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Predictors of plasma DDT and DDE concentrations among women exposed to indoor residual spraying for malaria control in the South African Study of Women and Babies (SOWB).

Whitworth KW, Bornman RM, Archer JI, Kudumu MO, Travlos GS, Wilson RE, Longnecker MP - Environ. Health Perspect. (2014)

Bottom Line: In DDT IRS households, women who reported taking more than six actions to prepare their home before IRS (e.g., covering water and food) had 40% lower DDT levels (95% CI: -63, -0.3%) than women who took fewer than four actions.The predictors of DDT and DDE plasma levels identified in the present study may inform interventions aimed at decreasing exposure.Among households where DDT is likely to be used for IRS, education regarding home preparations may provide an interventional target.

View Article: PubMed Central - PubMed

Affiliation: The University of Texas School of Public Health, San Antonio Regional Campus, San Antonio, Texas, USA.

ABSTRACT

Background: Few studies have examined predictors of DDT (dichlorodiphenyltrichloroethane) and DDE (dichlorodiphenyldichloroethylene) levels among residents in homes sprayed with DDT for malaria control with the aim of identifying exposure-reduction strategies.

Methods: The present analysis included 381 women enrolled in the Study of Women and Babies (SOWB) during 2010-2011, from eight South African villages in the Limpopo Province, South Africa. Indoor residual spraying (IRS) occurred in half of the villages. Questionnaires regarding various demographic and medical factors were administered and blood samples were obtained. We classified the women into three exposure groups by type of residence: unsprayed village (n = 175), IRS village in household with a low likelihood of DDT use (non-DDT IRS household, n = 106), IRS village in household with a high likelihood of DDT use (DDT IRS household, n = 100). We used multivariable models of natural log-transformed DDT plasma levels (in micrograms per liter) and DDE (in micrograms per liter) to identify predictors for each group.

Results: Median levels of DDT and DDE among women in unsprayed villages were 0.3 [interquartile range (IQR): 0.1-0.9] and 1.7 (IQR: 0.7-5.5), respectively. Median levels of DDT and DDE among women in DDT IRS households were 2.6 (IQR: 1.1-6.6) and 8.5 (IQR: 4.7-18.0), respectively. In unsprayed villages, women with water piped to the yard, rather than a public tap, had 73% lower DDT (95% CI: -83, -57%) and 61% lower DDE (95% CI: -74, -40%) levels. In DDT IRS households, women who reported taking more than six actions to prepare their home before IRS (e.g., covering water and food) had 40% lower DDT levels (95% CI: -63, -0.3%) than women who took fewer than four actions.

Conclusion: The predictors of DDT and DDE plasma levels identified in the present study may inform interventions aimed at decreasing exposure. Among households where DDT is likely to be used for IRS, education regarding home preparations may provide an interventional target.

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Related in: MedlinePlus

Temporal trends in the sum of DDT levels in human biomonitoring data, adapted from Ritter et al. (2011).
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f1: Temporal trends in the sum of DDT levels in human biomonitoring data, adapted from Ritter et al. (2011).

Mentions: The levels of DDT observed in the present study are similar to levels previously reported. Figure 1 depicts the sum of DDT and DDE levels (nanograms per gram lipids) among women in unsprayed villages and women in DDT IRS households, in relation to data originally presented by Ritter et al. (2011). In Figure 1, the Tropics populations include studies from the following areas: India, Southeast Asia, Africa, and South and Central America. Among these areas, the highly exposed population represents individuals in IRS-treated homes, whereas the general population represents individuals not in IRS-treated homes. The North, general population includes studies among non-Inuits in Greenland, Northern Europe, Canada, and Alaska. The levels of DDT observed in the present study among rural South African women are consistent with what one might expect based on the global trends previously described (Ritter et al. 2011). Although some studies continue to report specific populations with very high levels of DDT (Bouwman et al. 2012), it is reassuring that, overall, levels appear to be decreasing, even among women likely exposed to DDT through IRS. This downward trend may reflect declining use of DDT in agriculture and thereby lower exposures via food and contaminated air.


