Daño celular en una población infantil potencialmente expuesta a pesticidas
Palabras clave:
genotoxicidad, pesticidas, niños, medio ambienteResumen
Los pesticidas pueden producir efectos agudos o crónicos en la salud humana. Muchos de ellos pueden provocar daño en el material genético. Esta modificación en la información genética se ha relacionado con un alto riesgo de padecer cáncer. El objetivo del presente trabajo es indagar el daño en el material genético de una población infantil expuesta potencialmente a pesticidas en el ambiente. El diseño metodológico fue de tipo observacional y transversal. Participaron en el estudio 48 niños expuestos potencialmente a pesticidas y 46 niños no expuestos. Se obtuvo muestra de la mucosa bucal para determinar daño en el material genético a través de la frecuencia de micronúcleos (MN). Se encontró en el grupo expuesto potencialmente a pesticidas un promedio mayor de micronúcleos (5,1±2,9 vs 1,8±2,0; p<0,0001), un promedio mayor de células binucleadas, (3,5±2,7 vs 1,4±1,4; p<0,0001), mayor frecuencia de cariorrexis (18,2±18,4 vs 5,8±18,4; p<0,004) y picnosis (24,8± 18,0 vs 17,1±8,3; p<0,03). El 40% (19/47) de los niños expuestos potencialmente a pesticidas tuvieron un tiempo de exposición de 6 años. Esta investigación aporta evidencias de daño genético en la población expuesta potencialmente a pesticidas en el ambiente.
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1. Bolognesi C. Genotoxicity of pesticides: a review of human biomonitoring studies. Mutat Res. 2003;543:251-72. [ Links ]
2. Palani-Kumar L, Panneerselvam N. Toxic effects of pesticides: a review on cytogenetic biomonitoring studies. Medicine and Biology. 2008;15(2):46-50. [ Links ]
3. Oleskey C, Fleischman A, Goldman L, Hirschhorn K, Landrigan P, Lappé M, et-al. Pesticide testing in humans: ethics and public policy. Environ Health Perspect. 2004;112(8):914-19. [ Links ]
4. Thundiyil JG, Stober J, Besbelli N, Pronczuk J. Acute pesticide poisoning: a proposed classification tool. Bull World Health Organ. 2008;86:205-209. [ Links ]
5. Wild CP, Kleinjans J. Children and increased susceptibility to environmental carcinogens: evidence or empathy? Cancer Epidemiol Biomarkers Prev. 2003;12:1389-394. [ Links ]
6. Garry VF. Pesticides and children. Toxicol Appl Pharmacol. 2004;198:152-63. [ Links ]
7. Landrigan PJ, Kimmel CA, Correa A, Eskenazi B. Children’s health and the environment: public health issues and challenges for risk assessment. Environ Health Perspect. 2004;112(2):257-65. [ Links ]
8. Neri M, Bonassi S, Knudsen LE, Sram RJ, Holland N, Ugolini D, et-al. Children’s exposure to environmental pollutants and biomarkers of genetic damage. I. Overview and critical issues. Mutat Res. 2006; 612 ( 1): 1-13. [ Links ]
9. Merlo DF, Knudesen LE, Matusiewicz K, Niebro´j L, Va-há-kangas KH. Ethics in studies on children and environmental health. Med Ethics. 2007;33:408-13. [ Links ]
10. Manno M, Viau C. Biomonitoring for occupational health risk assessment (BOHRA). Toxicol Lett. 2010;192(1):3-16. [ Links ]
11. Holland N, Bolognesi C, Kirsh-Volders M, Bonassi S, Zeiger E, Knasmueller S, et-al. The micronucleus assay in human buccal cells as a tool for biomonitoring DNA damage: the HUMN project perspective on current status and knowledge gaps. Mutat Res. 2008;656(1-2):93-108. [ Links ]
