Determinants of Exposure to Pyrethroid Insecticides in the VHEMBE Cohort, South Africa.

Exposure to pyrethroid insecticides has been linked to adverse health effects, and can originate from several sources, including indoor residual spraying (IRS) for malaria control, home pest control, food contamination, and occupational exposure. We aimed to explore the determinants of urinary pyrethroid metabolite concentrations in a rural population with high pesticide use. The Venda Health Examination of Mothers, Babies and their Environment (VHEMBE) is a birth cohort of 752 mother-child pairs in Limpopo, South Africa. We measured pyrethroid metabolites in maternal urine and collected information on several factors possibly related to pesticide exposure, including IRS, home pesticide use, and maternal factors (e.g., dietary habits and body composition). We performed statistical analysis using both conventional bivariate regressions and Bayesian variable selection methods. Urinary pyrethroid metabolites are consistently associated with pesticide factors around homes, including pesticide application in yards and food stocks, and IRS in the home during pregnancy, while more distant factors such as village spraying are not. High fat intake is associated with higher metabolite concentrations, and women from homes drawing water from wells or springs had marginally higher levels. Home pesticide use is the most consistent correlate of pyrethroid metabolite concentrations, but IRS, dietary habits, and household water source may also be important exposure determinants.