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Do Workplace and Home Protective Practices Protect Farm Workers? Findings From the “For Healthy Kids” Study
Abstract
Objective:
To assess associations of protective workplace and home practices with pesticide exposure levels.
Methods:
Using data from orchard workers in the Yakima Valley, Washington, we examined associations of workplace and home protective practices with (1) urinary metabolite concentrations of dimethylthiophosphate (DMTP) in adults and children aged 2 to 6 years and (2) azinphos-methyl levels in house and vehicle dust.
Results:
Data were collected from 95 orchard workers and 94 children. Contrary to expectation, adult farm workers who wore boots or washed hands using hand sanitizer had higher concentrations of DMTP than those who did not. Children who attended daycare had higher DMTP concentrations than children who did not.
Conclusions:
Few workplace or home practices were associated with pesticide exposure levels; workers who used hand sanitizer had higher concentrations of DMTP, as did children who attended daycare.
... Of course, this evidence alone is insufficient to pinpoint the take-home pathway as the primary exposure route since the associations may be explained partially or entirely by exposure to pesticide drift, occupational exposure, or differential dietary and residential use patterns. In addition, 4 out of the 39 articles (10%) reported no evidence to support the take-home pathway [18][19][20][21]. ...
... A total of 25 (64%) studies utilized some type of biomarkers in children to determine exposure via the take-home pathway. There were 19 (49%) studies that investigated pesticide biomarker concentrations in children's urine [9,14,17,18,21,[27][28][29]31,[33][34][35][36][37][38][39][40][41][42]. The remaining six studies investigated pesticide biomarkers in blood or household dust. ...
... A small number of the studies (5,13%) considered the associations between individual behaviors within the home and household dust or urinary pesticide metabolite levels [18,26,[49][50][51][52]. Changing out of work clothes and work shoes inside of the home were the two primary behaviors that were associated with increased presence of dust or urinary pesticide metabolites [49][50][51][52]. ...
Background:
Exposure to pesticides via take-home can be an important pathway for farmworkers' families.
Objective:
The aim of this review was to summarize and analyze the literature published during the last decade of exposure to pesticides via take-home pathway in farmworkers' families.
Methods:
We conducted a systematic review to identify peer-reviewed articles of interest; only articles related to take-home pathway that included some sort of pesticide monitoring were considered for inclusion. Systematic reviews, literature reviews, and meta-analyses were excluded, resulting in a total of 39 articles elected for analysis. The articles were summarized based on the location of the study, population (sample size), pesticide analyzed, and type of sample.
Results:
The majority of the reviewed studies were conducted in the U.S., but there seems to be an increase in literature on pesticide take-home pathway in developing countries. Most of the articles provided evidence that farmworkers' families are exposed to pesticides at higher levels than non-farmworkers' families. The levels may depend on several factors such as seasonality, parental occupation, cohabitation with a farmworker, behavior at work/home, age, and gender. Community-based interventions disrupting the take-home pathway seem to be effective at reducing pesticide exposure.
Discussion/conclusion:
The take-home pathway is an important contributor to overall residential exposures, but other pathways such as pesticide drift, indoor-residential applications, and dietary intake need to be considered. A more comprehensive exposure assessment approach is necessary to better understand exposures to pesticides.
... This 2year educational interven tion about hygiene factors had no impact on house and vehicle dust levels of three organo phosphates studied (phosmet, azinphos methyl, and malathion). Coronado et al. (2012) examined a subset of 95 homes in this population and observed that azinphos methyl levels in house and vehicle dust were unrelated to the number of home hygiene practices undertaken (i.e., shoe removal, work clothing removal, laundering work clothes separately, vacuum and mopping frequency). ...
... Laundering clothes. None of the nine publications reporting the impact of laundry practices observed an association with concentrations of pesticides in residential dust (Coronado et al. 2012;Fenske et al. 2002;Lozier et al. 2012;Lu et al. 2000) or biolog ical samples from women (Acquavella et al. 2004;Alexander et al. 2006Alexander et al. , 2007Semchuk et al. 2003). In CHAMACOS, women who personally laundered agricultural work clothes had 2-42% significantly higher serum levels of DDT and HCH than women who did not, but this association was not significant after adjusting for living in Mexico, where DDT had been widely used (Bradman et al. 2007). ...
... Curwin et al. (2005) and Lozier et al. (2012) found evidence (suggestive and statis tically significant) of elevated levels of pesti cides in rooms where the farmer changed, compared with other rooms in the home. Five publications reported that shoe or clothing removal was unrelated to pesticide concen trations in residential dust (Coronado et al. 2012;Fenske et al. 2002;Golla et al. 2012;Lu et al. 2000) or biomarkers (Bradman et al. 2007). ...
Women living in agricultural areas may experience high pesticide exposures compared to women in urban or suburban areas due to their proximity to farm activities.
Our objective was to review the evidence in the published literature for the contribution of nonoccupational pathways of pesticide exposure in women living in North American agricultural areas.
We evaluated the following nonoccupational exposure pathways: para-occupational (i.e., take-home or bystander exposure), agricultural drift, residential pesticide use, and dietary ingestion. We also evaluated the role of hygiene factors (e.g., house cleaning; shoe removal).
Among 35 publications identified (published 1995-2013), several reported significant or suggestive (p<0.1) associations between para-occupational (n=19) and agricultural drift (n=10) pathways and pesticide dust or biomarker levels, while three observed that residential use was associated with pesticide concentrations in dust. The four studies related to ingestion reported low detection rates of most pesticides in water; additional studies are needed to draw conclusions about this pathway's importance. Hygiene factors were not consistently linked to exposure among the 18 relevant publications identified.
Evidence supported the importance of para-occupational, drift, and residential use pathways. Disentangling exposure pathways was difficult because agricultural populations are concurrently exposed to pesticides via multiple pathways. Most evidence was based on measurements of pesticides in residential dust, which are applicable to any household member and are not specific to women. An improved understanding of nonoccupational pesticide exposure pathways in women living in agricultural areas is critical for studying health effects in women and for designing effective exposure-reduction strategies.
