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在过去20年中在美国儿童中普遍存在，并一直在稳步增加。随着农业大规模生产的持续扩大，世界范围内的农药使用量达到了历史最高水平。人们通过熏蒸食物、家中和社区的虫害防治以及在某些经批准的虱子和溃烂治疗期间接触到杀虫剂。全世界最常用的杀虫剂是新烟碱类和胆碱酯酶抑制剂，包括有机磷和氨基甲酸酯类。较老的杀虫剂，如有机氯，目前令人担忧，因为它们是持久的，仍然在环境和人体中被检测到，尽管许多杀虫剂在40年前就被禁止了。有机磷和有机氯在较小程度上与儿童的神经行为迟缓有关，越来越多的证据表明，男孩比女孩对暴露更敏感。在儿童中，新烟碱类化合物还没有在这方面进行研究。2008年，我们在儿童和青少年次级农药暴露(Espina)研究中检查了居住在厄瓜多尔花卉种植社区的313名儿童(4-9岁)。这项拟议研究的目标是在2016年对Espina参与者进行跟踪调查，并为总共410名参与者(12-17岁)补充新的志愿者。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。我们建议两项考试：母亲节花卉生产高峰期(2016年4月)的简考和收获后不久(2016年7月/8月)的全面考试。我们将调查以下关联(假设)：1)接触杀虫剂(胆碱酯酶抑制剂、新烟碱和有机氯农药)与长期的神经行为改变有关，并将评估男孩是否比女孩更容易受到影响。2)农药暴露与焦虑和抑郁症状有关。3)农药暴露与一过性神经行为改变有关。我们将评估AChE活性的变化，以及缩略考试和完整考试之间注意力和抑制分数的变化。我们还将在一系列评估中测试自采花以来的时间是否与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会改变农药暴露与精神健康结果的关系。影响：很少有流行病学研究评估长期接触农药与精神健康的关系，我们也不知道有关于青少年的已发表研究。Espina 2016将从纵向上解决农药接触与精神健康症状的关系，并将首次提供与儿童接触农药有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.