Friday, December 2, 2011

It Ain't Easy Raising a Family on a Farm These Days...

If you were raised in a city or in suburbia, farm life must seem serene, bucolic, and wholesome. Sure, it means hard work, but it's honest and lets you escape to simpler times in human history...


Fields Near Greenfield, CA


In some ways, you'd be right. In most ways...


The Salinas Valley in California is known as the "Salad Bowl of the World" with its large production of lettuce, spinach, tomatoes and more. This title was not awarded simply by having small subsistence farms. Agriculture in the United States is big business, with heavy machinery, large acres of land, huge water needs, fertilizers, and pesticides. As such, farm life is complicated, scientific, and dangerous.


In 2007, organophosphate (OP) pesticides accounted for 36% of all pesticides used in the United States. This class of pesticides, whose membership includes chlorpyrifos, malathion, and phosmet, is greatly important to agriculture and the Californian economy.


Pesticides in the organophosphate class work by inhibiting the enzyme acetylcholinesterase. The targeted enzyme is important for proper neuron to neuron signalling in insect as well as human nervous systems, which makes it an excellent target for a pesticide.


However, many studies have shown associations with poorer neurobehavioral development in very young children who have been exposed to OP pesticides while in the womb or as an infant. Usually, this exposure to the pesticide is due to dietary consumption by the pregnant mother or infant. A recent study published in August of 2011 sought to examine whether these biological effects were long lasting, and at whether prenatal or postnatal exposure was a larger contributor to the observed neurobehavioral deficiencies.


The study examined data from a cohort of largely Latino pregnant mothers and children living in an agricultural community in the Salinas Valley. Their exposures to OP pesticides are, by and large, very high compared to other populations around the country, but are still within possible levels for the general population. They found, by measuring biological samples, that OP pesticide exposure to a pregnant mother is associated with lower IQ scores in her children even at the age of 7. Those children that had the highest exposure through their mothers had  an average deficit of 7 points! On the other hand, exposure during childhood was not associated with this outcome.


Now what do we do? We've been told to eat well and eat our veggies, especially when someone is pregnant. Are we simply poisoning our children with good intentions? No. Certainly not, agrees Elizabeth Marder, a University of California-trained toxicologist. "It is important to recognize that determining an exposure has occurred does not necessarily mean that a harmful exposure has occurred." But, there are clear indications for actions that can be taken for at risk people.


MINIMIZE EXPOSURE:
1) Pregnant mothers have many things to worry about during their pregnancies. If a pregnant mother is associated with or lives in a farming community, she should also be vigilant about possible ways to be exposed to these pesticides and avoiding them. For example, staying indoors on a crop dusting day, and making sure that any relatives that visit who work on the farm change into clean clothes before entering your home.


2) Always eat well--whether you're pregnant or not! This also means making sure any ingredients that are being used in a meal are cleaned thoroughly before being transformed into a healthy salad, casserole, or curry. Avoiding nutritionally healthy products based on a possible exposure is NOT the solution!


WAYS TO ACHIEVE:
1) For the population of women involved in this presented study, starting strong educational programs for avoiding or minimizing pesticide exposure while pregnant may be helpful. After all, knowledge is power. In this case, it's the power to know what other precautions a new mother can take as early as possible in pregnancy. Community outreach programs targeting agricultural populations in the languages they speak would seem to be the way to go.


2) A broader campaign may include television or radio ads encouraging the proper cleaning of fruits and vegetables before consumption. Reminders of good practices in common media can improve the chance the general population is maximally reducing their exposure to pesticides through their diets in ways they can afford.


DONE AND DUSTED (Wait, wait, not really):
Unfortunately, any opportunity to advocate good practices runs the risk of unintentionally alienating a population. The ability for persons to avoid exposures is also limited by their economic abilities. Migrant workers, for example, are a vital source of labor in California's agriculture infrastructure. They do not necessarily have the means to "avoid" pesticide exposures if a family depends upon the income generated by a working person. In this scenario, even a pregnant woman may insist on working in the fields during her pregnancy. Also, don't even bother thinking that she could use her maternity leave.


It is, indeed, difficult to raise a family, let alone raising one in an area where certain vulnerabilities are compounded by our environments. However, steps can be made to reduce our exposures to OP pesticides while still providing ourselves with food and an economy.