... The liquid may evaporate before it is evenly rubbed all over the hands, therefore compromising the efficacy of the sanitizers [37,39]. Also, the sanitizer may not work well when the hands are grossly dirty or contaminated with harmful chemicals [40]. diarrhoea [35,36]. ...
... The liquid may evaporate before it is evenly rubbed all over the hands, therefore compromising the efficacy of the sanitizers [37,39]. Also, the sanitizer may not work well when the hands are grossly dirty or contaminated with harmful chemicals [40]. Although hand sanitizers may be less effective than soaps in some situations, it is undeniable that they are the preferred form of hand hygiene in healthcare settings. ...
Hand hygiene is of utmost importance as it may be contaminated easily from direct contact with airborne microorganism droplets from coughs and sneezes. Particularly in situations like pandemic outbreak, it is crucial to interrupt the transmission chain of the virus by the practice of proper hand sanitization. It can be achieved with contact isolation and strict infection control tool like maintaining good hand hygiene in hospital settings and in public. The success of the hand sanitization solely depends on the use of effective hand disinfecting agents formulated in various types and forms such as antimicrobial soaps, water-based or alcohol-based hand sanitizer, with the latter being widely used in hospital settings. To date, most of the effective hand sanitizer products are alcohol-based formulations containing 62%–95% of alcohol as it can denature the proteins of microbes and the ability to inactivate viruses. This systematic review correlated with the data available in Pubmed, and it will investigate the range of available hand sanitizers and their effectiveness as well as the formulation aspects, adverse effects, and recommendations to enhance the formulation efficiency and safety. Further, this article highlights the efficacy of alcohol-based hand sanitizer against the coronavirus.
... One major downside of sanitizers is that the liquid can evaporate before wiping evenly on all hands, thereby reducing the effect of disinfectants [48,49]. Moreover, disinfectants are also ineffective when hands are covered by some chemicals or have dirt on them [50]. ...
Background
In the global health emergency caused by COVID-19, multiple experts have mandated the use of hand sanitizers as a safety measure from COVID-19. The sale of hand sanitizers has increased many folds. Therefore, when there is such large use of hand sanitizers, it becomes extremely important to study and understand hand sanitizers in a comprehensive manner.
Main body of the abstract
This article starts with the importance of sanitizers as a defence mechanism that is employed by the hand to fight against the coronavirus. This article provides information about history, types, composition, various dosage forms, and marketed formulations of hand sanitizers. The article sheds a detailed light on industrial production techniques for hand sanitizers and also outlines new innovative techniques that were employed by the industry to mass produce hand sanitizers in the wake of the pandemic. The article further dives into a comparison between hand sanitizers and soaps so as to give pros and cons of the use of soap against the use of hand sanitizers. One of the aims of the article is to study the side effects of sanitizers so as to develop a cautious approach while using hand sanitizers and therefore a comprehensive list of side effects of the use of hand sanitizers is given.
Conclusion
The review article finds that hand sanitizers are extremely efficient in fight the virus but along with it, it brings along arrange of risks which are outlined in the article.
... There is minimal evidence in the existing literature of the effectiveness of home hygiene practices that translate to improved practices and reduce take-home exposure risks. A community-based intervention, the "For Healthy Kids" study in Eastern Washington State, US, found that the recommended practices in the US chemical legislation (e.g., removing work shoes and laundering work clothing separately from household laundry) were not associated with the reduction of urinary dimethylthiophospate concentrations in farmworkers and their children, in addition to azinphosmethyl concentrations in the house dust [59]. This inconclusive evidence supports the recommendation that interventions to prevent and reduce take-home exposure should be targeted at the source of exposure; that is, at worksites where exposure occurs. ...
Para-occupational "take-home" exposure risks among forestry workers and their families in low-and middle-income countries (LMICs) have not been well characterized. This is a concern because research shows an association between chronic low-dose herbicide exposure and adverse health effects. This study explored take-home herbicide residue exposure risks among forestry workers in the Western Cape, South Africa, through the community-based participatory research approach of photovoice. A key finding of the study was the absence of provisions related to take-home exposure in the national legislation and workplace policies, which largely contributed to poor adherence to risk reduction practices at worksites, in addition to workers transporting residues to their homes. This study demonstrated evidence of the key omissions regarding take-home exposure at the policy level (e.g., recommendations for employers to reduce take-home risks among employees, and training of workers and their families on take-home exposure) and take-home herbicide residue exposure among worker's families, including children.
... Based largely on convenience ABHR in gel or foam formulations are typically favored, although liquid ABHRs typically leave less residue and dry more quickly [15]. The efficacy of ABHR is determined by the amount of hand sanitizer dispensed [16,17], the contact time [18,19], whether hands are soiled or contaminated with materials [20], and hand hygiene procedures [1,2]. ABHRs also do not eliminate all types of germs [16,17]. ...
The COVID-19 pandemic led to panic-buying of alcohol-based hand rubs (ABHRs). In response, governmental agencies (e.g., Health Canada) permitted the sale of ABHRs formulated with “technical-grade” ethanol to alleviate the growing demand. Technical-grade ethanol contains elevated concentrations of impurities (e.g., acetaldehyde, etc.), which may exhibit dose-dependent toxicity. In this study, a rapid solvent extraction was employed to analyze gelled ABHRs via gas chromatography with flame ionization detection. In total, 26 liquid and 16 gelled ABHRs were analyzed for nine common impurities to determine compliance with Health Canada interim guidelines. Of 42 samples analyzed, 11 ABHRs appear to be non-compliant with interim Health Canada guidelines. Non-compliant ABHRs exhibited elevated concentrations of acetaldehyde, with a maximal concentration observed of 251 ± 10 µL L−1; 3.3× higher than currently permitted. Nonetheless, frequent testing of ABHRs should be routinely conducted to reduce the risk of consumer exposure to non-compliant ABHRs.
