The primary research question in an article entitled, “Dietary Intake and its Contribution to Longitudinal Organophosphorus Pesticide Exposure in Urban/Suburban Children” by Chengsheng, Barr, Pearson and Waller (2008) involved considering to what extent pesticide exposure in children comes from food and water sources. The authors of the study noted that the type of pesticides found, which are called organiphosphorus pesticides (OP) are commonly used in several environments and that exposure in children has been documented.
One of the underlying reasons for this study was to examine the topic due to the risks that these chemicals pose to neurological development and function, although the authors recognize that there are not established or proven connections between low levels of exposure and symptoms caused by these toxins. The study’s research question looks at not only the source of pesticide contamination but seeks to offer suggestions. To best offer more concrete data, the researchers examined the study population by gauging their daily exposure to normal versus organic diets in order to best identify levels of exposure and to allow them to make suggestions and conclusions based on their findings.
The methodology utilized a study design that was based on a population of 23 children who were between ages 3-11 from Seattle area (both urban and suburban) schools and ran the course of four seasons in one year. To further enhance the results, the study was repeated with the exact same study design in Atlanta, Georgia two years following the initial Seattle study. Screening was conducted based on the voluntary participants’ family diets, their living situation, and whether or not the parents would agree to collect specimens. Following acceptance, questionnaires were given to all participant families about their use of pesticides at home. The study, which was stated to have no economic interests, was conducted with approval as human subjects formed the core of the research. Sampling periods lasted from 7, 15 and 12-day periods (depending on the season) during which children were given only pesticide-free organic items to eat but were allowed to continue with their normal diets outside of these periods.
Data collection for this study involved parent and child cooperation to ensure proper collection and storage of the samples. Research team members instructed children how to obtain samples and discussed with parents their unique responsibility. During seasonal sampling periods, samples were collected daily. Urine and saliva samples were used to provide the biological data from the participants with parents preserving the samples until daily collection was performed by study conductors. These samples were analyzed at the University of Washington, and urine samples were tested for “metabolites of selected OP pesticides, prethroid insecticides, and herbicides” (Chensheng, 2008).
The data from the urine sample was divided into three classes, including that which showed detectable amounts of OP, detectable but not enough to quantify, and undetectable. These were then assigned a value for reporting with “0” being assigned to that which could not be detected in the sample. Following this, researchers attempted to find a more median set of data by volume-weighing the found metabolites “by averaging the metabolite concentrations in the morning sample and the previous day’s bedtime sample, then normalizing for the total volume of these two urine samples (Chensheng, 2008). The researchers used the quantitative research software SPSS to break down the findings by various factors including age, sex, and the season to look for relationships.
After some participants, for various reasons dropped out of the study, the final total included 19 children overall with nine children between ages 3-5 and fourteen children between 6-11 years of age. While there were some samples that were not collected (researchers estimate around 7%, but this improved over time)researchers managed to acquire enough to form reliable results. The highest detection rate, which was chlorpyrifos, in 91% of the children was the most striking finding, followed by the metabolite for malathion. However, for the periods that children were give organic-only foods in the form of fresh food items, there was a reduction in the detection of both of these prominent metabolites. However, as soon as the diets of the children returned to normal consumption, their levels of these pesticides went right back up. When the levels went down during the organic period of sampling, levels were most visibly reduced with malathion with a lesser degree seen in chlorpyrifos. While the above statements cover some of the general, overarching results of this study, there were a number of related elements to this study’s conclusions that are worth noting. For instance, the study found that the consumption of fresh fruits that were not organic led to higher correlations with OP metabolites. In short, the authors conclude that children are exposed to OP pesticides in their everyday diets and that by incorporating a (proven and verified) organic diet that is sustained, this intake can be mitigated if not altogether eliminated.
The authors note that there have been very studies that looked at the issue of pesticides in urban and suburban children as most studies have, as one could imagine, focused on rural areas where there is more large-scale pesticide use. The authors also note that one limitation is that there were a relatively small number of participants, in part due to drop out and also because of budget constraints. Furthermore, this required a great deal of effort from parents and many potential parents were not accepted for the study for participation-related matters, thus they conclude that this might not have been a completely accurate or representative sampling, even if the study design was innovate and targeted at offering a more complete view by having varying sampling lengths and seasons. Consumption of these pesticides is highest in the summer due to local availability of produce and there is a correlated rise in the levels of OP pesticides with these foods within the summer season. They note too that in the fall and winter months when more produce is imported, levels rise but this might be due to the fact that imported fruits and vegetables use more pesticides than domestically-grown produce.
This issue holds a great deal of relevance for nurses, especially as their advice is often sought after by patients and others about how to best avoid risk factors that could compromise the health of children. While the authors of this study do make it clear that the negative neurological impacts of some of the OP pesticides examined in the research are based on lab tests with mice and rats and has offered little in the way of truly or fully conclusive data that correlate human negative effects, this is nonetheless to be considered a risk. However, nurses are going to put in the unique position of suggesting that eating a great number of fruits and vegetables can increase the detectable amounts of the OP pesticides discussed in the study, despite the fact that we have so often encouraged, for solid and sounds reasons, high levels of consumption of fruits and vegetables—especially for developing children. Furthermore, this study suggests that produce that is certified and verified to be organic (although there are many products on the shelves that make this dubious, unverified claim) does cut down extensively the detectable amounts of OP pesticides, but we cannot reasonably suggest that all families immediately turn to organic-only diets. This is simply not feasible and as nurses know, this option is not within the reach of many families with children due to the vast disparities in expenses between organic versus commercial and pesticide-containing produce. There are several questions about how nurses can best use the information in this study related to how to help patients and families make healthy, responsible decisions. Since it would not be viable to suggest that they do not offer their children any fresh fruits or vegetables and it is less obtrusive but still difficult for families to go to an organic-produce-only diet, there is a clear quandary. To address this issue of questioning where to go with such unsettling data, we must look to further research to learn more about the relative dangers in consuming non-organic produce versus the alternative of shifting, as a society, to an organic diet. This situation presents several challenges but is best left as a lingering issue as nurses advise patients. Clearly, we need to still encourage regular, plentiful consumption of fresh foods, but the question is, just how plentiful should such a consumption plan be? The best course of action seems to be to wait for more verified and quantifiable results that indicate risk levels in humans (children especially) instead of basic an entire paradigm shift in our dietary recommendations on non-human studies. This is important research and as so, needs to include a much larger, broader, and geographically diverse sample population before more recommendations about wide-scale changes can be advised for nurses.
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