Predictors of plasma DDT and DDE concentrations among women exposed to indoor residual spraying for malaria control in the South African Study of Women and Babies (SOWB).

Whitworth KW, Bornman RM, Archer JI, Kudumu MO, Travlos GS, Wilson RE, Longnecker MP - Environ. Health Perspect. (2014)

Temporal trends in the sum of DDT levels in human biomonitoring data, adapted from Ritter et al. (2011).
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4048257&req=5

f1: Temporal trends in the sum of DDT levels in human biomonitoring data, adapted from Ritter et al. (2011).
Mentions: The levels of DDT observed in the present study are similar to levels previously reported. Figure 1 depicts the sum of DDT and DDE levels (nanograms per gram lipids) among women in unsprayed villages and women in DDT IRS households, in relation to data originally presented by Ritter et al. (2011). In Figure 1, the Tropics populations include studies from the following areas: India, Southeast Asia, Africa, and South and Central America. Among these areas, the highly exposed population represents individuals in IRS-treated homes, whereas the general population represents individuals not in IRS-treated homes. The North, general population includes studies among non-Inuits in Greenland, Northern Europe, Canada, and Alaska. The levels of DDT observed in the present study among rural South African women are consistent with what one might expect based on the global trends previously described (Ritter et al. 2011). Although some studies continue to report specific populations with very high levels of DDT (Bouwman et al. 2012), it is reassuring that, overall, levels appear to be decreasing, even among women likely exposed to DDT through IRS. This downward trend may reflect declining use of DDT in agriculture and thereby lower exposures via food and contaminated air.

Bottom Line: In DDT IRS households, women who reported taking more than six actions to prepare their home before IRS (e.g., covering water and food) had 40% lower DDT levels (95% CI: -63, -0.3%) than women who took fewer than four actions.The predictors of DDT and DDE plasma levels identified in the present study may inform interventions aimed at decreasing exposure.Among households where DDT is likely to be used for IRS, education regarding home preparations may provide an interventional target.

View Article: PubMed Central - PubMed

Affiliation: The University of Texas School of Public Health, San Antonio Regional Campus, San Antonio, Texas, USA.

ABSTRACT

Background: Few studies have examined predictors of DDT (dichlorodiphenyltrichloroethane) and DDE (dichlorodiphenyldichloroethylene) levels among residents in homes sprayed with DDT for malaria control with the aim of identifying exposure-reduction strategies.

Methods: The present analysis included 381 women enrolled in the Study of Women and Babies (SOWB) during 2010-2011, from eight South African villages in the Limpopo Province, South Africa. Indoor residual spraying (IRS) occurred in half of the villages. Questionnaires regarding various demographic and medical factors were administered and blood samples were obtained. We classified the women into three exposure groups by type of residence: unsprayed village (n = 175), IRS village in household with a low likelihood of DDT use (non-DDT IRS household, n = 106), IRS village in household with a high likelihood of DDT use (DDT IRS household, n = 100). We used multivariable models of natural log-transformed DDT plasma levels (in micrograms per liter) and DDE (in micrograms per liter) to identify predictors for each group.

Results: Median levels of DDT and DDE among women in unsprayed villages were 0.3 [interquartile range (IQR): 0.1-0.9] and 1.7 (IQR: 0.7-5.5), respectively. Median levels of DDT and DDE among women in DDT IRS households were 2.6 (IQR: 1.1-6.6) and 8.5 (IQR: 4.7-18.0), respectively. In unsprayed villages, women with water piped to the yard, rather than a public tap, had 73% lower DDT (95% CI: -83, -57%) and 61% lower DDE (95% CI: -74, -40%) levels. In DDT IRS households, women who reported taking more than six actions to prepare their home before IRS (e.g., covering water and food) had 40% lower DDT levels (95% CI: -63, -0.3%) than women who took fewer than four actions.

Conclusion: The predictors of DDT and DDE plasma levels identified in the present study may inform interventions aimed at decreasing exposure. Among households where DDT is likely to be used for IRS, education regarding home preparations may provide an interventional target.

Show MeSH
Related in: MedlinePlus