Pesticide Exposure Among Latinx Child Farmworkers in North Carolina

Abstract

Background:

Although pesticides have adverse effects on child health and development, little research has examined pesticide exposure among child farmworkers. This analysis addresses two specific aims: (1) describe pesticide exposure among Latinx child farmworkers in North Carolina, and (2) delineate factors associated with this pesticide exposure.

Methods:

In 2018 (n=173) and 2019 (n=156) Latinx child farmworkers completed interviews and wore silicone wristbands for a single day to measure pesticide exposure. Wristbands were analyzed for 70 pesticides.

Results:

Most Latinx child farmworkers were exposed to multiple pesticides; the most frequent were pyrethroids (69.9% in 2018, 67.9% in 2019), organochlorines (51.4% in 2018, 55.1% in 2019), and organophosphates (51.4% in 2018, 34.0% in 2019). Children were exposed to a mean of 2.15 pesticide classes in 2018 and 1.91 in 2019, and to a mean of 4.06 pesticides in 2018 and 3.34 in 2019. Younger children (≤15 years) had more detections than older children; children not currently engaged in farm work had more detections than children currently engaged in farm work. Migrant child farmworkers had more detections than non-migrants. For specific pesticides with at least 20 detections, detections and concentrations were generally greater among children not currently engaged in farm work than children currently engaged.

Conclusions:

Children who live in farmworker communities are exposed to a plethora of pesticides. Although further research is needed to document the extent of pesticide exposure and its health consequences, sufficient information is available to inform policy needed to eliminate this pesticide exposure in agricultural communities.

1. INTRODUCTION

Children and adults living in farmworker communities in the United States (US) are exposed to pesticides.¹ Data from North Carolina documenting the detections and concentrations of pesticide urinary metabolites indicate that Latinx adult farmworkers are repeatedly exposed to a wide variety of pesticides across an agricultural season.^2-5 These pesticides include insecticides, fungicides, and herbicides. Analysis of adult migrant farmworker dwellings documents that these farmworkers are exposed to pesticides in their living quarters as well as at work.⁶

Similar pesticide urinary analysis data indicate that pesticide exposure is common among female as well as male Latinx farmworkers.^7-11 Life history data indicate that Latinx farmworkers experience greater pesticide exposure across their lives than do Latinx non-farmworkers,¹² but analyses of pesticide urinary metabolites indicate surprisingly similar levels of detection and concentrations when Latinx farmworkers and non-farmworkers are compared.^7-9 Analyses that compare pesticide urinary metabolites for Latinx farmworkers and non-farmworkers indicate that both groups (farmworkers and non-farmworkers) experience high levels of pesticide exposure.

Analyses focused on children living in Latinx farmworker communities demonstrate that these children are commonly exposed to pesticides, with exposure via environmental (e.g., drift from nearby fields), para-occupational (e.g., brought home on the clothes of those doing farm work), and residential (e.g., application to control residential pests) routes.¹³ Studies conducted in North Carolina found agricultural and residential pesticides, including pyrethroid (PYR) insecticides, organochlorine (OC) insecticides, and organophosphate (OP) insecticides, in Latinx farmworker family dwellings.¹⁴ Analyses of pesticide urinary metabolites for spouses and young children (age five years or younger) of Latinx farmworkers found high levels of the OP dialkylphosphate (DAP) metabolites present for most children.^15-17 Residential proximity to agricultural fields increases pesticide exposure.¹⁸ Longitudinal analyses of Latinx women and children in a California agricultural community documents that young children are exposed to high levels of OP insecticides based on levels of DAP pesticide urinary metabolites.^19-22 Adolescent girls in these same California agricultural communities are also exposed to a plethora of PYR, OC, and OP insecticides, as well as several fungicides and herbicides.²³ Research conducted in Washington using environmental and biomonitoring data reports that young children in farmworker families are widely exposed to OP insecticides.^24,25 Finally, analysis of pesticide exposure data collected from 8-year old Latinx children in North Carolina rural farmworker and urban non-farmworker families found that most of these children were exposed to PYR (65.4%), OC (85.7%), and OP insecticides (59.4%), as well as to other insecticides, fungicides, and herbicides.²⁶

Pesticide exposure causes adverse health and developmental outcomes for children as well as adults. Depending on dose, acute pesticide intoxication has immediate and drastic effects, which range from rash, burning eyes, and muscle ache, to coma and death.²⁷ The Agricultural Health Study (https://aghealth.nih.gov/)²⁸ documents the health effects of long-term, lower dose pesticide exposure, including increased risk for neurocognitive decline, pulmonary disease, cancer, and reproductive problems. The documented effects of low-dose exposure for adult farmworkers are limited to cholinesterase depression,^29,30 and impaired olfaction.³¹ Varnell et al.³² indicate that pesticide exposure is associated with menstrual irregularities among adolescent Latina farmworkers. Studies indicate that pre-natal,^21,33-37 and post-natal^38-40 pesticide exposure among the children of farmworkers and others adversely affects their neurocognitive development.

Although farm work is associated with high levels of pesticide exposure, and this pesticide exposure is associated with risk for immediate and long-term health and developmental problems, current federal labor regulations allow employers to hire children as young as 10 years of age for agricultural work in the US.^41,42 Some states have stricter regulations for hired child farmworkers, but most, including North Carolina, observe the federal regulations. These federal regulations allow children aged 10 or 11 years to be hired to work on farms not operated by their relatives as long as they are engaged in non-hazardous tasks on small farms to which Fair Labor Standard Act minimum wage requirements do not apply, they work outside of school hours, and have parental permission.⁴² Children 12 or 13 years old can hold any nonhazardous farm job outside school hours with parental permission. Those aged 14 or 15 years can hold any nonhazardous farm job outside school hours without parental permission. Those aged 16 or 17 years can hold any farm job, hazardous or not, with unlimited work hours. Children of any age can do any task, hazardous or not, on farms operated by their families.^43-45 The revised US Environmental Protection Agency’s Worker Protection Standard⁴⁶ is the only other federal regulation specifically addressing the work safety of children hired to do farm work. This regulation restricts anyone under the age of 18 years from applying pesticides, but does not restrict those under age 18 years from working and living in places to which pesticides have been applied.⁴⁶

The number of children aged 10 to 17 years hired to work on farms each year is not known. The best available estimates indicate that between 30,000 and 79,325 hired child farmworkers were employed annually between 2005 and 2016.^47,48 Most of these child farmworkers are Latinx, either immigrants themselves or the children of immigrants.⁴⁹ Agriculture is a hazardous industry, and children working in agriculture experience high rates of injury, illness, and death.^50-54

Pesticide exposure is one agricultural hazard experienced by child Latinx farmworkers that has received very little attention. Harley et al.²³ examine pesticide exposure among Latina adolescents living in a California agricultural community, and Arcury et al.²⁶ document pesticide exposure among Latino children living in rural North Carolina farmworker communities. The children in these two studies were not hired farmworkers, but both studies report that children living in agricultural communities experience substantial pesticide exposure. Several studies report that few Latinx child farmworkers receive pesticide safety training, including that mandated the Environmental Protection Agency’s Worker Protection Standard.^46,55-58 Whitworth and colleagues⁵⁹ report neurodevelopmental effects among adolescent Latinx farmworkers due to pesticide exposure.

