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年中，全球儿童的神经发育障碍和精神健康障碍一直在稳步增加。常见的农业杀虫剂（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。我们对厄瓜多尔儿童的初步研究表明，与农药暴露相关的神经行为下降可能会在消除暴露后随时间推移而改善。全世界最常用的杀虫剂是类烟碱和胆碱酯酶抑制剂（即有机磷酸酯和氨基甲酸酯）。尚未在此背景下研究新烟碱类化合物。有机磷酸盐也可能影响甲状腺激素水平，这是另一种可能影响心理健康的机制。在2008年，我们检查了313名儿童（4-9岁）生活在农业县佩德罗蒙卡约，厄瓜多尔，作为儿童和青少年（ESPINA）的二次农药暴露研究的一部分。这项建议的目标是：A）估计血液中农药暴露的普遍程度（有机磷，氨基甲酸酯，烟碱类），并评估假设农药与更大的外部症状（即多动症、攻击性、行为问题），2016年ESPINA研究的80名青少年（年龄12-17岁）的学校问题（即注意力和学习能力下降）和甲状腺激素增加。B）扩大佩德罗·蒙卡约县和厄瓜多尔Cimas基金会的研究能力。我们计划加强地方社区信息系统（LCIS），这是佩德罗蒙卡约县的一个地理编码监测系统，其中包括通过社区参与收集的15，000多名居民的社会经济（SES），文化和健康信息。我们建议对居住在佩德罗·蒙卡约县5个教区之一的所有户主进行健康调查（访谈）：图皮加奇（目标n个家庭= 1 000，n个人= 5 200，占人口的90%）。调查将提供关于人口统计、社会经济地位、职业、地理坐标、获得社会和保健服务（包括精神保健）、经济活动以及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。此外，LCIS是需求评估、干预战略和方案评估的有力工具，在快速招募参与者参与以人口为基础的研究方面具有巨大潜力。社区的参与使这在过去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，样本规模和时间轴将得到满足。这项研究的结果可以指导规划更大的调查，以评估在农业环境中的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.