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Human Exposure to naled mosquito control Human Exposure to naled mosquito control pesticides, Florida 2004pesticides, Florida 2004..
A. J. Becker, MPH, PhD 1, Z. Duprey, DVM, MPH 2, S.D.
Rivers, MS 1, G. Luber, MA, PhD 2, C. Blackmore, DVM, PhD 1, Carol Rubin, DVM, MPH 2. (1) Bureau of
Community Environmental Health, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL
32399. (2) National Center for Environmental Health, Centers for Disease Control and Prevention, MS F-46,
Atlanta, GA 30341
Hurricane season 2004Hurricane season 2004
Mosquito Average per trap by dateMosquito Average per trap by date
Mosquito Populations Over Time in St John's County, Florida
0
100
200
300
400
500
600
8/3/2004 8/9/2004 8/16/2004 8/23/2004 8/30/2004 9/13/2004 9/28/2004 10/5/2004 PosttreatmentDate
Avg
# pe
r tra
p
Cx nigripalpus
Ps columbiae
Trap total
Charley Frances
Florida’s Public Health Florida’s Public Health ResponseResponse
• Request aerial spraying with mosquito adulticide (naled)
• Invite CDC to assist in assessing human pesticide exposure
CHOLINERGIC FIBER
SprayingSpraying
Took place on the evening of October 4, 2004. Naled was applied at 2/3 an ounce per acre, covering approximately 228,000 acres of St. Johns County.
MethodsMethods
• Prospective study design – assessment of a baseline prior to
determining exposure
Post-Exposure Fate of a Nonpersistent Chemical in Post-Exposure Fate of a Nonpersistent Chemical in Blood and UrineBlood and Urine
Concentration vs timeConcentration vs time
Time (Days)
BloodToxicant/Metabolite
Urinary Metabolite
1 10 100 1000
Con
cent
ratio
n
MethodsMethods• Selection of Participants- Randomly chosen
census blocks from 5 proposed spray areas. • DOH/CDC Teams- Teams consisted of one FLDOH
and one CDC member and an attempt was made to have one male and one female per team. The teams were trained on how to recruit and complete questionnaires.
• Participants- Participants were required to meet the following criteria:
• - 18 years of age or older• - Able to speak English• - Able to give informed consent• - In the county during the spray event
Participant’s Participant’s Questionnaire and Questionnaire and Sample CollectionSample Collection
• Signed consent form
• Pre-spray questionnaire + urine specimen,
• Five post-spray collection cups and instructions on collecting, labeling and storing the samples
• Collections at 8 h increments (morning, noon and night).
• Teams returned two days post-spray to collect the samples and administer the post-questionnaire.
Verify exposure through Verify exposure through environmental samplingenvironmental sampling
• Not done
Pre-Exposure QuestionnairePre-Exposure Questionnaire• In the past 3 days…
– Handle or apply fertilizer
– Done farm field work, such as harvesting or weeding, worked in a packing or farm stand with raw fruits, vegetables, or flowers
– Worked in a nursery or greenhouse
– Worked in a cannery or food processing plant– Done lawn or other landscape maintenance
– Applied flea or tick shampoo, dips, powders, or flea collars on pets
– Eaten fresh fruit or vegetables– Experienced pesticide-poisoning like illness
Post-Exposure Post-Exposure QuestionnaireQuestionnaire
Added questions:• From the spray time to 12 hours post spray, how
many hours were you in the county?• Did you see or hear the spray plane?• Did you attempt to avoid contact with the
mosquito spray?– Close all windows– Turn the air conditioning to recirculate– Clean off all lawn furniture before using– Stay indoors for at least 1 hour after spraying– Clean off all children’s toys before they use them– Wash all garden vegetables before eating or serving
Dana Henehan, from CDC, aliquots the Dana Henehan, from CDC, aliquots the urine samples before shipping them to the urine samples before shipping them to the CDC/NCEH laboratory in Atlanta, GeorgiaCDC/NCEH laboratory in Atlanta, Georgia
AnalysisAnalysisOrganophosphate metabolites Organophosphate metabolites
• Gas chromatography/tandem mass spectrometry (GC/MSMS).
• Dimethylphosphate- Non-specific naled metabolite
• Other organophosphate metabolites tested in lab.
AnalysisAnalysis
• N > urine organophosphate metabolite levels post-spray
• N < decreases in urine metabolite levels post-spray
• Compare metabolite levels to household and workplace exposure questionnaires
• Compare metabolite levels to symptoms reported comparing pre and post samples
St John’s participation and completion ratesSt John’s participation and completion rates
• A total of 626 individuals were contacted by the 12 teams and 235 (37%) agreed to participate. Of those 235, 210 completed the study, an 89% study completion rate.
