Relationship between Pesticide Knowledge, Attitudes, and Practice (KAP) and Prenatal Organophosphate Exposure in a Pilot Thai Agricultural Birth Cohort Open Access

Czernizer, Eric Paul (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/n009w3086?locale=en
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Abstract

Chronic exposure to OP pesticides has been linked to several negative, long-term health outcomes, including the inhibition of neurodevelopment through prenatal exposure. Due to the high risk of OP exposure among agricultural workers and the high hazard of in utero exposure, it is important to understand the factors that may affect exposure in pregnant farmers. The SAWASDEE birth cohort was established in order to assess the effect of prenatal pesticide exposure on birth outcomes in pregnant farmers working in the Chiang Mai province in Northern Thailand. The purpose of this study is to assess the relationship between pesticide knowledge, attitudes, and practice (KAP) and prenatal organophosphate exposure in this cohort. Questionnaires were administered three times through pregnancy and used to generate seven different KAP scores. Prenatal OP exposure was measured an average of eight times through pregnancy using urinary levels of dialkyl phosphate (DAP) metabolites. Using linear regression models, the relationships between each of the seven KAP scores and trimester-specific exposure measurements were assessed, controlling for potential confounding by maternal income level and parity where necessary. Usefulness score was nominally (0.05 < p < 0.10) or strongly (p < .05) significantly related to urinary DAP levels at all trimesters, where increased perceived usefulness of pesticides was associated with increased DAP levels. Responsibility score was nominally significantly related to DAP levels in the second trimester, and strongly related in the third trimester, where an increased sense of responsibility for the safe use of pesticides was associated with decreased DAP levels. There was also nominal evidence that increased KAP score is associated with decreased third trimester DAP levels, and that increased number of risky practices at home is associated with decreased total DAP levels. There were no significant relationships seen with personal susceptibility, child susceptibility, and risky behaviors at work scores. The results suggest that there is a moderate relationship between attitudes towards pesticides and OP pesticide exposure, and a possible relationship between pesticide knowledge and OP exposure. This is the first study to assess the relationship between KAP scores and OP pesticide exposure through pregnancy.

Table of Contents

Table of Contents

I. BACKGROUND & SIGNIFICANCE…………………………………….......……1

II. METHODS……………………………………………………………...............4

A. Study Population……………………………….……………………4

B. KAP Measurement….…………………………………………….…5

C. Organophosphate Exposure Measurement……....……7

D. Analysis……..……………………………………………………….….8

III. RESULTS…………………………………………………………...………..….9

A. Descriptive Statisitics………………………………………...…9

B. KAP Scores………………..……………………………………..…..10

C. OP Pesticide Exposure..…………………………………….…..12

D. Linear Regression…………………………………………………….13

IV. DISCUSSION……………………………………………………………………14

V. CONCLUSIONS…………………………………..…………………………..…18

VI. REFERENCES……………………………………………………...…………..20

VII. TABLES & FIGURES………………………………………….………..…….26

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