12. Bonassi S, Znaor A, Ceppi M, Lando C, Chang WP, Holland N, et-al. An increased micronucleus frequency in peripheral blood lymphocytes predicts the risk of cancer in humans. Carcinogenesis. 2007;28(3):625-31. [ Links ]
13. Neri M, Ugolini D, Bonassi S, Fucic A, Holland N, Knudsen LE, et-al. Children’s exposure to environmental pollutants and biomarkers of genetic damage II. Results of a comprehensive literature search and meta-analysis. Mutat Res. 2006;612(1):14-39. [ Links ]
14. Ministerio de Salud Pública y Bienestar Social. Secretaria del Ambiente. Informe de la inspección de la Fábrica Chemtec SAE. Asunción: OPS/OMS; 2009. [ Links ]
15. Tolbert PE, Shy CM, Allen JW. Micronuclei and other nuclear anomalies in buccal smears: methods development. Mutat-Res. 1992;271(1):69-77. [ Links ]
16. Norppa H, Ghita C, Falck M. What do human micronuclei contain? Mutagenesis. 2003;18(3):221-33. [ Links ]
17. Kirsch-Volders M, Fenech M. Inclusion of micronuclei in non-divided mononuclear lymphocytes and necrosis/apoptosis may provide a more comprehensive cytokinesis block micronucleus assay for biomonitoring purposes. Mutagenesis. 2001;16(1):51-58. [ Links ]
18. Thomas P, Holland N, Bolognesi C, Kirsch-Volders M, Bonassi S, Zeiger E, et-al. Buccal micronucleus cytome assay. Nat Protoc. 2009;4(6):825-37. [ Links ]
19. Fenech M, Crott J, Turner J, Brown S. Necrosis, apoptosis, cytostasis and DNA damage in human lymphocytes measured simultaneously within the cytokinesis-block micronucleus assay: description of the method and results for hydrogen peroxide. Mutagenesis. 1999;14(6):605-12. [ Links ]
20. Celik A, Cavas T, S. Ergene-Gozukara S. Cytogenetic biomonitoring in petrol station attendants: micronucleus test in exfoliated buccal cells. Mutagenesis. 2003;18(5):417-21. [ Links ]
21. Gattás GJ, Cardoso-Lde A, Medrado-Faria-Mde A, Saldanha PH. Frequency of oral mucosa micronuclei in gas station operators after introducing methanol. Occup Med (Lond). 2001;51(2):107-13. [ Links ]
22. Pastor S, Creus A, Xamena N, Siffel C, Marcos R. Occupational exposure to pesticides and cytogenetic damage: results of a Hungarian population study using the micronucleus assay in lymphocytes and buccal cells. Environ Mol Mutagen. 2002;40:101-109. [ Links ]
23. Pastor S, Gutierrez S, Creus A, Xamena N, Piperakis S, Marcos R. Cytogenetic analysis of Greek farmers using the micronucleus assay in peripheral lymphocytes and buccal cells. Mutagenesis. 2001;16:539-45. [ Links ]
24. Suruda A, Schulte P, Boeniger M, Hayes RB, Livingston GT, Steenland K, et-al. Cytogenetic effects of formaldehyde exposure in students of mortuary science. Cancer Epidemiol Biomarkers Prev. 1993;2:453-60. [ Links ]
25. Ghosh P, Basu A, Singh KK, Giri AK. Evaluation of cell types for assessment of cytogenetic damage in arsenic exposed population. Mol Cancer. 2008;7:45. [ Links ]
26. Pastor S, Creus A, Parron T, Cebulska-Wasilewska A, Siffel C, Piperakis S, et-al. Biomonitoring of four european populations occupationally exposed to pesticides: use of micronuclei as biomarkers. Mutagenesis. 2003;18:249-58. [ Links ]
27. Hoyos LS, Carvajal S, Solano L, Rodríguez J, Orozco L, López Y, et-al. Cytogenetic monitoring of farmers exposed to pesticides in Colombia. Environ Health Perspect. 1996;104:535-38. [ Links ]
28. Lander BF, Knudsen LE, Gamborg MO, Jarventaus H, Norppa H. Chromosome aberrations in pesticide-exposed greenhouse workers. Scand J Work Environ Health. 2000; 26: 436-42. [ Links ]
