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BACKGROUND: Children's potential exposures to chemical and biological agents in tribal childcare centers are not well characterized. OBJECTIVES: (1) The environmental health of childcare centers in Portland Area Indian Country was characterized by measuring selected pesticides, polychlorinated biphenyls (PCBs), allergens, and lead (Pb) in outdoor soil and indoor dust. (2) We compared our results to other studies of childcare centers in both the United States and globally. METHODS: At 31 tribal childcare centers in Washington, Oregon, and Idaho, we collected indoor dust and outdoor soil samples from at least one classroom, multipurpose room, and outdoor play area. Number of rooms sampled depended on facility size. Surface wipes were collected from the floor, play/work surface, and windowsill and analyzed for selected pesticides and PCBs. Vacuum samples were collected from the floor and analyzed for selected allergens. Lead was measured in surface wipes and outdoor soil collected at 11 centers. A questionnaire collected information on demographics, cleaning habits, and pesticide usage. RESULTS: At least one pesticide was measured at all childcare centers. cis-Permethrin (surface wipes: 0.003-180 ng/cm2), trans-permethrin (surface wipes: 0.002-200 ng/cm2) and piperonyl butoxide (surface wipes: 0.001-120 ng/cm2) were measured in all centers. Lead was measured in most surface wipes (<0.25-14 ng/cm2) and all outdoor soil samples (8.4-50 mg/kg). Aroclors 1242 and 1254 were detected on indoor surfaces in three centers at very low loadings. Allergen residues were measured at very low concentrations in vacuum dust samples (Der p 1: <0.012-0.12 µg/g; Der f 1: <0.012-0.09 µg/g; Mus m 1: <0.002-10.055 µg/g). In general, we observed lower levels of chemical and biological agents than what has been reported previously. SIGNIFICANCE: By understanding the environmental health of childcare centers, we can better understand the role of child-specific environments in promoting children's health and well-being. IMPACT STATEMENT: To our knowledge, this is the first study to characterize the environmental health of tribal childcare centers in the Pacific Northwest. Combined with the information we have on childcare centers from around the world, this study expands our knowledge on young children's potential exposures to chemical and biological agents in locations where they spend significant amounts of time.

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Pyrethroid insecticides are widely used to control insects in both agricultural and residential settings worldwide. Few data are available on the temporal variability of pyrethroid metabolites in the urine of non-occupationally exposed adults. In this work, we describe the study design and sampling methodology for the Pilot Study to Estimate Human Exposures to Pyrethroids using an Exposure Reconstruction Approach (Ex-R study). Two major objectives were to quantify the concentrations of several pyrethroid metabolites in bedtime, first morning void (FMV), and 24-h urine samples as concentration (wet weight), specific-gravity (SG) corrected, creatinine (CR) corrected, and excretion rate values for 50 Ex-R adults over a six-week monitoring period and to determine if these correction approaches for urine dilution reduced the variability of the biomarker levels. The Ex-R study was conducted at the United States Environmental Protection Agency's Human Studies Facility in Chapel Hill, North Carolina USA and at participants' homes within a 40-mile radius of this facility. Recruitment of participants and field activities occurred between October 2009 and May 2011. Participants, ages 19-50 years old, provided daily food, activity, and pesticide-use diaries and collected their own urine samples (bedtime, FMV, and 24-h) during weeks 1, 2, and 6 of a six-week monitoring period. A total of 2503 urine samples were collected from the study participants. These samples were analyzed for the pyrethroid metabolites 3-phenoxybenzoic acid (3-PBA), cis/trans-3-(2,2-dichlorovinyl)-2,2-dimethyl-cyclopropane carboxylic acid (cis/trans-DCCA), and 2-methyl-3-phenylbenzoic acid (MPA) using high performance liquid chromatography/tandem mass spectrometry. Only 3-PBA was frequently detected (>50%) in the adult urine samples. Median urinary 3-PBA levels were 0.88 ng/mL, 0.96 ng/mL-SG, 1.04 ng/mg, and 1.04 ng/min for concentration, SG-corrected, CR-corrected, and excretion rate values, respectively, across all urine samples. The results showed that median urinary 3-PBA concentrations were consistently the lowest in FMV samples (0.77 ng/mL, 0.68 ng/mL-SG, 0.68 ng/mg, and 0.58 ng/min) and the highest in 24-h samples (0.92 ng/mL, 1.06 ng/mL-SG, 1.18 ng/mg, and 1.19 ng/min) across all four methods. Intraclass correlation coefficient (ICC) estimates for 3-PBA indicated poor reproducibility (<0.22) for all urine sample types and methods over a day, week, and six weeks. Correcting for urine sample dilution, based on either SG, CR or urine output, introduced additional measurement variability both between- and within-individuals. These results indicate that a single measure of urinary 3-PBA was not sufficient to characterize average exposure regardless of sample type, correction method, and time frame of collection. In addition, the study results can be used to inform the design of exposure characterization strategies in relevant environmental epidemiology studies in the future.

