Residential proximity to agricultural pesticide use and cardiovascular disease risk factors among adult Latina women in California's Salinas Valley.

Cardiovascular disease is a leading cause of death worldwide. There is limited evidence that exposure to current-use pesticides may contribute to cardiovascular disease risk. We examined the association between residential proximity to the application of agricultural pesticides and cardiovascular risk factors among 484 adult women in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a cohort based in an agricultural region of California. Outcome assessment was completed between 2010 and 2013. Using participant residential addresses and California's Pesticide Use Reporting database, we estimated agricultural pesticide use within one km of residences during the 2-year period preceding outcome assessment. We used Bayesian Hierarchical Modeling to evaluate associations between exposure to 14 agricultural pesticides and continuous measures of waist circumference, body mass index, and blood pressure. Each 10-fold increase in paraquat application around homes was associated with increased diastolic blood pressure (ß=2.60 mm Hg, 95% Credible Interval (CrI): 0.27-4.89) and each 10-fold increase in glyphosate application was associated with increased pulse pressure (ß=2.26 mm Hg, 95% CrI: 0.09-4.41). No meaningful associations were observed for the other pesticides examined. Our results suggest that paraquat and glyphosate pesticides may affect cardiovascular disease development in women with chronic environmental exposure.

Predictors of pesticide levels in carpet dust collected from child care centers in Northern California, USA.

BACKGROUND: Young children may be exposed to pesticides in child care centers, but little is known about determinants of pesticide contamination in these environments. OBJECTIVE: Characterize pesticide contamination in early care and education (ECE) centers and identify predictors of pesticide concentrations and loading in dust collected from classroom carpets. METHODS: Carpet dust samples were collected from 51 licensed child care centers in Northern California and analyzed for 14 structural and agricultural pesticides. Program characteristics were collected through administration of director interviews and observational surveys, including an integrated pest management (IPM) inspection. Pesticide use information for the prior year was obtained from the California Department of Pesticide Regulation to characterize structural applications and nearby agricultural pesticide use. RESULTS: The most frequently detected pesticides were cis-permethrin (98%), trans-permethrin (98%), bifenthrin (94%), fipronil (94%), and chlorpyrifos (88%). Higher bifenthrin levels were correlated with agricultural applications within 3 kilometers, and higher fipronil levels were correlated with professional pesticide applications in the prior year. In multivariable models, higher IPM Checklist scores were associated with lower loading of chlorpyrifos and permethrin. Placement of the sampled area carpet was also a predictor of chlorpyrifos loading. The strongest predictor of higher pesticide loading for the most frequently detected pesticides was location in California's San Joaquin Valley. SIGNIFICANCE: Our findings contribute to the growing understanding that pesticides are ubiquitous in children's environments. Pesticide levels in carpet dust were associated with some factors that ECE directors may have control over, such as IPM practices, and others that are beyond their control, such as geographic location. IPM is an important tool that has the potential to reduce pesticide exposures in ECE environments, even for pesticides no longer in use. IMPACT: One million children in California under six years old attend child care programs where they may spend up to 40 h per week. Children are uniquely vulnerable to environmental contaminants; however early care settings are under researched in environmental health studies. Little is known about predictors of pesticide levels found in environmental samples from child care facilities. This study aims to identify behavioral and environmental determinants of pesticide contamination in California child care centers. Findings can empower child care providers and consumers and inform decision makers to reduce children's exposures to pesticides and promote lifelong health.

Preschool-Age Children's Pesticide Exposures in Child Care Centers and at Home in Northern California.

INTRODUCTION: Young children may be exposed to pesticides used in child care centers and their family homes. We examined pesticide use and environmental and behavioral factors potentially associated with child exposures in these settings. METHOD: Preschool-age children (n = 125) wore silicone wristbands to assess pesticide exposures in their child care centers and home environments. Information about environmental and behavioral exposure determinants was collected using parent surveys, child care director interviews, and observations. RESULTS: Commonly detected pesticides were bifenthrin, chlorpyrifos, cypermethrin, fipronil, and cis- and trans-permethrin. Pesticide chemical storage onsite, cracks in the walls, using doormats, observed pests, or evidence of pests were associated with child exposures. Exposures were higher in counties with higher agricultural or commercial pesticide use or when children lived in homes near agricultural fields. DISCUSSION: Young children are being exposed to harmful pesticides, and interventions are needed to lower their risk of health problems later in life.

