Chemicals found in children's bodies and their health effects

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ContactosJosé Manuel CamachoCommunity Outreach CoordinatorCenter for Environmental Research and Children’s Health (CERCH)University of California, Berkeley

Melissa MalloryEducation Program AdvisorCalifornia Department of Education

Lizette RochaEducation Program AssistantCalifornia Department of Education

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CHAMACOS Study Objectives •To measure environmental exposures in pregnant women and children.

•To determine the relationship between Environmental Exposures and:

• neurodevelopment• growth• respiratory disease

•To reduce exposure to children and pregnant women with interventions and community outreach.

•To learn about policies to reduce the incidence of diseases related to the environment.

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Many Factors Influence Maternal and Child Health

Genes

Other factors

Immediate environment

Greater environment

Nutrition

Health

Pesticides

Poverty

Home environment

Housing Quality

Violence

Discrimination

Family Relations

Enrichment

Acculturation

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RISK

Ecological (acute & chronic)

Human health(acute & chronic)

Aquatic TerrestrialPopulations &Subpopulations Special

protection for children

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Children at Higher Risk of Exposure6

601 pregnant women living in the Salinas Valley:• They received prenatal care in 5 prenatal care clinics

that serve low-income residents

• They planned to give birth at Natividad Medical Center

Enrollment: 1999-2000

• 92% Spanish-Speaking• 85% Born in México• 54% < 5 years in USA• 44% 6th grade education or less• 44% worked in agriculture during pregnancy• 84% other agricultural workers in home

** Primarily Mexican immigrants from low-income households**

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Exposures

PesticidesOrganophosphates PyrethroidsManganese Fungicides

Ethylene bisdithiocarbamates(EBDCs)

Another current use of pesticides

Organochlorines

Flame retardants

Bisphenol A

Phthalates

Allergens (pollen / mold)

Housing quality

Social factors (race, nationality, income)

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Outcomes Birth outcomes (duration of pregnancy, birth

weight, etc.)

Neurobehavioral development

Respiratory functioning

Obesity and child metabolic syndrome

Puberty onset

Thyroid hormone

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California, The Leading Agricultural State

Salinas Valley

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Areas With High OP Use11

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Prenatal and child OP metabolites in CHAMACOS and NHANES*

Child 6 month

* National Health and Nutrition Examination SurveyBradman et al. EHP, 2005, 2011

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Chart1

13 Wks13 Wks13 Wks13 Wks

26 Wks26 Wks26 Wks26 Wks

NHANES 18-40NHANES 18-40NHANES 18-40NHANES 18-40

6M6M6M6M

12M12M12M12M

24M24M24M24M

3.5Y3.5Y3.5Y3.5Y

5Y5Y5Y5Y

NHANES 6-11NHANES 6-11NHANES 6-11NHANES 6-11

Volume

UpperBound

LowerBound

GM

113.2485

126.1491

101.6672

113.2485

113.0826

123.4459

103.5893

113.0826

78.23674

90.90115

67.33674

78.23674

38.88566

45.50433

33.22969

38.88566

54.48673

63.49088

46.75953

54.48673

65.11344

76.06649

55.73755

65.11344

69.38562

83.34863

57.76178

69.38562

80.39076

96.78611

66.77275

80.39076

69.636

79.85575

60.72414

69.636

Data

NGM(95% CI)

