title: An intervention to reduce residential insecticide exposure during pregnancy among an inner-city cohort.
abstract: 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.
authors.affiliation: Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
authors.forename: Megan K
authors.initials: MK
authors.lastname: Williams
authors.forename: Dana B
authors.initials: DB
authors.lastname: Barr
authors.forename: David E
authors.initials: DE
authors.lastname: Camann
authors.forename: Linda A
authors.initials: LA
authors.lastname: Cruz
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Carlton
authors.forename: Mejico
authors.initials: M
authors.lastname: Borjas
authors.forename: Andria
authors.initials: A
authors.lastname: Reyes
authors.forename: Dave
authors.initials: D
authors.lastname: Evans
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Kinney
authors.forename: Ralph D
authors.initials: RD
authors.lastname: Whitehead
authors.forename: Frederica P
authors.initials: FP
authors.lastname: Perera
authors.forename: Stephen
authors.initials: S
authors.lastname: Matsoanne
authors.forename: Robin M
authors.initials: RM
authors.lastname: Whyatt
mesh_terms: 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
chemical_list: D015415:Biomarkers; D007306:Insecticides