Glyphosate, the most widely used herbicide in the United States, is applied to control broadleaf weeds and grasses. Public concern is mounting over how pesticides affect human and environmental health. Glyphosate toxicity in animals is known, but human carcinogenicity is controversial, and limited epidemiologic evidence suggests associations between exposure and respiratory diseases (e.g., asthma) and adverse child neurodevelopment. Understanding the extent of the general U.S. population exposure to glyphosate is important. To examine temporal trends in exposure to glyphosate, we determined urinary concentrations of glyphosate among U.S. children and adults from three cycles of the National Health and Nutrition Examination Survey (NHANES) conducted 2013-2018. Most of the population (70.0%-81.7%, depending on cycle) was exposed, including children as young as 3 years of age. Concentrations decreased from 2013 to 2018 by 38%; the decline was smaller in younger age groups. The downward trend likely reflects changes in glyphosate use resulting, at least in part, from changes in agricultural practices, regulatory actions, and shifts in public awareness regarding glyphosate toxicity. Continuing glyphosate biomonitoring will help understand how changes in use and actions to restrict applications of this common pesticide affect human exposures.

BACKGROUND: Exposure to glyphosate, the most used herbicide in the United States, is not well characterized. We assessed glyphosate exposure in a representative sample of the U.S. population ≥ 6 years from the 2013-2014 National Health and Nutrition Examination Survey. METHODS: We quantified glyphosate in urine (N = 2,310) by ion chromatography isotope-dilution tandem mass spectrometry. We conducted univariate analysis using log-transformed creatinine-corrected glyphosate concentrations with demographic and lifestyle covariates we hypothesized could affect glyphosate exposure based on published data including race/ethnicity, sex, age group, family income to poverty ratio, fasting time, sample collection season, consumption of food categories (including cereal consumption) and having used weed killer products. We used multiple logistic regression to examine the likelihood of glyphosate concentrations being above the 95th percentile and age-stratified multiple linear regression to evaluate associations between glyphosate concentrations and statistically significant covariates from the univariate analysis: race/ethnicity, sex, age group, fasting time, cereal consumption, soft drink consumption, sample collection season, and urinary creatinine. RESULTS: Glyphosate weighted detection frequency was 81.2 % (median (interquartile range): 0.392 (0.263-0.656) μg/L; 0.450 (0.266-0.753) μg/g creatinine). Glyphosate concentration decreased from age 6-11 until age 20-59 and increased at 60+ years in univariate analyses. Children/adolescents and adults who fasted > 8 h had significantly lower model-adjusted geometric means (0.43 (0.37-0.51) μg/L and 0.37 (0.33-0.39) μg/L) than those fasting ≤ 8 h (0.51 (0.46-0.56) μg/L and 0.44 (0.41-0.48) μg/L), respectively. The likelihood (odds ratio (95 % CI)) of glyphosate concentrations being > 95th percentile was 1.94 (1.06-3.54) times higher in people who fasted ≤ 8 h than people fasting > 8 h (P = 0.0318). CONCLUSIONS: These first nationally representative data suggest that over four-fifths of the U.S. general population ≥ 6 years experienced recent exposure to glyphosate. Variation in glyphosate concentration by food consumption habits may reflect diet or lifestyle differences.

Organophosphorus pesticides are the most used pesticides in the United States. Most organophosphorus pesticides are composed of a phosphate (or phosphorothioate or phosphorodithioate) moiety and a variable organic group. Organophosphorus pesticides are scrutinized by regulatory bodies and agencies because of their toxicity or suspected carcinogenicity. Upon exposure, organophosphorus pesticides and their metabolites eliminate in urine; these urinary biomarkers are useful to evaluate human exposure. We developed a method using stable isotope dilution, ion chromatography tandem mass spectrometry for quantification in urine of 6 O,O-dialkylphosphates, metabolites of organophosphorus insecticides, and glyphosate, the most used herbicide in the United States. With simple and minimal sample preparation, the analytical method is selective and sensitive (limits of detection are 0.2-0.8 μg/L), accurate (>85%) and precise (relative standard deviation <20%), depending on the analyte. To assess the suitability of the method in real exposure scenarios, we analyzed samples collected anonymously from subjects with suspected exposure to pesticides (n = 40) or who had been on an organic diet (n = 50). We detected glyphosate in 80% of subjects reporting an organic diet and in 78% of those with suspected glyphosate exposure; concentrations ranged from <0.2 to 28.6 μg/L. Median concentrations were 0.39 μg/L for the organic diet group and 0.40 μg/L for individuals with suspected exposure. Interestingly, interquartile ranges were considerably higher among those reporting pesticide exposure (0.63 μg/L) than those consuming organic diets (0.42 μg/L). These data suggest that the method meets typical validation benchmark values and is sensitive to investigate background exposures in the general population.

