(Beyond Pesticides, March 7, 2017) Another study, published by a team of French scientists in the journal Occupational and Environmental Medicine, links childhood behavioral problems to pyrethroid insecticide exposure. Synthetic pyrethroids are a class of insecticides that have increased in use over the past decade due to assumptions that they pose fewer risks to human health than older pesticide chemistries, such as organophosphates. However, this latest study is part of a growing body of research showing that pyrethroids share similar neurocognitive health concerns as these older pesticides. .   In this research, scientists investigate the interplay between pyrethroid exposure and behavioral problems through a longitudinal cohort study, which tracks levels of pyrethroid metabolites, or breakdown products, in the urine of mothers beginning between six and 19 gestational weeks and then in their children up through six years of age. Children’s behavior is measured through a screening questionnaire known as the Strengths and Difficulties Questionnaire (SDQ). SDQ measures how social a child is (altruism), whether the child has difficulty sharing problems or asking for help (internalizing disorders), as well as how defiant or disruptive a child is (externalizing disorders). The study controlled for a number of confounding factors, such as weight, education, location (rural or […]

(Beyond Pesticides, September 16, 2016) Tell EPA to ban all uses of atrazine in the United States! Atrazine, widely used on food and feed crops, golf courses, and residential lawns, is a potent endocrine disruptor that is  strongly associated with birth defects, cancer, sex reversal and hermaphroditism in many different animals. The European Union and other countries have banned atrazine, however EPA continues to put U.S. citizens and the environment in harm’s way, allowing nonstop use of this toxic chemical. Sign Beyond Pesticides’ petition to ban atrazine by October 5, 2016. Atrazine is the second-most widely used pesticide in the U.S., with over 73 million pounds applied each year. Atrazine has washed into surface water and leached into groundwater, spurring community water utilities  across the U.S. to file class-action lawsuits to remove the pesticide from drinking water supplies. Even at levels established as “safe” or acceptable by EPA drinking water standards, atrazine is linked to endocrine-disrupting effects. EPA is not adequately assessing the effects of atrazine by using high dose testing models, which are not appropriate for hormonally-active substances  that  often show effects at minute doses. Studies by Tyrone Hayes, Ph.D., University of California, Berkeley,  and others have shown that […]

(Beyond Pesticides, August 25, 2016) The County of Miami-Dade announced Tuesday that it will no longer conduct aerial sprayings on weekdays, to avoid exposing children and teachers. In an effort to control the spread of Zika, the county is consulting with the Centers for Disease Control and Prevention (CDC) and the Florida Department of Health (FDOH), to spray a neighborhood in the county, Wynwood, with Bacillus thuringiensis israelensis (Bti) and Naled. Mosquito officials were conducting the spraying during the early hours of the morning, when fewer people were around, the first day of the school year in Miami-Dade started this week, putting teachers and students at risk of exposure at bus stops. The county’s move is encouraging, because as research has continuously shown, children and pesticides don’t mix.  Studies show children’s developing organs create “early windows of great vulnerability” during which exposure to pesticides can cause great damage. Childhood pesticide exposure has been linked to a range of adverse health endpoints, including cancer, asthma, impaired sexual development, ADHD and other learning disabilities. “We have adjusted our spraying schedule to avoid any inconvenience to our local school system, and the children, families, and teachers in our community,” the office of Mayor […]

(Beyond Pesticides, August 16, 2016) Young children are disproportionately poisoned by toxic pesticides used indoors, according to a study published in the Australian and New Zealand Journal of Public Health. Data analyzed from the Queensland, Australia Poisons Information Centre (QPIC) finds that 49% of 743 insecticide-related calls in 2014 concerned young children. Given that children are more sensitive to pesticide exposure than adults because they take in more of a chemical relative to their body size and have developing organ systems, this data underscores the importance of educating the general public about alternatives to the use of toxic pesticides in and around the home. A significant share of childhood pesticide poisonings occurred in very young children. “Children in the one-year age group were at greatest risk — as they’re at that stage where they spend a lot of the time on the floor and put things in their mouth,” said Karin English, PhD candidate at the University of Queensland. As a result of children’s propensity for hand to mouth motion, cockroach baits and ant liquid were found to be the most common source of insecticide exposure for kids under five, covering 39% of calls. However, Ms. English notes that enclosing […]