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Air pollution health studies often use outdoor concentrations as exposure surrogates. Failure to account for variability of residential infiltration of outdoor pollutants can induce exposure errors and lead to bias and incorrect confidence intervals in health effect estimates. The residential air exchange rate (AER), which is the rate of exchange of indoor air with outdoor air, is an important determinant for house-to-house (spatial) and temporal variations of air pollution infiltration. Our goal was to evaluate and apply mechanistic models to predict AERs for 213 homes in the Near-Road Exposures and Effects of Urban Air Pollutants Study (NEXUS), a cohort study of traffic-related air pollution exposures and respiratory effects in asthmatic children living near major roads in Detroit, Michigan. We used a previously developed model (LBL), which predicts AER from meteorology and questionnaire data on building characteristics related to air leakage, and an extended version of this model (LBLX) that includes natural ventilation from open windows. As a critical and novel aspect of our AER modeling approach, we performed a cross validation, which included both parameter estimation (i.e., model calibration) and model evaluation, based on daily AER measurements from a subset of 24 study homes on five consecutive days during two seasons. The measured AER varied between 0.09 and 3.48 h(-1) with a median of 0.64 h(-1). For the individual model-predicted and measured AER, the median absolute difference was 29% (0.19 h­1) for both the LBL and LBLX models. The LBL and LBLX models predicted 59% and 61% of the variance in the AER, respectively. Daily AER predictions for all 213 homes during the three year study (2010-2012) showed considerable house-to-house variations from building leakage differences, and temporal variations from outdoor temperature and wind speed fluctuations. Using this novel approach, NEXUS will be one of the first epidemiology studies to apply calibrated and home-specific AER models, and to include the spatial and temporal variations of AER for over 200 individual homes across multiple years into an exposure assessment in support of improving risk estimates.

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Limited published information exists on young children's exposures to bisphenol A (BPA) in the United States using urinary biomonitoring. In a previous project, we quantified the aggregate exposures of 257 preschool children to BPA in environmental and personal media over 48-h periods in 2000-2001 at homes and daycares in North Carolina and Ohio. In the present study for 81 Ohio preschool children ages 23-64 months, we quantified the children's urinary total BPA (free and conjugated) concentrations over these same 48-h periods in 2001. Then, we examined the quantitative relationships between the children's intakes doses of BPA through the dietary ingestion, nondietary ingestion, and inhalation routes and their excreted amounts of urinary BPA. BPA was detected in 100% of the urine samples. The estimated median intake doses of BPA for these 81 children were 109 ng/kg/day (dietary ingestion), 0.06 ng/kg/day (nondietary ingestion), and 0.27 ng/kg/day (inhalation); their estimated median excreted amount of urinary BPA was 114 ng/kg/day. Our multivariable regression model showed that dietary intake of BPA (p = 0.04) and creatinine concentration (p = 0.004) were significant predictors of urinary BPA excretion, collectively explaining 17% of the variability in excretion. Dietary ingestion of BPA accounted for >95% of the children's excreted amounts of urinary BPA.

