The ESPINA Study Follow-up Examination in 2016: Environmental Pollutants and Child/Adolescent Development

 描述（由申请人提供）：神经发育障碍和精神健康障碍是普遍存在的，并已在美国儿童在过去20年稳步上升。随着农业大规模生产的持续扩大，全世界农药的使用量达到了历史最高水平。人们通过熏蒸食品、家中和社区的虫害防治以及某些经批准的虱子和疥疮治疗接触农药。全世界最常用的杀虫剂类别是类烟碱和胆碱酯酶抑制剂，包括有机磷酸酯和氨基甲酸酯。有机氯等较老的农药目前令人关切，因为它们具有持久性，仍然在环境和人体中检测到，尽管许多农药在40年前就被禁止使用。有机磷酸盐，以及在较小程度上的有机氯，与儿童的神经行为迟缓有关，越来越多的证据表明，男孩比女孩对接触更敏感。尚未在儿童中进行过这方面的新烟碱类研究。在2008年，我们检查了313名儿童（年龄4-9岁）生活在花卉社区在厄瓜多尔的儿童和青少年（ESPINA）的研究中农药的二次暴露。拟议研究的目的是在2016年对ESPINA参与者进行随访，并补充新志愿者样本，共410名参与者（年龄12-17岁）。我们将纵向评估农药暴露与神经行为以及焦虑和抑郁症状的关系。我们提出两个考试：在母亲节花卉生产高峰期（2016年4月）进行简化考试，并在收获后不久进行全面考试（2016年7月/8月）。我们将调查以下关联（假设）：1）农药暴露（胆碱酯酶抑制剂，类烟碱和OCP）与长期神经行为改变相关，并将评估男孩是否比女孩更易感。 2)农药暴露与焦虑和抑郁症状有关。 3)农药暴露与短暂的神经行为改变有关。我们将评估AChE活性以及注意力和抑制力评分在简化考试和完整考试之间的变化。我们还将测试自鲜花收获以来的时间是否与全套评估中的神经行为表现呈正相关。 作为第二个目标，我们将评估肾上腺和性激素是否改变农药暴露与心理健康结果的关联。影响：很少有流行病学研究评估了农药暴露与心理健康的长期关系，我们也不知道有关于青少年的已发表研究。ESPINA 2016将解决农药暴露如何与心理健康症状纵向相关，并将首次提供与儿童农药暴露相关的短期神经行为变化的重复评估。

 DESCRIPTION (provided by applicant): Neurodevelopmental disabilities and mental health disorders are prevalent and have been steadily increasing in US children over the last 2 decades. Worldwide pesticide use is at an all-time high as agricultural mass production continues to expand. People are exposed to pesticides through fumigated food, pest control in their homes and communities, and during certain approved treatments for lice and scabies. The most commonly used classes of insecticides worldwide are neonicotinoids and cholinesterase inhibitors, including organophosphate and carbamates. Older pesticides, such as organochlorines, are of present concern because they are persistent and are still detected in the environment and people, even though many were banned 40 years ago. Organophosphates, and to a lesser extent organochlorines, have been associated with neurobehavioral delays in children and there is growing evidence that boys are more sensitive to exposures than girls. Neonicotinoids have not been studied in this context among children. In 2008, we examined 313 children (ages 4-9 y) living in floricultural communities in Ecuador in the Secondary Pesticide Exposure on Children and Adolescents (ESPINA) study. The objective of the proposed study is to conduct a follow-up of ESPINA participants in 2016 and supplement the sample with new volunteers for a total of 410 participants (ages 12-17 y). We will assess, longitudinally, the associations of pesticide exposures with neurobehavior and symptoms of anxiety and depression. We propose 2 exams: an Abbreviated exam during the peak of Mother's Day flower production (Apr 2016) and a Full exam soon after the harvest (Jul/Aug 2016). We will investigate the following associations (hypotheses): 1) Pesticide exposures (cholinesterase inhibitors, neonicotinoids and OCPs) are associated with long-term neurobehavioral alterations, and will assess whether boys are more susceptible than girls. 2) Pesticide exposures are associated with anxiety and depression symptoms. 3) Pesticide exposures are associated with transient neurobehavioral alterations. We will assess change of AChE activity and scores of attention and inhibition between the Abbreviated and Full exams. We will also test whether time since the flower harvest is positively associated with neurobehavioral performance in the full battery of assessments. As a secondary aim, we will assess whether adrenal and sex hormones modify the associations of pesticide exposures with mental health outcomes. Impact: Few epidemiologic studies have assessed pesticide exposures in relation to mental health for extended periods of time, and we know of no published studies on adolescents. ESPINA 2016 will address how pesticide exposure relates to mental health symptoms longitudinally, and will provide, for the first time, repeated assessments of short-term neurobehavioral changes associated with pesticide exposures in children.