... The short time effectiveness as alcohol-based antiseptics evaporate in 15 s, so the skin can be decontaminated (Bessonneau et al., 2010); 6. It can't reduce the spread of respiratory born virus bacteria in homes (PRLOG, 2010) and cannot remove harmful chemicals, like pesticides and heavy metals, from hands (Coronado et al., 2012); 7. Ingestion of alcohol (ethanol) causes adverse health effects such as liver cirrhosis, fatal alcohol syndrome and cancer (Bessonneau et al., 2010); 8. Expensive and not widely acceptable (Wolfe et al., 2017); and 9. Due to its flammability (Batra and Gupta, 2008;Rocos and Donaldson, 2012), alcohol-based antiseptics should be stored away from high temperatures and flames. WHO recommends not to produce more than 50 l of alcohol-based antiseptics, if sites lack air conditioning and ventilation (WHO, 2018). ...
The use of Alcohol-based antiseptics is efficient and approved, however it has some limitations. This paper examined the possibility of using hypochlorite water as a chlorine-based antiseptic for handwashing in public buildings and healthcare facilities. The electrolysis method was used, which produces Hypochlorous acid (HOCl) from mixing drinking water with small amounts of sodium hydroxide. Hypochlorous acid is usually produced by blood cells to surround pathogens when the skin is cut and exposed to pathogens. The methods used were based on hydrolysing drinking water at a different salt concentration (from 0 up to saline water 0.9% NaCl) under the different power supply. The results showed that 0.005-0.01% hydrochloride water can be a perfect antiseptic that can kill most bacteria and pathogenies within 12 s. In one prototype set up one litter of the prepared solution needed the only 2 g of NaCl, 12 V and 3 amps' power. However, the pH value should be maintained to be around 5-6. The results also showed that the most efficient way was to produce the solution on-site. However, if stored properly it can be used for 7-10 days after production.
... The eating and drinking habits of the respondents show that most of them (61%) eat and drink during spraying with or without washing their hands, and only 29% always wash their hands before eating or drinking anything. Hand washing with hand sanitizer in the field may also reduce health risks (Coronado, 2012). ...
Purpose:
Inappropriate application of pesticides is quite common in the study area, causing health issues and in some cases fatalities. The intent of the current study is to gauge the farmers' level of knowledge on the safe usage of pesticides and biosafety to keep the famers healthy through the focused extension programs.
Methodology:
The study is carried out in 41 union councils of Tehsil Sahiwal, District Sahiwal, Punjab, Pakistan. Data are collected through a cluster sampling technique by conducting face-to-face interviews. Statistical analysis is used to determine relationships and interpret them.
Results:
The findings show that the majority of farmers (87.2%) earn their livelihoods from farming and 2.1% are traders. More than half of the respondents (51.8%) own small land-holdings with an area of 4-8 ha, with only 16.4% having a land area of more than 12 ha. The results also reveal that the majority of respondents obtain information from private agents and only about one third (34.4%) respondents get information on the safe usage of pesticides from the Department of Agriculture (Extension). The internet has emerged as a fast and reliable source of information in the new paradigm; however, only 14.4% of the respondents take advantage of this economical and fast information tool/medium. The findings also reveal that the farmers employ unhealthy and poor practices by not following the recommendations regarding the safe usage of pesticides. The study also reveals that more than half of the farmers (54.4%) use unsafe storage practices on their farms, and about 48.2% do not follow the instructions.
Conclusions:
Inappropriate application of pesticides can have negative effects on human health and the adoption safety measures are necessary to avoid the harmful effects of pesticides. Due to high illiteracy in the area, farmers mainly seek advice of neighboring farmers, having ignorance on the biosafety issues. Variables like education level, land ownership, total land size and the trainings on safe pesticide usage significantly influence the knowledge level of farmers on the safe usage of pesticides.
Recommendations:
Farmers do not follow the recommendations of the extension department or the instructions printed on pesticide bottles/containers, therefore educational (formal and informal) and training programs are necessary on the safe pesticide usage to upgrade their skills and expertise on safe usage of pesticides and the importance of biosafety.
... Some studies have reported that agricultural workers received some training about handling pesticides and this has in turn improved their general practices and precautions. These studies have also found that even when agricultural workers possess the appropriate knowledge regarding how to handle pesticides, their families often keep engaging in dangerous and unhealthy practices around them (Coronado et al. 2012, Orozco et al. 2015. In this study, 68 % of women had a husband working with pesticides, and 62 % of them came from a family of agricultural workers and lived with them in the same house. ...
The adverse effects of pesticides on public health have been well documented in different populations across the world. Families of agricultural workers, particularly their wives, face pesticide exposures through a number of complex patterns even when they do not directly engage in agricultural work. Nonetheless, these patterns of exposure among women in agricultural communities remain understudied. Unfortunately, in Mexico there are no studies examining these patterns yet. In consequence, the main goals of this study were to: 1) evaluate pesticide exposure in a rural community of Southeast Mexico, 2) examine the patterns of environmental and para-occupational pesticide exposure, and 3) document the para-occupational and environmental pesticide exposure among women who are not agricultural workers but have an agricultural family or are wives of agricultural workers. We conducted a cross-sectional study of 78 women who did not themselves participate in any agricultural activity, but lived in an agricultural community. Questionnaires and interviews were used to construct a Pesticide Exposure Index (PEI) estimating the degree of pesticide exposure among women from agricultural families and wives of agricultural workers. Through the PEI we showed that women living in agricultural communities using pesticides are inherently exposed to a certain level of pesticides. With the PEI we showed that women from agricultural families, especially wives of agricultural workers, have a long-term para-occupational pesticide exposure that should not be underestimated because they are not agricultural workers. © 2018, Centro de Ciencias de la Atmosfera, UNAM. All rights reserved.
... In the developing countries, exposure to pesticides is considered as a major occupational risk among farmers. [12][13][14] The exposure to pesticides may occur due to spillage, improper usage, or non-caring attitude of pesticide handlers. Miss handling of pesticides while transfers may also cause human exposure to pesticides. ...
p align="justify"> Abstract
Background:   In recent decades, use of pesticides in agricultural practices has posed threat to human popu-lation.
Objectives:  Present research was designed to explore the adverse effects of insecticides on 339 individuals (study group farmers n = 256 and control n = 83) selected from 62 different sites of central Punjab. The sample was matched on socio-economic status and age.
Methodology:   A structured questionnaire was used to obtain the demographics and pesticide related details. For biochemical analysis blood samples were collected from both groups.