The objective of the study was to determine the human serum elimination half-life of polybrominated diphenyl ethers (PBDEs) adjusted for ongoing exposure in subjects moving from a higher exposure region (North America) to a lower exposure region (Australia). The study population was comprised of exchange students and long-term visitors from North America moving to Brisbane, Australia (N = 27) and local residents (N = 23) who were followed by repeated serum sampling every other month. The local residents were sampled to adjust for ongoing exposure in Australia. Only one visitor remained in Australia for a period of time similar to the elimination half-life and had a sufficiently high initial concentration of PBDEs to derive a half-life. This visitor arrived in Australia in March of 2011 and remained in the country for 1.5 years. Since the magnitude of PBDE exposure is lower in Australia than in North America we observed an apparent 1st order elimination curve over time from which we have estimated the serum elimination half-lives for BDE28, BDE47, BDE99, BDE100, and BDE153 to be 0.942, 1.19, 1.03, 2.16, and 4.12 years, respectively. Uncertainty in the estimates were estimated using a Monte Carlo simulation. The human serum elimination half-life adjusted for ongoing exposure can allow us to assess the effectiveness and reduction in exposure in the general population following phase out of commercial penta- and octaBDE in 2004 in the United States.

Health care-associated infections in the NICU are a major clinical problem resulting in increased morbidity and mortality, prolonged length of hospital stays, and increased medical costs. Neonates are at high risk for health care-associated infections because of impaired host defense mechanisms, limited amounts of protective endogenous flora on skin and mucosal surfaces at time of birth, reduced barrier function of neonatal skin, the use of invasive procedures and devices, and frequent exposure to broad-spectrum antibiotics. This statement will review the epidemiology and diagnosis of health care-associated infections in newborn infants. (Copyright 2012 by the American Academy of Pediatrics.)

The 2010 recommended childhood and adolescent immunization schedules have been approved by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, and the American Academy of Family Physicians. There are 3 schedules: one for children 0 through 6 years of age, one for people 7 through 18 years of age, and a catch-up immunization schedule for children and adolescents who start late or fall behind. These schedules reflect current recommendations for the use of vaccines licensed by the US Food and Drug Administration and include the following changes from last year: | Reference to the recommendations of the Advisory Committee on Immunization Practices for use of influenza A (H1N1) 2009 monovalent vaccine1 is included in a footnote. | Revaccination with meningococcal conjugate vaccine (MCV4) is recommended for children who remain at increased risk for meningococcal disease. A dose of MCV4 should be administered after 3 years in children who received the initial MCV4 dose at ages 2 through 6 years and after 5 years if the first dose was given at age 7 years or older. Additional doses of MCV4 are then given every 5 years.2 | Recommendations on use of combination vaccines have been updated (the use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines). The final dose in the inactivated poliovirus vaccine series should be administered on or after the 4th birthday and at least 6 months following the previous dose. If 4 doses are administered before age 4 years, an additional (fifth) dose should be administered at age 4 through 6 years.3 | Recommendations for use of the recently licensed bivalent human papillomavirus vaccine in females and the quadrivalent human papillomavirus vaccine in males are included. | Most of the footnotes for the individual vaccines have been revised to provide additional information and to clarify recommendations provided in the schedules.

Palivizumab was licensed in June 1998 by the US Food and Drug Administration for prevention of serious lower respiratory tract disease caused by respiratory syncytial virus (RSV) in pediatric patients who are at increased risk of severe disease. Safety and efficacy have been established for infants born at or before 35 weeks' gestation with or without chronic lung disease of prematurity and for infants and children with hemodynamically significant heart disease. The American Academy of Pediatrics (AAP) published a policy statement on the use of palivizumab in November 1998 (American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Fetus and Newborn. Pediatrics. 1998;102[5]:1211-1216) and revised it in December 2003 (American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Fetus and Newborn. Pediatrics. 2003;112[6 pt 1]:1442-1446), and an AAP technical report on palivizumab was published in 2003 (Meissner HC, Long SS; American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Fetus and Newborn. Pediatrics. 2003;112[6 pt 1]:1447-1452). On the basis of the availability of additional data regarding seasonality of RSV disease as well as the limitations in available data on risk factors for identifying children who are at increased risk of serious RSV lower respiratory tract disease, AAP recommendations for immunoprophylaxis have been updated in an effort to ensure optimal balance of benefit and cost from this expensive intervention. This statement updates and replaces the 2003 AAP statement and the 2006 Red Book and is consistent with the 2009 Red Book recommendations.