1. Helen Murphy – FNP, MHS Pacific Northwest Agricultural Safety and Health Center (PNASH) School of Public Health University of Washington Women’s and Children’s Vulnerability to Pesticides

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

3. Children and Adolescents Physically still developing –biologic risks Physically still developing –biologic risks Dependency – Parental role in preventing exposures Dependency – Parental role in preventing exposures Sources of food and water Sources of food and water Home and school proximity to agriculture sites Home and school proximity to agriculture sites Para-occupational exposures Para-occupational exposures Household and school use of pesticides (structural, garden and pet pest control measures) Household and school use of pesticides (structural, garden and pet pest control measures)

4. Children and Adolescents Risk taking behaviors * Risk taking behaviors * Learning by experimentation (e.g. Indonesia making rockets out of old pesticide containers) Learning by experimentation (e.g. Indonesia making rockets out of old pesticide containers) Perceptual development – overestimate physical abilities Perceptual development – overestimate physical abilities Social development – peers and sibling roles Social development – peers and sibling roles Impulse control – still developing by early 20’s 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. Cognitive Development – affects following directions, doing what the rules say, remembering understanding rules, sense of invulnerability, planning and organizing, consequences of decisions. *Source: David C. Schwebel, Ph.D. Department of Psychology, University of Alabama at Birmingham

5. Health Impacts on Children Health Impacts on Children Asthma Asthma Cancers Cancers Neuro-developmental problems Neuro-developmental problems Small for age at birth Small for age at birth Congenital defects Congenital defects

6. Cancers in Children: The Agriculture Health Study All cancer incidence: a third higher than rates in general population All cancer incidence: a third higher than rates in general population All lymphomas 2 x higher - Hodgkin's 2.5 x higher All lymphomas 2 x higher - Hodgkin's 2.5 x higher Exposure risks Exposure risks   risk if father NOT use chemically resistant gloves  NOT associated to parental application frequency   risk with aldrin (2.66) but not a known carcinogen Limitations: only 5 year follow up and small numbers Limitations: only 5 year follow up and small numbers Source: Flower KB, Hoppin JA, Lynch CF, Blair A, Knott C, Shore DL, Sandler DP. Cancer risk and parental pesticide application in children of Agricultural Health Study participants. Environ Health Perspect. 2004 Apr;112(5):631-5.

7. Congenital Anomalies Consistent findings with Consistent findings with Limb reductions - Uro-genital defects Limb reductions - Uro-genital defects Central nervous system Central nervous system Cleft palates/lips: marginal significant w/maternal exposure Cleft palates/lips: marginal significant w/maternal exposure Eye – heart defects Eye – heart defects Not definitive until better exposure analysis with the US Children’s Health Study Not definitive until better exposure analysis with the US Children’s Health Study Source: Sanborn M, Cole D, Kerr K, Vakil C, Sanin LH, Bassil K. Pesticides Literature Review. Ontario College of Family Physicians. Toronto 2004.

8. Probable link Probable link Fetal and maternal blood samples for OP by-products and newborn lengths Fetal and maternal blood samples for OP by-products and newborn lengths Chlorpyrifos and diazinon [by-products measured in fetal and maternal blood] associated to lower birth weight and length* Chlorpyrifos and diazinon [by-products measured in fetal and maternal blood] associated to lower birth weight and length* Small for Age at Birth * Whyatt RM et al. Biomarkers in assessing residential insecticide exposures during pregnancy and effects on fetal growth.Tox Applied Pharm 206 (2): 246-254 AUG 7 2005

9. Periods of Vulnerability for Women Adolescence Childbearing Years Pregnancy

10. The Adolescent Female Jobs or hobbies involving chemical exposures Jobs or hobbies involving chemical exposures Onset of puberty: still developing reproductive organs are sensitive to hormonally active pesticides Onset of puberty: still developing reproductive organs are sensitive to hormonally active pesticides

11. Women of Child Bearing Years Menstrual cycle disorders: Menstrual cycle disorders: 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 ) 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 ) Time to pregnancy delay: Time to pregnancy delay: 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) 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)

12. Women of Child Bearing Years Pre-conceptual risks: Pre-conceptual risks: 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) 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) Work to home pesticide exposures: Work to home pesticide exposures: Risks exposing families through work clothes, skin, and vehicles. (see Work to Home Exposure Pathway slides) Risks exposing families through work clothes, skin, and vehicles. (see Work to Home Exposure Pathway slides)

13. Pre-Natal Exposures Pre-Natal Exposures Neurodevelopmental risks to child: Prenatal exposure to chlorpyrifos, an organophosphate, is associated with: Prenatal exposure to chlorpyrifos, an organophosphate, is associated with: Increased odds of abnormal reflexes in neonates Increased odds of abnormal reflexes in neonates Poorer verbal IQ in 3½ and 5 year olds Poorer verbal IQ in 3½ 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