CHAMACOS 1ST TRIM.591113.2485101.6672126.1491

CHAMACOS 2ND TRIM.500113.0826103.5893123.4459

NHANES WOMEN 18-40 @ 199935578.2367467.3367490.90115

CHAMACOS 6M41738.8856633.2296945.50433

CHAMACOS 12M40554.4867346.7595363.49088

CHAMACOS 24M38165.1134455.7375576.06649

CHAMACOS 3.5Y29869.3856257.7617883.34863

CHAMACOS 5Y33080.3907666.7727596.78611

NHANES CHILDREN 6-11 @ 2003-200429069.63660.7241479.85575

Plot1

Upper boundLower boundGMUpper boundLower boundGM

13 Wks126.1101.7113.2

26 Wks123.4103.6113.1

NHANES 18-4090.967.378.2

6M45.533.238.9

12M63.546.854.5

24M76.155.765.1

3.5Y83.357.869.4

5Y96.866.880.4

NHANES 6-1179.960.769.6

Plot1

Upper bound

Lower bound

GM

Upper bound

Lower bound

GM

Plot2

NVolumeUpperBoundLowerBoundGM

59113 Wks113.2485126.1491101.6672113.2485

50026 Wks113.0826123.4459103.5893113.0826

355NHANES 18-4078.2367490.9011567.3367478.23674

4176M38.8856645.5043333.2296938.88566

40512M54.4867363.4908846.7595354.48673

38124M65.1134476.0664955.7375565.11344

2983.5Y69.3856283.3486357.7617869.38562

3305Y80.3907696.7861166.7727580.39076

290NHANES 6-1169.63679.8557560.7241469.636

Plot2

Volume

UpperBound

LowerBound

GM

ORGANOPHOSPHATE PESTICIDES

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Length of Gestation was Shorter for Infants of Women with Higher OP Pesticide Exposures

Photo by Julie Fisher

For every 10 fold increase in OP metabolites in the later half of pregnancy, there was a half week decrease in gestationEskenazi et al., EHP, 2004

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Higher use of some fumigants, (ex. methyl bromide and chloropicrin) also associated with slightly lower developmental scores.

Like OPs, methyl bromide at high levels can be bad for children's brains. We are working to learn more about fumigants.

Methyl bromide is no longer used in the Salinas Valley or CA!

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Guillette 1998

Representative drawings of 4-year-old Yaqui children from the valley and foothills of

Sonora, Mexico.

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Child Behavior Checklist 1½ - 5 year old DSM-Oriented Scale

• Afraid to try new things

• Avoids looking others in the eye

• Can’t stand having things out of place

• Disturbed by any change in routine

• Doesn’t answer when people talk to him/her

• Doesn’t get along well with other children

• Repeatedly rocks head or body

• Shows little affection towards people

• Speech problem (describe)

• Strange behavior (describe)

• Upset by new people or situations (describe)

• Withdrawn, doesn’t get involved with others

Pervasive Developmental Disorder

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Prenatal OPs and Behavior

Children born to moms with higher levels of OPs while pregnant tended to score:

↑ PDD at 24 months (maternal report) ↑ ADHD at 5 years (maternal report) ↑ ADHD at 5 years (CPT)

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Nearby OP Use and Child Development

When more OPs were used near homes during pregnancy, children had lower developmental scores at 7 years.

This is similar to what we saw when there were higher levels of OPs in the urine.

Detections in urine probably come from pesticides in food and less from pesticide drift. Using maps, we are better able to see that living near where pesticides are used can increase drift exposure.

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Prenatal OPs and Neurodevelopment

Children born to moms with higher levels of OPs while pregnant tended to score:

↓ neurodevelopment at 24 months ↓ verbal skills at 3 ½ years ↓ neurodevelopment at 7 years

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Organophosphate pesticides and asthma

We wanted to know:

Is there a link between exposure to organophosphate pesticides (OP) and asthma symptoms in CHAMACOS study?

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Incr

ease

d ris

k pe

r 10-

fold

incr

ease

Prenatal OP metabolites

Postnatal OP metabolites

Models adjusted for:Child’s gender, age, Maternal smoking, ETS, Season of birth, PM2.5, Breastfeeding, Mold, Traffic, CockroachesRaanan et al., EHP, 2015.

momscleanairforce.org

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2

Prenatal and childhood (0-5Y) OP metabolites related to respiratory

symptoms at school age

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In our CHAMACOS families

We measured OP pesticides in the urine of:• Mothers during pregnancy • Children between 6 months and 5 years

of age

We asked mothers if their child had asthma symptoms at 5 and 7 years of age

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Results of exposure to OP pesticides and asthma

We found more asthma symptoms in:

Children whose mothers were exposed to higher levels of OP pesticides during the second half of pregnancy

Children who were exposed to higher levels of OP pesticides in childhood

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OP use has also decreased!

