Comparison of questionnaire-based estimation of pesticide residue intake from fruits and vegetables with urinary concentrations of pesticide biomarkers

Flavonoid intake and risk of Parkinson's disease

BACKGROUND

Flavonoids have been proposed to reduce the risk of Parkinson's disease (PD). However, results from epidemiological studies have been inconclusive.

OBJECTIVE

To prospectively examine the association between the intake of flavonoids and their subclasses and the risk of PD and how pesticides may confound or modify that association.

METHODS

The study population comprised 80 701 women (1984-2016) and 48 782 men (1986-2016) from two large US cohorts. Flavonoid intake was ascertained at baseline and every 4 years thereafter using a semiquantitative Food Frequency Questionnaire. We conducted multivariable-adjusted Cox regression models to estimate HRs and 95% CIs of PD according to quintiles of baseline and cumulative average intakes of flavonoids and subclasses. We repeated the analyses, adjusting for intakes of high-pesticide-residue fruits and vegetables (FVs) and stratifying by servings/day of high-pesticide-residue FV intake.

RESULTS

We identified 676 incident PD cases in women and 714 in men after 30-32 years of follow-up. Higher total flavonoid intake at baseline was not associated with a lower PD risk, neither in men (HR comparing highest to lowest quintile: 0.89, 95% CI: 0.69 to 1.14) nor in women (HR comparing highest to lowest quintile: 1.27, 95% CI: 0.98 to 1.64). Similar results were observed for cumulative average intakes and flavonoid subclasses. Results remained similar after adjustment for and stratification by high-pesticide-residue FV and when analyses were restricted to younger PD cases.

CONCLUSION

These results do not support a protective effect of flavonoid intake on PD risk. Pesticide residues do not confound or modify the association.

Endocrine-disrupting chemicals and male reproductive health

Modifiable factors, such as environmental exposures, can impact human fertility. The objective of this review is to summarize the potential effects of exposure to important endocrine-disrupting chemicals on male reproductive health. Most experimental and animal data demonstrate strong evidence for the negative effects of exposure to phenols, phthalates, pesticides, and perfluoroalkyl and polyfluoroalkyl substances on male reproductive health. Although evidence of negative associations in humans was overall strong for phthalates and pesticides, limited and inconclusive relationships were found for the other examined chemical biomarkers. Reasons for the discrepancies in results include but are not limited to, differences in study populations, exposure concentrations, number of samples collected, sample sizes, study design, and residual confounding. Additional studies are needed, particularly for newer phenols and perfluoroalkyl and polyfluoroalkyl substances, given the scarce literature on the topic and increasing exposures over time.

Associations between dietary pesticide residue mixture exposure and mortality in a population-based prospective cohort of men and women

BACKGROUND

There is a concern that pesticide residues, regularly detected in foods, might pose a health risk to the consumer, but epidemiological evidence is limited. We assessed the associations between dietary exposure to a mixture of pesticide residues and mortality.

METHODS

Food consumption was assessed in 68,844 participants from the Swedish Mammography Cohort and the Cohort of Swedish Men, 45-83 years at baseline (1997). Concentrations of pesticide residues detected in foods on the Swedish market (1996-1998), mainly fruits and vegetables, were obtained via monitoring programs. To assess mixture effects, we summed per food item the ratios of each single pesticide mean residue concentration divided by its acceptable daily intake to create for each participant a Dietary Pesticide Hazard Index (adjusted for energy intake and expressed per kilogram of body weight). Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 %CI).

RESULTS

During 15 years of follow-up (1998-2014), a total of 16,527 deaths occurred, of which 6,238 were caused by cardiovascular disease (CVD) and 5,364 by cancer. Comparing extreme quintiles of Dietary Pesticide Hazard Index, the highest category was inversely associated with CVD mortality HR, 0.82 (95 % CI, 0.75-0.90) and with cancer mortality HR 0.82 (95 % CI 0.75-0.91). In analyses stratified by high/low Dietary Pesticide Hazard Index, similar inverse associations were observed by increasing fruit and vegetable consumption.

CONCLUSIONS

We observed no indications that dietary exposure to pesticide residue mixtures was associated with increased mortality, nor any clear indications that the benefits of fruit and vegetable consumption on mortality was compromised. Yet, our results need to be interpreted with caution.

Dietary pesticide exposure and non-communicable diseases and mortality: a systematic review of prospective studies among adults

BACKGROUND

Research on the effect of pesticide exposure on health has been largely focused on occupational settings. Few reviews have synthesized the associations between dietary pesticide exposure and health outcomes in non-occupationally exposed adults.

OBJECTIVE

We aim to summarize the evidence regarding dietary pesticide exposure and non-communicable diseases (NCD) in adults, using a systematic review of prospective studies.

METHODS

Electronic and manual searches were performed until July 2023. The inclusion criteria were the following: 1) adults aged ≥ 18years, 2) (non)-randomized trials, prospective cohort studies, 3) dietary exposure to pesticides. A bias analysis was carried out using the Nutrition Evidence Systematic Review guidelines based on the Cochrane ROBINS-I.

RESULTS

A total of 52 studies were retrieved and 6 studies that met the above criteria were included. Studies were conducted either in France or in the United States. The studies investigated the risk of cancer (n = 3), diabetes (n = 1), cardiovascular diseases (n = 1), and mortality (n = 1). The quality of the studies varied with overall grades derived from the bias analysis ranging from low to moderate bias. The level of evidence was estimated as low for the risk of cancer while the grading was not assignable for other outcomes, as only one study per outcome was available.