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A few studies have reported concurrent levels of chlorpyrifos (CPF) and diazinon (DZN) and their environmentally occurring metabolites, 3,5,6-trichloro-2-pyridinol (TCP) and 2-isopropyl-6-methyl-4-pyrimidinol (IMP), in food and in environmental media. This information raises questions regarding the reliability of using these same metabolites, TCP and IMP, as urinary biomarkers to quantitatively assess the everyday exposures of children to CPF and DZN, respectively. In this study, we quantified the distributions of CPF, DZN, TCP, and IMP in several environmental and personal media at the homes and day-care centers of 127 Ohio preschool children and identified the important sources and routes of their exposures. The children were exposed to concurrent levels of these four chemicals from several sources and routes at these locations. DZN and IMP were both detected above 50% in the air and dust samples. CPF and TCP were both detected in greater than 50% of the air, dust (solid), food, and hand wipe samples. TCP was detected in 100% of the urine samples. Results from our regression models showed that creatinine levels (<0.001), and dietary (P<0.001) and inhalation (P<0.10) doses of TCP were each significant predictors of urinary TCP, collectively explaining 27% of the urinary TCP variability. This information suggests that measurement of urinary TCP did not reliably allow quantitative estimation of the children's everyday environmental exposures to CPF.

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We estimated cumulative residential pesticide exposures for a group of nine young children (4-6 years) using three different methodologies developed by the US Environmental Protection Agency and compared the results with estimates derived from measured urinary metabolite concentrations. The Standard Operating Procedures (SOPs) for Residential Exposure Assessment are intended to provide a screening-level assessment to estimate exposure for regulatory purposes. Nonetheless, dermal exposure estimates were typically lower from the SOP (1-1300 nmol/day) than from SHEDS (5-19,000 nmol/day) or any of the four different approaches for estimating dermal exposure using the Draft Protocol for Measuring Children's Non-Occupational Exposure to Pesticides by all Relevant Pathways (Draft Protocol) (5-11,000 nmol/day). Indirect ingestion exposure estimates ranged from 0.02 to 21.5 nmol/day for the SOP, 0.5 to 188 nmol/day for SHEDS, and 0 to 3.38 nmol/day for the Draft Protocol. Estimates of total absorbed dose ranged from 3 to 37 nmol/day for the SOPs, 0.5 to 100 nmol/day for SHEDS, and 1 to 216 nmol/day for the Draft Protocol. The concentrations estimated using the Draft Protocol and SHEDS showed strong, positive relationships with the 3-phenoxybenzoic acid metabolite measured in the children's urine samples (R²=0.90 for the Draft Protocol; R²=0.92 for SHEDS). Analysis of different approaches for estimating dermal exposure suggested that the approach assuming an even distribution of pesticide residue on the child's body was most reasonable. With all three methodologies providing reasonable estimates of exposure and dose, selection should depend on the available data and the objectives of the analysis. Further research would be useful to better understand how best to estimate dermal exposure for children and what exposure factors (e.g., activities, transfer coefficients, measurement techniques) are most relevant in making dermal exposure estimates.