This analysis uses pesticide exposure data collected by The Hired Child Farmworker Study in 2018 and 2019 to address two specific aims. First, it describes pesticide exposure among Latinx child farmworkers in North Carolina. Second, it delineates the factors associated with pesticide exposure among these Latinx child farmworkers.

2. METHODS

2.1. Study Design

The Hired Child Farmworker Study is a community-based participatory research study examining the effects of farm work on the health and development of Latinx child farmworkers.⁶⁰ Research partners include investigators from Student Action with Farmworkers and Wake Forest School of Medicine. The study is informed by a professional advisory committee with representatives from organizations providing health, educational, and social services to migrant and seasonal farmworkers in North Carolina. It is also informed by a youth advisory committee consisting of members of the Student Action with Farmworkers Levante Leadership Institute.⁶¹ This longitudinal study initially recruited participants in 2017, with follow-up data collection in 2018 and 2019. The Wake Forest School of Medicine Institutional Review Board approved the study protocol. The study received a Certificate of Confidentiality from the National Institutes of Health.

2.2. Study Participants

Two-hundred and two participants were initially recruited to the study from April through November 2017. Inclusion criteria were: (1) age 10-17 years; (2) employed in farm work in the previous three months; (3) self-identify as Latino or Hispanic (Latinx); and (4) able to speak Spanish or English. There were no exclusion criteria. Participants included girls and boys. Farmworker community service and advocacy organizations helped recruit participants. Because interviewers worked through community partners, the number of potential participants or their parents who refused to participate is not known. Interviewers contacted the parents of potential participants to explain the study, ensure the child met the inclusion criteria, and obtain signed parental permission. The interviewers met with the potential participants to review the study, inclusion criteria, that they would receive a cash incentives for participating in the research, and obtain signed assent. Participants who became 18 years of age before the 2018 and 2019 follow-up contacts provided signed informed consent.

One-hundred and seventy-three (85.6%) of the original 202 participants completed an interview and wore a silicone wristband for one day to gather pesticide exposure data in 2018. In 2019, 156 (77.2%) of the original 202 participants completed an interview and wore a silicone wristband for one day. The participants for 2018 and 2019 were overlapping sets with 183 unique individuals participating across the two years: 146 participated in 2018 and 2019; 27 participated in 2018 only; and 10 participated in 2019 only. Participants received cash incentives each year for completing the interviews and wearing the silicone wristband.

2.3. Data Collection

This analysis uses interview data collected each year from 2017 through 2019 and pesticide exposure data collected with silicone wristbands in 2018 and 2019. The 2017 questionnaire addressed personal and work characteristics; results from this questionnaire have been published in several papers.^{41,55,60,62,63,64} The questionnaires for 2018 and 2019 included items to measure current year work activities. For each questionnaire, items from existing questionnaires and scales were used whenever possible.^65-67 Interviews were completed with tablets using REDCap (Research Electronic Data Capture), a secure web-based system, to record data.⁶⁸

Bilingual interviewers with knowledge of their local farmworker communities from across North Carolina enrolled participants and conducted the interviews. All interviewers had experience with farmworkers through employment with organizations that provide farmworker services. Each completed an intensive training program that included a didactic component that discussed recruitment procedures, procedures for obtaining parental permission and participant assent, the interview content, wristband procedures, and using the tablet and REDCap. Interviewers conducted audio-recorded practice interviewers that were reviewed by the investigators. Interviewers completed 172 (85.1%) of the 2017 interviews in English, and 30 (14.9%) in Spanish.

Participants were given a silicone wristband in a sealed Teflon bag and instructed to wear it for a single day while engaged in agricultural work.⁶⁹ Participants who were working in a non-agricultural job were instructed to wear the wristband when working. Participants who were not employed were instructed to wear the wristband during their normal daily activities. If participants wore gloves while working, they were given a safety-pin and instructed to wear the wristband pinned to their shirt. Participants were instructed to store the wristband in the sealed Teflon bag at the end of the day that they wore it until it was retrieved by the interviewer. Participants were instructed to log the date and time they put the wristband on, and time they took it off. Interviewers were trained to inspect the bag upon collection and ensure proper storage until project staff retrieval.

2.4. Laboratory Procedures

Wristbands were purchased from 24hourwristbands (Houston, TX). Conditioning, post-deployment cleaning, and extraction of the wristbands were performed as described previously.^69-71 Briefly, wristbands were rinsed in deionized water to remove particulates,⁶⁸ dried, and conditioned in a Blue-M Model# POM-18VC-2 vacuum-oven (300°C, 0.12 Torr) for three hours with periodic N₂ sweeps. Post-conditioning, individual wristbands were packaged in Teflon bags prior to deployment.

For post-deployment cleaning, the wristbands were rinsed with 18 MΩ·cm water and isopropanol to remove particulate matter. Extraction surrogates tetrachloro-meta-xylene (TCMX), decachlorobiphenyl, and PCB100 were added and the wristbands extracted with two 50 mL volumes of ethyl acetate, combined and quantitatively reduced to 1 mL. When necessary to remove analytical interferences, a 200 μL aliquot of extract underwent solid-phase extraction (SPE) on a C18 silica column with acetonitrile,^71,72 followed by a solvent exchange to isooctane for injection. All solvents were Optima-grade or equivalent (Fisher Scientific, Pittsburgh, PA). All analytical grade standards purchased from Accustandard (New Haven, CT) with purities of 95% or higher.

A 22-minute GC-ECD method has been developed and validated for analysis of pesticides in silicone wristbands.^23,72-74 4,4′-dibromooctafluorobipheny was added as an internal standard, and extracts analyzed using an Agilent 6890N gas chromatograph (GC) with dual micro-electron detectors (ECD), simultaneous injection was preformed using dual 7683 auto samplers onto DB-17MS and a DB-5MS column. A complete analyte list, detection limits, quantitation limits and chromatographic conditions are given in the electronic supplementary material (Supplementary Tables 1 and 2). For most analytes, identification and quantitation were made on the DB-17MS column, and the DB-XLB column was used for confirmation.

Sample handling, analysis, and quantitation were performed as defined by laboratory data quality objectives and standard operating procedures for quality assurance and quality control. Surrogate standard compounds accounted for any loss during extraction and analysis of passive sampling devices. Instrument blanks and continuing calibration checks were analyzed regularly during chromatography. Construction and process blanks were included in the analysis.

2.5. Measures

Measures of personal characteristics include gender (girl, boy), age in the categories 15 years or younger, 16 or 17 years, and 18 years or older, and whether the participant was unaccompanied (under age 18 years and not living with a parent or legal guardian). Work characteristics include whether the participant was employed as a farmworker in the current year (2018 and 2019). Among those employed as a farmworker in the current year, whether participant was a migrant worker (established a temporary residence across state lines for agricultural employment), and the number of weeks worked in the previous three months in the categories 1 or 2 weeks, 3 or 4 weeks, 5 to 7 weeks, and 8 to 12 weeks. The final work measure is whether the participant wore the silicone wristband while doing farm work. Among participants who wore the silicone wristband while doing farm work, the specific crops in which the participants worked the day they wore the wristband include tobacco, berries, tomatoes, sweet potatoes, green peppers, squash, hot peppers, cucumbers, melons, and other.

