Industrial agriculture is an increasingly important component of the economies of developing countries and women of reproductive age are an integral part of this labor force. The impact of job stress, poor working conditions, and occupational pesticide exposure on the health of women workers and their children is a pressing, but under-studied global public health concern. The proposed research presents a unique opportunity to study the impact of prenatal exposures in the Ecuadorian rose industry on child health within the social context of the family and community. The proposed study will provide crucial pilot data needed to design and implement our planned full-scale epidemiologic investigation of the effects of prenatal pesticide exposure on neurobehavioral development among children of greenhouse flower workers. This study will further our understanding of exposure to non-persistent, acutely toxic pesticides, which have become the most commonly used pesticides in agricultural industry in the Unites States and globally. Unlike other studies of Ecuadorian flower workers that have been done, this study: 1) follows pregnant women longitudinally through pregnancy and assesses the pesticide burden on the developing fetus;and 2) includes sensitive measures of maternal- child interaction and stimulation, early emotional regulation, maternal stress, and other important social and cultural factors which play a major role in child development. Using a community-based research approach and building on existing relationships with co-investigators in Ecuador and with community leaders and members, we will recruit and enroll 30 pregnant rose and non-rose workers in their second trimester, follow them through delivery and follow-up the mother-infant pair for 4 months. We will obtain biomarkers of pesticide exposure (urine, cord blood) from the mother during pregnancy and at delivery. Through maternal interviews, we will obtain data on health, working conditions during pregnancy, maternal stress levels and depression (PSI), maternal-child interactions, and socio-demographic factors. We will administer highly sensitive developmental screening and assessment tests (ASQ-3, Still-Face Paradigm) that will assess cognitive, motor, language, and social-behavioral development, and early executive function in infants at 4 months. Infants will also be measured for growth and nutritional status. We will quantify levels of pesticide exposure in mid pregnancy (urine) and late pregnancy (urine and cord blood). We will assess whether job tasks are associated with the pesticide biomarker levels, which will guide future questionnaire development. We will assess trends, correlations, and associations between pesticide exposure levels, developmental outcomes, and important confounding variables and will evaluate the feasibility of using our proposed developmental and maternal stress assessment tools in this culturally, linguistically, and economically distinct population.

Public Health Relevance

It is estimated that over 200 million children in the developing world are not reaching their full developmental potential and factors such as environmental toxic exposure, poor nutrition, poverty, maternal depression and stress, and social factors may all contribute to the loss of developmental potential in young children. Understanding how these factors impact child development is critical for developing and initiating interventions in affected communities that will promote better child health and development. This collaborative, international community-based pilot study, and the subsequent larger study we are planning, will begin to address these important issues.

National Institute of Health (NIH)
National Institute of Environmental Health Sciences (NIEHS)
Exploratory/Developmental Grants (R21)
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Infectious Diseases, Reproductive Health, Asthma and Pulmonary Conditions Study Section (IRAP)
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Dilworth, Caroline H
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University of New Mexico Health Sciences Center
Family Medicine
Schools of Medicine
United States
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Handal, Alexis J; Hund, Lauren; Páez, Maritza et al. (2016) Characterization of Pesticide Exposure in a Sample of Pregnant Women in Ecuador. Arch Environ Contam Toxicol 70:627-39
Handal, Alexis J; McGough-Maduena, Alison; Páez, Maritza et al. (2015) A Pilot Study Comparing Observational and Questionnaire Surrogate Measures of Pesticide Exposure Among Residents Impacted by the Ecuadorian Flower Industry. Arch Environ Occup Health 70:232-40