| 1. |
- Torres, Cecilia, et al.
(författare)
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Decreased Kidney Function of Unknown Cause in Nicaragua : A Community-Based Survey
- 2010
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Ingår i: American Journal of Kidney Diseases. - : Elsevier BV. - 0272-6386 .- 1523-6838. ; 55:3, s. 485-496
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Tidskriftsartikel (refereegranskat)abstract
- Background: End-stage kidney disease overwhelms health services in Central America. We determined prevalences of decreased kidney function in distinct populations in the most affected region of Nicaragua. Study Design: Cross-sectional survey. Setting & Participants: Total populations aged 20-60 years of 5 villages in Northwest Nicaragua: mining/subsistence farming (elevation, 100-300 m above sea level), banana/sugarcane (100-300 m), fishing (0-100 m), services (0-100 m), and coffee (200-675 m); 479 men and 617 women (83% response). Predictor or Factor: Village; participant sex, age, and occupation; conventional chronic kidney disease risk factors. Outcomes: Serum creatinine (SCr) values greater than laboratory reference range for sex, estimated glomerular filtration rate <60 mL/min/1.73 m(2), proteinuria stratified in the low (dipstick protein excretion, 30-300 mg/dL) and high (>300 mg/dL) range. Results: Prevalences of abnormal SCr levels: 18% (of all men) and 5% (of all women); in the mining/subsistence farming village, 26% and 7%; banana/sugarcane, 22% and 6%; fishing, 13% and 4%; services, 0% and 1%; and coffee, 7% and 0%. Prevalences of estimated glomerular filtration rate <60 mL/min/1.73 m2: 14% (of all men) and 3% (of all women); in the listed villages, 19% and 5%, 17% and 4%, 10% and 2%, 0% and 0%, and 7% and 0%, respectively. Proteinuria, predominantly in the low range, affected 14% and 11% of all men and women without marked differences between villages. By occupation, abnormal SCr levels occurred in 31% and 24% of male and female agricultural workers at 100-300 m above sea level, but not at higher altitudes, and also was high in male artisans (43%), construction workers (15%), and miners (14%). In logistic regression models, for the banana/sugarcane and mining/subsistence farming villages, high blood pressure and age were significant predictors of abnormal SCr levels in men, and for mining/subsistence farming, age in women. Limitations: Causality is not addressed. Conclusions: In some Nicaraguan villages and population segments, men in particular show a high prevalence of decreased kidney function of unknown origin, possibly environmental or occupational.
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| 2. |
- Smpokou, Evangelia Theano, et al.
(författare)
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Environmental exposures in young adults with declining kidney function in a population at risk of Mesoamerican nephropathy
- 2019
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Ingår i: Occupational and environmental medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 76:12, s. 920-926
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Tidskriftsartikel (refereegranskat)abstract
- Objectives There is an epidemic of Mesoamerican nephropathy (MeN) in Central America, where sugarcane production is prominent. Numerous causes are proposed, but to date limited evidence supports any one hypothesis. A nested case-control study using biosamples from a rural, community-based follow-up study of 350 young adults from Northwest Nicaragua at risk of MeN was conducted with the aim of characterising the associations between urinary concentrations of metals, pesticides and mycotoxins from samples collected in the first 6 months and decline in kidney function over 2 years. Methods Urine samples collected at baseline (pre-sugarcane harvest) and the first 6 month follow-up (post-sugarcane harvest) visit were tested. Twelve metals and metalloids (aluminium, total arsenic, cadmium, chromium, cobalt, copper, lead, manganese, mercury, selenium, silicon and strontium) were analysed by inductively coupled plasma-mass spectrometry. Twelve pesticides or their metabolites (2,4-dichlorophenoxyacetic acid, 3-phenoxybenzoic acid, 4-fluoro-3-phenoxybenzoic acid, chloro-3,3,3-trifluoro-1-propen-1-yl-2,2-dimethylcyclopropanecarboxylic acid, cis/trans 3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid, ethylenethiourea, glyphosate, 4-chloro-2-methylphenoxy acetic acid, 3-hydroxy-pyrimetanil, 5-hydroxytiabendazole, hydroxy-tebuconazole and 3,5,6-trichloro-2-pyridinol) and two mycotoxins (ochratoxin A (OTA) and citrinin (CIT)) were analysed by liquid chromatography coupled-mass spectrometry. Differences in the creatinine-corrected urinary concentrations of the measured exposures between outcome groups (participants with stable vs declining kidney function) were examined. Results Elevated levels of aluminium and total arsenic as well as metabolites of several pesticides were detected across the population. No differences were identified between the declining and stable groups in the levels of metals or pesticides tested. OTA and CIT were below the limit of detection. Conclusions The tested metals, metalloids, pesticides and mycotoxins were not associated with loss of kidney function in participants at-risk of MeN.
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| 3. |
- Rodriguez, Teresa, 1966-, et al.