The first measures of pesticide exposure are the wristband detections (presence/absence) of each of 70 specific pesticides and pesticide degradation products. Selection of pesticides and pesticide degradation products was based on toxicology and exposure studies⁶⁹ and previous studies,^23,26 coupled with method validation studies for the wristbands and the analytical method. The second measures of pesticide exposure are detections (presence/absence) of at least one specific pesticide from each of 14 pesticide classes; the pesticide classes are pyrethroid, organochlorine, organophosphate, phenylpyrazole, chloroneb, dicarboximide, pentachloronitrobenzene, thiadiazole, dinitroaniline, aniline, triazine, benzenedicarboxylic acid, oxadiazole, and thiocarbamate. Total specific pesticide detections is the number of different specific pesticides (0 to 70) detected in a wristband. Total pesticide class detections is the number of different pesticide classes (0 to 14) detected in a wristband. Number of organochlorine detections is the number of different organochlorine pesticides detected in a wristband (0 to 32), and the number of pyrethroid detections is the number of different pyrethroid pesticides detected in a wristband (0 to 8). This measure was not calculated for the other pesticide classes because usually only one pesticide from a class was detected in a wristband. Concentrations in ng/g are reported as geometric means and were calculated only for those pesticides with detections above the limit of detection and with a minimum number of 20 wristbands with detections.

2.6. Statistical Analysis

Participant personal and work characteristics and detection of specific pesticides were described using counts and percentages for each year. Summary statistics including means and standard deviations (SD) were used to describe the number of specific pesticide or pesticide class detections by year. For each year, bivariate association between the presence of a specific pesticide or pesticide class and selected participant personal and work characteristics were examined using chi-square tests or Fisher’s exact tests when appropriate. The number of detections was analyzed using linear mixed effects models (LMM) to account for the correlation among the two repeated measures. Least square estimates and standard errors (SE) were reported for each year. The concentrations were analyzed using LMMs on the log scale and the means were back transformed and reported with corresponding 95% confidence intervals (CI). All analyses were conducted using SAS 9.4 (Cary, NC).

3. RESULTS

3.1. Participant Characteristics

In each year, 2018 and 2019, about one-third of the participants were girls and two-thirds were boys (Table 1). As expected, the age distribution became older between 2018 and 2019. In 2018, 42.8% were age 15 years or younger and 20.8% were aged 18 years or older; in 2019, 27.6% were aged 15 years or younger and 39.1% were aged 18 years or older. About 5% of participants were unaccompanied in both years. All participants at baseline (2017) were farmworkers. In 2018, 96 (55.5%) of the participants worked as farmworkers; in 2019, 80 participants (51.3%) worked as farmworkers. About 22% in each year were migrant workers. About one-quarter in each year worked 8 to 12 weeks in farm work.

Table 1:

Participant Personal and Work Characteristics, Latinx Children in Farmworker Communities, North Carolina, 2018 and 2019.

Personal and Work Characteristics	2018 n (%)	2019 n (%)
Personal Characteristics of All Participants	(N = 173)	(N = 156)
Gender
Female	64 (37.0)	59 (37.8)
Male	109 (63.0)	97 (62.2)
Age (in years)
15 or younger	74 (42.8)	43 (27.6)
16 or 17	63 (36.4)	52 (33.3)
18 or older	36 (20.8)	61 (39.1)
Unaccompanied	9 (5.2)	7 (4.5)
Work Characteristics of Those Employed as Farmworkers this Year	(N=96)	(N=80)
Migrant Worker	22 (22.9)	18 (22.5)
Work in last 3 months
1-2 weeks	26 (27.1)	15 (18.8)
3-4 weeks	31 (32.3)	36 (45.0)
5-7 weeks	15 (15.6)	11 (13.8)
8-12 weeks	24 (25.0)	18 (22.5)
Farmworker Wearing Wrist Band While Working	76 (79.2)	60 (75.0)
Crops Worked on Day Wristband was Worn	(N=76)	(N=60)
Tobacco	23 (30.3)	21 (35.0)
Berries	24 (31.6)	13 (21.7)
Tomatoes	14 (18.4)	11 (18.3)
Sweet potatoes	6 (7.9)	3 (5.0)
Green peppers	4 (5.3)	0 (0.0)
Squash	0 (0.0)	2 (3.3)
Hot peppers	1 (1.3)	0 (0.0)
Cucumbers	1 (1.3)	3 (5.0)
Melons	1 (1.3)	2 (3.3)
Other	3 (3.9)	7 (11.7)

In 2018, 76 participants (79.2% of those doing farm work; 43.9% of all participants) wore a silicone wristband on a day they did farm work; in 2019, 60 participants (75.0% who did farm work, 38.5% of all participants) wore a wristband on a day they did farm work. The crops in which those who wore a wristband on a day they did farm work most commonly worked were tobacco (30.3% in 2018, 35.0% in 2019), berries (31.6%, 21.7%) and tomatoes (18.4%, 18.3%).

3.2. Pesticide Exposure

The child farmworkers were exposed to an array of pesticides in both years (Table 2). Eight PYR insecticides or degradation products were detected. Most child farmworkers had a detection for at least one PYR in 2018 (69.9%) and in 2019 (67.9%). The most commonly detected PYRs were bifenthrin (11.6% in 2018, 11.5% in 2019), cyfluthrin (10.4% in 2018, 9.0% in 2019), cypermethrin (48.6% in 2018, 47.4% in 2019), cis-permethrin (47.3% in 2018, 24.4% in 2019), and trans-permethrin (49.7% in 2018, 27.6% in 2019).

Table 2:

Specific Pesticides Included in Each Class and Their Frequency of Detection, Latinx Children in Farmworker Communities, North Carolina, 2018 and 2019

