文章基本信息

标题：Childhood Pesticide Exposures on the Texas–Mexico Border: Clinical Manifestations and Poison Center Use
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作者：Martin Belson ; Stephanie Kieszak ; William Watson 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2003
卷号：93
期号：8
页码：1310-1315
语种：English
出版社：American Public Health Association
摘要：Objectives. The purpose of this study was to describe differences in childhood pesticide exposures between counties on the Texas–Mexico border and nonborder counties. Method. The authors reviewed all pesticide exposures among children younger than 6 years reported to the South Texas Poison Center during 1997 through 2000. Results. Nonborder counties had twice the reported exposure rate of border counties. Parents of border children were significantly less likely to contact the poison center after an exposure and more likely to have their children evaluated in a health care facility. Conclusions. Increasing residents’ awareness of the poison center and identifying potential barriers to its use among residents of Texas–Mexico border communities may prevent unnecessary visits to health care facilities. The US Environmental Protection Agency (EPA) estimates that more than 1 billion pounds of conventional-pesticide active ingredients are used annually in the United States 1 and that 85% of all families store and use pesticides in and around their homes. 2 Human exposure to pesticides can occur in the home through residues in food and water and through drift from agricultural activities. 3– 7 Because they may be ubiquitous in and around households, pesticides represent a particular potential hazard to young children. Hospital-based data and poison control center reports suggest that children are commonly involved in unintentional pesticide poisonings. According to hospital surveys, half of all pesticide-related hospital admissions are reported to be caused by nonoccupational exposures, and half of these admissions involve young children. 8 From 1997 through 2000, the Toxic Exposure Surveillance System (TESS) of the American Association of Poison Control Centers received 388 635 reports of human pesticide exposures, 52% of which involved children younger than 6 years. Among reported poison exposures occurring between 1997 and 2000, pesticides accounted for 4.4% of all pediatric cases and represented the eighth-most-common exposure category overall. 9– 12 Pesticides commonly encountered by young children include rodenticides and insecticides. Insecticides such as carbamates (e.g., Sevin, Baygon), organophosphates (e.g., malathion, diazinon), and pyrethrins (e.g., permethrin) are constituents of numerous ant and roach extermination products and are widely used in agriculture. Permethrin (e.g., Elimite, Nix) is contained in products used to treat lice and scabies; lindane, an organochlorine insecticide, also is used to treat lice and scabies. Areas in the United States where urban communities are in close proximity to agriculture are of great concern with regard to pesticide exposures. 13 One such area is the Lower Rio Grande Valley (LRGV) of Texas, which includes 2 Texas–Mexico border counties, Hidalgo and Cameron, and 1 nonborder county, Willacy (Figure 1 ▶ ). Open in a separate window Open in a separate window FIGURE 1— The 47 South Texas counties shaded gray from which pesticide exposures among children younger than 6 years (n = 2520) were reported to the South Texas Poison Center, 1997–2000. Note. The 4 counties with the highest numbers of pesticide exposures reported to the South Texas Poison Center are indicated with patterns. The poison center is located in Bexar County. On both sides of the Texas–Mexico border, the population has increased more than 25% since 1990. 14 These increases are higher than those observed in 2 of the most heavily populated nonborder counties, Bexar and Nueces, which have seen population increases of only 15% and 7%, respectively since 1990. 15 During this period of growth along the Texas–Mexico border, concerns have been raised about health conditions, including exposure to pesticides. 14 Studies conducted in the 1960s and 1970s revealed that agricultural workers were exposed to certain organophosphates commonly used in this region. 16, 17 In the early 1990s, the EPA coordinated a monitoring study in the LRGV to assess human exposures to various environmental contaminants. 18, 19 In 1996, the Office of Border Health of the Texas Department of Health initiated the Texas–Mexico Border Environmental Health Survey as a follow-up project to address some of the issues identified in the EPA monitoring project, including pesticide exposures. The findings of this survey suggested that children in the LRGV might be exposed to potentially hazardous pesticides in nonoccupational settings. 14 The objective of our study was to describe pesticide exposures reported among children younger than 6 years in southern Texas, including the LRGV, and to evaluate differences in exposures between border and nonborder counties. The information obtained from this study can be used to determine whether a significant problem exists in terms of pesticide exposures among children of the border region, as well as other regions of southern Texas, and to develop intervention strategies designed to reduce the risk for pediatric pesticide exposures.