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014

Poun

ds A

pplie

d

FENAMIPHOS

METHIDATHION

MEVINPHOS

DISULFOTON

NALED

DIMETHOATE

BENSULIDE

OXYDEMETON-METHYL

CHLORPYRIFOS

ACEPHATE

MALATHION

DIAZINON

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Certified Organic Cropland in California

Source: United States Department of Agriculture, 2010

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Pesticides (fungicides) containing manganese

• Widely used in Salinas• Manganese is an important element

of our diet, but is toxic in high amounts

We wanted to know if use of pesticides with manganese:

• Increases manganese levels in homes

• Increases manganese levels in children's teeth

• It is related to children brain development

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Manganese in home dust and teeth

We measured manganese levels in home dust and children's teeth

We found higher levels of manganese when:Pesticides with manganese

were used in agricultural fields near home

Farm workers clothes or shoes were stored inside home

There was not a doormat at house entrance

Like tree rings

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Manganese in teeth and brain development

Children with highest manganese levels in their teeth had a small decrease in motor development at 6 months

These effects disappeared when children grew up

So far, we have not seen lasting effects of manganese exposure to levels we found in CHAMACOS' children

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Stress and children

When stress was higher, children had slightly lower developmental scores at 7 years.

For families with more stress, pesticides had a higher effect on the child's development.

In families with less stress and a positive learning environment, pesticides had a minor impact on the child's development.

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FIRE RETARDANTSPBDE’s

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PBDEsPBDEs are added

to household items to reduce

flammability.

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California Technical Bulletin 11734

California Technical Bulletin 117-2013

High PBDEs dust levels in California

0

600

1200

1800

2400

3000

3600

4200

4800

5400

6000

6600

Dus

t ave

rage

con

cent

ratio

n (n

g /

g)

UKN=10

SingaporeN=31

MAN=89

USN=10

DCN=17

TXN=20

CAN=10

CAN=39

CAN=10

CAN=13

CAN=15

PBDE 99 in home dust - several regions

Quiros-Alcala et al., 2011

Salinas

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* p < 0.05 compared to < 1 year

1020

3040

50Su

m P

BDEs

(ng/

g lip

ids)

= 11 For life

Years of residence in US

** *

*Ptrend < 0.001

Bradman, in prep

Do PBDE levels increase over time in US MOTHERS?

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It was found that Mexican children have much lower levels of flame retardants

Less than 5 years in

USA

Eskenazi et al., EHP

020

40

60

80

100

120

140

MEXICO CHAMACOS

5 to 15 years in

USA

More than 15 years in USA

Seru

m P

BDE

leve

ls (n

g/g

lipid

)

Levels in Mexican-American children in US were 7x higher than Mexican children

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Children in California have higher PBDE levels

Windham et al., 2010

0

20

40

60

80

100

CHAMACOS

Seru

m P

BDE

leve

ls (n

g/g

lipid

)

CALIFORNIA EE.UU.

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Health Effects

Scientists and doctors still do not know if PBDEs can affect our health. Current research is examining whether PBDEs are related to:

• Infertility problems

• Learning delay in children

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WHAT YOU CAN DO

Repair or replace upholstered items with torn covers or exposed foam.

Frequently clean dust with a wet rag and mop.

Use a vacuum with HEPA filter

Open windows to let in fresh air

Choose baby products and furniture that contain polyester, wool or cotton, they are less likely to have flame retardants.

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BISPHENOL A or BPA

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BPA

BPA is used in hard plastics, some food cans, and receipts

from stores

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BPA FREE PLASTICS44

RECOMMENDATIONS

• Avoid heating food in plastic containers

• Avoid heating foods wrapped in plastic in the microwave

• Reduce the amount of food you eat from plastic-lined packages

• Do not wash plastic containers in dishwasher

• Use alternatives like glass, metal or plastic # 1 containers

• Buy products labeled BPA-Free, Bisphenol A Free or Phthalate Free

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Endocrine Disruptors in Personal Care Products

Parabens (preservative)Phthalates (fragrances)

Triclosan(antibacterial)

Oxybenzone(sunscreen)

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Buy instead

Fragrances

Phthalates (fragrances)

Use: Make fragrances last longer and make nail polish smoother.

Found in: Perfumes, scented soaps, shampoos, lotions and other beauty products. Air fresheners and scented household cleansers. Nail polish.