Specific Pesticides and Pesticide Degradation Products	2018 (N = 173)	2019 (N = 156)
	n (%)	n (%)
Insecticides a
Any Pyrethroid (8 detected)	121 (69.9)	106 (67.9)
Bifenthrin	20 (11.6)	18 (11.5)
Cis-permethrin	82 (47.4)	38 (24.4)
Cyfluthrin	18 (10.4)	14 (9.0)
Cypermethrin	84 (48.6)	74 (47.4)
Deltamethrin and tralomethrin	5 (2.9)	3 (1.9)
Esfenvalerate	13 (7.5)	6 (3.8)
L-Cyhalothrin	18 (10.4)	25 (16.0)
Trans-permethrin	86 (49.7)	43 (27.6)
Any Organochlorine (26 detected) a	89 (51.4)	86 (55.1)
4,4'-DDD	1 (0.6)	0 (0.0)
4,4'-DDE	3 (1.7)	6 (3.8)
4,4'-DDT	5 (2.9)	2 (1.3)
Aldrin	0 (0.0)	1 (0.6)
Alpha-chlordane	39 (22.5)	47 (30.1)
Beta-BHC	1 (0.6)	0 (0.0)
Chlorobenzilate	0 (0.0)	1 (0.6)
Chlorothalonil	26 (15.0)	26 (16.7)
Dieldrin	5 (2.9)	8 (5.1)
EndosulfanI	1 (0.6)	2 (1.3)
EndosulfanII	1 (0.6)	0 (0.0)
Endosulfan-sulfate	2 (1.2)	3 (1.9)
Endrin	6 (3.5)	3 (1.9)
Endrin-aldehyde	6 (3.5)	0 (0.0)
Endrin-ketone	2 (1.2)	0 (0.0)
Gamma-chlordane	41 (23.7)	48 (30.8)
Heptachlor	0 (0.0)	1 (0.6)
Heptachlor-epoxide	9 (5.2)	1 (0.6)
Hexachlorobenzene	0 (0.0)	1 (0.6)
Isodrin	2 (1.2)	1 (0.6)
Methoxychlor	7 (4.0)	7 (4.5)
Mirex	2 (1.2)	0 (0.0)
o,p'-Dicofol	0 (0.0)	1 (0.6)
Perthane	3 (1.7)	0 (0.0)
p,p-Dicofol	2 (1.2)	0 (0.0)
Trans-nonachlor	26 (15.0)	26 (16.7)
Any Organophosphate (10 detected)b	89 (51.4)	53 (34.0)
Chlorpyrifos	67 (38.7)	48 (30.8)
Diazinon	15 (8.7)	1 (0.6)
Dimethoate	0 (0.0)	1 (0.6)
Ethion	5 (2.9)	3 (1.9)
Ethoprophos	7 (4.0)	1 (0.6)
Fenitrothion	6 (3.5)	1 (0.6)
Imidan	7 (4.0)	0 (0.0)
Parathion-ethyl	0 (0.0)	1 (0.6)
Parathion-methyl	1 (0.6)	0 (0.0)
Phorate	1 (0.6)	3 (1.9)
Any Phenylpyrazole (3 detected)	15 (8.7)	11 (7.1)
Fipronil	8 (4.6)	7 (4.5)
Fipronil-sulfide	7 (4.0)	5 (3.2)
Fipronil-sulfone	3 (1.7)	1 (0.6)
Fungicides
Aromatic Fungicide - Chloroneb	6 (3.5)	22 (14.1)
Any Dicarboximide (4 detected)	7 (4.0)	8 (5.1)
Captafol	1 (0.6)	0 (0.0)
Captan	7 (4.0)	7 (4.5)
Iprodion	1 (0.6)	1 (0.6)
Vinclozolin	0 (0.0)	1 (0.6)
Pentachloronitrobenzene	1 (0.6)	1 (0.6)
Thiadiazole - Etridiazole	1 (0.6)	0 (0.0)
Herbicides c
Any Dinitroaniline (2 detected)	19 (11.0)	7 (4.5)
Pendimethalin	1 (0.6)	4 (2.6)
Trifuralin	18 (10.4)	3 (1.9)
Any Aniline / Chloroacetanilide (2 detected) d	19 (11.0)	4 (2.6)
Metolachlor	0 (0.0)	1 (0.6)
Propachlor	19 (11.0)	3 (1.9)
Benzenedicarboxylic Acid – Dacthal	4 (2.3)	0 (0.0)
Oxadiazole - Oxadiazon	1 (0.6)	0 (0.0)

^aOrganochlorine pesticides not detected: alpha-BHC, chloropropylate, delta-BHC, lindane

^bOrganophosphate pesticides not detected: chlorpyrifos-methyl, malathion (included in the 2019 analysis only)

^cHerbicide classes not detected: triazine - atrazine; thiocarbamate - diallatel

^dAniline / Chloroacetanilide pesticides not detected: propanil; alachlor

Twenty-six different OC insecticides or degradation products were detected in the wristbands. Over half of the child farmworkers had a detection for at least one OC in 2018 (51.4%) and in 2019 (55.1%). Among the most common OCs detected were alpha-chlordane (22.5% in 2018, 30.1% in 2019), chlorothalonil (15.0% in 2018, 16.7% in 2019), gamma-chlordane (23.7% in 2018, 30.8% in 2019), and trans-nonachlor (15.0% in 2018, 16.7% in 2019).

Ten OP insecticides were detected, with 51.4% of the child farmworkers having a detection for at least one OP in 2018, and 34.0% in 2019. Chlorpyrifos was the only commonly detected OP (38.7% in 2018, 30.8% in 2019).

Three different phenylpyrazole insecticides were detected, but no more than 15 (8.7%) of the child farmworkers had a detection in either year. Eight different fungicides were detected in the wristbands worn by the child farmworkers, with chloroneb being the only commonly detected fungicide (3.5% in 2018, 14.1% in 2019). Six different herbicides were detected, with trifuralin (10.4% in 2018, 1.9% in 2019) and propachlor (11.0% in 2018, 1.9% in 2019) being the most commonly detected.

Twenty-two children in each year (2018 and 2019) had no detection for any pesticide. Three of these 22 children had no detection in either year. On average, the child farmworkers had detections of 2.15 different pesticide classes in 2018 and 1.91 different pesticide classes in 2019 (Table 3). They had a mean of 4.06 specific pesticide detections in 2018 and 3.34 in 2019. They averaged 1.88 PYR detections in 2018 and 1.42 in 2019, with 1.10 different OC detections in 2018 and 1.19 in 2019.

Table 3:

Mean Detections for Pesticide Classes, Specific Pesticides, Pyrethroid Insecticides, and Organochlorine Insecticides, Latinx Children in Farmworker Communities, North Carolina, 2018 and 2019.

Number of Pesticide Class Detections	2018 (N = 173)		2019 (N = 156)
	Range	Mean (SDa)	Range	Mean (SD)
Total Pesticide Class Detections	0-7	2.15 (1.33)	0-5	1.91 (1.29)
Total Specific Pesticide Detections	0-22	4.06 (3.19)	0-11	3.34 (2.75)
Pyrethroid Detections	0-7	1.88 (1.61)	0-5	1.42 (1.27)
Organochlorine Detections	0-9	1.10 (1.50)	0-6	1.19 (1.43)

^aSD: standard deviation

3.3. Factors Associated with Pesticide Exposure Among All Participants

The detection of at least one PYR, OC, OP, or phenylpyrazole insecticide was not associated with participant gender, age, whether engaged in any farm work that year, or whether wore the wristband on a day engaged in farm work for either 2018 or 2019, with one exception. In 2019, detection of any PYR insecticide had a statistically significant association with age such that 37 (86.0%) of those aged 15 years or younger had a detection, 28 (53.8%) of those aged 16 or 17 years had a detection, and 41 (67.2%) of those aged 18 years and older had a detection (p=0.0028).

The mean number of detections across all pesticide classes, all specific pesticides, organochlorine pesticides, and pyrethroid pesticides were associated with several personal and work characteristics (Table 4). Younger children had more pesticide class detections in both years; the number of different pesticide classes detected for those aged 15 years and younger was 2.41 in 2018 and 2.37 in 2019, while the number of classes detected for those age 18 and older was 1.69 in 2018 and 1.75 in 2019. Children who did not do any farm work versus those who did any farm work had detections for more different specific pesticides in 2018 (4.49 versus 3.52), for more PYR insecticides in 2018 (2.10 versus 1.61), and for more OC insecticides in 2018 (1.32 versus 0.71) and 2019 (1.35 versus 0.94). Children who wore a wristband on a day they did farm work had fewer OC insecticide detections in 2019 (0.93 versus 1.47).

Table 4:

Mean Number of Detections Across Pesticide Classes, Specific Pesticides, Pyrethroid Insecticides, and Organochlorine Insecticides by Personal and Work Characteristics 2018 (N = 173) and 2019 (N = 156), Latinx Children in Farmworker Communities, North Carolina.

