The Analysis of Exposure and Influencing Factors of Pyrethroid Pesticides in Rural Women during Different Pregnancy Stages in Xuanwei，Yunnan Province
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摘要:
目的 了解农村妇女每个孕期暴露于拟除虫菊酯类农药的情况。 方法 自2014年12月至2016年12月间在宣威农村地区选取2个乡镇，招募216名怀孕至分娩的妇女入组，在妇女孕早、中、晚3期进行问卷调查，并使用超高效液相色谱串联质谱法检测妇女各孕期尿样拟除虫菊酯类农药代谢产物3-PBA和cis/trans-DCCA，用SPSS进行重复测量方差分析，对妇女2个孕期拟除虫菊酯类农药暴露水平及其影响因素进行分析。 结果 （1） 大部分孕期妇女孕期仍然务农且自我报告孕期未接触主动接触农药，报告自己在孕期接触过农药的妇女3个孕期均未超过1.4%。然而实验室检测发现拟除虫菊酯类农药孕早、中、晚3期暴露率均超过90%，孕全程均暴露于拟除虫菊酯类农药的暴露率为67.1%。实验室检出率明显高于问卷调查结果；（2） 妇女孕早、中、晚3期尿拟除虫菊酯类农药代谢产物3-PBA中位数分别为3.61 ng/L、3.60 ng/mL、3.57 ng/mL， cis/trans-DCCA中位数分别为49.10 ng/mL、45.45 ng/mL、47.45 ng/mL。3个孕期拟除虫菊酯类农药暴露处于国内中等水平，超过国外大多数报道。重复测量方差分析妇女孕期拟除虫菊酯类农药暴露，结果显示，孕妇居住地、受教育程度与妇女3个孕期拟除虫菊酯类农药代谢产物值之间存在交互作用（F孕期×孕妇居住地=3.183、F孕期×孕妇受教育程度=2.731，P < 0.05），不同孕期cis/trans-DCCA浓度的孕妇民族组间效应差异有统计学意义（F孕妇民族=4.497，P < 0.05），可认为孕期汉族的cis/trans-DCCA检出较少数民族高。孕早、中期cis/trans-DCCA测定结果均高于孕晚期测定结果（LSD法P < 0.05）。卡方检验尚未发现妇女年龄、民族、受教育程度、工作情况、居住地、家庭年收入、季节性与孕期拟除虫菊酯类农药暴露间差异有统计学意义（P > 0.05）。 结论 本研究发现宣威农村妇女大多对农药暴露的认知程度低，绝大多数妇女存在拟除虫菊酯类农药不同程度的暴露，而且，孕早、中期暴露水平明显高于孕晚期，当地妇女居住地、受教育程度、家庭年收入对不同孕期妇女拟除虫菊酯类农药暴露水平有影响。建议在农村地区加强孕期健康教育，提高孕期健康意识，加大环境农药监测与管控力度，减少妇女孕期拟除虫菊酯类农药暴露。 Abstract:Objective The purpose of the study is to understand the exposure of rural women to pyrethroid pesticides during each pregnancy stage. Methods From December 2014 to December 2016, 216 pregnant and postpartum women with the average age between 24.81±5.256 years old were recruited from 2 townships in Xuanwei rural area. Results In this study, the majority of pregnant women were still engaged in farming during pregnancy and self-reported no active exposure to pesticides during pregnancy. The self-reporting exposure rates among the three trimesters were no more than 1.4%. However, Laboratory testing found that the exposure rates of pyrethroid pesticides among the three trimester of pregnancy were exceed 90.0%, and the total of 67.1% of women exposed to pyrethroid pesticides in every trimester of gestation. Women exposure rates of pyrethroid by laboratory detection were significantly higher than those by questionnaire. In the first, the second and the third trimester, the medians of urine pyrethroid metabolites 3-PBA were 3.61 ng/ml、3.60 ng/ml、3.57 ng/ml, respectively, and the medians of urine cis/trans-DCCA, pyrethroid metabolites, distributed 49.10 ng/ml、45.45 ng/ml、47.45 ng/ml, respectively. The pregnancy exposure to pyrethroid pesticides was in the middle level of domestic research, but exceeded the level of most foreign reports. The result of women who exposed to pyrethroid pesticides in each trimester of gestation by Repeated Measures Define Factor（s） showed that address, education and family income had interaction with the three trimester pyrethroid metabolites amount （F gestation×address=3.183, F gestation×education=2.731, P<0.05）, and the amount by laboratory test in the first trimester and the second trimester were higher than that in the third trimester（LSD, P < 0.05）. Chi-square test indicated that there were no significant