title: Potential short-term neurobehavioral alterations in children associated with a peak pesticide spray season: The Mother's Day flower harvest in Ecuador.
abstract: BACKGROUND
  Exposures to cholinesterase inhibitor pesticides (e.g. organophosphates) have been associated with children's neurobehavioral alterations, including attention deficit and impulsivity. Animal studies have observed transient alterations in neurobehavioral performance in relation to cholinesterase inhibitor pesticide exposures; however, limited evidence exists regarding transient effects in humans.
  
  
  METHODS
  We estimated the associations between neurobehavioral performance and time after Mother's Day flower harvest (the end of a heightened pesticide usage period) among 308 4-to 9-year-old children living in floricultural communities in Ecuador in 2008 who participated in the ESPINA study. Children's neurobehavior was examined once (NEPSY-II: 11 subtests covering 5 domains), between 63 and 100days (SD: 10.8days) after Mother's Day harvest (blood acetylcholinesterase activity levels can take 82days to normalize after irreversible inhibition with organophosphates).
  
  
  RESULTS
  The mean (SD) neurobehavioral scaled scores across domains ranged from 6.6 (2.4) to 9.9 (3.3); higher values reflect greater performance. Children examined sooner after Mother's Day had lower neurobehavioral scores than children examined later, in the domains of (score difference per 10.8days, 95%CI): Attention/Inhibitory Control (0.38, 0.10-0.65), Visuospatial Processing (0.60, 0.25-0.95) and Sensorimotor (0.43, 0.10-0.77). Scores were higher with longer time post-harvest among girls (vs. boys) in Attention/Inhibitory Control.
  
  
  CONCLUSIONS
  Our findings, although cross-sectional, are among the first in non-worker children to suggest that a peak pesticide use period may transiently affect neurobehavioral performance, as children examined sooner after the flower harvest had lower neurobehavioral performance than children examined later. Studies assessing pre- and post-exposure measures are needed.
authors.affiliation: Division of Global Health, Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0725, La Jolla, CA 92024-0725, USA; Fundacion Cimas del Ecuador, De los Olivos E14-226 y las Minas, Quito, Pichincha, Ecuador. Electronic address: jrsuarez@ucsd.edu.
authors.forename: Jose R
authors.initials: JR
authors.lastname: Suarez-Lopez
authors.affiliation: Division of Global Health, Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0725, La Jolla, CA 92024-0725, USA. Electronic address: hcheckoway@ucsd.edu.
authors.forename: Harvey
authors.initials: H
authors.lastname: Checkoway
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA. Electronic address: jacob004@umn.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.affiliation: Division of Global Health, Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0725, La Jolla, CA 92024-0725, USA.
authors.forename: Wael K
authors.initials: WK
authors.lastname: Al-Delaimy
authors.affiliation: Division of Academic General Pediatrics, Child Development and Community Health, Department of Pediatrics, University of California, 9500 Gilman Drive #0832, La Jolla, CA 92024-0832, USA. Electronic address: sgahagan@ucsd.edu.
authors.forename: Sheila
authors.initials: S
authors.lastname: Gahagan
mesh_terms: D000110:Acetylcholinesterase / Q000097:blood; D001288:Attention / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000139:chemically induced* / Q000175:diagnosis; D004484:Ecuador; D004781:Environmental Exposure / Q000009:adverse effects*; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D007858:Learning / Q000187:drug effects; D008297:Male; D008568:Memory / Q000187:drug effects; D009483:Neuropsychological Tests; D062025:Organophosphate Poisoning / Q000523:psychology*; D010575:Pesticides / Q000009:adverse effects*; D011597:Psychomotor Performance / Q000187:drug effects; D012621:Seasons
chemical_list: D002800:Cholinesterase Inhibitors; D010575:Pesticides; D000110:Acetylcholinesterase
keywords: Acute; Children; Cholinesterase; Neurobehavior; Pesticides; Transient