CONCLUSIONS

Although further research is warranted to examine more in depth the relationships between low-dose chronic exposure to pesticides through diet and NCD outcomes in non-occupationally-exposed adults, studies suggest a possible role of exposure to dietary pesticide on health. Standardized methodological guidelines should also be proposed to allow for comparison across studies.

Quantitative analysis of the minimum days of dietary survey to estimate dietary pesticide exposure: Implications for dietary pesticide sampling strategy

Populations are exposed to pesticides through diet on a daily basis. However, there is no research guiding how to evaluate dietary pesticide exposure, and researchers used 1-day, 3-days, 7-days or even longer dietary survey to evaluate without any consensus. It is important for dietary pesticide evaluation to identify the minimum survey days. To increase knowledge of this, a data combination was applied between a two-wave consecutive repeated-measures study in Baoding City and the Fifth China Total Diet Study. Further policy consistency on pesticides were evaluated to explain its credibility. We computed the sensitivity and specificity to evaluate how well different days of dietary survey classify participants with high exposure, and calculated the minimum days required to estimate the participant-specific mean at different acceptable error range. With 1 day of dietary survey, the classification sensitivity was low (<0.6) for total HCH, endosulfan, chlordane, cyhalothrin, allethrin, and prallethrin; that for the other pesticides was high sensitivity (≥0.6). Sensitivity increased as the number of days increased, and the maximum marginal sensitivity increase (≥0.039) occurred from 1 to 2 days for all pesticides except phenothrin, whose maximum marginal sensitivity increase (0.042) occurred from 2 to 3 days. The specificity increased gradually from 0.8 to 0.9 from 1 to 7 days. Under the acceptable error range of 0.5%, 3-28 days were required for participant-specific mean estimation and 1-7 days were required when acceptable error range was shrunk in 1%. Only 1 day was enough if 5% error range was acceptable. In conclusion, 3 days in the study period was cost-effective to distinguish high exposure group, and it rose to 7 when estimating participant-specific mean from a conservative perspective. This study can serve as a reference to determine the minimum survey days for epidemiological studies employing dietary surveys.

Impact of endocrine disruptors from mother's diet on immuno-hormonal orchestration of brain development and introduction of the virtual human twin tool

Diet has long been known to modify physiology during development and adulthood. However, due to a growing number of manufactured contaminants and additives over the last few decades, diet has increasingly become a source of exposure to chemicals that has been associated with adverse health risks. Sources of food contaminants include the environment, crops treated with agrochemicals, inappropriate storage (e.g., mycotoxins) and migration of xenobiotics from food packaging and food production equipment. Hence, consumers are exposed to a mixture of xenobiotics, some of which are endocrine disruptors (EDs). The complex interactions between immune function and brain development and their orchestration by steroid hormones are insufficiently understood in human populations, and little is known about the impact on immune-brain interactions by transplacental fetal exposure to EDs via maternal diet. To help to identify the key data gaps, this paper aims to present (a) how transplacental EDs modify immune system and brain development, and (b) how these mechanisms may correlate with diseases such as autism and disturbances of lateral brain development. Attention is given to disturbances of the subplate, a transient structure of crucial significance in brain development. Additionally, we describe cutting edge approaches to investigate the developmental neurotoxicity of EDs, such as the application of artificial intelligence and comprehensive modelling. In the future, highly complex investigations will be performed using virtual brain models constructed using sophisticated multi-physics/multi-scale modelling strategies based on patient and synthetic data, which will enable a greater understanding of healthy or disturbed brain development.

Fruit and vegetable consumption, pesticide residue intake from consumption of fruits and vegetables, and risk of uterine fibroids

OBJECTIVE

To examine the association between consumption of fruits and vegetables and pesticide residue intake from consumption of fruits and vegetables and risk of ultrasound- or hysterectomy-confirmed fibroids. Only a few studies have evaluated the association of fruit and vegetable intake with uterine fibroids, with inconsistent results. No studies have examined pesticide exposure through fruits and vegetables with fibroid risk.

DESIGN

Prospective cohort study. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).

SETTING

Not applicable.

PATIENT(S)

A total of 81,782 premenopausal participants from the Nurses' Health Study II cohort were followed from 1991 to 2009 for fruit and vegetable analysis, and 49,927 participants were followed from 1999 to 2009 for pesticide residue burden analysis. Their diet was assessed every 4 years with a food frequency questionnaire. Fruits and vegetables were classified into high- or low-pesticide residues using a validated method based on surveillance data from the US Department of Agriculture.

INTERVENTION(S)

Not applicable.

MAIN OUTCOME MEASURE(S)

Cases of ultrasound- or hysterectomy-confirmed fibroids were identified from self-reports to validated questionnaires.

RESULT(S)

From 1991 to 2009, 9,706 incident cases of ultrasound- or hysterectomy-confirmed fibroids were reported, and 4,195 incident cases were identified from 1999 to 2009. No association was observed between total fruit and vegetable consumption and uterine fibroid risk. Participants with the highest intake of total fruits (≥4/day) were 10% less likely to develop uterine fibroids compared with participants who consumed <1/day (95% CI = 0.80-1.01). No associations were observed with any other fruit or vegetable groups. An inverse association was observed between intake of high-pesticide-residue fruits and vegetables and fibroid risk (HR for 5th vs. 1st quintile = 0.87; 95% CI = 0.77-0.99), while no association with low-pesticide-residue fruits and vegetables was observed (HR for 5th vs. 1st quintile = 1.08; 95% CI = 0.95-1.23).

