Pesticides and health effects: Karpati et al. respond.In her letter, Ziem raises the issue of exacerbations of respiratory illness and other health effects of pesticide exposure that we did not measure in our study (Karpati et al. 2004). Our analysis was designed to evaluate only whether a population-level effect on emergency department visits, specifically on asthma and other respiratory illnesses, was evident following pyrethroid py·re·throid n. Any of several synthetic compounds similar to pyrethrin, used as an insecticide. pesticide spraying. Similar study designs, despite their limitations, have proven to be sensitive methods of identifying population-level health impacts from exposure to criteria air pollutants from exposure to unusual events, such as smoke from forest fires. Moreover, our analysis did identify adverse population-level health effects of elevated ozone and particulates. As we noted in our discussion, the results of the analysis for pesticide exposure do not rule out the possibility that certain individuals might have been affected by exposure to the agent. Also, our focus was on emergency department visits, which generally signify more serious illness, although in urban neighborhoods even milder illnesses are often treated in such settings. However, if, in fact, certain individuals experienced asthma exacerbations following exposure, we believe our study demonstrates that their number was small enough that it did not result in a population-level increase in emergency department visits for asthma and chronic obstructive pulmonary disease chronic obstructive pulmonary disease n. Abbr. COPD A chronic lung disease, such as asthma or emphysema, in which breathing becomes slowed or forced. . In our analysis we evaluated only respiratory complications of pesticide spraying to control West Nile virus West Nile virus, microorganism and the infection resulting from it, which typically produces no symptoms or a flulike condition. The virus is a flavivirus and is related to a number of viruses that cause encephalitis. , and we did not purport to measure possible neurotoxic neurotoxic pertaining to or emanating from a neurotoxin. neurotoxic state a case of poisoning by a neurotoxin. neurotoxic adjective or other nonrespiratory effects. Also, we did not evaluate the efficacy of pesticide spraying for mosquito control or its cost-benefit ratio Cost-benefit ratio The net present value of an investment divided by the investment's initial cost. Also called the profitability index. with regard to pesticide-related health effects. The authors declare they have no competing financial interests. REFERENCE Karpati AM, Perrin MC, Matte T, Leighton J, Schwartz J, Barr RG. 2004. Pesticide spraying for West Nile virus control and emergency department asthma visits in New York City New York City: see New York, city. New York City City (pop., 2000: 8,008,278), southeastern New York, at the mouth of the Hudson River. The largest city in the U.S. , 2000. Environ Health Perspect 112:1183-1187. Adam Karpati Mary C. Perrin Jessica Leighton Tom Matte New York City Department of Health and Mental Hygiene New York, New York E-mail: akarpati@health.nyc.gov Joel Schwartz Division of Environmental Health Harvard School of Public Health The Harvard School of Public Health is (colloquially, HSPH) is one of the professional graduate schools of Harvard University. Located in Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill, next to Harvard Medical School and Cambridge, Massachusetts, Boston, Massachusetts R. Graham Barr Department of Medicine Columbia University Medical Center Columbia University Medical Center is the name of the medical complex associated with Columbia University, and covers several blocks (primarily between 165th and 168th Streets from the Henry Hudson Parkway to Audubon Avenue) in the Washington Heights section of Manhattan. New York, New York |
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