29. Gómez-Arroyo S, Díaz-Sánchez Y, Meneses-Perez MA, Villalobos-Pietrini R, De-León-Rodríguez D. Cytogenetic biomonitoring in a Mexican floriculture worker group exposed to pesticidas. Mutat Res. 2000;466:117-24. [ Links ]
30. Martínez-Valenzuela C, Gómez-Arroyo S, Villalobos-Pietrini R, Waliszewski S,Calderón ME. Genotoxic biomonitoring of agricultural workers exposed to pesticides in the north of Sinaloa State, Mexico. Environment International. 2009;35(8):1155-159. [ Links ]
31. Bortoli GM, Azevedo MB, Silva LB. Cytogenetic biomonitoring of Brazilian workers exposed to pesticides: micronucleus analysis in buccal epithelial cells of soybean growers. Mutat Res. 2009;675(1-2):1-4. [ Links ]
32. Sailaja N, Chandrasekhar M, Rekhadevi PV, Mahboob M, Rahman MF, Vuyyuri SB, et-al. Genotoxic evaluation of workers employed in pesticide production. Mutat Res. 2006;609(1):74-80. [ Links ]
33. Ergene S, Celik A, Cavas T, Kaya F. Genotoxic biomonitoring study of population residing in pesticide contaminated regions in Göksu Delta: micronucleus, chromosomal aberrations and sister chromatid exchanges. Environ Int. 2007;33(7):877-85. [ Links ]
34. Mateuca RA, Roelants M, Lamarcovai G, Aka PV, Godderis L, Trem A, et al. Polymorphisms influence micronucleus frequencies in human lymphocytes in vivo. Mutagenesis. 2008;23(1):35-41. [ Links ]
35. Bonassi S, Biasotti B, Kirsch-Volders M, Knasmueller S, Zeiger E, Burgaz S, et-al. State of the art Survey of the buccal micronucleus assay--a first stage in the HUMN(XL) project initiative. Mutagenesis. 2009;24(4):295-302. [ Links ]
36. Bonassi S, Fenech M, Lando C, Lin YP, Ceppi M, Chang WP,et-al. Human MicroNucleus project: international database comparison for results with the cytokinesis-block micronucleus assay in human lymphocytes: I. Effect of laboratory protocol, scoring criteria, and host factors on the frequency of micronuclei. Environ Mol Mutagen. 2001;37(1):31-45. [ Links ]
37. Neri M, Fucic A, Knudsen LE, Lando C, Merlo F, Bonassi S. Micronuclei frequency in children exposed to environmental mutagens: a review. Mutat Res. 2003;544(2-3):243-54. [ Links ]
38. Neri M, Ceppi M, Knudsen LE, Franco Merlo D, Barale R, Puntoni R, et-al. Baseline micronuclei frequency in children: estimates from meta- and pooled analyses. Environ Health Perspect. 2005;113(9):1226-1229. [ Links ]
39. Lamphear BP, Bearer CF. Biomarkers in paediatric research and practice. Arch Dis Child. 2005;90:594-600. [ Links ]
40. Comisión Nacional del Medio Ambiente-Región Metropolitana. Guía para el control y prevención de la contaminación industrial: fabricación de plaguicidas, pesticidas y funguicidas. Santiago: Comisión Nacional del Medio Ambiente; 1998. [ Links ]
41. International Finance Corporation [homepage on the Internet]. Washington. Environmental Health and Safety Guidelines for Pesticide Manufacturing, Formulation, and Packaging. [citado 2010 Junio 20]; 2007. [ Links ]Disponible en: www.ifc.org/ifcext/enviro.nsf/Content/EnvironmentalGuidelines
42. Asmus CI, Alonzo HG, Palácios M, Silva AP, Freitas-Filhote MI, Buosi D, et-al. Assessment of human health risk from organochlorine pesticide residues in Cidade dos Meninos, Duque de Caxias, Rio de Janeiro, Brazil. Cad. Saúde Pública [serie en Internet]. 2008 Abril [citado 2010 Junio 27] ; 24(4): 755-766. [ Links ] Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2008000400005&lng=en.doi: 10.1590/S0102-311X2008000400005.