CONCLUSION(S)

Our findings suggest that pesticide residues on fruits and vegetables are not associated with a higher risk of uterine fibroids. Furthermore, our results suggest that intake of fruits may be associated with a lower risk of fibroids. Future research in this area should focus on dietary exposures across the life course as well as assessment of class-specific pesticides.

Pesticide residue intake from fruit and vegetable consumption and risk of laparoscopically confirmed endometriosis

OBJECTIVE

To examine the association between the intake of fruits and vegetables with high- vs. low-pesticide residue burden and diagnosis of laparoscopically confirmed endometriosis. The etiology of endometriosis is not well understood, but dietary factors may influence the risk. Pesticides may act as endocrine disruptors, and the intake of pesticide-contaminated food is a common exposure pathway.

DESIGN

Prospective cohort study. Hazard ratios and 95% confidence intervals were calculated using multivariable Cox proportional hazard models to evaluate the intake of fruits and vegetables with high- and low-pesticide residues in relation to the diagnosis of laparoscopically confirmed endometriosis.

SETTING

Not applicable.

PATIENT(S)

Premenopausal US women (N = 52,053) of the Nurses' Health Study II, aged 34-53 years at study baseline (1999), were followed until 2013. The diet was assessed every 4 years using a validated food frequency questionnaire. A previously developed and validated pesticide residue burden score (PRBS), on the basis of the US Department of Agriculture Pesticide Data Program, was used to assign fruits and vegetables to pesticide residue groups (high/low).

INTERVENTION(S)

Not applicable.

MAIN OUTCOME MEASURE(S)

Cases of laparoscopically confirmed endometriosis were identified from self-reports to validated questionnaires.

RESULT(S)

During 14 years of follow-up, 956 incidences of laparoscopically confirmed endometriosis were reported. No association was observed between the intake of high- or low-PRBS fruit and vegetable intake and endometriosis (hazard ratio for 5th vs. 1st quintile: high-PRBS intake = 0.94, 95% confidence interval = 0.73-1.23; low-PRBS intake = 1.07, 95% confidence interval = 0.82-1.40). No associations were observed for high- or low-PRBS fruit and vegetable intake by fertility status.

CONCLUSION(S)

No clear associations were observed between high- or low-PRBS fruit and vegetable intake and endometriosis risk among premenopausal women. To our knowledge, this is the first study to evaluate the association between dietary pesticide residue intake and endometriosis. Further research is needed, particularly to evaluate this association among a younger population of women (adolescence or early adulthood) and assess the dietary exposure to specific pesticides or chemical families.

Prenatal exposure to pesticide residues in the diet in association with child autism-related traits: Results from the EARLI study

Prior work has suggested associations between prenatal exposure to several classes of pesticides and child autism spectrum disorder (ASD). We examined a previously developed pesticide residue burden score (PRBS) and intake of high pesticide residue foods in association with ASD-related traits. Participants were drawn from the Early Autism Risk Longitudinal Investigation (EARLI) (n = 256), a cohort following mothers who previously had a child with ASD through a subsequent pregnancy and that child's development. ASD-related traits were captured according to total Social Responsiveness Scale (SRS) scores at age 3 (mean raw total SRS score = 35.8). Dietary intake was assessed through a food frequency questionnaire collected during pregnancy. We also incorporated organic intake and fatty foods in modified versions of the PRBS. Associations between high-residue fruit and vegetable intake, the overall PRBS and modified versions of it, and SRS scores were assessed using multivariable linear regression. Overall, we did not observe associations between pesticide residues in foods and ASD-related outcomes, and modified versions of the PRBS yielded similar findings. However, reductions in ASD-related traits were observed with higher overall fruit and vegetable intake (adjusted estimates for Q4 vs. Q1: β -12.76, 95%CI -27.8, 2.3). Thus, findings from this high familial probability cohort did not suggest relationships between pesticide residues in the diet according to the PRBS and ASD-related traits. Beneficial effects of fruit and vegetable intake may influence these relationships. Future work should consider fruit and vegetable intake in association with ASD-related outcomes. LAY SUMMARY: Diet is the main source of exposure to most pesticides in use today. In this study, we examined the relationship between pesticide exposure from residues in the diet during pregnancy and child autism-related traits. We found that these pesticide residues from the diet were not related to child autism-related outcomes at age three. However, higher prenatal fruit and vegetable intake was associated with reductions in child autism-related traits.