Results: Biochemical analysis shows that, farmers exposed with pesticidehave significant elevated levels of Urea ( p = 0.05) and alanine transaminase (ALT) ( p = 0.01) as compared with control. On contrary, low levels of BChE, albumin and total protein (TP) levels ( p = 0.001; p = 0.05 and p = 0.001 respectively) were found in pesticide exposed subjects than controls. Also, significant increase in serum creatinine ( p = 0.01), aspartate transaminase (AST) ( p = 0.01) and notable decrease in the albumin, TP and BChE ( p = 0.001) were evident in farmers with poor protective measures. However the statistical difference is not correlated with clinical difference.
Conclusions:   Several biomarkers have shown the possible hazards of pesticides to farmer’s health than controls. It was further explored that health indicators also associated with other factors like duration of ex-posure to pesticides, tobacco smoking and poor hand-ling practices amongst the studied population.
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... According to the EPA, these behaviors include washing hands before eating, smoking, or using the restroom; wearing protective clothing to minimize skin contact with residue at work (such as long-sleeved shirts, long pants, and work boots); showering and changing clothes immediately after work; and washing work clothes separately from other laundry and per the WPS, these behaviors are required to be taught to farmworkers as part of the informational component of the WPS. While not required to be taught, gloves have been reported to be efficacious in minimizing pesticide exposures (California Poison Control System, 2013;Furlong et al., 2015;Hernandez-Valero et al., 2001;Quandt et al., 2006;Salvatore et al., 2008);substituting hand sanitizer for handwashing in the field may exacerbate insecticide exposure risk (Coronado, 2012). ...
Agricultural pesticide exposure has potential adverse health effects for farmworkers that may be reduced by pesticide protective behaviors (PPBs). The Environmental Protection Agency's (EPA) Worker Protection Standard (WPS) requires PPBs be taught to farmworkers prior to field work. Studies to date have not utilized observational methods to evaluate the degree to which PPBs are practiced by Latino migrant and seasonal farmworkers in the United States. The purpose of this study was to describe, compare, and contrast observed and self-reported PPBs used by Latino farmworkers; both PPBs that the WPS requires be taught and other PPBs were included. Observed and self-reported data were collected from 71 Latino farmworkers during the 2014 tobacco growing season in North Carolina. Participants were consistent in reporting and using long pants and closed shoes in the field most of the time. In addition, gloves, hats/bandanas, and water-resistant outerwear were frequently observed, although they are not required to be taught by the WPS. Farmworkers reported more long-sleeve (p=.028) and glove use (p=.000) than what was observed. It was uncommon to observe washing behavior before eating or drinking, even when washing supplies were available. Washing behaviors were significantly overreported for hand (p=.000; p=.000) and face (p=.000; p=.058) washing before eating and drinking in the field. This study documents that protective clothing behaviors that the WPS requires be taught, plus a few others are commonly practiced by Latino migrant and seasonal farmworkers, but washing behaviors in the field are not. Targeted strategies to improve washing behaviors in the field are needed.
... Despite this, participants continued to conflate biospecimen research participation with clinical service, a phenomenon not uncommon among research participants of all ethnicities. 29,46,47 In addition to a Town Hall forum with CAB and community members to discuss study results, promotores returned to participant homes to deliver and answer questions about individualized information. This exchange benefited participants, the community, and the prospect for future research with minorities, who have been shown to be less likely to participate in research. ...
Objectives:
We elicited perspectives of rural Latino farmworkers and non-farmworkers about their participation in a community-based participatory pesticides exposure study in which they provided multiple biospecimens.
Methods:
Between March and April 2012, we conducted semistructured, one-on-one interviews with 39 rural Latino farmworkers and non-farmworkers in Washington State (n = 39). Nineteen open-ended interview questions aimed to elicit participants' attitudes toward, expectations and experiences of biospecimen collection for research, and willingness to participate in future biomedical research studies. We reviewed and coded transcriptions using qualitative principles of grounded theory in which concepts were identified and themes derived from interview data.
Results:
We grouped themes into 3 major categories: (1) motivation to participate, (2) challenges of participation, and (3) perceived rewards of participation. Many participants were motivated by the perceived importance of the study topic and a desire to acquire and contribute to new knowledge. Respondents said that the benefits of participation outweighed the challenges, and many expressed satisfaction to be able to contribute to research that would benefit future generations.
Conclusions:
Our findings supported the use of community-based participatory research to engage minorities as participants and invested parties in such studies.
Coronaviruses are a diverse family of viruses, and new strains can emerge. While the majority of coronavirus strains cause mild respiratory illnesses, a few are responsible for severe diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). SARS-CoV-2, the virus responsible for COVID-19, is an example of a coronavirus that has led to a pandemic. Coronaviruses can mutate over time, potentially leading to the emergence of new variants. Some of these variants may have increased transmissibility or resistance to existing vaccines and treatments. The emergence of the COVID-19 pandemic in the recent past has sparked innovation in curbing virus spread, with sanitizers and disinfectants taking center stage. These essential tools hinder pathogen dissemination, especially for unvaccinated or rapidly mutating viruses. The World Health Organization supports the use of alcohol-based sanitizers and disinfectants globally against pandemics. However, there are ongoing concerns about their widespread usage and their potential impact on human health, animal well-being, and ecological equilibrium. In this ever-changing scenario, metal nanoparticles hold promise in combating a range of pathogens, including SARS-CoV-2, as well as other viruses such as norovirus, influenza, and HIV-1. This review explores their potential as non-alcoholic champions against SARS-CoV-2 and other pandemics of tomorrow. This extends beyond metal nanoparticles and advocates a balanced examination of pandemic control tools, exploring their strengths and weaknesses. The manuscript thus involves the evaluation of metal nanoparticle-based alternative approaches as hand sanitizers and disinfectants, providing a comprehensive perspective on this critical issue.