Personal and Work Characteristics	Total Pesticide Class Detections		Total Specific Pesticide Detections		Total Pyrethroid Insecticide Detections		Total Organochlorine Insecticide Detections
	Number of Detections Mean (SEa)	p value	Number of Detections Mean (SE)	p value	Number of Detections Mean (SE)	p value	Number of Detections Mean (SE)	p value
	2018
Child Gender		0.8471		0.9140		0.9654		0.7682
Female	1.99 (0.12)		4.03 (0.37)		1.89 (0.18)		1.14 (0.18)
Male	2.16 (0.13)		4.08 (0.29)		1.88 (0.14)		1.07 )0.14)
Child Age		0.0249		0.4100		0.5712		0.2073
15 or younger	2.41 (0.15)		4.37 (0.35)		1.84 (0.17)		1.33 (0.17)
16 or 17	2.11 (0.16)		3.98 (0.38)		2.03 (0.18)		0.93 (0.18)
18 or older	1.69 (0.21)		3.58 (0.50)		1.73 (0.24)		0.93 (0.24)
Farmworker		0.4461		0.0340		0.0313		0.0210
No	2.22 (0.13)		4.49 (0.30)		2.10 (0.15)		1.32 (0.15)
Yes	2.06 (0.15)		3.52 (0.34)		1.61 (0.17)		0.81 (0.17)
Farm Work on Day Wristband was Worn		0.9578		0.3996		0.1408		0.2698
No	2.14 (0.15)		4.28 (0.34)		2.07 (0.17)		1.23 (0.17)
Yes	2.15 (0.13)		3.89 (0.31		1.74 (0.15)		0.99 (0.15)
	2019
Child Gender		0.6454		0.5621		0.5232		0.9451
Female	1.85 (0.17)		3.16 (0.39)		1.32 (0.19)		1.18 (0.19)
Male	1.95 (0.13)		3.44 (0.30)		1.47 (0.15)		1.20 (0.15)
Child Age		0.0227		0.1179		0.1240		0.2523
15 or younger	2.37 (0.20)		4.14 (0.46)		1.77 (0.22)		1.50 (0.22)
16 or 17	1.71 (0.18)		2.97 (0.41)		1.15 (0.20)		1.11 (0.20)
18 or older	1.75 (0.16		3.09 (0.38)		1.39 (0.19)		1.04 (0.19)
Farmworker		0.6616		0.1727		0.6993		0.0817
No	1.95 (0.13)		3.59 (0.30)		1.45 (0.15)		1.35 (0.15)
Yes	1.85 (0.17)		2.92 (0.38)		1.36 (0.19)		0.94 (0.19)
Farm Work on Day Wristband was Worn		0.8819		0.4332		0.5747		0.0213
No	1.89 (0.15)		3.53 (0.34)		1.35 (0.17))		1.47 (0.17)
Yes	1.93 (0.15)		3.15 (0.34)		1.48 (0.16)		0.93 (0.16)

^aSE = Standard Error

Differences in the detections and concentrations of specific pesticides by personal and work characteristics focused on those pesticides with detections for at least 20 of the wristbands in either year. No statistically significant differences in detections by child gender or age were observed. Differences in detections between those engaged in farm work versus those not engaged in farm work each year, and between who wore their wristband while doing farm work and those who did not, were observed each year (Tables 5 and 6). More of those not at all engaged in farm work had more detections of cis-permethrin and trans-permethrin in 2018, but fewer detections for l-cyhalothrin in 2018. More of those not at all engaged in farm work had detections for alpha-chlordane in 2018 and 2019, and gamma-chlordane in 2019, while those engaged in farm work had more detections for chlorothalonil (not significant for 2019).

Table 5:

Detection and Concentration (ng/g) Differences Between Participants Not Employed and Employed as Farmworkers, 2018 (N = 173) and 2019 (N = 156), for Pesticides Detected in at Least 20 Wristbands in Either Year, Latinx Children in Farmworker Communities, North Carolina, 2018 and 2019.

Pesticides and Pesticide Degradation Products	Employed Doing Farm Work During Year	Detection		Concentration for Those with a Detection
		n (%)	p-value	Mean (CIa)	p-value
Pyrethroids
Cypermethrin
2018	No	43 (55.8)	0.0943	32.33 (20.58, 50.78)	0.4753
	Yes	41 (42.7)		40.83 (25.75, 64.72)
2019	No	34 (44.7)	0.5256	19.77 (11.95, 32.72)	0.9785
	Yes	40 (50.0)		19.96 (12.51, 31.85)
Cis-Permethrin
2018	No	46 (59.7)	0.0057	14.32 (9.23, 22.21)	0.3880
	Yes	36 (37.5)		10.71 (6.52, 17.60)
2019	No	20 (26.3)	0.7094	42.34 (21.74, 82.43)	0.0017
	Yes	18 (22.5)		8.83 (4.37, 17.82)
Trans-Permethrin
2018	No	49 (63.6)	0.0013	18.22 (12.08, 27.46)	0.5864
	Yes	37 (38.5)		15.32 (9.55, 24.59)
2019	No	23 (30.3)	0.4792	71.93 (39.24, 131.84)	0.0015
	Yes	20 (25.0)		16.75 (8.77, 31.97)
L-Cyhalothrinb
2018	No	3 (3.9)	0.0126	-
	Yes	15 (15.6)		-
2019	No	13 (17.1)	0.8281	-
	Yes	12 (15.0)		-
Organochlorines
Alpha-Chlordane
2018	No	25 (32.5)	0.0061	1.44 (0.98, 2.11)	0.7100
	Yes	14 (14.6)		1.62 (0.97, 2.71)
2019	No	33 (43.4)	0.0005	1.36 (0.97, 1.91)	0.2707
	Yes	14 (17.5)		0.96 (0.57, 1.63)
Gamma-Chlordane
2018	No	23 (29.9)	0.1061	2.18 (1.32, 3.59)	0.4893
	Yes	18 (18.8)		1.67 (0.95, 2.95)
2019	No	31 (40.8)	0.0095	1.41 (0.92, 2.18)	0.2094
	Yes	17 (21.3)		0.89 (0.50, 1.60)
Chlorothalonil
2018	No	6 (7.8)	0.0189	3.88 (0.90, 16.69)	0.0002
	Yes	20 (20.8)		112.61 (51.36, 246.87)
2019	No	9 (11.8)	0.1355	18.19 (5.52, 59.87)	0.0014
	Yes	17 (21.3)		214.86 (92.19, 500.76)
Trans-Nonachlor
2018	No	16 (20.8)	0.0855	0.95 (0.56, 1.60)	0.1700
	Yes	10 (10.4)		1.71 (0.88, 3.33)
2019	No	16 (21.1)	0.1977	1.25 (0.74, 2.10)	0.5662
	Yes	10 (12.5)		0.98 (0.50, 1.90)
Organophosphates
Chlorpyrifos
2018	No	32 (41.6)	0.5320	1.52 (1.06, 2.19)	0.2113
	Yes	35 (36.5)		2.10 (1.48, 2.96)
2019	No	27 (35.5)	0.2284	1.68 (1.13, 2.50)	0.6404
	Yes	21 (26.3)		1.94 (1.24, 3.04)

^aCI = confidence interval

^bToo few detections to calculate concentrations

Table 6:

Detection and Concentration (ng/g) Differences Between Participants Who Did Not Wear Wristband on a Day They Did Farm Work versus Those Who Did the Wristband on Another Day, 2018 (N = 173) and 2019 (N = 156), for Pesticides Detected in at Least 20 Wristbands in Either Year, Latinx Children in Farmworker Communities, North Carolina, 2018 and 2019.