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The accuracy of the exposure assessment is a critical factor in epidemiological investigations of pesticide exposures and health in agricultural populations. However, few studies have been conducted to evaluate questionnaire-based exposure metrics. The Agricultural Health Study (AHS) is a prospective cohort study of pesticide applicators who provided detailed questionnaire information on their use of specific pesticides. A field study was conducted for a subset of the applicators enrolled in the AHS to assess a pesticide exposure algorithm through comparison of algorithm intensity scores with measured exposures. Pre- and post-application urinary biomarker measurements were made for 2,4-D (n=69) and chlorpyrifos (n=17) applicators. Dermal patch, hand wipe, and personal air samples were also collected. Intensity scores were calculated using information from technician observations and an interviewer-administered questionnaire. Correlations between observer and questionnaire intensity scores were high (Spearman's r=0.92 and 0.84 for 2,4-D and chlorpyrifos, respectively). Intensity scores from questionnaires for individual applications were significantly correlated with post-application urinary concentrations for both 2,4-D (r=0.42, P<0.001) and chlorpyrifos (r=0.53, P=0.035) applicators. Significant correlations were also found between intensity scores and estimated hand loading, estimated body loading, and air concentrations for 2,4-D applicators (r-values 0.28-0.50, P-values<0.025). Correlations between intensity scores and dermal and air measures were generally lower for chlorpyrifos applicators using granular products. A linear regression model indicated that the algorithm factors for individual applications explained 24% of the variability in post-application urinary 2,4-D concentration, which increased to 60% when the pre-application urine concentration was included. The results of the measurements support the use of the algorithm for estimating questionnaire-based exposure intensities in the AHS for liquid pesticide products. Refinement of the algorithm may be possible using the results from this and other measurement studies.

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A subset of private pesticide applicators in the Agricultural Health Study (AHS) epidemiological cohort was monitored around the time of their agricultural use of 2,4-dichlorophenoxyacetic acid (2,4-D) and O,O-diethyl-O-3,5,6-trichloro-2-pyridyl phosphorothioate (chlorpyrifos) to assess exposure levels and potential determinants of exposure. Measurements included pre- and post-application urine samples, and patch, hand wipe, and personal air samples. Boom spray or hand spray application methods were used by applicators for 2,4-D products. Chlorpyrifos products were applied using spray applications and in-furrow application of granular products. Geometric mean (GM) values for 69 2,4-D applicators were 7.8 and 25 microg/l in pre- and post-application urine, respectively (P<0.05 for difference); 0.39 mg for estimated hand loading; 2.9 mg for estimated body loading; and 0.37 microg/m(3) for concentration in personal air. Significant correlations were found between all media for 2,4-D. GM values for 17 chlorpyrifos applicators were 11 microg/l in both pre- and post-application urine for the 3,5,6-trichloro-2-pyridinol metabolite, 0.28 mg for body loading, and 0.49 microg/m(3) for air concentration. Only 53% of the chlorpyrifos applicators had measurable hand loading results; their median hand loading being 0.02 mg. Factors associated with differences in 2,4-D measurements included application method and glove use, and, for hand spray applicators, use of adjuvants, equipment repair, duration of use, and contact with treated vegetation. Spray applications of liquid chlorpyrifos products were associated with higher measurements than in-furrow granular product applications. This study provides information on exposures and possible exposure determinants for several application methods commonly used by farmers in the cohort and will provide information to assess and refine exposure classification in the AHS. Results may also be of use in pesticide safety education for reducing exposures to pesticide applicators.

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The U.S. Department of Housing and Urban Development in collaboration with the United States Environmental Protection Agency conducted a survey measuring lead, allergens, and insecticides in a randomly selected nationally representative sample of residential homes. Multistage sampling with clustering was used to select the 1131 homes of which a subset of 500 randomly selected homes included the collection of hard surface floor wipes. Samples were collected by trained field technicians between June 2005 and March 2006 using isopropanol wetted wipes. Samples were analyzed for a suite of 24 compounds which included insecticides in the organochlorine, organophosphate, pyrethroid and phenylpyrazole classes, and the insecticide synergist piperonyl butoxide. The most commonly detected were permethrin (89%), chlorpyrifos (78%), chlordane (64%), piperonyl butoxide (52%), cypermethrin (46%), and fipronil (40%). Mean and geometric mean (GM) concentrations varied widely among compounds, but were highest for trans-permethrin (mean 2.22 ng/cm2 and GM 0.14 ng/ cm2) and cypermethrin (mean 2.9 ng/cm2 and GM 0.03 ng/ cm2). Results show that most floors in occupied homes in the U.S. have measurable levels of insecticides that may serve as sources of exposure to occupants.

