Toxic exposure in early life and the effects on early language development

reference

JIANG H, Justice L, Purtell K, Bates R. Exposure to environmental toxins and early language development for children who grow up in households with low income. Clin Pediatr (Phila) . 2020; 59 (6): 557-565.

Study goal

evaluation of the scale to which the early exposure of children compared to toxins can be associated with delays in the early language development of children who are born in low -income households.

draft

A prospective observation study that used data from the kids in Columbus study-a 5-year birth cohort study by children who were born in families with low income.

participant

The participants were mothers who were pregnant at the time of enrollment or had children under 3 months; 18 years or older; And were able to speak English at a conversation level. 80 % of the participants stated that they had a family income of less than $ 30,000 a year. Children who were born too early or who were diagnosed with serious illness were excluded by the study. 322 mother-child dyads took part in the study; However, the study analyzed data from 190 families after the participant and the lack of data were taken into account.

study parameters evaluated

This study examined the exposure of mothers to environmental toxins during and shortly after pregnancy and 1.5 years after birth. The researchers collected data on child development aged 1 and 2.

primary result measurements

The investigators collected information through home visits to mothers in 5-month intervals, starting with the 2nd month of pregnancy up to 4 months after birth and continued until the child was 2 years old. The investigators asked mothers questions about exposure to certain environmental toxins. The investigators also gave the children the Bayley Scales of Infant and Toddler Development 3rd Edition.

When recruiting and 1.5 years after the birth, the mothers answered a number of questions about their exposure to toxins. At both times, the examiners asked the mothers for the following: (1) whether there was mold in their current apartment; (2) whether you used pesticides (at home, pets or on lawn/gardens) during pregnancy or within last year; And (3) whether you have used one of the articles from a list of potential household chemicals regularly (glass cleaner, oven cleaner, soil cleaner, drain cleaner, toilet cleaner, shoe cream, solvent, absorber, sealing, and insect spray) during pregnancy or over last year.

In addition, the investigators asked the mothers when registering whether they had lived within the last 5 years within a radius of 0.5 miles of one of the following 8 locations: landfills or landfills, closed and empty factories, strong traffic, vehicle residues, farms, industrial plants, dirty lakes and streams and hydropower plants.

The researchers assessed the language development of children aged 1 and 2 with the help of the Bayley Scales of Infant and Toddler Development 3rd Edition. They put together a scaled score that dealt with the partial areas of development and cognition. The investigators then examined the relationship with the toxin pollution and the language development values.

important knowledge

This study indicates that the use of toxins in the household, in particular the use of household cleaners in the first and second year of life, has a significant correlation with reduced values ​​in the early linguistic and cognitive development of children. The pollution from the neighborhood, exposure to mold and pesticides were not so strong.

If you look at early language development, exposure to toxins during pregnancy was responsible for a variance of 1 % to 1.6 % of the language skills, while exposure to toxins correlated after birth after birth with a variance of 6.7 % in the language result. In the cognitive results, toxic exposure during pregnancy corresponded to a variance of 1.8 % aged 1 year and a variance of 3.5 % aged 2 years.

In particular, the use of household cleaners seemed to be most effective. When using household cleaners with more than 1 standard deviation above the mean, children cut 0.21 standard deviations lower in the language and 0.24 standard deviations lower in cognition.

Practice implications

Firstly, African Americans represent around 28.5 % of the population of Columbus, Ohio, and yet 41 % of the participants in this study. One cannot discuss exposure to environmental toxins without pointing out structural racism, which means that black and brown populations are excessively exposed to environmental toxins. Black and brown people are disproportionately exposed to environmental pollutants, which result from the living segregation, the unequal access to economic possibilities and the concentration of factories, highways, landfill, etc. These population groups bear the main burden of the toxic exposure of our country, and this continues to contribute to an inheritance of Health and economic inequalities that are due to a policy that is influenced by racist injustice.

In addition, chronic stress can be lived with racism that increase susceptibility to negative health consequences of environmental impact.

It is absolutely necessary that all practitioners of integrative medicine not only consider exposure to environmental toxins as a question of personal decision. Instead, practitioners should understand the widespread effects of systemic racism on health consequences. We all have to train ourselves on topics of environmental justice and in our communities to work for the end of this special manifestation of injustice. Further information and resources on how to use these changes can be found under Black Lives Matter and Integrative Medicine for Under Versed.

In particular, the use of household cleaners seemed to be most effective. When using household cleaners with more than 1 standard deviation above the mean, children cut 0.21 standard deviations lower in the language and 0.24 standard deviations lower in cognition.

we come to the results of this special study, since it is a correlation study, many questions about the mechanisms remain, through which exposure to toxins affects language development and cognition. However, while we are waiting for further research, the Take Home Message seems to be clear. Inform pregnant women and parents about the effects of using toxic cleaning agents in the household. There are many cost -effective and safe alternatives to toxic cleaning agents such as vinegar, baking powder and chestling soap.

The American Academy of Pediatrics (AAP) has a relevant position on this topic. ^{3 In 2012, the AAP published a fundamental declaration on the pesticide exposure in children and warned of concerns about acute poisoning and the effects of chronic exposure on long -term development.}

While the study checked here showed no influence of the pesticide exposure, which correlated specifically with reduced language development or cognition, she showed that 20 % of households used pesticides after 1 year and 30 % of households. This illustrates why the education about pesticides is still of crucial importance. This study is an important addition to the growing literature on the negative influence of toxic exposure to children. It contains specific action elements that are easily applicable in practice: If you ask patients about your exposure and offer you information about alternatives. This is a simple intervention that we can offer while we are working to reduce the systems that lead to an unequal distribution of environmental risks