Pesticide Residue Intake From Fruit and Vegetable Consumption and Risk of Glioma

We aimed to determine whether intake of pesticide residues from fruits and vegetables was associated with glioma. Within 3 prospective cohorts from 1998-2016-the Nurses' Health Study (NHS), Nurses' Health Study II (NHSII), and Health Professionals Follow-up Study-we computed multivariable-adjusted hazard ratios (MVHRs) and 95% confidence intervals (CI) for glioma by quintiles of intake of low- and high-pesticide-residue fruits and vegetables using Cox proportional hazards regression. Fruits and vegetables were categorized as high or low residue using a validated method based on pesticide surveillance data. We confirmed 275 glioma cases across 2,745,862 person-years. A significant association was observed between intake of high-residue fruits and vegetables and glioma in NHS (MVHR = 2.99, 95% CI: 1.38, 6.44 comparing highest with lowest quintile, P for trend = 0.02). This was not identified in NHSII (MVHR = 0.52, 95% CI: 0.19, 1.45, P for trend = 0.20) or Health Professionals Follow-up Study (MVHR = 1.01, 95% CI: 0.42, 2.45, P for trend = 0.39). No significant associations were observed by intake of low-residue fruits and vegetables; overall intake was not significantly associated with glioma in any cohort. We found no evidence for an inverse relationship of fruit and vegetable intake with glioma. Although limited in power, this study suggests a possible association between fruit-and-vegetable pesticide residue intake and risk of glioma that merits further study.

Pesticide residue intake from fruits and vegetables and alterations in the serum metabolome of women undergoing infertility treatment

BACKGROUND

Pesticide exposure is linked to a myriad of negative health effects; however, the mechanisms underlying these associations are less clear. We utilized metabolomics to describe the alterations in the serum metabolome associated with high and low pesticide residue intake from fruits and vegetables (FVs), the most common route of exposure in humans.

METHODS

This analysis included 171 women undergoing in vitro fertilization who completed a validated food frequency questionnaire and provided a serum sample during controlled ovarian stimulation (2007-2015). FVs were categorized as high or low-to-moderate pesticide residue using a validated method based on pesticide surveillance data from the USDA. We conducted untargeted metabolic profiling using liquid chromatography with high-resolution mass spectrometry and two chromatography columns. We used multivariable generalized linear models to identified metabolic features (p < 0.005) associated with high and low-to-moderate pesticide residue FV intake, followed by enriched pathway analysis.

RESULTS

We identified 50 and 109 significant features associated with high pesticide residue FV intake in the C18 negative and HILIC positive columns, respectively. Additionally, we identified 90 and 62 significant features associated with low-to-moderate pesticide residue FV intake in the two columns, respectively. Four metabolomic pathways were associated with intake of high pesticide residue FVs including those involved in energy, vitamin, and enzyme metabolism. 12 pathways were associated with intake of low-to-moderate pesticide residue FVs including cellular receptor, energy, intercellular signaling, lipid, vitamin, and xenobiotic metabolism. One energy pathway was associated with both high and low-to-moderate pesticide residue FVs.

CONCLUSIONS

We identified limited overlap in the pathways associated with intake of high and low-to-moderate pesticide residue FVs, which supports findings of disparate health effects associated with these two exposures. The identified pathways suggest there is a balance between the dietary antioxidant intake associated with FVs intake and heightened oxidative stress as a result of dietary pesticide exposure.

Intake of fruits and vegetables according to pesticide residue status in relation to all-cause and disease-specific mortality: Results from three prospective cohort studies

BACKGROUND

Intake of conventionally grown fruits and vegetables (FVs) is an important route of exposure to pesticide residues in the general population. However, whether health risk stemming from exposure to pesticides through diet could offset benefits of consuming FVs is unclear.

OBJECTIVE

We assessed the association of FV intake, classified according to their pesticide residue status, with total and cause-specific mortality.

METHODS

We followed 137,378 women (NHS, 1998-2019, and NHSII, 1999-2019) and 23,502 men (HPFS, 1998-2020) without cardiovascular disease, cancer, or diabetes at baseline. FV intake was assessed using validated food frequency questionnaires and categorized as having high- or low-pesticide-residues using data from the USDA Pesticide Data Program. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for total and cause-specific mortality associated with high- and low-pesticide-residue FV intake.

RESULTS

A total of 27,026 deaths, including 4,318 from CVD and 6,426 from cancer, were documented during 3,081,360 person-years of follow-up. In multivariable-adjusted analyses, participants who consumed ≥4 servings/day of low-pesticide-residue FVs had 36% (95% CI: 32%-41%) lower mortality risk compared to participants who consumed <1 serving/day. The corresponding estimate for high-pesticide residue FV intake was 0.93 (95% CI: 0.81-1.07). This pattern was similar across the three most frequent causes of death (cardiovascular disease, cancer and respiratory diseases).

CONCLUSIONS

High-pesticide-residue FV intake was unrelated whereas low-pesticide residue FV intake was inversely related to all-cause mortality, suggesting that exposure to pesticide residues through diet may offset the beneficial effect of FV intake on mortality.

Maternal dietary patterns during pregnancy and exposure to persistent endocrine disrupting chemicals in two European birth cohorts

Food consumption, particularly of animal-based products, is considered the most important contributor to persistent endocrine disrupting chemical (EDC) exposure. This study aims to describe the association between maternal diet during pregnancy and exposure to persistent EDCs using dietary pattern analysis. This study is based on subsamples of the Avon Longitudinal Study of Parents and Children (ALSPAC) (N=422) and the Norwegian Mother, Father, and Child Cohort Study (MoBa) (N=276) which uses data from the Medical Birth Registry of Norway (MBRN). Women in both studies completed food frequency questionnaires (FFQs) during pregnancy, from which consumption data were categorized into 38 aggregated food groups. Maternal blood samples were collected during pregnancy and concentrations of perfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs) in serum/plasma were measured. Dietary patterns were identified using reduced rank regression, with blood EDC concentrations as response variables. Within ALSPAC, all patterns (PFAS, PCB, and OCP) were characterized by high consumption of meat, poultry, white fish, and biscuits. In MoBa, high consumption of sausages and burgers (representing processed meats), pasta, and chocolate bars characterized PCB and OCP dietary patterns, while high consumption of cheese characterized the PFAS pattern. Across both cohorts, PFAS patterns were characterized by high consumption of cheese, PCB patterns by high consumption of rice, and OCP patterns by poultry. Dietary patterns explained between 8 and 20% of the variation in serum EDC concentrations, with explained variance being the highest for PCBs in both cohorts. In conclusion, dietary patterns high in animal-based products appear to be associated with persistent EDC concentrations among pregnant women. Diet explains more variation in PCB concentrations than for other persistent EDC classes.