Age and gender demographics Age and gender demographics
• Age (n=204)
Mean: 50.19, Range 18-78
• Sex (n=205) Male: 92 (44.9%)
Female: 113 (55.1%)
Ethnicity Census 2000 vs. StudyEthnicity Census 2000 vs. Study
Ethnicity 2000 census data St. John’s study
White 90.92 % 88.3 %
African American 6.29 % 6.8 %
Hispanic/Latino 2.6 % 3.4%
Native American 0.26 % 1.0 %
Asian 0.95 % 0.5 %
Pacific Islander 0.05 % 0.0 %
Area participant's residenceArea participant's residence• N=203• Hastings: 42 (20.7%)• Jacksonville: 23 (11.3%)• Ponte Verda Beach: 11 (5.4%)• St. Augustine: 125 (61.6%)• Switzerland, FL: 2 (1.0%
Risk FactorsRisk Factors• Pre
• Eat Fruit & Veg- 72%• Lawn- 35.6% (73)• Handled-18.5% (38)• Flea- 7.8% (16)• Field Work- 3.4% (7)• Fruit Stand-0.5% (1)
• Post• Eat Fruit & Veg- 72%• Lawn- 20% (40)• Handled- 8.5% (17)• Flea- 3.5% (7)• Field Work- 2% (4)• Fruit Stand- 0.5% (1)
Post BehaviorsPost Behaviors• Saw plane- 45% (91)• Closed windows- 67% (136)• AC to recirculate- 58% (117)• Wiped lawn furniture- 4.5% (9)• Stayed indoors- 58% (117)• Wiped toys- 1.5% (3)
Symptoms Raw ResultsSymptoms Raw Results• Pre symptoms
• Headaches 18% (37)
• Dizziness 6% (12)
• Nausea 5% (10)
• Abdominal Pain 5% (10)
• Weakness 4% (9)
• Excess tearing 4% (9)
• Trembling hands 3% (6)
• Post symptoms• Headaches 13% (26)
• Nausea 5% (10)
• Abdominal Pain 4% (9)
• Dizziness 3% (7)
• Excess tearing 2% (4)
• Diarrhea 2% (4)
• Weakness 2% (4)
• Trembling hands 2% (3)
Evaluation of pre and post Evaluation of pre and post questionnaires for symptomsquestionnaires for symptoms
No pre questionnaire symptoms
Pre questionnaire symptoms
No post questionnaire symptoms
133 27
Post questionnaire symptoms
12 32
Symptoms reported by post Symptoms reported by post questionnaire onlyquestionnaire only
Diarrhea Head ache
Dizziness Throat irritation
Nausea Tearing
Total 3 10 2 1 3 1
Pesticide Exposure Reported to Pesticide Exposure Reported to Pesticide Exposure Surveillance Pesticide Exposure Surveillance
Program (PESP)Program (PESP)
• Two complaints
a. Small child waiting for the bus the next morning developing respiratory symptoms.
b. Skateboarders with irritation to the upper
respiratory tract, eyes stinging and skin burning (They reportedly observed the plane fly over).
Results-lab analysisResults-lab analysis
Time period*
Total n of samples
% with detectable
DMP
Median level of DMP (ug/L)
Baseline 229 67.25 3.14
Post-spray 1 123 47.97 <LOD
Post-spray 2 218 40.83 <LOD
Post-spray 3 223 41.70 <LOD
Post-spray 4 112 41.07 <LOD
Post-spray 5 149 32.89 <LOD
Post-spray 6 28 57.14 1.85
Behavior(Number
responses)
N Pre-
sprayn (%)
N Post-spray
n (%)
N Pre- and Post-spray
n (%)P-value
Handling pesticides (203)
37 (18.2) 17 (8.4) 6 (3.0) 0.06
Field/farm work(202)
7 (3.5) 4 (2.0) 3(1.5) <0.01
Produce stand work (203)
1 (0.5) 1 (0.5) 0 (0) 1.00
Lawn work(n=203)
72 (35.5) 40 (19.7) 27 (13.3) <0.01
Applying pet flea products (202)
16 (7.9) 7 (3.5) 3 (1.5) 0.01
Eating fresh produce (185)
136 (73.5)
133 (71.9) 116 (62.7) <0.01
Symptoms (Number of responses)
Symptoms, Pre-sprayn (%)
Symptoms, Post-sprayn (%)
Symptoms Pre- and Post-sprayn (%)
P-value
Nausea (196) 10 (5.1) 10 (5.1) 4 (2.0) <0.01
Vomiting(196)
3 (1.5) 2 (1.0) 1 (0.5) 0.03
Diarrhea(196)
3 (1.5) 4 (2.0) 1 (0.5) 0.06
Abdominal cramps (196)
10 (5.1) 9 (4.6) 5 (2.6) <0.01
Headache(199)
37 (18.6) 26 (13.0) 16 (8.0) <0.01
Trembling(197)
6 (3.0) 3 (1.5) 3 (1.5) <0.01
QuestionsQuestions