Our prior work shows that azinphos-methyl pesticide exposure is associated with altered oral microbiomes in exposed farmworkers. Here we extend this analysis to show the same association pattern is also evident in their children. Oral buccal swab samples were analyzed at two time points, the apple thinning season in spring-summer 2005 for 78 children and 101 adults and the non-spray season in winter 2006 for 62 children and 82 adults. The pesticide exposure for the children were defined by the farmworker occupation of the cohabitating household adult and the blood azinphos-methyl detection of the cohabitating adult. Oral buccal swab 16S rRNA sequencing determined taxonomic microbiota proportional composition from concurrent samples from both adults and children. Analysis of the identified bacteria showed significant proportional changes for 12 of 23 common oral microbiome genera in association with azinphos-methyl detection and farmworker occupation. The most common significantly altered genera had reductions in the abundance of Streptococcus, suggesting an anti-microbial effect of the pesticide. Principal component analysis of the microbiome identified two primary clusters, with association of principal component 1 to azinphos-methyl blood detection and farmworker occupational status of the household. The children's buccal microbiota composition clustered with their household adult in ∼95% of the households. Household adult farmworker occupation and household pesticide exposure is associated with significant alterations in their children's oral microbiome composition. This suggests that parental occupational exposure and pesticide take-home exposure pathways elicit alteration of their children's microbiomes.
Pesticide exposures represent inequities among a vulnerable population of migrant and seasonal farmworkers. A social justice theory synthesized from an environmental health research framework, a middle range theory of critical caring, and literature on pesticide exposure is presented as a situation-specific public health practice theory. Concepts from the physiological, epistemological, vulnerability, and health protection domains are related to concepts of critical caring revealing protective strategies for vulnerable populations exposed to pesticides. The key concepts are risk exposure, community assessment, transpersonal health promotion, community competence, and controllability. Protection from exposure involves raising awareness, critically assessing communities, educating for empowerment, building capacity, and advocating to ensure social justice. Critical caring protection is provided in a mutually respectful relationship that promotes responsibility at the individual and population levels.
Since 1998, the University of Washington’s Center for Child Environmental Health Risks Research has followed a community-based participatory research strategy in the Lower Yakima Valley of Washington State to assess pesticide exposure among families of Hispanic farmworkers. As a part of this longitudinal study, house dust samples were collected from both farmworker and non-farmworker households, across three agricultural seasons (thinning, harvest and non-spray). The household dust samples were analyzed for five organophosphate pesticides: azinphos-methyl, phosmet, malathion, diazinon, and chlorpyrifos. Organophosphate pesticide levels in house dust were generally reflective of annual use rates and varied by occupational status and agricultural season. Overall, organophosphate pesticide concentrations were higher in the thinning and harvest seasons than in the non-spray season. Azinphos-methyl was found in the highest concentrations across all seasons and occupations. Farmworker house dust had between 5- and 9-fold higher concentrations of azinphos-methyl than non-farmworker house dust. Phosmet was found in 5–7-fold higher concentrations in farmworker house dust relative to non-farmworker house dust. Malathion and chlorpyriphos concentrations in farmworker house dust ranged between 1.8- and 9.8-fold higher than non-farmworker house dust. Diazinon showed a defined seasonal pattern that peaked in the harvest season and did not significantly differ between farmworker and non-farmworker house dust. The observed occupational differences in four out of five of the pesticide residues measured provides evidence supporting an occupational take home pathway, in which workers may bring pesticides home on their skin or clothing. Further, these results demonstrate the ability of dust samples to inform the episodic nature of organophosphate pesticide exposures and the need to collect multiple samples for complete characterization of exposure potential.
Organophosphate pesticides are commonly used in the United States, and farmworkers are at risk for chronic exposure. Using data from a community randomized trial to interrupt the take-home pathway of pesticide exposure, we examined the association between floor surface type (smooth floor, thin carpet, and thick carpet) and rooms in which dust samples were collected (living room vs. non-living room) and concentrations of azinphos-methyl residues in home environments. We also examined the association between vehicle type (truck, auto, or other) and footwell floor surfaces (carpeted, smooth surface, or no mat) and concentrations of azinphos-methyl in vehicle dust samples. Dust samples were collected from 203 and 179 households and vehicles, respectively. All households had at least one child aged 2-6. Vehicle dust samples were collected from footwells of the vehicle used for commuting to and from work. A total of 183 samples were collected from living rooms, and 20 were collected from other rooms in the home. Forty-two samples were collected from thick carpets, 130 from thin carpets, and 27 from smooth floor surfaces. Thick and thin carpets had a significantly greater dust mass than smooth floor surfaces (6.0 g/m(2) for thick carpets, 7.8 g/m(2) for thin carpets, and 1.5 g/m(2) for smooth surfaces). Of the 179 vehicle samples, 113 were from cars, 34 from trucks, and 32 from other vehicles. Vehicles with no mats had a significantly higher mass of dust (21.3 g) than those with hard mats (9.3 g) but did not differ from vehicles with plush mats (12.0 g). Further research is needed to characterize the environment in which children may be exposed to pesticides.
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.
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.
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.
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.
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.
Exposure to neurotoxic chemicals is of particular concern when it occurs during early development. The immature brain is highly vulnerable prenatally and is therefore at risk due to occupational exposures incurred by pregnant women. A systematic search of the literature has been performed with emphasis on epidemiological studies on female workers and the neurodevelopment of their children. The majority of recent occupational studies focused on organic solvents and pesticides, which were associated with neurobehavioral impairments in the progeny. Additional evidence on environmental exposures demonstrates the vulnerability of the developing brain to substances like lead and methylmercury. Despite the evident hazards involved, the number of occupational cohort studies carried out in this field is very low. However, the lack of evidence for assumed neurotoxicants should not divert the attention by occupational health researchers and practitioners from the need to protect pregnant workers. Due to the vulnerability of the brain during early development, a precautionary approach to neurodevelopmental toxicity needs to be applied in occupational health.
The etiology of childhood brain cancer remains largely unknown. However, previous studies have yielded suggestive associations with parental pesticide use.
We aimed to evaluate parental exposure to pesticides at home and on the job in relation to the occurrence of brain cancer in children.
