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American Academy of Pediatrics recommends using IPM to reduce children’s exposure to pesticides

Increased support for IPM adoption is one of the recommendations by the American Academy of Pediatrics in a position paper on pesticides published in Pediatrics this month. The article also expresses concern about children’s exposure to pesticides and makes several recommendations overseeing pesticide marketing, labeling and usage.

The authors begin by discussing how children can encounter pesticides in their day-to-day activities, and state that evidence has shown that diet is the primary factor in pesticide exposure in children. In a previous study that placed several children on a pesticide-free diet for several weeks, scientists found that pesticide metabolites (by-products produced when the chemical breaks down in the body) in urinary excretions decreased drastically through the course of the study.

When exposure to a pesticide causes extreme toxic effects, the authors argue, medical professionals often do not immediately recognize the symptoms to diagnose the problem. Pesticide poisonings can be diagnosed as other illnesses or chronic syndromes, and because they are misdiagnosed, they are also not appropriately treated. In addition, there is no current database that stores or tracks the incidence of pesticide exposure and illness in children in the U.S., nor any database on the use of pesticides by consumers or licensed professionals. Better education of medical professionals, reliable indicators for toxicity testing and better diagnostics to identify pesticide poisoning would improve diagnoses and treatments.

The pesticide label itself, state the authors, also needs improvement. The current label includes information on the active ingredient, acute health consequences, the EPA registration number, instructions on use (that must be followed), and the manufacturers contract information. However, although the active ingredient is included, by-products of the pesticide, some of which can be equally as toxic as the main ingredient, are not stated on the label. Also not included is information on the pesticide class, which sometimes can be helpful in identifying symptoms in a poisoning case.

For instance, organophosphates and carbamate insecticides can cause headache, nausea, muscle weakness, respiratory stress and changes in heartbeat rhythm, whereas pyrethroid insecticides can cause similar symptoms in addition to dermal irritation (see Table 2 in the article).

The authors state that pesticide toxicity can be a factor in many adverse birth defects such as premature births, low birth weight, congenital defects, pediatric cancers, neurobehavioral and cognitive deficits and asthma. Because of the risks that pesticides pose to infants and children, the authors make 6 recommendations to pediatricians and 9 recommendations to government:

To pediatricians:

  1. Become familiar with the signs and symptoms of acute pesticide poisoning.
  2. Become familiar with effects of chronic exposures and the routes of exposure for each pesticide class.
  3. Find local resources for acute toxicity management.
  4. Understand the information that is and is not contained on a pesticide label.
  5. Ask parents about pesticide use in and around the house, and recommend the use of integrated pest management.
  6. Work with schools and local government to implement IPM in public buildings and areas.

To government:

  1. Ensure that pesticide products are not marketed to be attractive to children.
  2. Include a section on the pesticide label that indicates risks to children.
  3. Promote practices that reduce children’s exposure.
  4. Create a central database for pesticide-related poisonings.
  5. Aid in identification of least toxic alternatives for export.
  6. Enforce public notification of pesticide spraying in public places.
  7. Increase economic incentives for growers who use IPM and support research to expand IPM in agriculture and non-ag settings.
  8. Support toxicologic research to better identify health risks associated with children’s exposure to pesticides.
  9. Support education of health care providers about acute pesticide poisoning.

Source: Roberts, J.R., and Karr, C.J. “Pesticide Exposure in Children.” Council on Environmental Health, Pediatrics 2012; 130;e1757; originally published online November 26, 2012; DOI: 10.1542/peds.2012-2757. Accessed December 14, 2012. Online at http://pediatrics.aappublications.org/content/130/6/e1757.full.html

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