43. Wang G, Lu Y, Wang T, Zhang X, Han J, Luo W, et-al. Factors influencing the spatial distribution of organochlorine pesticides in soils surrounding chemical industrial parks. J Environ Qual. 2009;38:180-187. [ Links ]
44. Alarcon WA, Calvert GM, Blondell JM, Meheler LN, Sievert J, Propeck M et-al. Acute Illnesses Associated With Pesticide Exposure at Schools. JAMA. 2005;294:455-65. [ Links ]
45. Prieto-González EA. Deterioro genómico y manipulación genética: desequilibrio en la prioridad de las agendas públicas. Acta Bioethica. 2007;13(2):223-31. [ Links ]
46. Bearer C. How are children different from adults? Environ Health Perspect. 1995;103(Suppl 6):7-12. [ Links ]
47. World Health Organization. Principles for evaluating health risks in children associated with exposure to chemicals. Ginebra: WHO; 2006. [ Links ]
48. Landrigan PJ, Kimmel CA, Correa A, Eskenazi B. Children’s health and the environment: public health issues and challenges for risk assessment. Environ Health Perspect. 2004;112(2):257-65. [ Links ]
49. Perera FP, Ilman SM, Kinney PL, Whyatt RM, Kelvin EA, Shepard P, E. et-al. The challenge of preventing environmentally related disease in young children: community-based research in New York City. Environ Health Perspect. 2002;110(2):197-204. [ Links ]
2. Palani-Kumar L, Panneerselvam N. Toxic effects of pesticides: a review on cytogenetic biomonitoring studies. Medicine and Biology. 2008;15(2):46-50. [ Links ]
3. Oleskey C, Fleischman A, Goldman L, Hirschhorn K, Landrigan P, Lappé M, et-al. Pesticide testing in humans: ethics and public policy. Environ Health Perspect. 2004;112(8):914-19. [ Links ]
4. Thundiyil JG, Stober J, Besbelli N, Pronczuk J. Acute pesticide poisoning: a proposed classification tool. Bull World Health Organ. 2008;86:205-209. [ Links ]
5. Wild CP, Kleinjans J. Children and increased susceptibility to environmental carcinogens: evidence or empathy? Cancer Epidemiol Biomarkers Prev. 2003;12:1389-394. [ Links ]
6. Garry VF. Pesticides and children. Toxicol Appl Pharmacol. 2004;198:152-63. [ Links ]
7. Landrigan PJ, Kimmel CA, Correa A, Eskenazi B. Children’s health and the environment: public health issues and challenges for risk assessment. Environ Health Perspect. 2004;112(2):257-65. [ Links ]
8. Neri M, Bonassi S, Knudsen LE, Sram RJ, Holland N, Ugolini D, et-al. Children’s exposure to environmental pollutants and biomarkers of genetic damage. I. Overview and critical issues. Mutat Res. 2006; 612 ( 1): 1-13. [ Links ]
9. Merlo DF, Knudesen LE, Matusiewicz K, Niebro´j L, Va-há-kangas KH. Ethics in studies on children and environmental health. Med Ethics. 2007;33:408-13. [ Links ]
10. Manno M, Viau C. Biomonitoring for occupational health risk assessment (BOHRA). Toxicol Lett. 2010;192(1):3-16. [ Links ]
11. Holland N, Bolognesi C, Kirsh-Volders M, Bonassi S, Zeiger E, Knasmueller S, et-al. The micronucleus assay in human buccal cells as a tool for biomonitoring DNA damage: the HUMN project perspective on current status and knowledge gaps. Mutat Res. 2008;656(1-2):93-108. [ Links ]
12. Bonassi S, Znaor A, Ceppi M, Lando C, Chang WP, Holland N, et-al. An increased micronucleus frequency in peripheral blood lymphocytes predicts the risk of cancer in humans. Carcinogenesis. 2007;28(3):625-31. [ Links ]
13. Neri M, Ugolini D, Bonassi S, Fucic A, Holland N, Knudsen LE, et-al. Children’s exposure to environmental pollutants and biomarkers of genetic damage II. Results of a comprehensive literature search and meta-analysis. Mutat Res. 2006;612(1):14-39. [ Links ]
14. Ministerio de Salud Pública y Bienestar Social. Secretaria del Ambiente. Informe de la inspección de la Fábrica Chemtec SAE. Asunción: OPS/OMS; 2009. [ Links ]
15. Tolbert PE, Shy CM, Allen JW. Micronuclei and other nuclear anomalies in buccal smears: methods development. Mutat-Res. 1992;271(1):69-77. [ Links ]
