A Linkage Study of Adverse Birth Outcomes With Agricultural Land Use Practices in Missouri

Background: Missouri is an agriculturally intensive state, growing primarily corn, soybeans, and wheat, with additional high-intensity rice and cotton farming in the southeastern counties in the state. There is limited evidence that communities residing in close proximity to pesticide-treated fields may have increased exposure to pesticides as well as increased risks of adverse birth outcomes including certain birth defects and adverse birth outcomes such as low birth weight and preterm births. The study aims were (1) to evaluate the relationship between county-level measures of agricultural production and adverse birth outcomes in Missouri, and (2) to evaluate the importance of incorporating spatial and temporal information into the modeling of this data. Methods: Corn, soybean, wheat, rice, and cotton crop densities were evaluated for their relationship with both low birth weight and preterm births in Missouri between 20042006. The covariates considered as potential confounders and effect modifiers in this study included gender, mother’s race and ethnicity, mother’s age at birth, maternal smoking, access to prenatal care, quarter of birth, county median household income, and population density. Three statistical approaches were taken to evaluate the relationship between each measure of crop density and each outcome: (1) Poisson regression, (2) generalized estimating equations, and (3) distance decay random effects Poisson regression. Results: Strong positive associations were observed between rice and cotton density and both low birth weight and preterm births. Rice density was associated with significant increased risk of preterm births across all three models, as was cotton density with low birth weight births. Only 58 counties in Missouri produced rice or cotton between 2004 and 2006, with complete geographic overlap. Despite the geographic correlation between these counties, both rice and cotton densities remained significant predictors of low birth weight and preterm births in dual-exposure models with a slight weakening of the effect in the distance decay models. Conclusions: The associations between both rice and cotton and low birth weight and preterm births should be viewed cautiously because of the many limitations of the study including its ecological study design, limited data on other risk factors, and a lack of chemical-specific exposure estimates. Nonetheless these findings warrant further investigation

Adverse Birth Outcomes and Contamination of Drinking Water by Arsenic, Atrazine, and Nitrate-Nitrite

Increasing concern exists about whether prenatal exposure to arsenic, atrazine, and nitrate-nitrite (NN) in drinking water is associated with adverse reproductive and developmental outcomes. The goals of this research were to examine the relationships between these three water contaminants and the following birth outcomes: small for gestational age (SGA), low birth weight among term infants (term LBW), very low birth weight (VLBW), preterm birth (PTB), and very preterm birth (VPTB). We used data from the Safe Drinking Water Information System (SDWIS) and Atrazine Monitoring Program (AMP) as well as birth certificate data from the state of Ohio. We examined the relationship between each contaminant and birth outcome through generalized estimating equation logistic regression models, adjusting for important covariates. For arsenic and NN models, we performed sensitivity analyses by restricting models to those counties with a low percentage (<20 or <10%) of the population using private well water. Atrazine analyses were limited to those communities served by AMP water systems. In counties with low private well usage, we found that the odds of VLBW and preterm birth increased with increasing levels of annual mean arsenic concentrations in drinking water. Our findings were unchanged when we restricted our analyses to only those infants with exposure below the current permissible level of arsenic in drinking water. Within rural counties in which <20 or <10% of the population derived drinking water from private wells, we observed a significant increase in the odds of VLBW births with increasing mean gestational NN concentrations. In communities receiving public drinking water from AMP water systems, we found a significant increase in the odds of term LBW births with increasing atrazine exposure in drinking water over the entire gestational period of the pregnancy, as well as within the first and second trimesters. The associations observed in these analyses were present at exposure levels that are below current Maximum Contaminant Levels (MCLs) for each contaminant examined. Our findings suggest that additional research should examine the effects of arsenic, atrazine, and NN on term LBW, VLBW, and PTB in areas of low contaminant exposure

Atrazine Contamination of Drinking Water and Adverse Birth Outcomes in Community Water Systems with Elevated Atrazine in Ohio, 2006–2008

Atrazine, a common water contaminant in the U.S., has been associated with adverse birth outcomes in previous studies. This study aimed to determine if atrazine concentrations in drinking water are associated with adverse birth outcomes including small for gestational age (SGA), term low birth weight (term LBW), very low birth weight (VLBW), preterm birth (PTB), and very preterm birth (VPTB). This study included 14,445 live singleton births from Ohio communities served by 22 water systems enrolled in the U.S. Environmental Protection Agency&rsquo;s Atrazine Monitoring Program between 2006 and 2008. Mean gestational and trimester-specific atrazine concentrations were calculated. Significantly increased odds of term LBW birth was associated with atrazine exposure over the entire gestational period (OR 1.27, 95% CI 1.10, 1.45), as well as the first (OR 1.20, 95% CI 1.08, 1.34) and second trimesters (OR 1.13, 95% CI 1.07, 1.20) of pregnancy. We observed no evidence of an association between atrazine exposure via drinking water and SGA, VLBW, PTB, or VPTB. Our results suggest that atrazine exposure is associated with reduced birth weight among term infants and that exposure to atrazine in drinking water in early and mid-pregnancy may be most critical for its toxic effects on the fetus

Demographic, exposure and clinical characteristics in a multinational registry of engineered stone workers with silicosis.

To investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry. With ethics board approval in Israel, Spain, Australia and the USA, ES workers ages 18+ with a physician diagnosis of work-related silicosis were enrolled. Demographic, occupational, radiologic, pulmonary function and silica-related comorbidity data were compared cross-sectionally among countries using analysis of variance, Fisher's exact tests and logistic regression. Among 169 ES workers with silicosis, most were men, with mean age 51.7 (±11.4) years. Mean work tenure in stone fabrication or masonry was 19.9 (±9.8) years. Different methods of case ascertainment explained some inter-country differences, for example, workers in Queensland, Australia with a state-based surveillance program were likely to be identified earlier and with shorter work tenure. Overall, 32.5% of workers had progressive massive fibrosis, the most severe form of dust-related pneumoconiosis, of whom 18.5% reported ≤10 years of work tenure. Lung function impairment including restriction, reduced diffusion capacity and hypoxaemia was common, as was autoimmunity. Findings from a multinational registry represent a unique effort to compare demographic, exposure and clinical information from ES workers with silicosis, and suggest a substantial emerging population of workers worldwide with severe and irreversible silica-associated diseases. This younger worker population is at high risk for disease progression, multiple comorbidities and severe disability. The ESSI registry provides an ongoing framework for investigating epidemiological trends and developing prospective studies for prevention and treatment of these workers