Intake of fruits and vegetables by pesticide residue status in relation to cancer risk

BACKGROUND

Conventionally grown fruits and vegetables (FVs) are the main source of general population exposure to pesticide residues.

OBJECTIVE

To evaluate the relation of intake of high- and low-pesticide-residue FVs with cancer risk.

METHODS

We followed 150,830 women (Nurses' Health Study, 1998-2016, and Nurses' Health Study II, 1999-2017) and 29,486 men (Health Professionals Follow-up Study, 1998-2016) without a history of cancer. We ascertained FV intake via validated food frequency questionnaires and categorized FVs as having high or low pesticide residue levels based on USDA surveillance data. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) of total and site-specific cancer related to quintiles of high- and low-pesticide-residue FV intake.

RESULTS

We documented 23,678 incident cancer cases during 2,862,118 person-years of follow-up. In the pooled multivariable analysis, neither high- nor low-pesticide-residue FV intake was associated with cancer. The HRs (95% CI) per 1 serving/day increase in intake were 0.99 (0.97-1.01) for high- and 1.01 (0.99-1.02) for low-pesticide-residue FVs. Additionally, we found no association between high-pesticide-residue FV intake and risk of specific sites, including malignancies previously linked to occupational pesticide exposure ([HR, 95% CI comparing extreme quintiles of intake] lung [1.17 (0.95-1.43)], non-Hodgkin lymphoma [0.89 (0.72-1.09)], prostate [1.31 (0.88-1.93)]) or inversely related to intake of organic foods (breasts [1.03 (0.94-1.31)]).

CONCLUSIONS

These findings suggest that overall exposure to pesticides through FV intake is not related to cancer risk, although they do not rule out associations with specific chemicals or sub-types of specific cancers.

Prenatal exposure to pesticides and risk of preeclampsia among pregnant women: Results from the ELFE cohort

BACKGROUND

Preeclampsia is a pregnancy-specific syndrome caused by abnormal placentation. Although environmental chemicals, including some pesticides, are suspected of impairing placentation and promoting preeclampsia, its relationship with preeclampsia has been insufficiently explored.

OBJECTIVES

We aimed to investigate the relation between non-occupational exposure to pesticides during pregnancy and the risk of preeclampsia.

METHODS

The study cohort comprised 195 women with and 17,181 without preeclampsia from the ELFE birth cohort. We used toxicogenomic approaches to select 41 pesticides of interest for their possible influence on preeclampsia. We assessed household pesticide use (self-reported data), environmental exposure to agricultural pesticides (geographic information systems), and dietary exposure (food-frequency questionnaire with data from monitoring pesticide residues in food and water). Dietary exposures to pesticides were grouped into clusters of similar exposures to resolve collinearity issues. For each exposure source, pesticides were mutually adjusted, and odds ratios estimated with logistic regression models.

RESULTS

The quantity of prochloraz applied within a kilometer of the women's homes was higher in women with than without preeclampsia (fourth quartile vs. others; adjusted odds ratio [aOR] = 1.54; 95%CI: 1.02, 2.35), especially when preeclampsia was diagnosed before 34 weeks of gestation (aOR = 2.25; 95%CI: 1.01, 5.06). The reverse was observed with nearby cypermethrin application (aOR = 0.59, 95%CI: 0.36, 0.96). In sensitivity analyses, women with preeclampsia receiving antihypertensive treatment had a significantly higher probability of using herbicides at home during pregnancy than women without preeclampsia (aOR = 2.20; 95%CI: 1.23, 3.93). No statistically significant association was found between dietary exposure to pesticide residues and preeclampsia.

DISCUSSION

While the most of the associations examined remained statistically non-significant, our results suggest the possible influence on preeclampsia of residential exposures to prochloraz and some herbicides. These estimations are supported by toxicological and mechanistic data.

Measurement of urinary pesticide biomarkers among Latina farmworkers in southwestern Idaho

BACKGROUND

Women who work in agriculture may have greater risk of pesticide exposure than men who share this occupation. Despite an increase in the fraction of the agricultural workforce comprised by women, few studies have characterized pesticide exposure in the USA with a focus on among these workers.

OBJECTIVE

This pilot study aimed to describe pesticide exposure in a cohort of Latina farmworkers in farming communities in southwestern Idaho.

METHODS

We collected urine samples from 29 Latina farmworkers, which were analyzed for 11 pesticide biomarkers. We evaluated the effect of pesticide spray season on urinary biomarker levels, and explored the effect of self-reported status as a pesticide handler on measured exposures.