(författare)
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Pyrethroids exposure and neurobehavioral performance in school age children in rural Nicaragua
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: This cross-sectional study explored whether pre or postnatal pyrethroid exposure impaired cognitive performance and behavior in school-aged children from a rural area in Nicaragua.Methods: Pyrethroid exposure was assessed in 110 children age 7-9, attending grade 1-3, with cumulative parental pyrethroid use indices of hours of spraying, during pregnancy, the first year of life, and older than age one. Cypermethrin accounted for most of the pyrethroid use. Cognitive performance of the children was evaluated with 12 sub-tests and total IQ of Wechsler Intelligence Scale for Children (WISC IV), grouped into indices for perceptual reasoning, verbal comprehension, working memory, and processing speed. Behavior at school was measured with the oppositional, cognitive problem/inattention, hyperactivity and ADHD index subscales of the Conners’ Teacher Rating Scale-Revised:Short form (CTRS-R:S). One year later, the pyrethroid metabolite 3-PBA was measured in 211 urine samples from 74 children (median 3.3 µg/g creatinine, max. 547) and the effect of recent exposure on cognitive and behavior was assessed with a shortened battery. Results:Pyrethroid exposure indices during the first year of life significantly decreased performance of perceptual reasoning in children aged 7-9. For each 10-fold increasein hours of pyrethroid application , children’s performance on the Perceptual Reasoning Index decreased on average with 1.1 point. Postnatal exposures, during the first year and after age 1, associated with hyperactivity and attention problem. Urinary 3-PBA levels were negatively associated with a number of cognitive functions and, noteworthy, with increased scores for ADHD in girls but not in boys.Conclusion:Pyrethroid exposure in the first year of life was associated with decreased perceptual reasoning in rural children and with hyperactivity and ADHD predominantly in girls.
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| 4. |
- Rodriguez, Teresa, 1966-, et al.
(författare)
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Pyrethroids exposure and neurobehavioral performance in school age children in rural Nicaragua
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Annan publikation (populärvet., debatt m.m.)abstract
- Objective: This cross-sectional study explored whether pre or postnatal pyrethroid exposure impaired cognitive performance and behavior in school-aged children from a rural area in Nicaragua.Methods: Pyrethroid exposure was assessed in 110 children age 7-9, attending grade 1-3, with cumulative parental pyrethroid use indices of hours of spraying, during pregnancy, the first year of life, and older than age one. Cypermethrin accounted for most of the pyrethroid use. Cognitive performance of the children was evaluated with 12 sub-tests and total IQ of Wechsler Intelligence Scale for Children (WISC IV), grouped into indices for perceptual reasoning, verbal comprehension, working memory, and processing speed. Behavior at school was measured with the oppositional, cognitive problem/inattention, hyperactivity and ADHD index subscales of the Conners’ Teacher Rating Scale-Revised:Short form (CTRS-R:S). One year later, the pyrethroid metabolite 3-PBA was measured in 211 urine samples from 74 children (median 3.3 µg/g creatinine, max. 547) and the effect of recent exposure on cognitive and behavior was assessed with a shortened battery. Results:Pyrethroid exposure indices during the first year of life significantly decreased performance of perceptual reasoning in children aged 7-9. For each 10-fold increasein hours of pyrethroid application , children’s performance on the Perceptual Reasoning Index decreased on average with 1.1 point. Postnatal exposures, during the first year and after age 1, associated with hyperactivity and attention problem. Urinary 3-PBA levels were negatively associated with a number of cognitive functions and, noteworthy, with increased scores for ADHD in girls but not in boys.Conclusion:Pyrethroid exposure in the first year of life was associated with decreased perceptual reasoning in rural children and with hyperactivity and ADHD predominantly in girls.
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| 5. |
- Rodriguez, Teresa, et al.
(författare)
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Assessment of long-term and recent pesticide exposure among rural school children in Nicaragua
- 2012
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 69:2, s. 119-125
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Tidskriftsartikel (refereegranskat)abstract
- Objective This study assessed pesticide exposure of children in rural Nicaragua in relation to parental pesticide use, from around conception to current school age, as part of an epidemiological evaluation of neurodevelopment effects. Methods We included 132 children whose parents were subsistence farmers or plantation workers, or had an agricultural history. As proxies for children's long-term exposures, we constructed cumulative parental pesticide-specific use indices for periods before and after the child's birth from data obtained using an icon-calendar-based questionnaire, of application hours (h) for plantation workers and subsistence farmers, and of kilograms of active ingredients (ai) only for subsistence farmers. Pesticide residues of TCPY, 3-PBA and 2,4-D were analysed in children's urine as indicators for current exposures. Results Life-time indices were highest for the organophosphates chlorpyrifos (median 114 h (min 2; max 1584), 19.2 kg ai (min 0.37; max 548)) and methamidophos (84 h (6; 1964), 12.2 kg ai (0.30; 780)). The P50 values of children's urinary residues were 3.7 mu g/g creatinine for TCPY, 2.8 for 3-PBA and 0.9 for 2,4-D; TCPY values are comparable with those in other countries, but 3-PBA and 2,4-D are considerably higher. The maximum levels for all three pesticides are the highest reported for children. Residues increased on days after application, but most high residue levels were unrelated to parental pesticide applications. Conclusion Urinary pesticide residues reveal high environmental exposure among children in rural Nicaragua. The quantitative parental pesticide use indices as proxies for children's exposures during different periods may be useful for the evaluation of developmental health effects.