Pesticides and Pesticide Degradation Products	Wore Wristband on Day Doing Farm Work	Detection		Concentration for Those with a Detection
		n (%)	p-value	Mean (CIa)	p-value
Pyrethroids
Cypermethrin
2018	No	57 (58.8)	0.0035	35.53 (24.03, 52.52)	0.8069
	Yes	27 (35.5)		38.68 (21.99, 68.03)
2019	No	44 (45.8)	0.6251	23.07 (14.83, 35.89)	0.2948
	Yes	30 (50.0)		15.94 (9.30, 27.30)
Cis-Permethrin
2018	No	58 (59.8)	0.0002	16.49 (11.20, 24.28)	0.0124
	Yes	24 (31.6)		6.59 (3.61, 12.02)
2019	No	30 (31.3)	0.0127	28.29 (16.52, 48.45)	0.0075
	Yes	8 (13.3)		5.64 (1.99, 16.00)
Trans-Permethrin
2018	No	61 (62.9)	0.0001	20.73 (14.44, 29.78)	0.0395
	Yes	25 (32.9)		10.23 (5.81, 18.01)
2019	No	34 (35.4)	0.0058	51.74 (31.86, 84.02)	0.0021
	Yes	9 (15.0)		9.59 (3.74, 24.61)
L-Cyhalothrinb
2018	No	5 (5.2)	0.0127	-
	Yes	13 (17.1)		-
2019	No	14 (14.6)	0.6543	-
	Yes	11 (18.3)		-
Organochlorines
Alpha-Chlordane
2018	No	32 (33.0)	0.0002	1.67 (1.21, 2.31)	0.1040
	Yes	7 (9.2)		0.92 (0.48, 1.78)
2019	No	37 (38.5)	0.0041	1.45 (1.07, 1.96)	0.0184
	Yes	10 (16.7)		0.65 (0.36, 1.18)
Gamma-Chlordane
2018	No	31 (32.0)	0.0040	2.49 (1.66, 3.74)	0.0118
	Yes	10 (13.2)		0.86 (0.42, 1.76)
2019	No	36 (37.5)	0.0317	1.46 (1.00, 2.14)	0.0322
	Yes	12 (20.0)		0.64 (0.33, 1.23)
Chlorothalonil
2018	No	9 (9.3)	0.0194	7.89 (2.83, 22.05)	<.0001
	Yes	17 (22.4)		161.49 (75.91, 343.55)
2019	No	11 (11.5)	0.0452	10.76 (3.96, 29.24)	<.0001
	Yes	15 (25.0)		345.33 (162.12, 735.59)
Trans-Nonachlor
2018	No	22 (22.7)	0.0012	1.24 (0.79, 1.95)	0.6339
	Yes	4 (5.3)		0.94 (0.33, 2.72)
2019	No	19 (19.8)	0.2693	1.23 (0.75, 2.00)	0.4261
	Yes	7 (11.7)		0.84 (0.38, 1.88)
Organophosphates
Chlorpyrifos
2018	No	45 (46.4)	0.0274	1.70 (1.25, 2.31)	0.5045
	Yes	22 (28.9)		2.03 (1.31, 3.16)
2019	No	34 (35.4)	0.1534	1.77 (1.24, 2.52)	0.8709
	Yes	14 (23.3)		1.87 (1.07, 3.25)

^aCI = confidence interval

^bToo few detections to calculate concentrations

More of those not wearing a wristband on a day they did farm work had detections for cypermethrin (2018 only), cis-permethrin, and trans-permethrin than those wearing a wristband on a farm work day. Those wearing a wristband on a farm work day had more detections of l-cyhalothrin than those not wearing a wristband on a farm work day (2018 only). More of those not wearing a wristband on a day they did farm work had detections for alpha-chlordane and gamma-chlordane for both years, and for trans-nonachlor in 2018, than those who wore wristbands while doing farm work. More of those wearing a wristband while engaged in farm work had detections for chlorothalonil in both years. More of those not wearing a wristband on a day they did farm work had detections for chlorpyrifos (2018 only) than those wearing a wristband on a farm work day.

No statistically significant differences in concentrations by child age were observed. Statistically significant differences in concentrations by gender for three pesticides – one each for PYRs, OCs, and OPs – were observed for exposure data collected in 2019. In each case, boys had greater concentrations than girls. The concentration of trans-permethrin for boys was 54.76 (confidence interval (CI) 30.61, 97.97) and for girls was 19.55 (CI 9.53, 40.10) (p=0.0293). The concentration of alpha-chlordane for boys was 1.62 (CI 1.14, 2.31) and for girls was 0.84 (CI 0.57, 1.25) (p=0.0164). The concentration of chlorpyrifos for boys was 12.26 (CI 1.55, 3.29) and for girls was 1.23 (CI 0.77, 1.97) (p=0.0484).

Those who did not do any farm work versus those employed as farmworkers had significantly greater concentrations of cis-permethrin (in 2019) and trans-permethrin (in 2019). Those who did not wear a wristband on a day they did farm work versus those who did wear a wristband while doing farm work had a significantly greater concentrations of cis-permethrin (in 2018 and 2019) and trans-permethrin (in 2018 and 2019).

Those who did not wear a wristband on a day they did farm work had a significantly greater concentration of alpha- (for 2019) and gamma-chlordane (for 2018 and 2019). Those who did any farm work had significantly greater concentrations of chlorothalonil (in 2018 and 2019). Those who wore a wristband on a day they did farm work had a significantly greater concentrations of chlorothalonil (in 2018 and 2019).

3.4. Factors Associated with Pesticide Exposure Among Participants Engaged in Farm Work

Differences in the detection of any PYR, OC, or OP insecticides were associated with personal and work characteristics among participants who were employed doing any farm work during a year they wore a wristband (n = 96 in 2018; n = 80 in 2019) (Table 7). More of the youngest children (15 years and younger) had detections, with these differences being significant for PYRs (in 2019) and OCs (in 2018 and 2019). More of the migrant farmworkers had detections, with all differences being significant except for PYRs in 2018 and OPs in 2019. The percent with PYR detections increased with the number of weeks worked (in 2019). Significantly more of those not working in tobacco had OC detections in 2018 and 2019. Significantly more of those working in tomatoes had OC detections (in 2018 and 2019) and OP detections in 2018.

Table 7.

Any Detection of a Pyrethroid, Organochlorine, and Organophosphate Insecticide by Personal and Work Characteristics for Those Engaged in Any Farm Work Only, 2018 (N = 96) and 2019 (N = 80), Latinx Children in Farmworker Communities, North Carolina, 2018 and 2019.