RESULTS

No significant differences were found between biomarker levels in samples collected during the nonspray and spray seasons. We observed 11 extreme outlying values in samples collected during the pesticide spray season. The most extreme outlying values (MDA: 51.7 ng/mL; 3-PBA: 11.8 ng/mL; trans-DCCA: 23.4 ng/mL; and 2,4-D: 31.1 ng/mL) were all provided during the spray season by women who reported loading, mixing or applying pesticides.

CONCLUSIONS

These results provide suggestive evidence that Latina farmworkers who handle pesticides during the spray season may be at an increased risk of exposure to organophosphate and pyrethroid insecticides, as well as the herbicide 2,4-D. We recommend that future research into pesticide exposures among farmworkers should include particular focus on this group.

Understanding Challenges to Well-Being among Latina FarmWorkers in Rural Idaho Using in an Interdisciplinary, Mixed-Methods Approach

The aim of this study was to identify social, cultural and workplace-related risk factors affecting well-being among Latina farmworkers in rural Idaho. We recruited 70 Latina farmworkers from southwestern Idaho in 2019. We employed an inter-disciplinary, mixed-methods approach—including surveys, focus groups, interviews, and pesticide biomonitoring—to characterize multiple domains that influence well-being, including food security and access, housing conditions, social supports, access to medical care, and workplace safety. Six major themes emerged as primary challenges to Latina farmworkers’ well-being. In the public sphere, study participants identified these challenges as long working hours, concerns regarding pesticide exposure, and lack of enforcement of regulatory protections. Participants’ concerns regarding pesticide exposure were underscored by biological sampling results; multiple biomarkers of pesticide exposure were detected in all samples, with the highest concentrations measured in samples collected from women who reported mixing, loading or applying pesticides. Within the private sphere, food security and provisioning, childcare responsibilities, and social isolation were identified as significant challenges to well-being. Gender, ethnicity, and geography emerged as important, intersecting statuses that shaped the life experiences of these agricultural workers. Our findings suggest that gender may play a particularly critical role in the unique challenges facing Latina farmworkers. As a result, the services and regulations needed to support well-being in this population may be highly specific, and almost certainly include attention to work–family dynamics, pesticide exposure, and social connections.

Pesticide residue intake from fruits and vegetables and fecundability in a North American preconception cohort study

Intake of conventionally-grown fruits and vegetables with higher levels of pesticide residue contamination has been associated with poorer semen quality and lower probability of live birth among couples undergoing fertility treatment. We examined the association between dietary intake of pesticide residues and fecundability, the per cycle probability of conception, in a preconception cohort of pregnancy planners. We enrolled women aged 21-45 years who were attempting to conceive without use of fertility treatment into Pregnancy Study Online (PRESTO) from June 2013 through September 2019. Participants completed a baseline questionnaire on demographics, lifestyle factors, and medical and reproductive histories, and bimonthly follow-up questionnaires for up to 12 months or until reported conception. Ten days after baseline, participants completed the National Cancer Institute's Diet History Questionnaire II, a validated food frequency questionnaire. Using data from the USDA Pesticide Data Program, we classified fruits and vegetables as having high or low pesticide residues using a validated method. We examined the relation between greater intake of high- and low-pesticide residue fruits and vegetables with fecundability using proportional probabilities regression models, adjusted for potential confounders and accounting for consumption of organic produce. We restricted our analysis to 5234 women who had been attempting conception for ≤6 cycles at study entry, and further stratified by pregnancy attempt time at study entry (<3 vs. 3-6 cycles) to evaluate potential for reverse causation. Intakes of high- and low-pesticide residue fruits and vegetables were not appreciably related to fecundability in the full sample, or among women trying to conceive for <3 cycles at study entry. However, among women trying to conceive for 3-6 cycles at study entry, both high- and low-pesticide residue fruit and vegetable intakes were strongly inversely related to fecundability, indicating potential reverse causation bias. These results do not support the hypothesis that intake of pesticide residues from conventionally-grown fruits and vegetables is harmful to fertility, although non-differential exposure misclassification may have attenuated our findings.

Application of the Food Quality Protection Act children's health safety factor in the U.S. EPA pesticide risk assessments

BACKGROUND

The Food Quality Protection Act of 1996, or FQPA, required the Environmental Protection Agency to set allowable levels for pesticides in a way that would "ensure that there is a reasonable certainty that no harm will result to infants and children from aggregate exposure to the pesticide chemical residue." The act stipulated that an additional tenfold margin of safety for pesticide risk assessments shall be applied to account for pre- and postnatal toxicity and for any data gaps regarding pesticide exposure and toxicity, unless there are reliable data to demonstrate that a different margin would be safe for infants and children.

DISCUSSION

To examine the implementation of the FQPA-mandated additional margin of safety, this analysis reviews 59 pesticide risk assessments published by the EPA between 2011 and 2019. The list includes 12 pesticides used in the largest amount in the U.S.; a group of 35 pesticides detected on fruits and vegetables; and 12 organophosphate pesticides. For the non-organophosphate pesticides reviewed here, the EPA applied an additional children's health safety factor in 13% of acute dietary exposure scenarios and 12% of chronic dietary exposure scenarios. For incidental oral, dermal and inhalation exposures, additional FQPA factors were applied for 15, 31, and 41%, respectively, of the non-organophosphate pesticides, primarily due to data uncertainties. For the organophosphate pesticides as a group, a tenfold children's health safety factor was proposed in 2015. Notably, in 2017 that decision was reversed for chlorpyrifos.