(Beyond Pesticides, October 6, 2015) Last week, the International Federation of Gynecology and Obstetrics (FIGO) released a statement encouraging broad-based policy measures that prevent exposure to toxic environmental chemicals. “The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year,” the report unequivocally states. FIGO’s statement follows a similar call to action from the American College of Obstetricians and Gynecologists in 2013 and the American Academy of Pediatrics in 2012. The piece lays out broad themes surrounding exposure to toxic chemicals, including issues of environmental justice, prenatal exposure and subsequent health effects, and overall global health and economic burden. Based on these impacts, several recommendations are submitted for obstetricians, gynecologists, midwives, women’s health nurse practitioners, nurses, and other health professionals to follow to achieve a goal of “prevention for all.” FIGO highlights how people of low-income, particularly in poverty-stricken countries, bare a higher burden of toxic exposure than richer nations. “[A]t every stage of development, the consequences of exposure to toxic chemicals —including morbidity and mortality, loss of family income and productivity, and environmental degradation— are disproportionately borne by people with low incomes,” the piece states. FIGO […]

(Beyond Pesticides, October 05, 2015) According to a Yale University study, prenatal exposure to the widely used agricultural pesticide chlorpyrifos is linked to tremors — involuntary contraction or twitching of muscles — in childhood. Chlorpyrifos, a broad-spectrum chlorinated organophosphate insecticide also known as Dursban, may also affect the cardiovascular and respiratory systems and is acutely toxic to bees, birds, mammals, and aquatic life. The study, titled Prenatal exposure to the organophosphate pesticide chlorpyrifos and childhood tremor  and published in the journal Neurotoxicology, measured the presence of chlorpyrifos in umbilical cord blood samples in 263 low-income, inner-city minority children. In 2001, the U.S. Environmental Protection Agency (EPA) banned residential use of chlorpyrifos, which was prominent in urban areas at the time. However, the study participants  —263 minority mothers  and their children, all from low income  communities in New York  City— were assembled in 1997,  before the ban was imposed. In  1997, the initial measure of each  child’s prenatal exposure to CPF  was taken from umbilical cord  blood. The children were then followed until approximately 11 years of age, after which they underwent a neurophysical assessment, which included a short drawing test. Researchers found that compared to all other children, those who […]

(Beyond Pesticides, June 15, 2015) A community in central Michigan is still dealing with the fallout of a pesticide company that produced DDT nearly half a century ago. St. Louis, MI, a city about one hour north of the state capital Lansing, has long dealt with contamination left behind by the Velsicol Chemical Corporation, which manufactured pesticides in the town until 1963, when it left  and  abandoned loads of DDT in its wake. DDT, known for accumulating in food webs and persisting for decades in soil and river sediment, was banned in the U.S.  in 1972, but problems associated with its prevalent use until that time still plague the community to this day. This situation  has led to a multi-million dollar clean-up effort at taxpayers’ expense  by Environmental Protection Agency (EPA) and the Michigan Department of Environmental Quality (DEQ). EPA took control of the Velsicol plant as a Superfund site in 1982, but decades-long delays in the cleanup of the old chemical factory have left songbirds, and potentially people at risk nearly thirty years later. After years of complaints from residents, researchers  recently reported  that robins and other birds are dropping dead from DDT poisoning. The dead robins and other […]

(Beyond Pesticides, March 13, 2015) Exposure to endocrine (hormone) disrupting chemicals (EDC) results in approximately € 150 billion ($162 billion) in health care costs in the European Union each year, according to panels of scientists tasked by the EU Commission to study their impact. “The shocking thing is that the major component of that cost is related to the loss of brain function in the next generation,” Philippe Grandjean, M.D. of Harvard University, one of the report’s authors, told the Guardian. EDCs, contained in common household products such as detergents, disinfectants, furniture, plastics, and pesticides, interfere with the body’s hormone system either by mimicking naturally produced hormones, blocking hormone receptors in cells, or effecting the transport, synthesis, metabolism or excretion of hormones. These impacts can result in devastating effects on one’s health, including behavioral and learning disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), birth defects, obesity, early puberty, infertility, cardiovascular disease, and childhood and adult cancers. Nearly 100 percent of people have detectable amounts of EDCs in their bodies, according to the introductory guide to EDCs published by the Endocrine Society and IPEN. “Our brains need particular hormones to develop normally —the thyroid hormone and sex hormones like testosterone […]

