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      Pesticides

      1 , 2 , 2
      Pediatrics
      American Academy of Pediatrics (AAP)

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          Abstract

          Pesticides are a broad group of heterogeneous chemicals that have a significant public health benefit by increasing food production productivity and decreasing food-borne and vector-borne diseases. However, depending on the agent and the exposure, they may pose health risks. Because of their behavior, acute accidental toxic exposures occur more commonly in children. Because of the dietary habits and greater intake of foods per kilogram in children and because some infants are breastfed, there is also concern about the effects on them of low-level environmental exposures. In the absence of direct conclusive evidence, consistent and relevant observations have led some investigators to infer that chronic low-dose exposure to certain pesticides might pose a potential hazard to the health and development of infants and children. Other investigators have concluded that such inferences can be neither supported nor refuted at the present time. The pediatrician has a role to play in recognizing the symptoms of acute exposure and to be able to provide appropriate treatment. It is essential to study whether there are subtle neurologic effects that may result from low-level pesticide exposures in individual patients.

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          Most cited references50

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          Resurgent vector-borne diseases as a global health problem.

          D J Gubler (1998)
          Vector-borne infectious diseases are emerging or resurging as a result of changes in public health policy, insecticide and drug resistance, shift in emphasis from prevention to emergency response, demographic and societal changes, and genetic changes in pathogens. Effective prevention strategies can reverse this trend. Research on vaccines, environmentally safe insecticides, alternative approaches to vector control, and training programs for health-care workers are needed.
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            Persistent DDT metabolite p,p'-DDE is a potent androgen receptor antagonist.

            The increase in the number of reports of abnormalities in male sex development in wildlife and humans coincided with the introduction of 'oestrogenic' chemicals such as DDT (1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane) into the environment. Although these phenotypic alterations are thought to be mediated by the oestrogen receptor, they are also consistent with inhibition of androgen receptor-mediated events. Here we report that the major and persistent DDT metabolite, p,p'-DDE (1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene), has little ability to bind the oestrogen receptor, but inhibits androgen binding to the androgen receptor, androgen-induced transcriptional activity, and androgen action in developing, pubertal and adult male rats. The results suggest that abnormalities in male sex development induced by p,p'-DDE and related environmental chemicals may be mediated at the level of the androgen receptor.
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              Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child.

              When thyroid deficiency occurs simultaneously in a pregnant woman and her fetus, the child's neuropsychological development is adversely affected. Whether developmental problems occur when only the mother has hypothyroidism during pregnancy is not known. In 1996 and 1997, we measured thyrotropin in stored serum samples collected from 25,216 pregnant women between January 1987 and March 1990. We then located 47 women with serum thyrotropin concentrations at or above the 99.7th percentile of the values for all the pregnant women, 15 women with values between the 98th and 99.6th percentiles, inclusive, in combination with low thyroxine levels, and 124 matched women with normal values. Their seven-to-nine-year-old children, none of whom had hypothyroidism as newborns, underwent 15 tests relating to intelligence, attention, language, reading ability, school performance, and visual-motor performance. The children of the 62 women with high serum thyrotropin concentrations performed slightly less well on all 15 tests. Their full-scale IQ scores on the Wechsler Intelligence Scale for Children, third edition, averaged 4 points lower than those of the children of the 124 matched control women (P= 0.06); 15 percent had scores of 85 or less, as compared with 5 percent of the matched control children. Of the 62 women with thyroid deficiency, 48 were not treated for the condition during the pregnancy under study. The full-scale IQ scores of their children averaged 7 points lower than those of the 124 matched control children (P=0.005); 19 percent had scores of 85 or less. Eleven years after the pregnancy under study, 64 percent of the untreated women and 4 percent of the matched control women had confirmed hypothyroidism. Undiagnosed hypothyroidism in pregnant women may adversely affect their fetuses; therefore, screening for thyroid deficiency during pregnancy may be warranted.
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                Author and article information

                Journal
                Pediatrics
                American Academy of Pediatrics (AAP)
                0031-4005
                1098-4275
                April 01 2004
                April 01 2004
                April 01 2004
                April 01 2004
                : 113
                : Supplement_3
                : 1030-1036
                Affiliations
                [1 ]Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
                [2 ]US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia
                Article
                10.1542/peds.113.S3.1030
                837e217c-872f-4fd4-9671-772f843c3f50
                © 2004
                History

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