5 August 2013. One of the greatest challenges in regard to chemical brain drain is how to advise a pregnant woman who, for some reason, has been unfortunate enough to be exposed to a toxic substance that could damage her child. Pregnant women should of course not be anywhere near neurotoxic chemicals, but accidents occur, errors are made, regulations may be outdated, and labeling of chemical products is often insufficient. Knowledge that pregnant women are actually being exposed should be used to prevent this from happening again.
But what about the exposed woman herself? The incident and the knowledge about toxic threats may be stressful, which by itself could be harmful to her child, and she might very well feel guilty if her child has any problem at all, whether or not it has any possible connection with the chemicals.
When a doctor or researcher is contacted by a pregnant woman on such occasion, it is difficult to provide supportive advice after the fact. To illustrate the problem, here is an excerpt from an email received last week. Given last week’s news about deadly exposures to pesticides in an Indian school, perhaps it is no surprise that this message came from a woman in India:
“I’m 8 months pregnant and a month ago while I was working in office at 31 weeks of pregnancy, the housekeeping staff sprayed a lot of anti-termite spray (2% Chlorpyrifos ie 20g Chlorpyrifos mixed with 1 litre Kerosene) just a couple of feet away from me. It had a very strong smell but I didnt leave office for 30-45 minutes since I didnt realise how dangerous this could be for the baby.
Later I read that Chlorpyrifos is an organophosphate pesticide, banned in America for non-agricultural use due to research that exposure inhibits acetylcholinesterase in synapses etc and causes a range of brain disorders in fetuses…
I am now desperate to prevent any further exposure to the fetus, but in India there are no regulations or controls for pesticide use and no awareness of the health impact of pesticides. Chlorpyrifos is 4th most used pesticide in India and Indian studies say that due to indiscriminate use of Chlorpyrifos & other chemicals for agriculture and termite treatment of the foundations of new buildings, the air, drinking water, milk, fruits & vegetables here contain Chlorpyrifos, Endosulfan, DDT, HCH, other organochloride & organophosphate pesticide residues much above the limits set by WHO.”
From the email, I understand that blood tests have been done to determine the cholinesterase activity (an enzyme that is inhibited by pesticides like chlorpyrifos), and that the result was within the range considered normal, although somewhat low. Even so, we cannot be absolutely sure that the exposure was innocuous. First of all, chlorpyrifos is an established brain toxicant that is associated with adverse effects on brain development. Second, as the woman notes herself, there are many, too many, sources of exposure to pesticides, and a total of 67 pesticides prohibited in other parts of the world are widely being used in India. It is impossible to judge whether this woman’s baby is in any danger. We can only hope for the best.
The plight of the pregnant woman is obvious, and we share the frustration that prevention is not possible after the exposure has already happened. Can’t we do better?