title: Home-based community health worker intervention to reduce pesticide exposures to farmworkers' children: A randomized-controlled trial.
abstract: We conducted a randomized-controlled trial of a home-based intervention to reduce pesticide exposures to farmworkers' children in Monterey County, California (n=116 families). The intervention consisted of three home-based educational sessions delivered by community health workers in Spanish. Measurements of organophosphate (OP) insecticide metabolites in child urine (n=106) and pesticides in home floor wipes (n=103) were collected before and after the intervention. Median child urinary dialkyl phosphate (DAP) metabolite levels were slightly lower among the intervention group children at follow-up compared with baseline, albeit nonsignificantly. DAP metabolite levels in the control group children were markedly higher at follow-up compared with baseline. In adjusted models, intervention participation was associated with a 51% decrease in total DAP metabolite levels. Carbaryl, chlorpyrifos, cypermethrin, dacthal, diazinon, malathion, and trans-permethrin were commonly detected in the floor wipes. In adjusted models, intervention participation was significantly associated with a 37% decrease in trans-permethrin floor wipe levels in homes, but not OP or other agricultural pesticides. In summary, intervention group children had slightly reduced pesticide exposures, whereas child exposures were higher among the control group. Additional intervention studies evaluating methods to reduce pesticide exposures to farmworker families and children are needed.
authors.affiliation: University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, OK, USA.|Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Alicia L
authors.initials: AL
authors.lastname: Salvatore
authors.affiliation: Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Castorina
authors.affiliation: Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), Clínica de Salud del Valle de Salinas, Salinas, CA, USA.
authors.forename: José
authors.initials: J
authors.lastname: Camacho
authors.affiliation: Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), Clínica de Salud del Valle de Salinas, Salinas, CA, USA.
authors.forename: Norma
authors.initials: N
authors.lastname: Morga
authors.affiliation: California Rural Legal Assistance, Salinas, CA, USA.
authors.forename: Jesús
authors.initials: J
authors.lastname: López
authors.affiliation: Battelle Memorial Institute, Columbus, OH, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Nishioka
authors.affiliation: Emory University, School of Public Health, Atlanta, Georgia, USA.
authors.forename: Dana B
authors.initials: DB
authors.lastname: Barr
authors.affiliation: Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Eskenazi
authors.affiliation: Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Asa
authors.initials: A
authors.lastname: Bradman
mesh_terms: D000328:Adult; D000383:Agriculture / Q000706:statistics & numerical data*; D002140:California; D002675:Child, Preschool; D003150:Community Health Workers / Q000458:organization & administration; D004781:Environmental Exposure / Q000032:analysis / Q000517:prevention & control*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007306:Insecticides / Q000032:analysis / Q000652:urine; D008297:Male; D062025:Organophosphate Poisoning / Q000517:prevention & control; D010755:Organophosphates / Q000652:urine; D010575:Pesticides / Q000009:adverse effects* / Q000032:analysis / Q000652:urine
chemical_list: D007306:Insecticides; D010755:Organophosphates; D010575:Pesticides