We included 526 one-to-one-matched case-control pairs. Brain cancer cases were diagnosed at < 10 years of age, and were identified from statewide cancer registries of four U.S. Atlantic Coast states. We selected controls by random digit dialing. We conducted computer-assisted telephone interviews with mothers. Using information on residential pesticide use and jobs held by fathers during the 2-year period before the child's birth, we assessed potential exposure to insecticides, herbicides, and fungicides. For each job, two raters independently classified the probability and intensity of exposure; 421 pairs were available for final analysis. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression, after adjustment for maternal education.
A significant risk of astrocytoma was associated with exposures to herbicides from residential use (OR = 1.9; 95% CI, 1.2-3.0). Combining parental exposures to herbicides from both residential and occupational sources, the elevated risk remained significant (OR = 1.8; 95% CI, 1.1-3.1). We observed little association with primitive neuroectodermal tumors (PNET) for any of the pesticide classes or exposure sources considered.
Our observation is consistent with a previous literature reporting suggestive associations between parental exposure to pesticides and risk of astrocytoma in offspring but not PNET. However, these findings should be viewed in light of limitations in exposure assessment and effective sample size.
Rhinitis is common, but the risk factors are not well described. To investigate the association between current rhinitis and pesticide use, we used data from 2245 Iowa commercial pesticide applicators in the Agricultural Health Study.
Using logistic regression models adjusted for age, education and growing up on a farm, we evaluated the association between current rhinitis and 34 pesticides used in the past year.
74% of commercial pesticide applicators reported at least one episode of rhinitis in the past year (current rhinitis). Five pesticides used in the past year were significantly positively associated with current rhinitis: the herbicides 2,4-D, glyphosate and petroleum oil, the insecticide diazinon and the fungicide benomyl. The association for 2,4-D and glyphosate was limited to individuals who used both in the past year (OR 1.42, 95% CI 1.14 to 1.77). Both petroleum oil and diazinon showed consistent evidence of an association with rhinitis, based on both current use and exposure-response models. We saw no evidence of confounding by common agricultural rhinitis triggers such as handling grain or hay.
Exposure to pesticides may increase the risk of rhinitis.
To investigate the effect of prenatal exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyl-dichloroethylene (DDE) on weight, height and body mass index (BMI) in adult female offspring of the Michigan fisheater cohort examined between 1973 and 1991.
259 mothers from the Michigan fisheater cohort were studied. Prenatal exposure to PCBs and DDE was estimated by extrapolating maternal measurements to the time that the women gave birth. 213 daughters aged 20-50 years in 2000 were identified and 83% of them participated in at least one of two repeated investigations in 2001/02 (n = 151) and 2006/07 (n = 129). To assess the effect of prenatal PCB and DDE exposure on anthropometric measurements, generalised estimating equations nested for repeated measurements (2001/02 and 2006/07) and for sharing the same mother were used. We controlled for maternal height and BMI and for daughters' age, birth weight, having been breastfed and number of pregnancies.
Maternal height and BMI were significant predictors of the daughters' height, weight and BMI. Low birth weight (<2500 g) was significantly associated with reduced adult offspring weight and BMI. The weight and BMI of adult offspring were statistically significantly associated with the extrapolated prenatal DDE levels of their mothers. Controlling for confounders and compared to maternal DDE levels of <1.503 microg/l, offspring BMI was increased by 1.65 when prenatal DDE levels were 1.503-2.9 microg/l and by 2.88 if levels were >2.9 microg/l. Prenatal PCB levels showed no effect.
Prenatal exposure to the oestrogenic endocrine-disrupting chemical DDE may contribute to the obesity epidemic in women.
Size exclusion chromatography (SEC) was used as a cleanup method for the analysis of organophosphorus pesticides in household and vehicle dusts. The pesticides investigated were diazinon, methyl parathion, chlorpyrifos, malathion, phosmet, and azinphosmethyl. These compounds are of interest due to their use in agricultural tree fruit production and/or urban pest control. Pesticides were determined via gas chromatography/mass spectrometry with selected-ion monitoring and cool on-column injection. The lower limit of method validation was 0.20 microg/g. Method limits of detection in dust ranged from 0.012-0.055 microg/g. Dust samples were collected with vacuums from the homes and vehicles of people living and working in a rural agricultural region in the central part of Washington State. The analytes were extracted from the dust by sonication in acetone. The extracts were solvent-exchanged to cyclohexane, frozen, thawed, and centrifuged prior to SEC injection. Following SEC, the eluent was split into 2 fractions, concentrated, and injected on-column into the gas chromatograph. This method represents the first complete publication describing the SEC cleanup of organophosphorus pesticides in dusts. Recoveries of pesticides in dusts ranged from 63.5-110.8 +/- 4.9-19.6% over a fortification range of 0.20-10.00 microg/g. This optimized, automated, and reproducible SEC method does not require further treatment or cleanup for trace determination of these organophosphorus pesticides.
Developing internally valid, and perhaps generalizable, farmworker exposure studies is a complex process that involves many statistical and laboratory considerations. Statistics are an integral component of each study beginning with the design stage and continuing to the final data analysis and interpretation. Similarly, data quality plays a significant role in the overall value of the study. Data quality can be derived from several experimental parameters including statistical design of the study and quality of environmental and biological analytical measurements. We discuss statistical and analytic issues that should be addressed in every farmworker study. These issues include study design and sample size determination, analytical methods and quality control and assurance, treatment of missing data or data below the method's limits of detection, and post-hoc analyses of data from multiple studies. Key words: analytical methodology, biomarkers, laboratory, limit of detection, omics, quality control, sample size, statistics.
Although biomonitoring has been used in many occupational and environmental health and exposure studies, we are only beginning to understand the complexities and uncertainties involved with the biomonitoring process--from study design, to sample collection, to chemical analysis--and with interpreting the resulting data. We present an overview of concepts that should be considered when using biomonitoring or biomonitoring data, assess the current status of biomonitoring, and detail potential advancements in the field that may improve our ability to both collect and interpret biomonitoring data. We discuss issues such as the appropriateness of biomonitoring for a given study, the sampling time frame, temporal variability in biological measurements to nonpersistent chemicals, and the complex issues surrounding data interpretation. In addition, we provide recommendations to improve the utility of biomonitoring in farmworker studies.
