title: Neurobehavioral deficits and increased blood pressure in school-age children prenatally exposed to pesticides.
abstract: BACKGROUND
  The long-term neurotoxicity risks caused by prenatal exposures to pesticides are unclear, but a previous pilot study of Ecuadorian school children suggested that blood pressure and visuospatial processing may be vulnerable.
  
  
  OBJECTIVE
  In northern Ecuador, where floriculture is intensive and relies on female employment, we carried out an intensive cross-sectional study to assess children's neurobehavioral functions at 6-8 years of age.
  
  
  METHODS
  We examined all 87 children attending two grades in the local public school with an expanded battery of neurobehavioral tests. Information on pesticide exposure during the index pregnancy was obtained from maternal interview. The children's current pesticide exposure was assessed from the urinary excretion of organophosphate metabolites and erythrocyte acetylcholine esterase activity.
  
  
  RESULTS
  Of 84 eligible participants, 35 were exposed to pesticides during pregnancy via maternal occupational exposure, and 23 had indirect exposure from paternal work. Twenty-two children had detectable current exposure irrespective of their prenatal exposure status. Only children with pre-natal exposure from maternal greenhouse work showed consistent deficits after covariate adjustment, which included stunting and socioeconomic variables. Exposure-related deficits were the strongest for motor speed (Finger Tapping Task), motor coordination (Santa Ana Form Board), visuospatial performance (Stanford-Binet Copying Test), and visual memory (Stanford-Binet Copying Recall Test). These associations corresponded to a developmental delay of 1.5-2 years. Prenatal pesticide exposure was also significantly associated with an average increase of 3.6 mmHg in systolic blood pressure and a slight decrease in body mass index of 1.1 kg/m2. Inclusion of the pilot data strengthened these results.
  
  
  CONCLUSIONS
  These findings support the notion that prenatal exposure to pesticides-at levels not producing adverse health outcomes in the mother-can cause lasting adverse effects on brain development in children. Pesticide exposure therefore may contribute to a "silent pandemic" of developmental neurotoxicity.
authors.affiliation: Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral, Quito, Ecuador.
authors.forename: Raul
authors.initials: R
authors.lastname: Harari
authors.forename: Jordi
authors.initials: J
authors.lastname: Julvez
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Murata
authors.forename: Dana
authors.initials: D
authors.lastname: Barr
authors.forename: David C
authors.initials: DC
authors.lastname: Bellinger
authors.forename: Frodi
authors.initials: F
authors.lastname: Debes
authors.forename: Philippe
authors.initials: P
authors.lastname: Grandjean
mesh_terms: D000328:Adult; D000382:Agricultural Workers' Diseases / Q000139:chemically induced*; D001288:Attention / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000139:chemically induced*; D004484:Ecuador; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016273:Occupational Exposure; D010755:Organophosphates / Q000633:toxicity* / Q000652:urine; D010575:Pesticides / Q000633:toxicity* / Q000652:urine; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*; D011597:Psychomotor Performance / Q000187:drug effects*
chemical_list: D010755:Organophosphates; D010575:Pesticides