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In this study, we investigated the 2,4-dichlorophenoxyacetic acid (2,4-D) herbicide exposures of 135 preschool-aged children and their adult caregivers at 135 homes in North Carolina (NC) and Ohio (OH). Participants were randomly recruited from six NC and six OH counties. Monitoring was performed over a 48-h period at the participants' homes. Environmental samples included soil, outdoor air, indoor air, and carpet dust. Personal samples collected by the adult caregivers concerning themselves and their children consisted of solid food, liquid food, hand wipe, and spot urine samples. All samples were analyzed for 2,4-D (free acid form) by gas chromatography/mass spectrometry. 2,4-D was detected in all types of environmental samples but most often in carpet dust samples, with detection frequencies of 83% and 98% in NC and OH, respectively. The median level of 2,4-D in the carpet dust samples was about three times higher in OH homes compared to NC homes (156 vs. 47.5 ng/g, P<0.0002). For personal samples, 2,4-D was more frequently detected in the hand wipe samples from OH participants (>48%) than from NC participants (<9%). Hand wipe levels at the 95th percentile were about five times higher for OH children (0.1 ng/cm(2)) and adults (0.03 ng/cm(2)) than for the NC children (0.02 ng/cm(2)) and adults (<0.005 ng/cm(2)). 2,4-D was detected in more than 85% of the child and adult urine samples in both states. The median urinary 2,4-D concentration was more than twice as high for OH children compared to NC children (1.2 vs. 0.5 ng/ml, P<0.0001); however, the median concentration was identical at 0.7 ng/ml for both NC and OH adults. The intraclass correlation coefficient of reliability for an individual's urinary 2,4-D measurements, estimated from the unadjusted (0.31-0.62) and specific gravity-adjusted (0.37-0.73) values, were somewhat low for each group in this study. The variability in urinary 2,4-D measurements over the 48-h period for both children and adults in NC and OH suggests that several spot samples were needed to adequately assess these participants' exposures to 2,4-D in residential settings. Results from this study showed that children and their adult caregivers in NC and OH were likely exposed to 2,4-D through several pathways at their homes. In addition, our findings suggest that the OH children might have been exposed to higher levels of 2,4-D through the dermal and nondietary routes of exposure than the NC children and the NC and OH adults.

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The potential exposures of 127 preschool children to the pyrethroid insecticides, cis- and trans-permethrin, in their everyday environments were examined. Participants were recruited randomly from 127 homes and 16 daycare centers in six Ohio (OH) counties. Monitoring was performed over a 48-h period at the children's homes and/or daycare centers. Samples collected included soil, carpet dust, indoor air, outdoor air, diet, hand wipes, surface wipes, transferable residues, and urine. The environmental samples were analyzed for the cis and trans isomers of permethrin, and the urine samples were analyzed for the pyrethroid urinary metabolite, 3-phenoxybenzoic acid (3-PBA), by gas chromatography/mass spectrometry. The isomers were detected most often in the dust (100%) and hand wipe (>78%) samples collected at both homes and daycare centers. The median levels of cis-permethrin (470 and 1010 ng/g) were higher than the median levels of trans-permethrin (344 and 544 ng/g) in the dust samples at both the children's homes and daycare centers, respectively. In the children's hand wipe samples, the median levels of cis- and trans-permethrin were similar, ranging from 0.03 to 0.04 ng/cm(2), at both locations. The urinary metabolite 3-PBA was detected in 67% of the children's urine samples. The median urinary 3-PBA concentration for the children was 0.3 ng/mL, and the maximum value for one child was 33.8 ng/mL. The primary route of the children's exposure to the combined isomers was through dietary ingestion, followed by indirect ingestion. In addition, our calculated aggregate absorbed doses of permethrin accounted for about 60% of the excreted amounts of 3-PBA found in the children's urine. In conclusion, these children were potentially exposed to low levels of permethrin from several sources, and through several pathways and routes.