Organophosphate (OP) pesticides are commonly used in the United States, and farmworkers are at risk for chronic exposure. Using a sample of 218 farmworkers in 24 communities and labor camps in eastern Washington State, we examined the association between agricultural crop and OP pesticide metabolite concentrations in urine samples of adult farmworkers and their children and OP pesticide residues in house and vehicle dust samples. Commonly reported crops were apples (71.6%), cherries (59.6%), pears (37.2%), grapes (27.1%), hops (22.9%), and peaches (12.4%). Crops were grouped into two main categories: pome fruits (apples and pears) and non-pome fruits. Farmworkers who worked in the pome fruits had significantly higher concentrations of dimethyl pesticide metabolites in their urine and elevated azinphos-methyl concentrations in their homes and vehicles than workers who did not work in these crops. Among pome-fruit workers, those who worked in both apples and pears had higher urinary metabolites concentrations and pesticide residue concentrations in dust than did those who worked in a single pome fruit. Children living in households with pome-fruit workers were found to have higher concentrations of urinary dimethyl metabolites than did children of non-pome-fruit workers. Adult urinary concentrations showed significant correlations with both the vehicle and house-dust azinphos-methyl concentrations, and child urinary concentrations were correlated significantly with adult urinary concentrations and with the house-dust azinphos-methyl concentration. The results provide support for the take-home pathway of pesticide exposure and show an association between measures of pesticide exposure and the number of pome-fruit crops worked by farmworkers.
Farmworkers and their family members are exposed to pesticides in their homes as well as at work. Using a sample of nine farmworker household in western North Carolina and Virginia, this analysis describes the organophosphate (OP) pesticide urinary metabolite levels of adults and children in these households, and compares these farmworker household OP metabolite levels to the national reference data. Data from survey and in-depth interviews are analyzed to find dwelling, household, and work characteristics related to OP metabolite levels. All participants had measurable OP metabolites. Every household had a high level of OP metabolites when compared to national reference data. There were common factors among the households that could cause the high household OP exposure, including farm employment and living adjacent to agricultural fields. Factors associated with household variability in OP exposure included having a non-nuclear family structure, and, therefore, having more adult males who were employed doing farm work, living in rental housing, not owning a vacuum cleaner, residing in a dwelling that is difficult to clean, and the season (spring versus summer) in which urine samples were collected. These results indicate that regulatory changes that improve low income housing, improve industrial hygiene standards, and provide farmwokers informations about their pesticides exposure are needed to protect farmworkers and their families.
Background
Farmworkers and their families are exposed to pesticides through multiple pathways. Few studies have examined the frequency with which farmworkers engage in pesticide safety practices and the factors associated with their adoption.Methods
Using a large sample of farmworkers (n = 554), we evaluated relationships between pesticide safety behaviors and farmworkers' beliefs, training history, handling of pesticides at work, perceived occupational exposure, and employers' provision of personal protective equipment.ResultsPerforming behaviors at work was determined largely by whether personal protective equipment was provided. For home behaviors, female gender, living in a labor camp, being trained in the last 5 years, handling pesticides directly, and not perceiving organizational barriers to protecting oneself were associated with taking more precautions.Conclusions
These findings call for interventions that involve and engage multiple stakeholders to increase adoption of pesticide safety behaviors and reduce pesticide exposure in farmworkers. Am. J. Ind. Med. 51:69–81, 2008. © 2007 Wiley-Liss, Inc.
Studies of cancer among farm workers are difficult to conduct and interpret given the unique nature of this occupational group. The transitory nature of the work, high levels of poverty, and lack of legal documentation make epidemiologic studies difficult to accomplish. Nevertheless, this workforce in the United States, which numbers as much as 3 million persons, is a high risk population due to exposures to numerous toxic substances, including excessive sunlight, heat, dangerous machinery, fumes, fertilizers, dust, and pesticides. We summarize characteristics of farm workers (i.e., demographics, health care) from the National Agricultural Workers Survey (NAWS) and the California Agricultural Workers Survey (CAWS) and present findings from a series of studies conducted among farm workers in California. The epidemiology literature was reviewed and methods for a unique farm worker union-based epidemiologic study are presented. Farm workers in California and the rest of the United States, many of whom are seasonal and migrant workers are at elevated risk for numerous forms of cancer compared to the general population and specific pesticides may be associated with this altered risk. Elevated risks have been found for lymphomas and prostate, brain, leukemia, cervix, and stomach cancers.
Seasonal variation in fruit and vegetable consumption has been documented in a limited number of previous investigations and is important for the design of epidemiologic investigations and in the evaluation of intervention programs.
This study investigates fruit and vegetable consumption behaviors among Hispanic farmworkers and non-farmworkers in a rural agricultural community.
A larger study recruited 101 farmworker families and 100 non-farmworker families from the Yakima Valley in Washington State between December 2004 and October 2005. All families were Hispanic. An in-person administered questionnaire collected information on consumption of locally grown fruits and vegetables and sources of obtaining fruits and vegetables. Data on dietary intake asked whether or not the respondent had consumed a given fruit or vegetable in the past month. Data were collected longitudinally, coinciding with three agricultural seasons: thinning (summer), harvest (fall), and nonspray (winter).
Generalized estimating equations were used to test for statistical significance between proportions of the population who consumed a given fruit or vegetable across agricultural seasons. Multivariable logistic regression was performed and corresponding odds ratios and 95% confidence intervals are reported.
The proportion of respondents who ate apples, pears, plums, peaches, apricots, peppers, corn, and cucumbers was highest in the fall harvest season, whereas the proportions of those who ate cherries and asparagus were highest in the summer thinning season. Compared to non-farmworkers, a higher proportion of farmworkers reported having eaten peaches, apricots, cherries, green beans, carrots, peppers, corn, pumpkin, squash, and onions, in the past month.
Epidemiologic investigations and public health interventions that examine the consumption of fruits and vegetables should consider seasonal variation in consumption patterns, especially in agricultural communities.
We studied the relationship between behaviors promoted through the US Environmental Protection Agency Worker Protection Standard (WPS) and other programs and agricultural pesticide exposures in 73 strawberry fieldworkers employed in Monterey County, California.
