The infant´s environmental health study (ISA) a birth cohort situated in rural Costa Rica

Abstract

The infant´s environmental health study (ISA) is a prospective cohort study on neurodevelopment, growth, and respiratory health of children and their mothers living in a banana growing region in Costa Rica, using ecosystem health approaches. This cohort is uniquely suited to provide information on health effects of pesticides used globally, as well as manganese, a key part of the fungicide mancozeb, in both children and their mothers.We enrolled 451 pregnant women during 2010-2011, of whom 300 mother-children pairs are still actively followed. We performed 1-3 visits during pregnancy, and then followed mother-children pairs shortly after birth, and at the child age of 1, 5, 6, and 8 years. Results show mothers and children are exposed to a diverse group of pesticides, including: mancozeb, pyrimethanil, thiabendazole, chlorpyrifos, pyrethroids, and 2,4-D. We have explored exposure routes, and measured repeat biomarkers of exposure in urine, maternal blood and hair; we are well-suited for an exposome characterization. We found several biomarkers of exposure explain thyroid hormone concentrations, neurodevelopment and respiratory symptoms.International collaborations have been key to the creation, development and maintenance of the cohort. Ever since we obtained more constant funding, the number of mother-child pairs has remained stable (n~300). The ISA team has gained extensive experience working with the study population of whom many live in conditions of vulnerability. We created an excellent rapport with both the women and children, as well as other community members. Finally, collaborations with the personnel of more than 30 primary schools situated in the study area has been crucial.The ISA study also aims to contribute to the reduction of pesticide exposure and risk management. Future directions include studying the effects of mixtures of environmental exposures, explore possibilities to design an exposome, and the evaluation of strategies to mitigate the effect of pesticides on health.