An intervention to reduce residential insecticide exposure during pregnancy among an inner-city cohort.
BACKGROUND
We previously reported widespread insecticide exposure during pregnancy among inner-city women from New York City. Here we report on a pilot intervention using integrated pest management (IPM) to reduce pest infestations and residential insecticide exposures among pregnant New York City African-American and Latina women (25 intervention and 27 control homes).


METHODS
The IPM consisted of professional cleaning, sealing of pest entry points, application of low-toxicity pesticides, and education. Cockroach infestation levels and 2-week integrated indoor air samples were collected at baseline and one month postintervention. The insecticides detected in the indoor air samples were also measured in maternal and umbilical cord blood collected at delivery.


RESULTS
Cockroach infestations decreased significantly (p = 0.016) after the intervention among intervention cases but not control households. Among the intervention group, levels of piperonyl butoxide (a pyrethroid synergist) were significantly lower in indoor air samples after the intervention (p = 0.016). Insecticides were detected in maternal blood samples collected at delivery from controls but not from the intervention group. The difference was significant for trans-permethrin (p = 0.008) and of borderline significance (p = 0.1) for cis-permethrin and 2-isopropoxyphenol (a propoxur metabolite).


CONCLUSIONS
To our knowledge, this is the first study to use biologic dosimeters of prenatal pesticide exposure for assessing effectiveness of IPM. These pilot data suggest that IPM is an effective strategy for reducing pest infestation levels and the internal dose of insecticides during pregnancy.
Williams
Megan K
MK
Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
Barr
Dana B
DB
Camann
David E
DE
Cruz
Linda A
LA
Carlton
Elizabeth J
EJ
Borjas
Mejico
M
Reyes
Andria
A
Evans
Dave
D
Kinney
Patrick L
PL
Whitehead
Ralph D
RD
Perera
Frederica P
FP
Matsoanne
Stephen
S
Whyatt
Robin M
RM
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D016902:Air Pollution, Indoor / Q000032:analysis* / Q000517:prevention & control; D000818:Animals; D015415:Biomarkers / Q000097:blood; D003058:Cockroaches; D015331:Cohort Studies; D004781:Environmental Exposure / Q000517:prevention & control*; D004784:Environmental Monitoring; D005260:Female; D006266:Health Education; D006630:Hispanic or Latino; D006798:Housing; D006801:Humans; D007300:Insect Control / Q000379:methods*; D007306:Insecticides / Q000032:analysis* / Q000097:blood; D009519:New York City; D011247:Pregnancy
D015415:Biomarkers; D007306:Insecticides