Health effects: Linked to behavior problems and allergies in children. May effect reproductive development in males.

How it’s listed on the label: “Fragrance” or “perfume”

Buy instead: Unscented or naturally scented products.

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Buy instead

preservative Parabens

Use: A preservative to prevent growth of mold or bacteria

Found in: Foundation, mascara, eye liner, eye shadow, and other cosmetics

Health effects: Mimics estrogen. Has been linked to breast cancer, but little is known about how it affects our health

How it’s listed on the label: Methyl paraben, ethyl paraben, propyl paraben.

Buy instead: Mineral based make-up made without parabens

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Buy instead

AntibacterialTriclosan

Use: To kill bacteria

Found in: Antibacterial or antimicrobial soaps and cleansers. Colgate Total toothpaste

Health effects: Linked to changes in estrogen and thyroid hormone. Long term health effects not known

How it’s listed on the label: Triclosan, “antibacterial”

Buy instead: Regular soap or toothpaste eliminate germs just as well

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Buy instead

Oxybenzone

Use: To block UV radiation

Found in: Sunscreens, foundation, blush, and other cosmetics

Health effects: Associated with decreases in sperm production in animal tests (rats) and with birth weight changes in humans

How it’s listed on the label: oxybenzone, BP-3

Buy instead: Zinc oxide or titanium dioxide base sunscreens

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Future directions ...

We want to learn more about how chemical exposures can affect health at older ages and find out what we can do

to make sure our children grow up healthy. We hope to follow children

passed 18 years of age, paying special attention to changes in

neurodevelopment and behavior!

Pregnancy 6 months

Birth 1 Yr

12 yrs2 yrs

10 ½ yrs

9 yrs

7 yrs

5 yrs

3 ½ yrs

18 yrs +

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•We are starting an exciting new project that will allow us to see how a person's brain reacts as they perform different thinking tasks during the 18-year visit

• They will use a cap with special sensors that show us which parts of the brain are being used to complete certain tasks

•We will use this data to help determine if there is a relationship between altered brain function and chemical exposures

18-Year Visits 52

Housing Quality53

Household food insecurity 2005-2006

Rosas et al., JADA, 2009

% f

ood

inse

cure

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Chart1

CHAMACOS

NHANES

% Food Insecure

39

19.5

Sheet1

% Food InsecureColumn2

CHAMACOS3919.52

NHANES19.54.42

Category 33.51.83

Category 44.52.85

To resize chart data range, drag lower right corner of range.

Background• Many youth in the United States are

overweight.

• Healthy food and exercise are important for our health.

• It can be difficult to obtain healthy foods, cook fresh foods, or find the time or place to exercise.

• The scientists want to know if the chemicals in the environment increase the chances of becoming overweight.

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Tips to stay healthy

There is a lot we can do to stay healthy:

Eat healthy food Exercise Sleep well Read Do not smoke or abuse

alcohol or drugs Talk to friends / family when

you need help Spend time with family

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Projects to Reduce Pesticide Exposure

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Field Intervention

Farm workers received gloves

Lightweight coverall developed and provided

Workers left their work clothes at the fields to be washed

Method developed to provide hot water in

the field.Trained crew leaders to use

the system. The crew leaders filled tanks.

5 field-based education sessions

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Bradman et al., JESEE, 2009

Gloves reduced pesticides on hands And in the body

No Yes

Urin

e M

DA

(ug/

g)

Wore Gloves?

*

Skin

sam

ple

MD

A (u

g/g)

No YesWore Gloves?

***

* p

• 42% had no pesticide safety training.

• 52% didn’t know when pesticides were applied

• 92% didn’t know names of pesticides

• 62% worry that pesticides could hurt their family’s health

Farm Worker Education

Over 30,000+ people reached !

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We also acted to reduce take-home pesticide exposures

Home Intervention61

We developed a curriculum in home for families

3 sessions with farmworker households

Developed action plan to reduce pesticide exposure

Identified barriers to action

Salvatore et al., submitted.

