Proximity to Floricultural Production and Childhood Neuropsychological Function

摘要

Background: Pesticide exposure during early childhood may be a risk factor for a range of pediatric neurologic deficits. Chronic exposure to these pesticides among children can occur due to drift from or direct contact with pesticide-treated areas. Methods: We examined 4-9 year-old participants who lived in agricultural communities in Ecuador (The ESPINA study). Two exposures were calculated: residential distance from the nearest flower plantation perimeter and total area of flower plantations within 200m of the home. Five neurodevelopment domains were assessed (NEPSY-2): Attention/inhibitory control, memory/learning, language, sensorimotor, and visuospatial processing. Linear and logistic regression models were adjusted for child's age, sex, race, height-forage z-score, hemoglobin, mother's education, and cohabitation with a floricultural worker. Results: The 307 children in this study (mean age 6.6 years, 51% boys) lived on average 446m (SD 344) from a flower plantation. Mean (SD) neurobehavioral domain scores ranged from 6.6 (2.4) to 9.9 (3.3). For a 100m increase in distance between homes and plantations, there was better performance in the language domain by 0.09 units (95% CI: 0.00, 0.17). Children living within 185m of a plantation (quartile 1) had increased odds of clinically significant "low" scores in the language (OR [95% CI]: 2.4 [1.$15.5]) and memory/learning (4.8 [1.$319.0]) domains compared to children living >610m (quartile 4) from treated areas. Children with >3061m2 (tertile 3 of non-zero values) of plantation area within 200m of their homes, compared to those with 0m2 of plantation area, had increased odds for low memory/learning scores (4.3 [1.30, 14.1]). Conclusions: Residential proximity to floriculture plantations was associated with adverse neuropsychological performance in the domains of language and memory/learning among children, highlighting the importance of reducing pesticide exposures for children living near plantations.