Alan Becker

Case Report: Three Farmworkers Who Gave Birth to Infants with Birth Defects Closely Grouped in Time and Place—Florida and North Carolina, 2004–2005

Context There is little evidence linking adverse reproductive effects to exposure to specific pesticides during pregnancy. Case Presentation In February 2005, three infants with congenital anomalies were identified in Collier County, Florida, who were born within 8 weeks of one another and whose mothers worked for the same tomato grower. The mothers worked on the grower’s Florida farms in 2004 before transferring to its North Carolina farms. All three worked during the period of organogenesis in fields recently treated with several pesticides. The Florida and North Carolina farms were inspected by regulatory agencies, and in each state a large number of violations were identified and record fines were levied. Discussion Despite the suggestive evidence, a causal link could not be established between pesticide exposures and the birth defects in the three infants. Nonetheless, the prenatal pesticide exposures experienced by the mothers of the three infants is cause for concern. Farmworkers need greater protections against pesticides. These include increased efforts to publicize and comply with both the U.S. Environmental Protections Agency’s Worker Protection Standard and pesticide label requirements, enhanced procedures to ensure pesticide applicator competency, and recommendations to growers to adopt work practices to reduce pesticide exposures. Relevance to Professional Practice The findings from this report reinforce the need to reduce pesticide exposures among farmworkers. In addition, they support the need for epidemiologic studies to examine the role of pesticide exposure in the etiology of congenital anomalies.

COMMUNITY AERIAL MOSQUITO CONTROL AND NALED EXPOSURE

ABSTRACT In October 2004, the Florida Department of Health (FLDOH) and the Centers for Disease Control and Prevention (CDC) assessed human exposure to ultra-low volume (ULV) aerial application of naled. Teams administered activity questionnaires regarding pesticide exposure and obtained baseline urine samples to quantify prespray naled metabolite levels. Following the spray event, participants were asked to collect postspray urine specimens within 12 h of the spray event and at 8-h intervals for up to 40 h. Upon completion, a postspray activity questionnaire was administered to study participants. Two hundred five (87%) participants completed the study. The urine analysis showed that although 67% of prespray urine samples had detectable levels of a naled metabolite, the majority of postspray samples were below the limit of detection (40 h) following exposure, the number of samples with detectable levels exceeded 50%. There was a significant decrease in naled metabolites from prespray to postspray ( = .02), perhaps associated with a significant reduction (≤0.05) in some participants that may have resulted in pesticide exposure by means other than the mosquito control operations. These data suggest that aerial spraying of naled does not result in increased levels of naled in humans, provided the naled is used according to label instructions.

Sun Safety Among Farmers and Farmworkers: A Review

ABSTRACT Farmers and farmworkers face increased risks of skin cancer from exposure to solar ultraviolet radiation (UVR) when working outdoors. The objective of this study was to evaluate the evidence from behavioral and intervention studies from the peer-reviewed studies related to sun safety among farmers and farmworkers and identify any gaps in the literature. A comprehensive review was conducted between 1990 and 2013; 22 studies were identified related to behavior and health interventions of sun safety among these targeted groups. The inconsistency of data collection methods makes it difficult to estimate with accuracy any overall meaningful results of behavior. However, from the studies reviewed, farmers and farmworkers most frequently reported wearing some type of hat (23.6%–100%) as a primary method of protection from the sun when working outdoors. Female farmers were more likely than male farmers to use sunscreen and engage in indoor tanning behavior. All sun safety educational interventions studies reviewed reported positive increases in behavioral change. To a large degree, adequate sun protection is lacking and varies geographically among farmers. Although targeted education is key to making improvements on sun protection behavior, aggressive attempts have to be made. Studies related to farmworkers, sun safety behavior, and skin cancer are scarce and more research is needed in this area.

