Non-occupational Pesticide Exposure Pathways for Agricultural Women

摘要

Women living in agricultural regions may be exposed to relatively high levels of pesticides due to their participation in and proximity to farming activities. Exposure pathways in these women are not well-characterized. We reviewed the evidence from the published literature for the contribution of non-occupational exposure pathways in women living in agricultural areas in North America. Non-occupational exposure pathways included para-occupational (take-home or bystander exposure), agricultural drift, residential pesticide use, and dietary ingestion. Among the 37 publications identified, there was strong evidence for the importance of the para-occupational and agricultural drift pathways, while evidence that residential use of pesticides contributed significantly to exposure was moderate. There was insufficient evidence to understand the contribution of diet to total pesticide exposure. Our review did not identify any hygiene factors commonly recommended in pesticide safety training, such as house cleaning practices, shoe/clothing removal, and separate laundering of contaminated clothes, which were consistently linked to exposure. Exposure metrics predominantly used in the literature, such as pesticide levels in residential dust and biomarkers, aggregated over multiple pathways; therefore disentangling contributions from each pathway was difficult. The strongest evidence for specific pathways came from residential dust measurements. Results based on dust samples and biomarkers were inconsistent, possibly reflecting different exposure time windows and routes, or differences in activity-related contact rates. Our review highlights the need to better understand the relationship between pesticide levels in residential dust and biomarker levels in adults. Moreover, an improved understanding of the important pathways of pesticide exposure in women living in agricultural areas is critical for epidemiologic studies and for designing effective risk mitigation strategies.