Increased odds of abnormal reflexes in neonates Poorer verbal IQ in 3 ½ and 5 year olds Poorer verbal IQ in 3 ½ and 5 year olds Increased odds of pervasive developmental disorder Increased odds of pervasive developmental disorder Whyatt RM et al. 2005, Ruah VA. et al, 2006, Young JG et al 2005, Roberts EM 2007

Pesticide Health Effects Medical Education Database (PHEMED) 2010 Toddlers GREATER EXPOSURE –Hand to mouth behaviors –SKIN contact with floors and lawns –Lighter less clothing –Eats (12x) and drinks (2x) more per weight than adults GREATER ABSORPTION –  Breathing rates (1.7x more) –  Heart rates –  Skin surface/weight (2.7 x more) GREATER SENSITIVITY –Sensitive developing organs (reproductive, neurological) –Less ability to detoxify (immature hepatic cells) Selevan SG, Kimmel CA, Mendola P. 2000

Pesticide Health Effects Medical Education Database (PHEMED) 2010 Children and Adolescents Physically still developing – biologic risks Dependency – Parental role in preventing exposures –Sources of food and water –Home and school proximity to agriculture sites –Para-occupational exposures –Household and school use of pesticides (structural, garden and pet pest control measures) *Source: David C. Schwebel, Ph.D. Department of Psychology, University of Alabama at Birmingham

Pesticide Health Effects Medical Education Database (PHEMED) 2010 Children and Adolescents Risk taking behaviors* –Learning by experimentation (e.g. Indonesia making rockets out of old pesticide containers) –Perceptual development – overestimate physical abilities –Social development – peers and sibling roles –Impulse control – still developing by early 20 ’ s –Cognitive Development – affects following directions, doing what the rules say, remembering understanding rules, sense of invulnerability, planning and organizing, consequences of decisions.

Pesticide Health Effects Medical Education Database (PHEMED) 2010 Young Male Adults 81% of hired farm workers are male, 77% < age 44farm workers Sole breadwinners thus likely to value work productivity over personal safety. Reproductive hazards possibly male mediated - e.g. spontaneous abortions (SAB) –Risk for SAB increased four fold if father did not use PPE (Arbuckle et al 1999) –Critical window for SAB risk is the 3 months of spermatogenesis prior to conception (Sanborn et al 2007) –Birth defect critical window pre conception and 1 st trimester (Sanborn et al 2007) Risk taking behaviors – sense of invulnerability Risks exposing families through work clothes, skin, and vehicles. ( see Work to Home Exposure Pathway slides )

Pesticide Health Effects Medical Education Database (PHEMED) 2010 Women of Child Bearing Years Women using hormonally active pesticides (lindane, atrazine, mancozeb or maneb) have 1.5 x increased odds of longer cycles, missing a period, mid cycle bleeding (Farr SL et al 2004 ) Studies suggest that occupational exposure to certain herbicides ( dicamba, glyphosate, 2,4-D ) fungicide-insecticides ( thiocarbamates ) increase by 20% time needed to become pregnant ( Curtis et al 1999 ) May not know they will become pregnant at the pre conception critical window of exposure relative to risks for birth defects (Sanborn et al 2007) Risks exposing families through work clothes, skin, and vehicles. (see Work to Home Exposure Pathway slides)

Pesticide Health Effects Medical Education Database (PHEMED) 2010 References Selevan SG, Kimmel CA, Mendola P. Identifying critical windows of exposure for children's health. Environ Health Perspect Jun;108 Suppl 3: Review Whyatt RM et al. Biomarkers in assessing residential insecticide exposures during pregnancy and effects on fetal growth. Tox Applied Pharm 206 (2): AUG  Ruah VA. et al. Years of Life Among Inner-City Children Impact of Prenatal Chlorpyrifos Exposure on Neurodevelopment in the First 3. Pediatrics 2006;18: Young JG et al. Association between in utero organophosphate pesticide exposure and abnormal reflexes in neonates. Neurotoxicology Mar;26(2):

Pesticide Health Effects Medical Education Database (PHEMED) 2010 References Roberts EM et al. Maternal residence near agricultural pesticide applications and autism spectrum disorders among children in the California Central Valley. Environ Health Perspect Oct;115(10): Arbuckle TE, Savitz DA, Mery LS, Curtis KM. Exposure to phenoxy herbicidesand the risk of spontaneous abortion. Epidemiology 1999;10: Sanborn M, Kerr KJ, Sanin LH, Cole DC, Bassil KL, Vakil C. Non-cancer health effects of pesticides: systematic review and implications for family doctors. Can Fam Physician Oct;53(10): Farr SL, Cooper GS, Cai J, Savitz DA, Sandler DP. Pesticide use and menstrual cycle characteristics among premenopausal women in the Agricultural Health Study. (2004). Curtis KM, Savitz DA, Weinberg CR, Arbuckle TE. The effect of pesticide exposure on time to pregnancy. Epidemiology Mar;10(2):112-7.