CONCLUSIONS

For the majority of pesticides reviewed in this study, the EPA did not apply an additional FQPA safety factor, missing an opportunity to fully use the FQPA authority for protecting children's health.

Association between intake of fruits and vegetables by pesticide residue status and coronary heart disease risk

BACKGROUND

Fruit and vegetable (FV) intake is recommended for the prevention of coronary heart disease (CHD). FVs are also an important source of exposure to pesticide residues. Whether the relations of FV intake with CHD differ according to pesticide residue status is unknown.

OBJECTIVE

To examine the associations of high- and low-pesticide-residue FVs with the risk of CHD.

METHODS

We followed 145,789 women and 24,353 men free of cardiovascular disease and cancer (excluding non-melanoma skin cancer) at baseline and participating in three ongoing prospective cohorts: the Nurses' Health Study (NHS: 1998-2012), the NHS-II (1999-2013), and the Health Professionals Follow-up Study (HPFS: 1998-2012). FV intake was assessed via food frequency questionnaires. We categorized FVs as having high- or low-pesticide-residues using a validated method based on pesticide surveillance data from the US Department of Agriculture. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CI) of CHD in relation to high- and low-pesticide-residue FV intake.

RESULTS

A total of 3707 incident CHD events were identified during 2,241,977 person-years of follow-up. In multivariable-adjusted models, a greater intake of low-pesticide-residue FVs was associated with a lower risk of CHD whereas high-pesticide-residue FV intake was unrelated to CHD risk. Specifically, compared with individuals consuming <1 serving/day of low-pesticide-residue FVs, those consuming ≥4 servings/day had 20% (95CI: 4%, 33%) lower risk of CHD. The corresponding HR (comparing ≥4 servings/day to <1 serving/day) for high-pesticide-residue FV intake and CHD was 0.97 (95%CI: 0.72, 1.30).

CONCLUSIONS

Our data suggested exposure to pesticide residues through FV intake may modify some cardiovascular benefits of FV consumption. Further confirmation of these findings, especially using biomarkers for assessment of pesticide exposure, is needed.

Development of a questionnaire-based insecticide exposure assessment method and comparison with urinary insecticide biomarkers in young Australian children

Environmental and behavioural factors assessed via an online questionnaire were compared to insecticide metabolite concentrations in urine collected from 61 children from South East Queensland, Australia. Metabolite concentrations (μg/L urine) were transformed using the natural logarithm prior to regression analysis and adjusted for age and creatinine. A significant dietary association was reported for vegetable intake and 3-phenoxybenzoic acid (3-PBA) (β: 1.47 for top quartile of intake versus bottom quartile of intake 95% CI: 0.36, 2.57). Intake of vegetables and fruit were also positively associated with sum non-specific organophosphate metabolites (ƩnsOP). ƩnsOP concentrations were lower when fruits and vegetables were always or almost always washed prior to cooking or eating (β: -0.69 95% CI: -1.25, -0.12). In multivariable modelling 3-PBA concentrations were also associated with hand-washing frequency (β: 1.69 95% CI: 0.76, 2.61 for <1 day versus > 3 day), presence of a dog in the home (β: 0.73 95% CI: 0.07, 1.38), frequency of pest-spray use in the summer months (β: 0.88 95% CI: 0.22, 1.54 weekly versus less than weekly) and season (β: 0.88 95% CI: 0.32, 1.44 for spring/summer versus winter/autumn). This is the first study in Australia to report dietary, behavioural and environmental factors associated with biomarkers of insecticide exposure in young children.

Effect of a 24-week randomized trial of an organic produce intervention on pyrethroid and organophosphate pesticide exposure among pregnant women

BACKGROUND

Introduction of an organic diet can significantly reduce exposure to some classes of pesticides in children and adults, but no long-term trials have been conducted.

OBJECTIVES

To assess the effect of a long-term (24-week) organic produce intervention on pesticide exposure among pregnant women.

METHODS

We recruited 20 women from the Idaho Women, Infants, and Children (WIC) program during their first trimester of pregnancy. Eligible women were nonsmokers aged 18-35 years who reported eating exclusively conventionally grown food. We randomly assigned participants to receive weekly deliveries of either organic or conventional fruits and vegetables throughout their second or third trimesters and collected weekly spot urine samples. Urine samples, which were pooled to represent monthly exposures, were analyzed for biomarkers of organophosphate (OP) and pyrethroid insecticides.

RESULTS

Food diary data demonstrated that 66% of all servings of fruits and vegetables consumed by participants in the "organic produce" group were organic, compared to <3% in the "conventional produce" group. We collected an average of 23 spot samples per participant (461 samples total), which were combined to yield 116 monthly composites. 3-Phenoxybenzoic acid (3-PBA, a non-specific biomarker of several pyrethroids) was detected in 75% of the composite samples, and 3-PBA concentrations were significantly higher in samples collected from women in the conventional produce group compared to the organic produce group (0.95 vs 0.27 μg/L, p = 0.03). Another pyrethroid biomarker, trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid, was detected more frequently in women in the conventional compared to the organic produce groups (16% vs 4%, p = 0.05). In contrast, we observed no statistically significant differences in detection frequency or concentrations for any of the four biomarkers of OP exposure quantified in this trial.

