Pesticides and Mental Health among Adolescents in Ecuadorian Agricultural Communities

 描述(由申请人提供)：神经发育障碍和精神健康障碍很普遍，在过去20年里，全球儿童的比例一直在稳步上升。常见的农用杀虫剂(即有机磷)与儿童的神经行为改变有关，包括注意力缺陷、冲动和认知能力下降。然而，目前还没有关于青少年之间这些联系的信息。我们在厄瓜多尔儿童中的初步工作表明，在移除农药暴露后，与农药暴露相关的神经行为下降可能会随着时间的推移而改善。全世界最常用的杀虫剂是新烟碱和胆碱酯酶抑制剂(即有机磷和氨基甲酸酯)。新烟碱类化合物尚未在此背景下进行研究。有机磷还可能影响甲状腺激素水平，这是它们影响心理健康的另一种可能机制。2008年，作为儿童和青少年次级农药暴露(Espina)研究的一部分，我们调查了居住在厄瓜多尔佩德罗蒙卡约农业县的313名儿童(4-9岁)。这项建议的目标是：a)估计血液中农药暴露的流行率(有机磷、氨基甲酸酯、新烟碱)，并评估杀虫剂与更严重的外在症状(即多动、攻击性、品行问题)、学习问题(即注意力和学习能力下降)和甲状腺激素增加有关的假设。B)扩大佩德罗·蒙卡约县和厄瓜多尔西马斯基金会的研究能力。我们计划加强当地社区信息系统，这是佩德罗·蒙卡约县的一个地理编码监测系统，包括通过社区参与收集的15,000多名居民的社会经济、文化和健康信息。我们建议对佩德罗蒙卡约县5个教区之一的所有户主进行健康调查(访谈)：图皮卡奇(目标n个家庭=1 000个家庭，n个人˜5200个，˜占人口的90%)。这项调查将提供有关人口、社会经济地位、职业、地理坐标、获得社会和卫生服务(包括精神健康)、经济活动和所有家庭成员发病率的信息。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。此外，智库信息系统是进行需求评估、干预战略和项目评估的强大工具，在快速招募参与者参加以人口为基础的研究方面具有巨大潜力。过去，社区参与使这成为一种有效和低成本的方法；我们相信，在现有资源的情况下，样本规模和时间表将得到满足。这项研究的结果可以指导规划更大规模的调查，以评估农业环境中心理健康的决定因素。

 DESCRIPTION (provided by applicant): Neurodevelopmental disabilities and mental health disorders are prevalent and have been steadily increasing in children worldwide over the last 2 decades. Common agricultural pesticides (i.e. organophosphates) have been associated with neurobehavioral alterations including attention deficit, impulsivity and cognitive decrease in children. However, there is currently no information of these associations among adolescents. Our preliminary work in Ecuadorian children suggests that neurobehavioral declines associated with pesticide exposures may improve over time after removal of the exposure. The most commonly used insecticides worldwide are neonicotinoids and cholinesterase inhibitors (i.e. organophosphates and carbamates). Neonicotinoids have not been studied in this context. Organophosphates may also influence thyroid hormone levels, another possible mechanism by which they could affect mental health. In 2008, we examined 313 children (ages 4-9 y) living in the agricultural county of Pedro Moncayo, Ecuador, as part of the Secondary Pesticide Exposure on Children and Adolescents (ESPINA) study. The objectives of this proposal are to: A) estimate the prevalence of pesticide exposures in blood (organophosphate, carbamate, neonicotinoid), and to assess the hypothesis that pesticides are associated with greater externalizing symptoms (i.e. hyperactivity, aggression, conduct problems), school problems (i.e. decreased attention and learning) and increased thyroid hormones among 80 adolescents (ages 12-17 y) of the ESPINA study in 2016. B) to expand the research capabilities of Pedro Moncayo County and Fundación Cimas del Ecuador. We plan to strengthen the Local Community Information System (LCIS), a geocoded surveillance system of Pedro Moncayo County that includes socio-economic (SES), cultural and health information of over 15,000 residents, collected through community participation. We propose to conduct a Health Survey (interviews) of all household heads living in 1 of the 5 parishes of Pedro Moncayo County: Tupigachi (target n families=1000, nindividuals˜5200, ˜90% of the population). The survey will provide information on demographics, SES, occupation, geographic coordinates, access to social and health services (including mental health), economic activities, and morbidity of all household members. 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. Also, the LCIS is a powerful tool for needs assessments, intervention strategies and program evaluations, and has tremendous potential for rapid enrolment of participants in population-based studies. Community participation has made this an efficient and low-cost approach in the past; we are confident that the sample size and timeline will be met with the available resources. The findings of this study can guide the planning of larger investigations to assess determinants of mental health in agricultural settings.