Exposures were assessed for seven small-scale farmers using chlorpyrifos on corn and ten banana plantation employees applying diazinon, and for one child of each worker. Metabolites (TCPYand IMPY) were measured in urine before and after applications. TCPY concentrations peaked at 27 and 8.5 hours post-application for applicators and children, respectively (geometric means, 26 and 3.0 microg/L). Proximity to spraying and spray mixture preparation in homes were important exposure factors. IMPY concentrations differed substantially across workers at two plantations (geometric means, 1.3 and 168 mirog/L); however, their children had little or no diazinon exposure. These workers and children were also exposed to chlorpyrifos, most likely through contact with chlorpyrifos-impregnated bags used in banana production. Several recommendations are offered: (1) monitor children's activities during applications; (2) do not store or prepare pesticides in homes; (3) institute sound occupational hygiene practices at banana plantations; (4) dispose of plastic insecticide bags properly at the worksite.

A cross-sectional study with repeated sample collection in multiple days was conducted to assess diazinon exposures. Saliva and limited blood samples were collected from 10 banana plantation workers involved with diazinon application and their children aged 2-12 years living in Chinandega, Nicaragua. Diazinon concentration-time profiles in saliva varied between two plantations, which reflects the differences of work practices in each plantation. Salivary concentrations of diazinon measured in Plantation 1 applicators continued to increase 2 days after self-reported diazinon application, suggesting an ongoing exposure among these workers. However, salivary diazinon concentrations measured in Plantation 2 applicators were peaked 12 h prior to the first application, and then decreased 36 h post the first application. Diazinon concentrations in saliva were significantly correlated with the time-matched plasma samples collected from the same workers, which is in agreement with the previous published data from animal models. Children's exposure to diazinon through take-home pathway does not exist, as evident by the majority of nondetected saliva samples, and this finding was confirmed by the results from the urine samples. Severe dehydration was observed in many plantation workers and their children, resulting in the loss of some saliva samples, which no doubt have impaired the overall quality of the study results. Regardless, this article has demonstrated that saliva can be used to assess exposures to diazinon in pesticide applicators and children.

The aim of this study is to evaluate the Nicaraguan screening program for congenital hypothyroidism in terms of coverage and effectiveness of detection and confirmation of cases with the condition throughout a decade. Thyrotropin was quantified in cord-blood samples by a validated ELISA and a cut-off of 20 mU/l was applied. Coverage, positive predictive value, recall rate and prevalence were retrospectively analysed. Babies with positive screening results were contacted for confirmation by means of determination of thyrotropin and thyroid profile in serum samples. 272,338 babies were screened during the period 2005-2015. The mean coverage reached by the program in the participating departments was 71%, with a positive predictive value of 83% and a recall rate of 0.055%. Eighty cases of congenital hypothyroidism were identified, representing an incidence of 1 in 3229 live births, most of them (81%) being severe. The performance of the Nicaraguan screening program is comparable to those in Latin America also using cord-blood samples. The incidence of congenital hypothyroidism is within the low range of other countries worldwide. Strategies are needed to expand the program to the whole country, improve recall rates and achieve earlier treatment of babies, with the condition.