title: Aerial application of mancozeb and urinary ethylene thiourea (ETU) concentrations among pregnant women in Costa Rica: the Infants' Environmental Health Study (ISA).
abstract: BACKGROUND
  Mancozeb and its main metabolite ethylene thiourea (ETU) may alter thyroid function; thyroid hormones are essential for fetal brain development. In Costa Rica, mancozeb is aerially sprayed at large-scale banana plantations on a weekly basis.
  
  
  OBJECTIVE
  Our goals were to evaluate urinary ETU concentrations in pregnant women living near large-scale banana plantations, compare their estimated daily intake (EDI) with established reference doses (RfDs), and identify factors that predict their urinary ETU concentrations.
  
  
  METHODS
  We enrolled 451 pregnant women from Matina County, Costa Rica, which has large-scale banana production. We visited 445 women up to three times during pregnancy to obtain urine samples (n = 872) and information on factors that possibly influence exposure. We determined urinary ETU concentrations using liquid chromatography mass spectrometry.
  
  
  RESULTS
  Pregnant women's median urinary ETU concentrations were more than five times higher than those reported for other general populations. Seventy-two percent of the women had EDIs above the RfD. Women who lived closest (1st quartile, < 48 m) to banana plantations on average had a 45% (95% CI: 23, 72%) higher urinary ETU compared with women who lived farthest away (4th quartile, ≥ 565 m). Compared with the other women, ETU was also higher in women who washed agricultural work clothes on the day before sampling (11%; 95% CI: 4.9, 17%), women who worked in agriculture during pregnancy (19%; 95% CI: 9.3, 29%), and immigrant women (6.2%; 95% CI: 1.0, 13%).
  
  
  CONCLUSIONS
  The pregnant women's urinary ETU concentrations are of concern, and the principal source of exposure is likely to be aerial spraying of mancozeb. The factors predicting ETU provide insight into possibilities for exposure reduction.
authors.affiliation: Programa Infantes y Salud Ambiental (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica.
authors.forename: Berna
authors.initials: B
authors.lastname: van Wendel de Joode
authors.forename: Ana María
authors.initials: AM
authors.lastname: Mora
authors.forename: Leonel
authors.initials: L
authors.lastname: Córdoba
authors.forename: Juan Camilo
authors.initials: JC
authors.lastname: Cano
authors.forename: Rosario
authors.initials: R
authors.lastname: Quesada
authors.forename: Moosa
authors.initials: M
authors.lastname: Faniband
authors.forename: Catharina
authors.initials: C
authors.lastname: Wesseling
authors.forename: Clemens
authors.initials: C
authors.lastname: Ruepert
authors.forename: Mattias
authors.initials: M
authors.lastname: Oberg
authors.forename: Brenda
authors.initials: B
authors.lastname: Eskenazi
authors.forename: Donna
authors.initials: D
authors.lastname: Mergler
authors.forename: Christian H
authors.initials: CH
authors.lastname: Lindh
mesh_terms: D000293:Adolescent; D000328:Adult; D000383:Agriculture; D000393:Air Pollutants / Q000009:adverse effects*; D003364:Costa Rica; D004781:Environmental Exposure; D005031:Ethylenethiourea / Q000032:analysis*; D005260:Female; D005659:Fungicides, Industrial / Q000009:adverse effects*; D005865:Gestational Age; D006801:Humans; D008344:Maneb / Q000009:adverse effects*; D018811:Maternal Exposure; D011247:Pregnancy; D011296:Prenatal Diagnosis; D015038:Zineb / Q000009:adverse effects*
chemical_list: D000393:Air Pollutants; D005659:Fungicides, Industrial; D008344:Maneb; D005031:Ethylenethiourea; C013099:mancozeb; D015038:Zineb