DISCUSSION

To our knowledge, this is the first long-term organic diet intervention study, and the first to include pregnant women. These results suggest that addition of organic produce to an individual's diet, as compared to conventional produce, significantly reduces exposure to pyrethroid insecticides.

Intake of Antioxidants in Relation to Infertility Treatment Outcomes with Assisted Reproductive Technologies

BACKGROUND

Randomized trials of supplementation with antioxidant mixtures during infertility treatment show no benefit on pregnancy or live birth rate. However, the roles of individual antioxidants are poorly understood. We examined the association of baseline intake of vitamins A, C, E, and carotenoids with outcomes of assisted reproductive technologies (ARTs).

METHODS

We followed 349 women undergoing a total of 588 ART cycles for infertility treatment at the Massachusetts General Hospital. We assessed antioxidant intakes from food and supplements before treatment using a validated food frequency questionnaire. We used generalized linear mixed models to account for multiple ART cycles per woman while adjusting for confounding.

RESULTS

Mean (SD) age and body mass index were 35.1 years (4.0 years) and 24.1 kg/m (4.3 kg/m), respectively. Total intake of vitamins A, C, and E was not associated with the probability of live birth. Women in the highest intake category of β-carotene from foods had a lower probability of live birth than women in the lowest intake quartile (50% vs. 22%; P trend = 0.03); for lutein and zeaxanthin, the probability for the highest intake group was 44% vs. 28% for the lowest. Intake of β-carotene from supplements and intakes of retinol and all other carotenoids were unrelated to live birth rates.

CONCLUSIONS

We found unexpected inverse associations of β-carotene intake from foods and of lutein and zeaxanthin intake with live birth rates. Within the observed intake ranges, total consumption of vitamins A, C, and E before starting infertility treatment with ART was not associated with live birth rates.

Maternal intake of pesticide residues from fruits and vegetables in relation to fetal growth

OBJECTIVES

To examine the associations of maternal intake of fruits and vegetables (FVs), considering pesticide residue levels, with fetal growth.

METHODS

We studied 1777 mothers (1275 white, 502 non-white) and their infants from Project Viva, a prospective pre-birth cohort (1999-2002). We categorized FVs as containing high or low pesticide residues using data from the US Department of Agriculture. We then used a food frequency questionnaire to estimate each participant's intake of high and low pesticide residue FVs in the first and second trimester. The primary outcomes were small-for-gestational-age (SGA; <10th percentile in birth-weight-for-gestational-age), large-for-gestational-age (LGA; ≥10th percentile in birth-weight-for-gestational-age) and preterm birth (gestational age <37 weeks). We also evaluated whether the associations between high pesticide residue FV intake and birth outcomes were modified by race/ethnicity.

RESULTS

5.5% of newborns were SGA, 13.7% were LGA, and 7.3% were preterm. Intakes of high or low pesticide residue FVs, regardless of pregnancy trimester, were not associated with risks of SGA, LGA, or preterm birth. In addition, the associations of high pesticide FV intake with SGA and LGA were not modified by race/ethnicity. However, we observed heterogeneity in the relationship between first trimester high pesticide FV intake and risk of preterm birth by race/ethnicity (P value for interaction = 0.01), although this relationship did not persist after correction for multiple comparisons (Bonferroni corrected level of significance: P < 2.8 × 10-3).

CONCLUSIONS

There were no clear associations between high or low pesticide FV intake during pregnancy with SGA, LGA or preterm birth.

Association Between Pesticide Residue Intake From Consumption of Fruits and Vegetables and Pregnancy Outcomes Among Women Undergoing Infertility Treatment With Assisted Reproductive Technology

Importance

Animal experiments suggest that ingestion of pesticide mixtures at environmentally relevant concentrations decreases the number of live-born offspring. Whether the same is true in humans is unknown.

Objective

To examine the association of preconception intake of pesticide residues in fruits and vegetables (FVs) with outcomes of infertility treatment with assisted reproductive technologies (ART).

Design, Setting, and Participants

This analysis included 325 women who completed a diet assessment and subsequently underwent 541 ART cycles in the Environment and Reproductive Health (EARTH) prospective cohort study (2007-2016) at a fertility center at a teaching hospital. We categorized FVs as having high or low pesticide residues using a validated method based on surveillance data from the US Department of Agriculture. Cluster-weighted generalized estimating equations were used to analyze associations of high- and low-pesticide residue FV intake with ART outcomes.

Main Outcomes and Measures

Adjusted probabilities of clinical pregnancy and live birth per treatment cycle.

Results

In the 325 participants (mean [SD] age, 35.1 [4.0] y; body mass index, 24.1 [4.3]), mean (SD) intakes of high- and low-pesticide residue FVs were 1.7 (1.0) and 2.8 (1.6) servings/d, respectively. Greater intake of high-pesticide residue FVs was associated with a lower probability of clinical pregnancy and live birth. Compared with women in the lowest quartile of high-pesticide FV intake (<1.0 servings/d), women in the highest quartile (≥2.3 servings/d) had 18% (95% CI, 5%-30%) lower probability of clinical pregnancy and 26% (95% CI, 13%-37%) lower probability of live birth. Intake of low-pesticide residue FVs was not significantly related to ART outcomes.

Conclusions and Relevance

Higher consumption of high-pesticide residue FVs was associated with lower probabilities of pregnancy and live birth following infertility treatment with ART. These data suggest that dietary pesticide exposure within the range of typical human exposure may be associated with adverse reproductive consequences.