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| 6. |
- Wesseling, Catharina, et al.
(författare)
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The Epidemic of Chronic Kidney Disease of Unknown Etiology in Mesoamerica: A Call for Interdisciplinary Research and Action.
- 2013
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Ingår i: American Journal of Public Health. - 1541-0048 .- 0090-0036. ; 103:11, s. 1927-1930
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Tidskriftsartikel (refereegranskat)abstract
- During the last 20 years, several regions in Central America and Mexico have seen a dramatic increase of a rapidly progressive chronic kidney disease, unexplained by diabetes and hypertension.(1-3) This regional epidemic of chronic kidney disease of unknown origin (CKDu) is also being referred to as the Mesoamerican nephropathy or MeN.(4) It has been estimated that this largely unknown epidemic has caused the premature death of at least 20 000 men.(3) In MeN-affected areas in Nicaragua(3) and Costa Rica (C. W., unpublished data), chronic kidney disease mortality is up to five-fold the national rates. In El Salvador, kidney disease was the second most common cause of death among males in 2009.(5) MeN primarily, but not only, affects young and middle-aged male laborers in the agricultural sector, in particular sugarcane workers.(1-3) (Am J Public Health. Published online ahead of print September 12, 2013: e1-e4. doi:10.2105/AJPH.2013.301594).
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| 7. |
- Crowe, Jennifer, et al.
(författare)
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A pilot field evaluation on heat stress in sugarcane workers in Costa Rica : what to do next?
- 2009
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Ingår i: Global Health Action. - : Co-action publishing. - 1654-9716 .- 1654-9880. ; 2, s. 71-80
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Climate change is producing major impacts including increasing temperatures in tropical countries, like Costa Rica, where the sugarcane industry employs thousands of workers who are exposed to extreme heat.OBJECTIVES: This article outlines a pilot qualitative evaluation of working conditions and heat in the sugarcane industry.DESIGN: A literature review, direct observations and exploratory interviews with workers were conducted to reach a preliminary understanding of the dimensions of heat-related health issues in the sugarcane industry, as a basis for the design of future studies.RESULTS: The industry employs temporary workers from Nicaragua and Costa Rica as well as year-round employees. Temporary employees work 12-hour shifts during the harvest and processing ('zafra') season. In many cases, sugarcane field workers are required to carry their own water and often have no access to shade. Sugar mill workers are exposed to different levels of heat stress depending upon their job tasks, with the most intense heat and workload experienced by the oven ('caldera') cleaners.CONCLUSIONS: Research is needed to achieve better understanding of the multiple factors driving and interacting with heat exposures in the sugarcane industry in order to improve the health and safety of workers while maintaining worker productivity.
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| 8. |
- Rodriguez, Teresa, 1966-, et al.
(författare)
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Cognitive deficits in organophosphate exposed children of Nicaraguan subsistence farmers
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: This study examined cognitive and behavioral performance among school-age children in Nicaragua in relation with long-term and recent organophosphate exposures.Methods: Long-term organophosphate was assessed in 110 children aged 7-9 through a parental use index of kg of organophosphate during de pregnancy, first year of life and from 1 year old to the present. Recent exposure was determined in a subset of 74 children by urinary 3,5,6-trichloro-2-pyridinol (TCPY) levels. Cognitive function was evaluated with Wechsler Intelligence Scale for Children (WISC IV), total IQ and subtests grouped into indices for perceptual reasoning, verbal comprehension, working memory, and processing speed. Behavior at school was measured with the Conners’ Teacher Rating Scale-Revised:Short (CTRS-R:S). Multivariate linear regression models assessed adjusted associations.Results: For each 10-fold increase in prenatal indices for total OP use, children’s performance on working memory significantly decreased with 3.5 points, and similarly for chlorpyrifos and methamidophos. Prenatal methamidophos use was, in addition, significantly associated with poorer verbal comprehension and decrease in total IQ, a 10-fold use increase decreasing scores with 3.8 and 3.3 points respectively. Urinary TCPY (mg/g of creatinine) also affected, not significantly, working memory with a 3.2 point decrease for each 10-fold increase. This study did not find associations between postnatal organophosphate use indices and cognitive performance, or pre or postnatal use indices with behavior. Conclusion: Prenatal exposure to organophosphates decreased the cognitive abilities in Nicaraguan children, particularly in working memory. Methamidophos was also associated with poor verbal comprehension and total IQ.
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