16. Norppa H, Ghita C, Falck M. What do human micronuclei contain? Mutagenesis. 2003;18(3):221-33. [ Links ]
17. Kirsch-Volders M, Fenech M. Inclusion of micronuclei in non-divided mononuclear lymphocytes and necrosis/apoptosis may provide a more comprehensive cytokinesis block micronucleus assay for biomonitoring purposes. Mutagenesis. 2001;16(1):51-58. [ Links ]
18. Thomas P, Holland N, Bolognesi C, Kirsch-Volders M, Bonassi S, Zeiger E, et-al. Buccal micronucleus cytome assay. Nat Protoc. 2009;4(6):825-37. [ Links ]
19. Fenech M, Crott J, Turner J, Brown S. Necrosis, apoptosis, cytostasis and DNA damage in human lymphocytes measured simultaneously within the cytokinesis-block micronucleus assay: description of the method and results for hydrogen peroxide. Mutagenesis. 1999;14(6):605-12. [ Links ]
20. Celik A, Cavas T, S. Ergene-Gozukara S. Cytogenetic biomonitoring in petrol station attendants: micronucleus test in exfoliated buccal cells. Mutagenesis. 2003;18(5):417-21. [ Links ]
21. Gattás GJ, Cardoso-Lde A, Medrado-Faria-Mde A, Saldanha PH. Frequency of oral mucosa micronuclei in gas station operators after introducing methanol. Occup Med (Lond). 2001;51(2):107-13. [ Links ]
22. Pastor S, Creus A, Xamena N, Siffel C, Marcos R. Occupational exposure to pesticides and cytogenetic damage: results of a Hungarian population study using the micronucleus assay in lymphocytes and buccal cells. Environ Mol Mutagen. 2002;40:101-109. [ Links ]
23. Pastor S, Gutierrez S, Creus A, Xamena N, Piperakis S, Marcos R. Cytogenetic analysis of Greek farmers using the micronucleus assay in peripheral lymphocytes and buccal cells. Mutagenesis. 2001;16:539-45. [ Links ]
24. Suruda A, Schulte P, Boeniger M, Hayes RB, Livingston GT, Steenland K, et-al. Cytogenetic effects of formaldehyde exposure in students of mortuary science. Cancer Epidemiol Biomarkers Prev. 1993;2:453-60. [ Links ]
25. Ghosh P, Basu A, Singh KK, Giri AK. Evaluation of cell types for assessment of cytogenetic damage in arsenic exposed population. Mol Cancer. 2008;7:45. [ Links ]
26. Pastor S, Creus A, Parron T, Cebulska-Wasilewska A, Siffel C, Piperakis S, et-al. Biomonitoring of four european populations occupationally exposed to pesticides: use of micronuclei as biomarkers. Mutagenesis. 2003;18:249-58. [ Links ]
27. Hoyos LS, Carvajal S, Solano L, Rodríguez J, Orozco L, López Y, et-al. Cytogenetic monitoring of farmers exposed to pesticides in Colombia. Environ Health Perspect. 1996;104:535-38. [ Links ]
28. Lander BF, Knudsen LE, Gamborg MO, Jarventaus H, Norppa H. Chromosome aberrations in pesticide-exposed greenhouse workers. Scand J Work Environ Health. 2000; 26: 436-42. [ Links ]
29. Gómez-Arroyo S, Díaz-Sánchez Y, Meneses-Perez MA, Villalobos-Pietrini R, De-León-Rodríguez D. Cytogenetic biomonitoring in a Mexican floriculture worker group exposed to pesticidas. Mutat Res. 2000;466:117-24. [ Links ]
30. Martínez-Valenzuela C, Gómez-Arroyo S, Villalobos-Pietrini R, Waliszewski S,Calderón ME. Genotoxic biomonitoring of agricultural workers exposed to pesticides in the north of Sinaloa State, Mexico. Environment International. 2009;35(8):1155-159. [ Links ]
31. Bortoli GM, Azevedo MB, Silva LB. Cytogenetic biomonitoring of Brazilian workers exposed to pesticides: micronucleus analysis in buccal epithelial cells of soybean growers. Mutat Res. 2009;675(1-2):1-4. [ Links ]
32. Sailaja N, Chandrasekhar M, Rekhadevi PV, Mahboob M, Rahman MF, Vuyyuri SB, et-al. Genotoxic evaluation of workers employed in pesticide production. Mutat Res. 2006;609(1):74-80. [ Links ]
33. Ergene S, Celik A, Cavas T, Kaya F. Genotoxic biomonitoring study of population residing in pesticide contaminated regions in Göksu Delta: micronucleus, chromosomal aberrations and sister chromatid exchanges. Environ Int. 2007;33(7):877-85. [ Links ]
34. Mateuca RA, Roelants M, Lamarcovai G, Aka PV, Godderis L, Trem A, et al. Polymorphisms influence micronucleus frequencies in human lymphocytes in vivo. Mutagenesis. 2008;23(1):35-41. [ Links ]