(Beyond Pesticides, February 5, 2015) A brewing  battle in the European Union (EU) over removing from the market  Endocrine Disrupting Chemicals (EDC)s has  heated up. An investigative report in  The Guardian  reveals that a European Union (EU) scientific paper, prepared to assist in the development of new mandatory EDC risk assessment standards, was never made public. According to the report, EU Commission sources say the release of the paper was quashed as a result of chemical industry pressure and political influence. At the core of the debate lies two EU regulations, one concerning biocidal products (EU 528/2012) and the second on “plant pest protectants” (EU 1107/2009). Both of these regulations required the EU Commission to produce draft measures concerning specific scientific criteria for the determination of endocrine disrupting properties by December 14, 2013. Under the regulations, chemicals within the biocidal and plant pest protectant categories that are  categorized as having endocrine disrupting properties that may cause adverse effects in humans would be prohibited from use in the market place. As noted in the purpose and subject matter of the biocidal regulations, “The purpose of [the] Regulation is to improve the functioning of the internal market through the harmonization of the […]

(Beyond Pesticides, January 7, 2015) On Monday, the U.S. Environmental Protection Agency (EPA) released a revised human health assessment for the insecticide, chlorpyrifos, which finds risks to workers who mix, load and apply chlorpyrifos, and that the chemical has the potential to pose risks to drinking water in small watersheds. The assessment also notes that EPA will retain the 10X (10-fold) safety factor to protect children from all routes of exposures. EPA’s latest finding confirms long-standing scientific data that  has documented chlorpyrifos’ toxicity to humans and environmental contamination. However, despite these findings, EPA proposes to place additional restrictions on chlorpyrifos’ use, instead of a widespread ban. This latest assessment updates the June 2011 preliminary human health risk assessment, which was widely criticized by environmental and farmworker groups. EPA is releasing this assessment based on new information received since 2011, including public comments. The assessment is, in part, in response to a petition submitted by Natural Resources Defense Council (NRDC) and Pesticide Action Network (PAN) in 2007, which called on the agency to ban all uses of the insecticide. In 2000, EPA orchestrated a voluntary cancellation with the manufacturer Dow AgroSciences of  most residential uses of chlorpyrifos to limit children’s exposure, […]

(Beyond Pesticides, August 8, 2014) Despite the continued documentation of weed resistance all over the United States, as well as the world, another line of herbicide-tolerant crops developed by Monsanto is currently in the pipeline awaiting likely approval by U.S. regulators. The U.S. Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) released a draft environmental impact statement (EIS) on Tuesday, which, according to regulators, will pave the way for the approval of new  genetically modified cotton and soybean plants tolerant to a mixture of the herbicides glyphosate and dicamba. Monsanto’s new soybean and cotton crops were developed to withstand their new herbicide formulation, called Roundup Xtend, which combines the pesticides dicamba and glyphosate. The “Roundup Ready Xtend crop system” was developed to curb the proliferation of millions of acres of weeds that have grown resistant to Monsanto’s glyphosate-based Roundup, which has been used on the company’s biotech corn, soybeans, and cotton. Weed resistance due to cropping systems dependent on herbicides has been documented for years, making APHIS’ conclusions in the EIS all the more alarming. A report that Beyond Pesticides published 12 years ago, “The Environmental Risks of Transgenic Crops: An Agroecological Assessment is the failed pesticide […]

(Beyond Pesticides, July 21, 2014) According to figures released by the British Government last week, over 60% of the county’s bread supply is tainted with pesticide residues. This is a shocking increase from numbers recorded in 2001, which found 28% of bread to be tainted. According to the Department for Environment, Food and Rural Affairs (Defra) Expert Committee on Pesticides Residues in Food (PRIF), 2,951 bread samples were tested. According to a Pesticide Action Network UK report, a majority of the reoccurring pesticides were glyphosate and chlormequat. Glyphosate is an herbicide that can lead to non-Hodgkin’s Lymphoma, genetic damage, cancer, reproductive issues, liver damage, and endocrine disruption as well environmental damage such as water contamination and harmful effects to amphibians. Unfortunately, very little research has been done on what the effects can be on humans. Chlormequat, the second most-commonly found pesticide in British bread, is a plant growth regulator. A study conducted by the UN’s Food and Agriculture Organization (FAO) linked Chlormequat to developmental toxicity in animals. Very little research has been performed assessing the public health impact of this pesticide. In the U.S., it is only allowed for use on ornamental plants. Pan UK spokesman Nick Mole said, “The […]

