Maternal peripartum urinary pyrethroid metabolites are associated with thinner children at 3.5 years in the VHEMBE birth cohort (Limpopo, South Africa)

Abstract

Background: Pyrethroids are the most widely used insecticides globally for domestic, agricultural, and malaria vector control. In 10 countries, dichlorodiphenyl trichloroethane (DDT) is also used for the latter. Thus, high exposure to pyrethroids and DDT have been reported among women and children from rural and/or malaria-endemic areas. Experimental studies suggest that fetal exposure to pyrethroids, particularly cypermethrin, and DDT may have sex-specific growth effects. However, epidemiologic investigations are scarce and inconsistent and have not considered postnatal environment or susceptibility factors. Methods: In 665 mother–child dyads participating in the Venda Health Examination of Mothers, Babies, and their Environment (VHEMBE), a rural South African birth cohort with high insecticide exposure, we examined associations of maternal peripartum uri-nary pyrethroid metabolites and serum DDT concentrations with child anthropometrics at 3.5 years using multivariable linear regression. We investigated effect modification by child sex, maternal nutrition and HIV status, and household poverty. Results: Pyrethroid metabolites cis -3-(2,2-dibromovinyl)-2,2-dimethyl-cyclopropane carboxylic acid ( cis -DBCA), cis -3-(2,2,-dicholorvinyl)-2,2-dimethyl-cyclopropane carboxylic acid ( cis -DCCA), trans -DCCA, and 3-phenoxybenzoic acid (3-PBA) were quantified in nearly all mothers. A 10-fold increase in cis -DCCA concentration was associated with 0.21 kg/m 2 lower body mass index (95% confidence interval = −0.41, −0.01), with similar estimates for other cypermethrin or permethrin metabolites ( trans -DCCA and 3-phenoxybenzoic acid). In stratified analyses, stronger associations were observed with lower weight, body mass index, arm circumference, and weight-for-height among boys relative to girls. Associations with cis -3-(2,2-dibromovinyl)-2,2-dimethyl-cyclopropane carboxylic acid, a metabolite specific to deltamethrin, were weaker or absent. No substantial associations were observed with DDT. Discussion: In a population with ubiquitous pyrethroid exposure, maternal concentrations of metabolites of cypermethrin and permethrin were associated with thinness at 3.5 years.

Associations between prenatal exposure to DDT and DDE and allergy symptoms and diagnoses in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), South Africa

“…No studies of DDT or DDE and allergies have been conducted in countries where DDT is applied for IRS and, to our knowledge, no human study has investigated associations between prenatal exposure to DDT or DDE and non-respiratory allergies. Considering the high levels of exposure to insecticides among populations living in IRS areas (11,12,19,(226)(227)(228)(229)(230)(231)(232)(233) and the potential vulnerability of these populations to the adverse effects of insecticides due to poverty, poor health, and malnutrition (117,(234)(235)(236)(237)(238)(239)(240), the VHEMBE study was developed to determine whether exposure to IRS insecticides was associated with adverse health outcomes among children born and raised in an IRS area. As there is good biological evidence for the effects of DDT and DDE on allergy outcomes but limited research in humans, my study aimed to evaluate whether prenatal exposure to DDT and DDE was associated with elevated odds of allergy symptoms and diagnoses in South African children aged 3.5 years from an area where IRS is conducted annually.…”

Assessing the external exposome of South African children using wearable passive samplers and high-resolution mass spectrometry

“…This practice can result in elevated exposure to dichlorodiphenyltrichloroethane (DDT) and pyrethroids which may interfere with immune function by inducing oxidative stress or by disrupting sex hormones (Pérez-Maldonado et al 2005;Nasuti et al 2007;Han et al 2008;Meeker et al 2009;Yoshinaga et al 2014;Molina et al 2021). Environmental exposure to insecticides from IRS in the Limpopo province of South Africa has recently been associated with accelerated fetal growth (Chevrier et al 2019a), reduced social-emotional scores at 1 and 2 years of age (Eskenazi Brenda et al), allergies in children at 3.5 yrs (Huq et al 2020), hypertensive disorders among pregnant mothers (Murray et al 2018), weight gain in girls (Coker et al 2018), and other health impacts (Bornman et al 2016;Murray et al 2018;Huang et al 2018;Verner et al 2018;Chevrier et al 2019a, b;Huq et al 2020;Eskenazi Brenda et al;Huang Jonathan et al).…”

“…Understanding the extent to which these factors contribute to poor health, requires a comprehensive assessment of environmental exposures. The studies that have been conducted to date in sub-Saharan Africa have focused on a limited panel of pesticides or regulated air pollutants (Bornman et al 2016;Murray et al 2018;Huang et al 2018;Verner et al 2018;Chevrier et al 2019a, b;Huq et al 2020;Eskenazi Brenda et al;Huang Jonathan et al). The lack of available technology which can be feasibly deployed with children in a LMIC context has presented challenges in the breadth and scale of environmental measurements that can be captured.…”

“…Exposures were evaluated for children between the ages of 5 and 6.5 years enrolled in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE) Birth Cohort using the Fresh Air wristband. While the health impacts of criteria air pollutants and insecticide use are recognized (Bornman et al 2016;Murray et al 2018;Huang et al 2018;Verner et al 2018;Chevrier et al 2019a, b;Huq et al 2020;Huang Jonathan et al), other sources of environmental exposures may be missed in rural African populations. We determined likely chemical structures for 637 chemicals, including 50 chemical exposures of concern consisting of combustion products, insecticides and other biocides, dyes, fragrances, organophosphates, and plasticizers.…”

Association between Prenatal Exposure to Household Pesticides and Neonatal Weight and Length Growth in the Japan Environment and Children’s Study

“…For example, maternal serum p,p’-DDT concentrations have been positively associated with body weight in girls aged 1−2 years, and maternal urinary pyrethroid metabolite concentrations; notably, cis-3-(2,2-dibromovinyl)-2,2-dimethyl-cyclopropane carboxylic acid (cis-DBCA) and trans-DCCA, have been negatively associated with body weight in boys aged 1−2 years [ 15 ]. Furthermore, an epidemiologic study found that a 10-fold increase in cis-DCCA concentration was associated with a 0.21 kg/m 2 lower body mass index at age 3.5 years [ 16 ]. However, previous studies have not fully examined the relationship between maternal household pesticide exposure during pregnancy and the growth of neonates, whose neurodevelopment is particularly immature.…”