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CHAMACOSCommunity Outreach

CHAMACOS Advisory Structure

CABFarmworker

Council

ScientificAdvisory

Board

Youth Community

Council

Growers Council

Community Advisory Board

(40+ youth, 6+ years)

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We work with the entire community

Community Outreach

Youth

Childcare Providers

Clinicians

Social Service

Providers

Policy Makers

Parents and

Families

Children

Pregnant Women

Industry

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Reflections From Youth Council

Belonging: “I (now) feel like I fit into a whole other clique…a spark of

hope for future generations… its given me the power to believe I can change things...”

Teamwork: “I learned to collaborate with my team (on) amazing

adventures, ones that I’ll never forget.”Capacity Building: “My skills… were enhanced: team building, data collection, kit

cleaning, data entry, team communication, public speaking, respect towards adults, (and) interviewing…”

“I now wont be afraid to speak out (loud) to my classmates or future bosses.”

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Pilot and Collaboration with California Migrant Education

Training of Trainers Project (La Semilla):• Trained volunteers• Provided them with a curriculum,

presentation, educational activities, handouts

• Each volunteer trained more parents to protect their families from pesticides

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New Collaboration with Migrant Education

• Aim to reach 5 sites in 5 counties/regions across California

• Provide pesticide exposure prevention and Worker Protection Standards training

• Help attendees learn how to be strong presenters

• Provide community members with educational resources

• Hold a series of educational puppet shows for children of farmworkers

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Brenda Eskenazi, MA, PhD, Director

Kim Harley, PhD, Associate Director for Health Effects

Asa Bradman, MS, PhD., Associate Director for Exposure Assessment

Katie Kogut, MPH, CHAMACOS Study Coordinator

Nina Holland, PhD, Director, Children’s Environmental Health Laboratory

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Stay informed...

For more information about the CHAMACOS study visit us online:

www.cerch.berkeley.edu

and sign up for our e-newsletter

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http://www.cerch.berkeley.edu/

Give us a “Like” and a “follow” to know the latest news from CHAMACOS

www.facebook.com/CHAMACOS.CERCH/

(@CHAMACOS.CERCH)

CHAMACOS is on Facebook!74

http://www.facebook.com/CHAMACOS.CERCH/

CHAMACOS Funders

Instituto Nacional de Ciencias de la Salud Ambiental

Agencia de Protección Ambiental de Estados Unidos

Programa de Investigación del Cáncer de Mama

Oficina de EducaciónMigrante de California

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Thank You!

Questions?

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�Slide Number 2CHAMACOS Study Objectives Slide Number 4Slide Number 5Children at Higher Risk of ExposureSlide Number 7ExposuresOutcomesCalifornia, The Leading Agricultural StateSlide Number 11Slide Number 12Slide Number 13Slide Number 14Length of Gestation was Shorter for Infants of Women with Higher OP Pesticide ExposuresSlide Number 16Slide Number 17Slide Number 18Prenatal OPs and BehaviorNearby OP Use and Child DevelopmentPrenatal OPs and NeurodevelopmentSlide Number 22Slide Number 23Slide Number 24Results of exposure to OP pesticides and asthmaOP use has also decreased!Certified Organic Cropland in CaliforniaSlide Number 28Manganese in home dust and teethManganese in teeth and brain developmentStress and childrenSlide Number 32Slide Number 33Slide Number 34California Technical Bulletin 117-2013High PBDEs dust levels in CaliforniaSlide Number 37It was found that Mexican children have much lower levels of flame retardantsChildren in California have higher PBDE levelsHealth EffectsWHAT YOU CAN DOBISPHENOL A or BPABPABPA FREE PLASTICS RECOMMENDATIONSEndocrine Disruptors in Personal Care ProductsBuy insteadBuy insteadBuy insteadBuy insteadFuture directions ...Slide Number 52Slide Number 53Household food insecurity 2005-2006BackgroundTips to stay healthySlide Number 57Field Intervention Slide Number 59Farm Worker EducationWe also acted to reduce �take-home pesticide exposures Slide Number 62Slide Number 63Slide Number 64Slide Number 65Reflections From Youth CouncilSlide Number 67New Collaboration with �Migrant EducationSlide Number 69Slide Number 70Slide Number 71Slide Number 72Stay informed...Slide Number 74CHAMACOS FundersThank You!