Geographic differences in exposures to metals and essential elements in pregnant women living in Suriname.

BACKGROUND: In Suriname, 20% of pregnancies end in adverse birth outcomes. While prenatal exposure to metals may lead to adverse health outcomes, exposure assessments in Suriname are scant. Environmental contamination from mercury (Hg) used in artisanal goldmining in the Amazonian Interior, and the uncontrolled use of pesticides in suburban regions are of particular concern. OBJECTIVE: This study assessed geographic differences in exposures to metals and essential elements in pregnant Surinamese women. METHODS: This study is a subset (n = 400) of the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) cohort study. Sector-field inductively-coupled plasma mass spectrometry was used to determine concentrations of lead (Pb), Hg, selenium (Se), cadmium (Cd), manganese (Mn) and tin (Sn) in whole blood of the pregnant women. High vs. low exposures to Pb and Hg were determined and were based respectively on CDC (3.5 ug/dL) and USEPA (3.5 ug/L) action levels. Differences in geographic exposures were tested with the Mann-Whitney U-test, and differences between blood elemental concentrations and action levels for Pb and Hg with the Wilcoxon signed rank test. The association between demographics and high exposures of Pb and Hg was examined with multivariate logistic regression models. RESULTS: The median concentrations of Pb, Hg and Se (5.08 µg/dL, 7.87 µg/L, and 228.26 µg/L respectively) in Interior women, were higher than the Urban and Suburban regions (p < 0.001), and higher than internationally accepted action levels (p < 0.001). The median concentrations of Mn and Sn found in Suburban women (17.55 and 0.97 ug/L respectively) were higher than Urban and Interior regions (p < 0.02). SIGNIFICANCE: Pregnant women living in Suriname's Amazonian Interior are exposed to Hg and Pb at levels of public health concern. Urgently needed is a comprehensive source characterization assessment and the development, implementation and monitoring of environmental health policies, specifically addressing the chemicals of concern. IMPACT: In a subset of participants enrolled in the CCREOH environmental epidemiology cohort study elevated levels of Hg and Pb were identified. This is the first comprehensive exposure assessment in the Surinamese population. Health concerns include adverse birth- and neurodevelopmental outcomes. Geographic differences require a tailored approach to health intervention and comprehensive source characterization. Future research should ascertain the role of Se as a potential protective factor. Environmental policy development, implementation and monitoring is pivotal to mitigate exposures to these neurotoxicants.

Characterization of Urinary Pesticide Metabolite Concentrations of Pregnant Women in Suriname.

Prenatal exposure to pesticides and the association with adverse health outcomes have been examined in several studies. However, the characterization of pesticide exposure among Surinamese women during pregnancy has not been assessed. As part of the Caribbean Consortium of Research in Environmental and Occupational Health research program, 214 urine samples were collected from pregnant women living in three regions in Suriname with different agricultural practices: capital Paramaribo, the rice producing district Nickerie, and the tropical rainforest, the Interior. We used isotope dilution tandem mass spectrometry to quantify urinary concentrations of biomarkers of three pesticide classes, including phenoxy acid herbicides and organophosphate and pyrethroid insecticides, all of which are commonly used in agricultural and residential settings in Suriname. We observed that participants residing in Nickerie had the highest urinary metabolite concentrations of 2,4-dichlorophenoxyacetic acid and pyrethroids compared to those from Paramaribo or the Interior. Paramaribo had the highest concentrations of organophosphate metabolites, specifically dialkyl phosphate metabolites. Para-nitrophenol was detected in samples from Paramaribo and the Interior. Samples from Nickerie had higher median urinary pesticide concentrations of 2,4-dichlorophenoxyacetic acid (1.06 µg/L), and the following metabolites, 3,5,6-trichloro-2-pyridinol (1.26 µg/L), 2-isopropyl-4-methyl-6-hydroxypyrimidine (0.60 µg/L), and 3-phenoxybenzoic acid (1.34 µg/L), possibly due to residential use and heavy rice production.

Sociodemographic Influences on Perceived Stress during Pregnancy: Results from the CCREOH Environmental Epidemiologic Study, Suriname.

Screening for prenatal stress is not routine in Suriname, despite its significant impact on maternal and newborn health. This study assessed the prevalence of high perceived prenatal stress and its sociodemographic predictors in three geographic areas in Suriname. In this cross-sectional study, data from 1190 participants of the Caribbean Consortium for Research in Environmental and Occupational Health cohort study were analyzed. Cohen's Perceived Stress Scale was completed during pregnancy to ascertain high perceived stress (cut-off score 20). The association between maternal sociodemographic factors and high perceived stress was examined using the chi-square test and logistic regression models; 27.5% of all participants had high perceived stress with statistically significant lower rates in Nickerie (18.8%) compared with Paramaribo (29.8%; p = 0.001) and the Interior (28.6%; p = 0.019). Maternal sociodemographic factors moderated the difference between the Interior and Nickerie. Participants from Paramaribo had statistically significant higher odds of high perceived stress compared to those from Nickerie, independent of their age and educational level (adjusted OR = 1.94; 95% confidence interval 1.32-2.86). Perceived stress during pregnancy is predicted by sociodemographic factors. These findings identified target groups for interventions in Suriname. Policy makers should consider integrating perceived stress assessment as a routine part of prenatal care.