35. Bonassi S, Biasotti B, Kirsch-Volders M, Knasmueller S, Zeiger E, Burgaz S, et-al. State of the art Survey of the buccal micronucleus assay--a first stage in the HUMN(XL) project initiative. Mutagenesis. 2009;24(4):295-302. [ Links ]
36. Bonassi S, Fenech M, Lando C, Lin YP, Ceppi M, Chang WP,et-al. Human MicroNucleus project: international database comparison for results with the cytokinesis-block micronucleus assay in human lymphocytes: I. Effect of laboratory protocol, scoring criteria, and host factors on the frequency of micronuclei. Environ Mol Mutagen. 2001;37(1):31-45. [ Links ]
37. Neri M, Fucic A, Knudsen LE, Lando C, Merlo F, Bonassi S. Micronuclei frequency in children exposed to environmental mutagens: a review. Mutat Res. 2003;544(2-3):243-54. [ Links ]
38. Neri M, Ceppi M, Knudsen LE, Franco Merlo D, Barale R, Puntoni R, et-al. Baseline micronuclei frequency in children: estimates from meta- and pooled analyses. Environ Health Perspect. 2005;113(9):1226-1229. [ Links ]
39. Lamphear BP, Bearer CF. Biomarkers in paediatric research and practice. Arch Dis Child. 2005;90:594-600. [ Links ]
40. Comisión Nacional del Medio Ambiente-Región Metropolitana. Guía para el control y prevención de la contaminación industrial: fabricación de plaguicidas, pesticidas y funguicidas. Santiago: Comisión Nacional del Medio Ambiente; 1998. [ Links ]
41. International Finance Corporation [homepage on the Internet]. Washington. Environmental Health and Safety Guidelines for Pesticide Manufacturing, Formulation, and Packaging. [citado 2010 Junio 20]; 2007. [ Links ]Disponible en: www.ifc.org/ifcext/enviro.nsf/Content/EnvironmentalGuidelines
42. Asmus CI, Alonzo HG, Palácios M, Silva AP, Freitas-Filhote MI, Buosi D, et-al. Assessment of human health risk from organochlorine pesticide residues in Cidade dos Meninos, Duque de Caxias, Rio de Janeiro, Brazil. Cad. Saúde Pública [serie en Internet]. 2008 Abril [citado 2010 Junio 27] ; 24(4): 755-766. [ Links ] Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2008000400005&lng=en.doi: 10.1590/S0102-311X2008000400005.
43. Wang G, Lu Y, Wang T, Zhang X, Han J, Luo W, et-al. Factors influencing the spatial distribution of organochlorine pesticides in soils surrounding chemical industrial parks. J Environ Qual. 2009;38:180-187. [ Links ]
44. Alarcon WA, Calvert GM, Blondell JM, Meheler LN, Sievert J, Propeck M et-al. Acute Illnesses Associated With Pesticide Exposure at Schools. JAMA. 2005;294:455-65. [ Links ]
45. Prieto-González EA. Deterioro genómico y manipulación genética: desequilibrio en la prioridad de las agendas públicas. Acta Bioethica. 2007;13(2):223-31. [ Links ]
46. Bearer C. How are children different from adults? Environ Health Perspect. 1995;103(Suppl 6):7-12. [ Links ]
47. World Health Organization. Principles for evaluating health risks in children associated with exposure to chemicals. Ginebra: WHO; 2006. [ Links ]
48. Landrigan PJ, Kimmel CA, Correa A, Eskenazi B. Children’s health and the environment: public health issues and challenges for risk assessment. Environ Health Perspect. 2004;112(2):257-65. [ Links ]
49. Perera FP, Ilman SM, Kinney PL, Whyatt RM, Kelvin EA, Shepard P, E. et-al. The challenge of preventing environmentally related disease in young children: community-based research in New York City. Environ Health Perspect. 2002;110(2):197-204. [ Links ]
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2017-12-28
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Benítez-Leite, S., Macchi, M., Fernández, V., Franco, D., Ferro, E., Mojoli, A., Cuevas, F., Alfonso, J., & Sales, L. (2017). Daño celular en una población infantil potencialmente expuesta a pesticidas. Pediatría (Asunción), 37(2), 97-106. Recuperado a partir de https://www.revistaspp.org/index.php/pediatria/article/view/202
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