Home-based Community Health Worker Intervention to Reduce Pesticide Exposures to Farmworkers’ Children: A Randomized Controlled Trial

摘要

We conducted a randomized-controlled trial of a home-based intervention to reduce pesticide exposures to farmworkers’ children in Monterey County, California (n=116 families). The intervention consisted of three home-based educational sessions delivered by community health workers in Spanish. Measurements of organophosphate (OP) insecticide metabolites in child urine (n=106) and pesticides in home floor wipes (n=103) were collected before and after the intervention. Median child urinary dialkylphosphate (DAP) metabolite levels were slightly lower among the intervention group children at follow-up compared to baseline, albeit nonsignificantly. DAP metabolite levels in the control group children were markedly higher at follow-up compared to baseline. In adjusted models, intervention participation was associated with a 51% decrease in total DAP metabolite levels. Carbaryl, chlorpyrifos, cypermethrin, dacthal, diazinon, malathion and trans-permethrin were commonly detected in the floor wipes. In adjusted models, intervention participation was significantly associated with a 37% decrease in trans-permethrin floor wipe levels in homes, but not organophosphate (OP) or other agricultural pesticides. In summary, intervention group children had slightly reduced pesticide exposures, whereas child exposures were higher among the control group. Additional intervention studies evaluating methods to reduce pesticide exposures to farmworker families and children are needed.