Development of an online curriculum for California early care and education providers on healthy beverages.

BACKGROUND: Children's consumption of sugar-sweetened beverages is associated with obesity, diabetes, and dental decay. California's Healthy Beverages in Child Care Act (AB 2084) requires all licensed child care centers and family child care homes to comply with healthy beverages standards, however many licensed providers in California are unaware of the law and few are fully compliant with the law's requirements. The aim of the current project is to describe the development of a self-paced online training on best practices and implementation of AB 2084 in English and Spanish for family child care home and child care center providers; and to evaluate the feasibility, defined as being accessible, acceptable, and satisfactory to providers, of this new online course. METHODS: The project was broken into two main stages: (1) development of the online course; and (2) evaluation of the final online course. The first stage was completed in five phases: (1) identify relevant course content and develop narration script; (2) conduct in-person focus groups with child care providers to review and edit the content; (3) adapt course content and translate for Spanish-speaking providers; (4) build the online course and resources; and (5) pilot online course and evaluate accessibility. The second stage, evaluation of the acceptability and satisfaction of the final course was rated on a Likert scale from 1 to 4; the evaluation was completed as part of a larger randomized control trial with 43 child care providers. The course features four key requirements of AB 2084 as the main sections of the course (milk, sweetened beverages, juice, and water), plus background information about beverages and children's health, special topics including caring for children with special needs, family engagement, written policies, and child engagement. RESULTS: The child care providers who completed the evaluation found the online training was easily understandable (median(Q1,Q3,IQR) = 4 (4,4,0)), included new information (3 (1, 3, 4)), provided useful resources (4(4,4,0)), and was rated with high overall satisfaction (3 (1, 3, 4)). CONCLUSION: Online training in English and Spanish designed for child care providers is a feasible medium to deliver important health messages to child care providers in an accessible, acceptable, and satisfactory manner.

National Health and Safety Standards: Family Child Care Homes Compared With Child Care Centers.

INTRODUCTION: The study objectives are to describe the national health and safety standards in family child care homes (FCCHs) and child care centers and compare them by child care type. METHOD: Child care health consultants and research assistants completed the standardized Health and Safety Checklist, which comprised key national health and safety standards, in a convenience sample of 21 FCCHs and 31 child care centers enrolled in two larger studies conducted in CA. RESULTS: The checklist was completed in 1 or 2 hours in FCCHs and centers, respectively. The internal consistency of the overall checklist subscales was moderate to strong. Eight of 10 checklist subscales were not significantly different in FCCHs and centers, but outdoor facilities (p < .05) and supervision, interaction, and physical activity (p < .05) were different. DISCUSSION: The Health and Safety Checklist is valid in FCCHs and centers and identifies targeted interventions for nurses to improve child care quality.

An Integrated Pest Management Intervention Improves Knowledge, Pest Control, and Practices in Family Child Care Homes.

To reduce young children's exposure to pesticides when attending family child care homes (FCCHs), we developed an integrated pest management (IPM) intervention for FCCH directors. First, we developed IPM educational materials and resources to provide the foundation for an IPM educational intervention for FCCHs. Next, we conducted and evaluated a six-month nurse child care health consultant (CCHC)-led education and consultation IPM intervention to increase IPM knowledge, IPM practices, IPM policies, and decrease the presence or evidence of pests. The pilot intervention study was conducted by three CCHCs in 20 FCCHs in three counties in California. Pre- and post-intervention measures were completed by the FCCH directors and observation measures were completed by the CCHCs. Results indicated significant increases in IPM knowledge, (t-statistic (degrees of freedom), (t(df) = 2.55(10), p < 0.05), increases in IPM practices (t(df) = -6.47(17), p < 0.05), and a 90% reduction in the prevalence of pests. There were no significant differences in changes in IPM practices based on director education, FCCH county, or IPM intervention intensity or duration. A nurse-led IPM education and consultation intervention can reduce exposures of young children attending family child care homes to harmful chemicals.