Farmworkers' behaviors were assessed via self-report and organophosphorus (OP) pesticide exposure was measured using dimethyl alkylphosphate (DMAP) and malathion dicarboxylic acid (MDA) urinary metabolite levels.
Wearing WPS-recommended clothing, wearing clean work clothes, and the combination of handwashing with soap and wearing gloves were associated with decreases in DMAP and MDA metabolite levels. Despite these protective behaviors, however, participants had significantly higher levels of exposure as compared with a national reference sample.
Interventions that facilitate compliance with these behaviors may be effective in decreasing fieldworkers' pesticide exposures. However, further efforts are needed to reduce the exposure disparities experienced by farmworkers and decrease the potential for "take home" exposures to farmworkers' families.
The relationship between plasma-cholinesterase (ChE) measures and the uptake of anti-cholinesterase agents among 125 greenhouse sprayers in connection with normal working conditions were studied. An in-season ChE depression was observed indicating absorption of organophosphate (OP) or carbamate insecticides (p = 0.0001). The in-season enzyme depression among sprayers, exclusively exposed to carbamates (p = 0.06), probably reflects chronic percutaneous or oral uptake in the intervals between spraying by cultivating pretreated flowers. The frequency of applications (p = 0.03) and the wearing of protective clothings (p = 0.02) seems to be working habits, which significantly influenced the ChE activities, whereas gloves or face mask did not (p greater than 0.05). Especially, the wearing of whole-body protective clothing (p = 0.008) are of particular value in preventing percutaneous absorption.
Twelve workers were monitored for exposure to 18.75% lindane dust formulation during manual wheat seed treatment. The mean total actual exposure rate was 32.89 mg/hr. Potential respiratory exposure averaged 0.0057 mg/hr (less than 1% of the total), with seven workers receiving no measurable respiratory exposures. Mean hand exposure was 1.84 mg/hr (5.6%). Dermal exposure to the head and neck averaged 4.28 mg/hr (13%). Exposure measured beneath the workshirt and workpants averaged 26.8 mg/hr (81.4%). The workshirt and workpants provided 3.4-fold and 11.5-fold protection factors, respectively. Forearm exposure measured beneath the workshirt represented more than 40% of total actual exposure. The small contribution of hand exposure to total dermal exposure was consistent with the use of chemical-resistant gloves by all workers. Total dermal exposure could be reduced substantially by wearing coveralls over regular work clothing, and by the use of guantlet-type gloves. It is recommended that worker education concerning personal hygiene and the appropriate use of protection clothing be made essential components of exposure reduction programs.
Mixer-loaders and applicators of the pesticide dicofol in Florida citrus groves were monitored for exposure. Alpha-cellulose pads were placed inside and outside regular work clothing. When protective suits were in use, pads were also placed outside the suit. Dicofol accumulation rates were measured when gloves and/or facemasks were worn. Hand rinses were collected. Results showed that an ungloved, normally attired applicator reduced his total dermal exposure 38% by wearing a disposable Tyvek® protective suit, 27% by wearing gloves, and 65% by wearing both. Suits reduced total dermal exposure by 40% for mixer-loaders, but the use of gloves led to an exposure increase, probably because the inside of the gloves became contaminated.
Chemical protective clothing (CPC) is often recommended as a method of exposure mitigation among pesticide applicators. This study evaluated four CPC regimens (cotton work shirts and work pants, cotton/polyester coveralls, and two non-woven garments) during 33 airblast applications of the organophosphorus insecticide ethion in central Florida citrus groves. CPC performance was determined by measurement of fluorescent tracer deposition on skin surfaces beneath garments with a video imaging analysis instrument (VITAE system), and by alpha-cellulose patches placed outside and beneath the garments. Non-woven coveralls allowed significantly greater exposure than did traditional woven garments, primarily because of design factors (e.g., large sleeve and neck openings). The greatest exposure occurred on the forearms beneath the non-woven garments. Fabric penetration was detected for all test garments; 5% to 7% of the ethion measured outside the garments was found beneath the garments. The clothing materials tested were not chemically resistant under these field conditions. Exposurepathways that would probably be undetected by the patch technique were characterized effectively with fluorescent tracers and video imaging analysis. However, the patch technique was more sensitive in detecting fabric penetration. CPC garments have been improved since this study was conducted, but performance testing under field conditions is not widespread. Workers conducting airblast applications would be better protected by closed cab systems or any technology that places an effective barrier between the worker and the pesticide spray.
Little is known about environmental exposure to pesticides and the extent to which exposure is affected by drift from agricultural applications and take home exposure from agricultural workers. The study focused on 24 agricultural families in the northwestern United States and measured levels of organophosphate pesticides (OP) in house dust. Pesticide residues were significantly associated with the number of individuals in the home whose work included high exposure pesticide activities. Mean levels of pesticides were higher in the homes of workers who reported waiting more than 2 hours before changing out of their work clothes compared with homes where workers change within 2 hours after returning from work (p < .01). The results of this study provide evidence that workers can inadvertently carry agricultural chemicals from their work into their homes, thereby increasing the risk of pesticide exposure to other family members inside the home.
We have developed a method to measure 12 urinary phenolic metabolites of pesticides or related chemicals. The target chemicals for our method are 2-isopropoxyphenol; 2,4-dichlorophenol; 2,5-dichlorophenol; carbofuranphenol; 2,4,5-trichlorophenol; 2,4,6-trichlorophenol; 3,5,6-trichloro-2-pyridinol; para-nitrophenol, ortho-phenylphenol, pentachlorophenol, 1-naphthol and 2-naphthol. The sample preparation involves enzyme hydrolysis, isolation of the target chemicals using solid phase extraction cartridges, a phase-transfer catalyzed derivatization, cleanup using sorbent-immobilized liquid/liquid extraction cartridges, and concentration of the sample. Derivatized samples are analyzed by capillary gas chromatography-tandem mass spectroscopy using isotope dilution calibration for quantification. The limits of detection are in the mid ng/L range and the average coefficient of variation was below 15% for most of the analytes. Using our method, we measured concentrations of the target chemicals in urine samples from the general population.
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