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The U.S. Department of Housing and Urban Development, in collaboration with the U.S. Consumer Product Safety Commission and the U.S. Environmental Protection Agency, characterized the environments of young children (<6 years) by measuring lead, allergens, and pesticides in a randomly selected nationally representative sample of licensed institutional child care centers. Multi-stage sampling with clustering was used to select 168 child care centers in 30 primary sampling units in the United States. Centers were recruited into the study by telephone interviewers. Samples for pesticides, lead, and allergens were collected at multiple locations in each center by field technicians. Field sampling was conducted from July through October 2001. Wipe samples from indoor surfaces (floors, tabletops, desks) and soil samples were collected at the centers and analyzed using a multi-residue GC/MS analysis method. Based on the questionnaire responses, pyrethroids were the most commonly used pesticides among centers applying pesticides. Among the 63% of centers reporting pesticide applications, the number of pesticides used in each center ranged from 1 to 10 and the frequency of use ranged from 1 to 107 times annually. Numerous organophosphate and pyrethroid pesticides were detected in the indoor floor wipe samples. Chlorpyrifos (0.004-28 ng/cm2), diazinon (0.002-18 ng/cm2), cis-permethrin (0.004-3 ng/cm2), and

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As part of the Children's Total Exposure to Persistent Pesticides and Other Persistent Organic Pollutants (CTEPP) study, we investigated the exposures of preschool children to chlorpyrifos and its degradation product 3,5,6-trichloro-2-pyridinol (TCP) in their everyday environments. During this study, the participants were still able to purchase and apply chlorpyrifos at their homes or day care centers. Participants were recruited randomly from 129 homes and 13 day care centers in six North Carolina counties. Monitoring was performed over a 48-h period at the children's homes and/or day care centers. Samples that were collected included duplicate plate, indoor and outdoor air, urine, indoor floor dust, play area soil, transferable residues (PUF roller), and surface wipes (hand, food preparation, and hard floor). The samples were extracted and analyzed by gas chromatography/mass spectrometry. Chlorpyrifos was detected in 100% of the indoor air and indoor floor dust samples from homes and day care centers. TCP was detected at homes and day care centers in 100% of the indoor floor dust and hard floor surface wipe, in >97% of the solid food, and in >95% of the indoor air samples. Generally, median levels of chlorpyrifos were higher than those of TCP in all media, except for solid food samples. For these samples, the median TCP concentrations were 12 and 29 times higher than the chlorpyrifos concentrations at homes and day care centers, respectively. The median urinary TCP concentration for the preschool children was 5.3 ng/ml and the maximum value was 104 ng/ml. The median potential aggregate absorbed dose (ng/kg/day) of chlorpyrifos for these preschool children was estimated to be 3 ng/kg/day. The primary route of exposure to chlorpyrifos was through dietary intake, followed by inhalation. The median potential aggregate absorbed dose of TCP for these children was estimated to be 38 ng/kg/day, and dietary intake was the primary route of exposure. The median excreted amount of urinary TCP for these children was estimated to be 117 ng/kg/day. A full regression model of the relationships among chlorpyrifos and TCP for the children in the home group explained 23% of the variability of the urinary TCP concentrations by the three routes of exposure (inhalation, ingestion, dermal absorption) to chlorpyrifos and TCP. However, a final reduced model via step-wise regression retained only chlorpyrifos through the inhalation route and explained 22% of the variability of TCP in the children's urine. The estimated potential aggregate absorbed doses of chlorpyrifos through the inhalation route were low (median value, 0.8 ng/kg/day) and could not explain most of the excreted amounts of urinary TCP. This suggested that there were other possible sources and pathways of exposure that contributed to the estimated potential aggregate absorbed doses of these children to chlorpyrifos and TCP. One possible pathway of exposure that was not accounted for fully is through the children's potential contacts with contaminated surfaces at homes and day care centers. In addition, other pesticides such as chlorpyrifos-methyl may have also contributed to the levels of TCP in the urine. Future studies should include additional surface measurements in their estimation of potential absorbed doses of preschool children to environmental pollutants. In conclusion, the results showed that the preschool children were exposed to chlorpyrifos and TCP from several sources, through several pathways and routes. .

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