body weight, length,
head circumference)
weight ( p
for
trend
¼ 0.013)
No association with
other birth outcomes
Zhang et al.,
2014
[18]
Japan
Longitudinal
birth cohort
study
2009–2011
147 mother and child
pairs
Blood and spot urine
from the pregnant
women (11–14 weeks)
Urinary 3-PBA from
the pregnant women
Birth size (weight,
length, chest, and head
circumference of neonates) (maternal and
neonatal thyroid
hormones)
No association
between 3-PBA
levels in maternal
urine in the
first trimester of pregnancy
and neonatal thyroid
hormones or with
body size
Birth defects
Rappazzo
et al., 2019
[39]
USA
Case-control
study
2003–2005
Cases ranged from
1,020 for atrial septal
defects and patent
ductus arteriosus to
39 for lower limb
defects; 298,548
controls
Residential exposure
estimates based on the
poundage of pesticides
applied within 0.5 km
of maternal address
Cyhalothrin
Ten birth defects: three
congenital heart
defects and structural
defects affecting the
gastrointestinal, genitourinary, and musculoskeletal systems
Association of atrial
septal defects with
higher levels of exposure (OR; 95%
CI
¼ 1.81; 1.43–2.29
for
>90th exposures)
Carmichael
et al., 2016
[40]
USA
Case-control
study
1997–2006
367 unique cases
(95 anotia/microtia,
77 anorectal atresia/
stenosis, 59 transvers
limb deficiency,
79 craniosynostosis,
62 diaphragmatic hernia) and 785 controls
Residential exposure
estimates based on the
poundage of pesticides
applied within 0.5 km
of maternal address
Group and individual
(cyfluthrin only indicated) pyrethroid use
during a 3-month
periconceptional window (any/none
application)
Anotia, microtia,
anorectal atresia/stenosis, transverse limb
deficiency, craniosynostosis, diaphragmatic
hernia
Association between
cyfluthrin and craniosynostosis (OR; 95%
CI
¼ 4.6; 1.5–14.0)
Carmichael
et al., 2014
[41]
USA
Case-control
study
1997–2006
569 cases and
785 controls
Residential exposure
estimates based on the
poundage of pesticides
applied within 0.5 km
of maternal address
Group and individual
(lambda-cyhalothrin,
permethrin and
cyfluthrin, only indicated) pyrethroid use
during a 3-month
periconceptional
Congenital heart
defects
Association between
lambda-cyhalothrin
and atrial septum
defect (OR; 95%
CI
¼ 2.9; 1.1–7.9)
(continued)
Human Risk Associated with Long-Term Exposure to Pyrethroid Insecticides
277
head circumference)
weight ( p
for
trend
¼ 0.013)
No association with
other birth outcomes
Zhang et al.,
2014
[18]
Japan
Longitudinal
birth cohort
study
2009–2011
147 mother and child
pairs
Blood and spot urine
from the pregnant
women (11–14 weeks)
Urinary 3-PBA from
the pregnant women
Birth size (weight,
length, chest, and head
circumference of neonates) (maternal and
neonatal thyroid
hormones)
No association
between 3-PBA
levels in maternal
urine in the
first trimester of pregnancy
and neonatal thyroid
hormones or with
body size
Birth defects
Rappazzo
et al., 2019
[39]
USA
Case-control
study
2003–2005
Cases ranged from
1,020 for atrial septal
defects and patent
ductus arteriosus to
39 for lower limb
defects; 298,548
controls
Residential exposure
estimates based on the
poundage of pesticides
applied within 0.5 km
of maternal address
Cyhalothrin
Ten birth defects: three
congenital heart
defects and structural
defects affecting the
gastrointestinal, genitourinary, and musculoskeletal systems
Association of atrial
septal defects with
higher levels of exposure (OR; 95%
CI
¼ 1.81; 1.43–2.29
for
>90th exposures)
Carmichael
et al., 2016
[40]
USA
Case-control
study
1997–2006
367 unique cases
(95 anotia/microtia,
77 anorectal atresia/
stenosis, 59 transvers
limb deficiency,
79 craniosynostosis,
62 diaphragmatic hernia) and 785 controls
Residential exposure
estimates based on the
poundage of pesticides
applied within 0.5 km
of maternal address
Group and individual
(cyfluthrin only indicated) pyrethroid use
during a 3-month
periconceptional window (any/none
application)
Anotia, microtia,
anorectal atresia/stenosis, transverse limb
deficiency, craniosynostosis, diaphragmatic
hernia
Association between
cyfluthrin and craniosynostosis (OR; 95%
CI
¼ 4.6; 1.5–14.0)
Carmichael
et al., 2014
[41]
USA
Case-control
study
1997–2006
569 cases and
785 controls
Residential exposure
estimates based on the
poundage of pesticides
applied within 0.5 km
of maternal address
Group and individual
(lambda-cyhalothrin,
permethrin and
cyfluthrin, only indicated) pyrethroid use
during a 3-month
periconceptional
Congenital heart
defects
Association between
lambda-cyhalothrin
and atrial septum
defect (OR; 95%
CI
¼ 2.9; 1.1–7.9)
(continued)
Human Risk Associated with Long-Term Exposure to Pyrethroid Insecticides
277