Citations:
Bouchard, MF, Chevrier, J, et al. Prenatal Exposure to Organophosphate Pesticides and IQ in 7-Year-Old Children. Environmental Health Perspectives, Vol 119, No 8, Aug 2011. 
Photos sourced through the Creative Commons Licenses.


Chandresh Ladva filled his lungs with pesticides and oil refinery fumes for 18 years while living in the San Joaquin Valley before he moved eastward to study philosophy and epidemiology at the University of Pennsylvania and Yale, respectively. He longs to return to California someday, but not before finding solutions to problems associated with development and environmental toxins. He is currently a pre-doctoral candidate in environmental health sciences at Emory University.


chandresh.ladva@emory.edu

7 comments:

  1. I am thinking I should've held my breath on my trips through the Salinas Valley! Very interesting. I wonder about future health effects as well. I like how you go beyond just saying "pregnant women need education" since the population of migrant workers may have many obstacles to such programs, including language barriers, social isolation, and need for the income. Also you did a nice job with "lay" tone.

    ---Laura Plantinga

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  2. Way to go on bringing up this unique issue! Your article was organized nicely and you explained the information well. I wonder if there are very many organic farms in the Salinas Valley?

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  3. Chandresh,

    I enjoyed your take on this, particularly your comments about migrant health workers and the challenges they might face in trying to avoid something that is potentially harmful. I would add that migrant farm workers often do not have regular health care access, making it even more challenging to identify immediate health problems or risks that are resulting from large exposures (like during crop dusting).

    I recall reading about a very translational approach to this issue in a community of migrant farm workers in the Yakima Valley in Washington State. They started community air monitoring so parents, children, pregnant women, etc. would know when they should be especially vigilant of health risks (sort of like pollution warnings). Check it out - I think it definitely fits in your "ways to achieve": http://washington.chenw.org/pdfs/FarmWorkerPesticideProject.pdf

    -Gillian

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  4. Nice summary of the study. Why is everything in environmental health so difficult to explain and interpret? I think your summary is targeted at other public health professionals or at least an audience with 12th grade or more reading level. For the lay person, you'd have to bring the reading level down. You could also make this relevant for people not living near a farm by describing their risk of exposure. You could offer suggests for minimizing pesticide exposure and for taking action as an individual by supporting healthy farm practices. Probably beyond this assignment but I'm thinking of the general reading who might be wondering or worrying about how this applies to them.

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  5. I agree with Heather's comment above about reading level. Even being married to a neurologist (i.e., having neurology information potentially being leeched into my brain as I sleep), I'm still not quite able to understand your explanation of the neurological impact of OPs.

    Similarly, I giggled a little when I read "bucolic" in the first line because my mind immediately went back to studying for the GRE many years ago thinking, "bucolic: rural, pastoral." Overall, I just think some of the words you chose to use aren't known by your average lay person.

    Question for you: How would you explain what an IQ point difference of 7 points means for a person? I have always struggled with this measure and have not been able to explain the functional/visable/etc. difference between one IQ score and another.

    Very interesting post!

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  6. Tara Redd (Ariela's colleague from the Emory PH Training Ctr)December 4, 2011 at 9:32 PM

    Chandresh,
    I enjoyed reading your article. I would agree with the other comments that you tackled a very technical issue and tried to bring it down to a more understandable level. I am sure the literature where you gathered your information was very technical.

    I do agree with the comments that the reading level was geared higher than the average reader. This was due in part to the use of less common words like "bucolic" (believe it or not)and big words like "vulnerabilities", the use of more technical language as well as the more sophisticated writing style and phrasing("done and dusted"). For example, the sentence "Those children that had the highest exposure through their mothers had an average deficit of 7 points!" might have been easier to read and understand if re-phrased.

    Overall, I found your article interesting and relevant for those living on a farm and the general public, esp. for woman who are pregnant. I liked your author's description as it tied in your own experience and interest in the area of environmental exposure.

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  7. I liked that the paragraphs were short and the pictures were engaging, but this post, like most of the others, was too long. When I read a blog, I expect it to be short short short. And it is full of jargon, "Pesticides in the organophosphate class work by inhibiting the enzyme acetylcholinesterase" (who cares?), "neurobehavioral development" (you mean they are stupid or something?). It could be 1/3 the length.

    David H Howard
    Department of Health Policy and Management
    Emory University

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