differences in the amounts of pyrethroid exposure among women age groups, between the minority and the majority, among different education levels, between on work and stopping work, between the two towns, across different family income and among the four seasons. Conclusion Rural pregnancy women are with low awareness of pesticide in Xuan wei. The vast majority of pregnancy women are exposed to pyrethroid pesticides in varying degrees and in the middle level of domestic research. Pyrethroid exposure in the third trimester is likely less serious than the other trimesters. The address, education and family income affect the pyrethroid exposure level. Therefore, it is necessary to strengthen health education and improve the health consciousness of pregnant women to reduce pyrethroids pesticides exposure as much as possible in rural areas. -
Key words:
- Pregnancy /
- Pyrethroid pesticides /
- Exposure /
- Rural area
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表 1 研究对象社会人口学特征[n（%），n = 216]
Table 1. Socio-demographic characteristics of the study subjects[n（%），n = 216]
组别 人数（构成比） 民族 汉族 174（80.2） 少数民族 42（19.8） 受教育程度 小学及以下 71（32.9） 初中毕业 118（54.4） 高中/职校及以上 27（12.7） 从事职业 务农 177（81.6） 非务农 39（18.4） 妇女孕期工作情况 孕早期 继续工作者 104（48.1） 停止工作者 112（51.9） 孕中期 继续工作者 98（45.4） 停止工作者 118（54.6） 孕晚期 继续工作者 96（44.4） 停止工作者 120（55.6） 家庭年收入（元） < 10000 32（14.8） 10 000～ 56（25.9） 20 000～ 35（16.2） 30 000～ 11（5.1） 40 000～50 000 73（33.8） 拒绝回答 9（4.2） 
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表 2 孕期妇女拟除虫菊酯类农药自我报告暴露率与实验室检出率一致性检测
Table 2. Consistency test between self-reported exposure rate and laboratory detection rate of pyrethroid pesticides in pregnant women
孕期 问卷调查 实验室检测 Kappa值 暴露 非暴露 孕早期 暴露 2 0 0.001 非暴露 198 16 孕中期 暴露 3 0 0.001 非暴露 200 13 孕晚期 暴露 3 0 0.001 非暴露 200 13 孕全程 暴露 0 0 0 非暴露 145 71
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表 3 妇女孕期拟除虫菊酯类农药暴露水平（ng/mL）
Table 3. Exposure levels of pyrethroid pesticides in pregnant women（ng/mL）
孕期 ≥L0D（%） P25 P50 P75 P95 最大值 最小值 3-PBA 孕早期 80.60 3.46 3.61 3.76 6.04 56.00 3.23 孕中期 84.30 3.43 3.60 3.79 4.63 22.30 3.23 孕晚期 81.00 3.40 3.57 3.76 4.94 29.30 3.24 cis/trans-DCCA 孕早期 59.70 19.60 49.10 86.70 202.00 427.00 0.95 孕中期 60.60 19.40 45.45 93.76 303.60 559.00 2.01 孕晚期 60.20 22.90 47.45 89.25 282.15 419.00 0.53
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表 4 3个孕期拟除虫菊酯类农药暴露水平的影响因素
Table 4. Factors influencing exposure levels of pyrethroid pesticides during three pregnancy periods
组别 人数 孕期 F P 孕早期 孕中期 孕晚期 cis/trans-DCCA 孕妇居住地 倘塘镇 75 2.432±1.973 1.992±1.990 1.243±0.531 3.183 0.012* 热水镇 141 2.071±2.027 2.459±2.104 1.093±0.668 χ 2 0.000 0.000 0.371 P 1.000 1.000 0.542 孕妇民族 汉族 174 2.330±2.023 2.385±2.070 1.169±0.623 4.497 0.014* 少数民族 42 1.641±1.882 1.932±2.068 1.078±0.494 χ 2 0.065 0.494 0.000 P 0.798 0.482 1.000 3-PBA 孕妇受教育程度 小学及以下 71 1.233±0.768 1.086±0.501 1.143±0.585 2.731 0.029* 初中毕业 118 1.027±0.604 1.168±0.525 1.064±0.593 高中及以上 27 1.120±0.589 0.958±0.581 0.997±0.548 χ 2 0.541 1.150 0.651 P 0.763 0.563 0.722 注：表中$ \bar x \pm s $为对数值，*P < 0.05。
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