Personal and Work Characteristics	Pyrethroids				Organochlorines				Organophosphates
	Any Detection N (%)	p value	Any Detection N (%)	p value	Any Detection N (%)	p value	Any Detection N (%)	p value	Any Detection N (%)	p value	Any Detection N (%)	p value
	2018		2019		2018		2019		2018		2019
Child Gender
Female	43 (67.2)	0.5012	37 (71.2)	1.0000	34 (53.1)	0.8303	25 (48.1)	0.4881	35 (54.7)	1.0000	15 (28.8)	0.8015
Male	19 (59.4)		20 (71.4)		16 (50.0)		16 (57.1)		18 (56.3)		9 (32.1)
Child Age
15 or younger	34 (72.3)	0.2766	23 (92.0)	0.0028	26 (55.3)	0.0436	17 (68.0)	0.0666	29 (61.7)	0.4623	7 (28.0)	0.9086
16 or 17	20 (57.1)		14 (50.0)		21 (60.0)		10 (35.7)		17 (48.6)		8 (28.6)
18 or older	8 (57.1)		20 (74.1)		3 (21.4)		14 (51.9)		7 (50.0)		9 (33.3)
Migrant Farmworker
Yes	15 (68.2)	0.8021	16 (88.9)	0.0783	18 (81.8)	0.0016	15 (83.3)	0.0027	19 (86.4)	0.0012	2 (11.1)	0.0772
No	47 (63.5)		41 (66.1)		32 (43.2)		26 (41.9)		34 (45.9)		22 (35.5)
Amount of farm work
1-2 weeks	16 (61.5)	0.9627	8 (53.3)	0.0427	11 (42.3)	0.5210	8 (53.3)	0.4561	11 (42.3)	0.4406	2 (13.3)	0.2685
3-4 weeks	21 (67.7)		24 (66.7)		16 (51.6)		16 (44.4)		18 (58.1)		10 (27.8)
5-7 weeks	10 (66.7)		8 (72.7)		10 (66.7)		8 (72.7)		10 (66.7)		5 (45.5)
8-12 weeks	15 (62.5)		17 (94.4)		13 (54.2)		9 (50.0)		14 (58.3)		7 (38.9)
Tobacco
No	35 (67.3)	0.6689	38 (70.4)	1.0000	34 (65.4)	0.0074	33 (61.1)	0.0165	32 (61.5)	0.2180	17 (31.5)	0.7969
Yes	27 (61.4)		19 (73.1)		16 (36.4)		8 (30.8)		21 (47.7)		7 (26.9)
Berries
No	40 (63.5)	0.8247	42 (76.4)	0.1830	31 (49.2)	0.5206	29 (52.7)	0.8104	37 (58.7)	0.3908	19 (34.5)	0.2923
Yes	22 (66.7)		15 (60.0)		19 (57.6)		12 (48.0)		16 (48.5)		5 (20.0)
Tomatoes
No	50 (64.9)	1.0000	45 (68.2)	0.3291	32 (41.6)	<.0001	29 (43.9)	0.0067	36 (46.8)	0.0007	23 (34.8)	0.0536
Yes	12 (63.2)		12 (85.7)		18 (94.7)		12 (85.7)		17 (89.5)		1 (7.1)

Among participants who wore the wristband on a day they were doing farm work in either year (n = 76 in 2018; n = 60 in 2019), differences in the detection of any PYR, OC, or OP insecticide were associated with personal and work characteristics (Table 8). More of the youngest children (15 years and younger) had detections, but this difference was significant only for PYRs in 2019. Significantly more of the migrant farmworkers had detections across the insecticides, except for PYRs in 2018 and OPs in 2019. Significantly more of those not working in tobacco had OC detections. Significantly more of those working in tomatoes had PYR detections (in 2019), OC detections (in 2018 and 2019), and OP detections (in 2018).

Table 8.

Any Detection of a Pyrethroid, Organochlorine, and Organophosphate Insecticide by Personal and Work Characteristics for Those Who Wore the Wristband on a Day They Did Farm Work Only, 2018 (N = 76) and 2019 (N = 60), Latinx Children in Farmworker Communities, North Carolina, 2018 and 2019.

Personal and Work Characteristics	Pyrethroids				Organochlorines				Organophosphates
	Any Detection N (%)	p value	Any Detection N (%)	p value	Any Detection N (%)	p value	Any Detection N (%)	p value	Any Detection N (%)	p value	Any Detection N (%)	p value
	2018		2019		2018		2019		2018		2019
Child Gender
Female	36 (66.7)	0.4322	27 (69.2)	0.7651	28 (51.9)	0.4533	19 (48.7)	0.1085	28 (51.9)	1.0000	10 (25.6)	0.5596
Male	12 (54.5)		16 (76.2)		9 (40.9)		15 (71.4)		12 (54.5)		7 (33.3)
Child Age
15 or younger	28 (71.8)	0.2797	18 (90.0)	0.0227	20 (51.3)	0.1172	15 (75.0)	0.1143	23 (59.0)	0.5820	5 (25.0)	0.9360
16 or 17	13 (54.2)		9 (50.0)		14 (58.3)		8 (44.4)		11 (45.8)		5 (27.8)
18 or older	7 (53.8)		16 (72.7)		3 (23.1)		11 (50.0)		6 (46.2)		7 (31.8)
Migrant Farmworker
Yes	13 (68.4)	0.7843	13 (100.0)	0.0122	15 (78.9)	0.0032	12 (92.3)	0.0038	16 (84.2)	0.0015	1 (7.7)	0.0857
No	35 (61.4)		30 (63.8)		22 (38.6)		22 (46.8)		24 (42.1)		16 (34.0)
Amount of farm work
1-2 weeks	10 (55.6)	0.8397	7 (53.8)	0.2613	6 (33.3)	0.2933	8 (61.5)	0.3414	6 (33.3)	0.3395	1 (7.7)	0.2246
3-4 weeks	18 (64.3)		19 (70.4)		13 (46.4)		15 (55.6)		16 (57.1)		9 (33.3)
5-7 weeks	6 (60.0)		7 (77.8)		7 (70.0)		7 (77.8)		6 (60.0)		4 (44.4)
8-12 weeks	14 (70.0)		10 (90.9)		11 (55.0)		4 (36.4)		12 (60.0)		3 (27.3)
Tobacco
No	36 (67.9)	0.2070	30 (76.9)	0.2432	31 (58.5)	0.0126	28 (71.8)	0.0023	31 (58.5)	0.1402	11 (28.2)	1.0000
Yes	12 (52.2)		13 (61.9)		6 (26.1)		6 (28.6)		9 (39.1)		6 (28.6)
Berries
No	33 (63.5)	1.0000	33 (70.2)	0.7402	27 (51.9)	0.4649	26 (55.3)	0.7603	31 (59.6)	0.0878	14 (29.8)	0.7402
Yes	15 (62.5)		10 (76.9)		10 (41.7)		8 (61.5)		9 (37.5)		3 (23.1)
Tomatoes
No	40 (64.5)	0.7602	32 (65.3)	0.0247	24 (38.7)	0.0002	23 (46.9)	0.0014	28 (45.2)	0.0073	15 (30.6)	0.7123
Yes	8 (57.1)		11 (100.0)		13 (92.9)		11 (100.0)		12 (85.7)		2 (18.2)