Inflammation and inducible nitric oxide synthase have no effect on monoamine oxidase activity in glioma cells

Heightened monoamine oxidase (MAO) and inducible nitric oxide synthase (iNOS) activity can contribute to oxidative stress, the formation of active neurotoxins, and associated neurodegenerative diseases of the brain. Although these enzymes co-exist within astrocytes, there has been little research examining the correlation between the two during inflammation. In this study, C6 glioma cells were stimulated with lipopolysaccharide (LPS):Escherichia coli 0111:B4 (6 micro g/mL):rat interferon-gamma (IFN-gamma) (100U/mL). In LPS/IFN-gamma-treated cells, the MAO substrates dopamine (DA) and tyramine caused a concentration-dependent attenuation of NO(2)(-) and NO(3)(-). In contrast, treatment with an MAO-A inhibitor (clorgyline) or an MAO-B inhibitor ((-)-deprenyl) did not reverse these effects. MAO activity was inhibited effectively by clorgyline and deprenyl; however, neither MAO inhibitor had an effect on NO(2)(-) in stimulated cells. Inversely, increasing concentrations of LPS/IFN-gamma resulted in heightened iNOS protein expression and NO(2)(-); however, these events did not correlate with any distinctive change in MAO enzyme activity. Moreover, a selective iNOS inhibitor, N(6)-(1-iminoethyl)-L-lysine, in LPS/IFN-gamma-stimulated cells caused a concentration-dependent attenuation of NO(2)(-) with no effects on MAO activity or iNOS protein expression. The attenuating effects of DA on iNOS were blocked completely by ICI 118-551 [(+/-)-1-[2,3-(dihydro-7-methyl-1H-inden-4-yl)oxy]-3-[(1-methylethyl)amino]-2-butanol hydrochloride], indicating a role for the beta(2)-adrenergic receptor. In conclusion, these data indicate that activity or expression of iNOS does not influence MAO activity in activated rat glioma cells. Moreover, DA exerts an inhibitory effect on glial iNOS through a receptor-mediated cascade.

Arsenic and type 2 diabetes: commentary on association of inorganic arsenic exposure with type 2 diabetes mellitus: a meta-analysis by Wang et al.

A meta-analysis by Wang et al 1 examined the association of inorganic arsenic (iAs) exposure with type 2 diabetes mellitus (T2DM). Arsenic is ubiquitous and contaminates water through geological and manufacturing processes.2 Arsenic in water is a major public health problem, as it is acutely toxic and a carcinogen and millions of people worldwide are exposed to arsenic by drinking contaminated water.3 Countries where arsenic levels in drinking water have been found to exceed the WHO standard of 10 μg/L include Argentina, Australia, Bangladesh, Chile, China, Hungary, India, Mexico, Peru, Taiwan and the USA.4 Worldwide in 2010 285 million people suffered from T2DM and it is estimated this will increase to 439 million by 2030.5 T2DM is accountable for more than 90–95% of all diabetes with unknown specific aetiology. Important risk factors include genetics, aging and obesity.6 The inclusion criteria for this study included recent and complete articles comprising case-control or cross-sectional studies or cohort studies. The meta-analysis for iAs in drinking water and in urine identified an association of iAs exposure with increased T2DM incidence in iAs-endemic areas. In addition the dose-response analysis suggested T2DM risk increased by 13% for every 100 µg/L increment of iAs in drinking water. In general most of these studies reported that higher levels of iAs increased the risk of T2DM. In previous studies, microvascular and macrovascular disease was found in patients with and without diabetes when comparing iAs between endemic areas with non-endemic areas.7 Furthermore, increased risk of hypertension8 and heart disease9 may occur with high-level arsenic exposure from drinking water. Studies that investigated higher levels of iAs in drinking water and greater duration of exposure also showed a strong association with T2DM.8 ,10 ,11–13 Two …

Methamphetamine Exposure, Iron Deficiency, and Implications for Cognitive-Communicative Function: A Case Study

Methamphetamine (meth) exposure during fetal development has the potential to adversely affect the development of multiple organ systems. An interdisciplinary case study of a 4-year 11-month-old child born to a mother addicted to meth revealed significant cognitive and communicative delays. Possible meth-related consequences for these delays included stroke in utero with associated hemiparesis and epilepsy, congenital eye dysfunction, recurrent middle ear infections, attention-deficit/hyperactivity disorder (ADHD), social adjustment problems, and parental neglect. An important additional finding was the child’s nondietary iron deficiency anemia, which could contribute to or compound meth-related behavioral problems. The influence of chronic iron deficiency anemia on cognitive-communicative function speaks to the importance of including dietitians in the interdisciplinary team assessment of children exposed to meth.