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Until recently, public health workers have considered pesticide exposure a rural problem, not an urban concern. But New York City residents use more than 3 million pounds of pesticides each year to rid their homes of cockroaches and other pests.

In the first study of pesticide exposure in pregnant minority women living in an urban area, Mailman School of Public Health researchers have found that exposure to some chemicals may exceed daily doses established by the Environmental Protection Agency.

Dr. Frederica Perera, director of the Center for Children's Environmental Health, and colleagues analyzed the contents of air monitors worn for two days by 72 African-American and Dominican women from Manhattan during their third trimester of pregnancy.

Four pesticides were detected in all 72 air monitors: diazinon, chlorpyrifos, propoxur, and o-phenylphenol. Based on the level of diazinon measured and the volume of air inhaled by an average person, the authors conclude that some of the pregnant women may be exposed to more diazinon than recommended by the EPA. The EPA is phasing out the use of diazinon in indoor pesticides and today's legal products no longer contain the insecticide.

"We're also concerned about the other pesticides even though they were below EPA limits," says Dr. Robin Whyatt, lead author of the study and the center co-deputy director. "When the EPA set the limits, they did not consider exposure in utero, which may be the most sensitive time."

In animal studies, pups born to mothers exposed to diazinon and several of the other pesticides during pregnancy developed learning problems.

The researchers are continuing to study the children to determine if the mother's pesticide exposure, which was less than the laboratory animals' exposure, affects the children's ability to learn. The study is published in the May issue of Environmental Health Perspectives and was funded partly by the National Institute of Environmental Health Sciences and EPA.

– Susan Conova

Many herb and dietary supplements have negative effects on the heart when taken on their own and can be dangerous when used in combination with common heart medications, according to a new review by two P&S researchers.

"The review should help cardiologists spot symptoms related to interactions between herbs and prescribed drugs," says Dr. Elsa-Grace Giardina, the paper's senior author and professor of clinical medicine in the division of cardiology. Dr. Georgianne Valli, P&S '01, analyzed the data as a fourth-year student.

Of the 20 herbs the authors reviewed, ma huang stood out as particularly dangerous for heart patients. The herb is a natural source of ephedrine, a stimulant used to treat asthma, and raises heart rate and blood pressure. "It also can cause heart problems in young unsuspecting people who consume ma huang in sports and energy drinks," says Dr. Giardina, also the director of the Center for Women's Health.

The review additionally reports several herbs, including garlic, ginkgo, and ginseng, interfere with or enhance the effect of warfarin, a commonly prescribed drug that prevents stroke by reducing the ability of blood to clot.

Dr. Giardina says cardiologists, and doctors in general, need to ask their patients about the use of herbal remedies and begin educating patients about the herbs' adverse effects.

"As more and more people take herbs, I think you'll see adverse interactions becoming more common," she says, "and doctors should be in a better position to recognize and treat the symptoms."

The review was published in the April 3 Journal of the American College of Cardiology and was supported in part by the Department of Health and Human Services and the National Institutes of Health's National Center for Complementary and Alternative Medicine.

– Susan Conova

Heterosexual contact with an HIV-infected male is overtaking intravenous drug use as the most likely HIV infection route for women. In areas such as New York City and where HIV-infection rates are high, young adult minority women are particularly at high risk of infection.

Seeing an opportunity to reach these at-risk women, Columbia Health Sciences researchers designed a study and an intervention to help a group of inner-city women reduce their unsafe sex practices. As part of the project, the researchers also tried to understand why women get HIV tests and if the study's intervention would be successful in promoting HIV testing for women and their partners so people would know their current HIV status.

Led by Dr. Anke A. Ehrhardt, professor of medical psychology in psychiatry at P&S and director of the HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute, and Dr. Theresa Exner, assistant professor in psychiatry in P&S, the investigators studied 360 lower income and minority heterosexual women aged 18 to 30, with an average of 13 years of education, who were clients at a Brooklyn, N.Y.-based Planned Parenthood clinic. The National Institute of Mental Health supports the HIV Center through a grant that also provided funds for the study.

Before the intervention, almost half of the women believed getting tested for HIV was a good way to prevent getting the virus. The women were randomly assigned to a four- or eight-week intervention or a control group, and were followed intermittently for one year. The researchers found that the intervention motivated previously tested women to get tested again and rates of mutual testing were significantly higher for the women in the intervention group compared to the control. However, the intervention did not have much of an effect on women who had been tested only once or not at all.

The researchers were encouraged by the intervention's results but noted that HIV test counselors should stress to women that testing is not a prevention strategy by itself, Dr. Exner says. The research was reported in the March/April Perspectives on Sexual and Reproductive Health.

– Matthew Dougherty


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