4. DISCUSSION

Most of the North Carolina Latinx child farmworkers who participated in this study were exposed to a wide variety of pesticides, including PYR, OC, and OP insecticides, fungicides and herbicides. This is the case even though they wore the silicone wristbands for only a single day compared to the seven days adolescents living in California²³ and younger children living in North Carolina²⁶ agricultural communities wore them. These North Carolina child farmworkers were exposed to these pesticides whether or not they were employed in agriculture in a specific year (2018, 2019), and whether or not they wore the wristband on a day they actually did farm work, indicating that simply living in rural, agricultural communities results in pesticide exposure. The number of detections for specific pesticides differed between the two years, with fewer detections in 2019. This could simply reflect variability in the environmental availability of pesticides, particularly as the wristbands were worn for a short duration. Research conducted with adult farmworkers that measured pesticide urinary metabolites also found this year-to-year variability.^7-9

An interesting pattern within these results is the often greater level of detections and greater concentrations of detected pesticides among those children not engaged in farm work for a specific year. A similar pattern, greater detections among urban, non-farmworker adults compared to rural, farmworkers for some pesticide urinary metabolites, has also been reported.^7-9 Many of the pesticides detected more in the wristbands of children not actively involved in farm work compared to children actively involved in farm work are PYRs and OCs. The PYRs are widely used for residential as well as agricultural insect control. The OCs have been banned for agricultural and residential use for several decades. Greater research to examine the amount of exposure to these insecticides and the potential health consequence of this exposure is needed.

Among those engaged in farm work, migrant status is associated with more detections. Similarly, those working in tomatoes and not working in tobacco tend to have more pesticide detections. Earlier analysis found that migrant child farmworkers, who are often located in western North Carolina, work in tomatoes but not in tobacco, indicating that these characteristics are confounding.⁶⁰ More importantly, this is another instance that migrant child farmworkers have greater jeopardy than those who do not migrant for both the health and educational sequelae of farm work.^41,64

Young age is also a risk factor for pesticide exposure among these child farmworkers. Among all participants, the youngest age group (those aged 15 years and younger) had detections for more total pesticide classes. Among those children engaged in farm work in a specific year, those in the youngest age group had more detections for the PYR, OC, and OP insecticides. Younger age increases the risk for immediate and long-term health effects from pesticide exposure.⁷⁵

Two recent studies facilitate comparison of these results for Latinx child farmworkers with those for other Latinx children living in agricultural communities. Harley and colleagues²³ used the same wristbands analyzed for the same pesticides to measure exposure of adolescent Latinas living in a California agriculture community. Although the current study included both girls and boys, gender differences in exposure were negligible. Arcury and colleagues²⁶ also used the same wristbands analyzed for the same pesticides to measure exposure among a sample of 8-year old Latinx children living in rural, farmworker and urban non-farmworker communities. Participants in both of these studies wore the wristbands for seven days compared to the one day worn by this study’s participants.

Fewer of the Latinx child farmworkers in this study generally had detections for most of the monitored pesticides than did the Latinx adolescent girls residing in a California agricultural community reported by Harley and colleagues,²³ or the young Latinx boys and girls residing in rural farmworker and urban non-farmworker communities in North Carolina reported by Arcury and colleagues²⁶ (Table 9). The detection of PYRs was similar across the three studies, with a single exception. Esfenvalerate was much more common among the California Latinx adolescent girls than among either set of the North Carolina children. The Latinx child farmworkers in the present study were exposed to a different set of OCs relative to the California Latinx adolescent girls,²³ and to young North Carolina children. Many more of the California Latinx adolescent girls were exposed to DDE, dieldrin, dicofol, and endrin aldehyde, while more of the child farmworkers in North Carolina were exposed to alpha- and gamma-chlordane. Many more of the young North Carolina children were exposed to alpha- and gamma-chlordane, dieldrin, and trans-nonachlor than were the older, North Carolina child farmworkers.

Table 9.

Percent detections for frequently detected pesticides (≥15% in at least one study) comparing results from Harley et al. 2019 with those of the current study.

Pesticide	Harley et al.23	Arcury et al.26	Current Study
	Percent Detections for 2016	Percent Detections for 2018-19	Percent Detections for 2018	Percent Detections for 2019
Pyrethroids
Cypermethrin	55.7	49.6	48.6	47.4
Esfenvalerate	41.2	7.5	7.5	3.8
ΣPermethrin	54.6	36.8	49.7	27.6
Cis-Permethrin	48.5	36.8	47.4	24.4
Trans-Permethrin	51.5	39.1	49.7	27.6
Organochlorines
DDE	55.7	15.0	1.7	3.8
Alpha-Chlordane	12.3	69.2	22.5	30.1
Gamma-Chlordane	9.4	66.2	23.7	30.8
Dieldrin	22.7	43.6	2.9	5.1
Dicofol	33.0	Not detected	Not detected	0.6
Endrin aldehyde	21.6	0.8	3.5	0.0
Trans-Nonachlor	14.4	67.7	15.0	16.7
Organophosphates
Chlorpyrifos	36.1	54.9	38.7	30.8
Ethion	39.2	Not detected	2.9	1.9
Ethoprophos	34.0	5.3	4.0	0.6
Phenylpyrazoles
Fipronil-sulfide	86.6	12.8	4.0	3.2
Fipronil-sulfone	45.4	4.5	1.7	0.6
Fungicide
Chloroneb	34.0	7.5	3.5	14.1
Herbicides
Propachlor	53.6	8.3	11.0	1.9
Dacthal	52.6	0.8	2.3	Not detected
Oxadiazon	21.6	0.8	0.6	Not detected

Similar percentages of North Carolina child farmworkers, California Latinx adolescent girls, and young North Carolina Latinx children had detections for the OP chlorpyrifos, but greater percentages of the California participants had detections for ethion and ethoprophos than did either of the North Carolina samples. Finally, greater percentages of the California participants had detections for the phenylpyrazoles insecticides, the fungicide chloroneb, and the herbicides propachlor, dacthal, and oxadiazon than did either of the North Carolina samples.

4.1. Strengths and Limitations

This study is part of a long-term community-based participatory research program that has established trust among members of the North Carolina farmworker and service provider communities. Although study participants were recruited from 20 counties across North Carolina, they were not randomly selected. Community organization involvement supported recruitment, but may have imposed a bias in those who participated. These features limit the study’s generalizability. The silicone wristbands have been widely used,^23,70,76 and the laboratory procedures measure a large number of pesticides. However, the measures of specific pesticide detection and concentration are limited by current laboratory procedures, and some pesticides to which participant may have been exposed are not included in this analysis. Finally, that the participants wore the wristbands for a single day limits the detection of pesticides to which they may normally be exposed.

4.2. Conclusions

This study further documents the pesticide exposure of Latinx children who live and work in agricultural communities in North Carolina and across the US. These Latinx child farmworkers are exposed to a plethora of pesticides, including those that have been banned from agricultural and residential use for decades. Further research needs to document the extent of pesticide exposure and the immediate and long health consequences of this exposure for these Latinx child farmworkers, as well as all children who live in rural communities.

While further research is important, sufficient information is already available on the level and health effects of pesticide exposure to argue for improved pesticide use and workplace safety policy. Policy should address procedures that eliminate pesticide exposure in agricultural communities. This policy must go beyond teaching farmworkers and their families about pesticide safety to address ways to remove pesticide residue from their residential and work environments, change the manner in which pesticides are applied, and reduce the amounts of pesticides used. Changes in occupational safety policy should limit the manner in which children work on farms. Adopting the same child labor policies in agriculture that apply to all other industries in the US would reduce Latinx child farmworker pesticide exposure.