(Beyond Pesticides, July 16, 2014) The Canadian Environmental Law Association (CELA) and Clean Production Action (CPA) released a comprehensive assessment of the hazards posed by triclosan and its chemical cousin triclocarbon Thursday, calling on the Canadian Government to create a comprehensive phase-out plan for these harmful antibacterial chemicals. The report, which finds that the chemicals are accumulating in the waters of the Great Lakes, also suggests that the U.S. and all provinces and states bordering the Great Lakes should prohibit use of the chemicals. The two antibacterial chemicals are commonly used in consumer products ranging from liquid soaps and toothpaste to kitchen cutting boards, and have come under increased scrutiny amidst human health concerns and lack of efficacy. The Canadian Medical Association (CMA) has been calling for a ban on the household use of triclosan since 2009, and in 2012, the Canadian government declared triclosan as toxic to the environment. In the U.S., Beyond Pesticides has petitioned the Food and Drug Administration (FDA) and its counterpart, the U.S. Environmental Protection Agency (EPA) (which regulates non-cosmetic products with triclosan) for years to immediately ban triclosan from consumer products, citing endocrine disruption, and other human health concerns. Last December,  FDA announced  it […]

(Beyond Pesticides, July 2, 2014) According to a new study, few obstetricians offer their pregnant  patients advice on how to avoid environmental toxins that might harm their babies, even though doctors recognize that exposure to chemicals like pesticides, bisphenol-A (BPA), and metals can affect  a pregnancy. The study recommends that the medical community improve medical education and training, develop recommendations for prevention and less toxic alternatives, as well as lend support to policy change. The first of its kind study of prenatal counselling, published in the journal  PLOS ONE, Counseling Patients on Preventing Prenatal Environmental Exposures – A Mixed-Methods Study of Obstetricians, found that U.S. obstetricians and gynaecologists feel they lack the medical education and training, and evidence-based guidelines and tools for communicating potential environmental risks to patients. Exposure to environmental toxins, the researchers from the University of California, San Francisco (UCSF) found, is rarely discussed with pregnant patients, even though a national survey shows that 80 percent of physicians agree they should play a part in reducing patients’ exposure to toxins. But, of the 2,500 respondents, only one in five routinely asked  their  patients about these exposures, and just one in 15 said they received training on the harmful […]

(Beyond Pesticides, June 24, 2014) Research from the University of California, Davis CHARGE (Childhood Autism Risks from Genetics and the Environment) study finds that pregnant women who lived within a mile of agricultural fields treated with insecticides are more likely to have their child develop autism. The results of the CHARGE study, published in Environmental Health Perspectives, strengthens calls from public health and environmental groups urging regulators take a precautionary approach to agricultural chemicals and institute increased protections for those who live, work, or go to school near pesticide-treated fields. The CHARGE study looked at pregnant women’s addresses to determine their location relative to fields treated with pesticides. For women who lived less than one mile from crops sprayed with organophosphate insecticides during their pregnancy, researchers found the likelihood of their child being diagnosed with autism increased 60%. Women in the second trimester living near fields treated with chlorpyrifos, a widely used organophosphate insecticide banned for household use in 2001, are 3.3 times more likely to have their children diagnosed with autism. In response to a legal petition, the U.S. Environmental Protection Agency (EPA) in 2012 instituted risk mitigation measures for chlorpyrifos, including reduced application rates and no-spray buffer zones […]

(Beyond Pesticides, June 9, 2014) Triclosan, the antibacterial pesticide found in numerous hand soaps, toothpastes, and other cosmetics, has had a ubiquitous presence on the consumer market for over 30 years. But due to public pressure led by Beyond Pesticides, our allies, and concerned supporters, many manufacturers have been washing their hands of triclosan. Now after years of inaction, the U.S. Food and Drug Administration (FDA) is going to require data to support triclosan’s claims of being “safe and effective.” The time is now to let the agency know that triclosan is NOT safe or effective for human and environmental health. Raise your voice with a unique public comment to FDA! Use the sample letter below for guidance. Rising Evidence Against Safety Beyond Pesticides has generated extensive documentation  of the potential human and environmental health effects of triclosan and its cousin triclocarban. Studies show that triclosan can interfere with thyroid and estrogen hormones, and may promote the progression of cancer cells. This is alarming given that the CDC has found that 75% of the U.S. population contain triclosan in their bodies, even in breast milk, and at levels that are rising. Triclosan is an endocrine disruptor and has been shown […]

(Beyond Pesticides, December 20, 2013) The European Food Safety Authority (EFSA) announced on Tuesday that pesticides linked to honey bee deaths worldwide may also damage human nervous systems ””in particular the brain, and recommended that the European Commission lower the guidance levels of acceptable exposure until more research is conducted. This new determination heightens the call to ban the use of these toxic chemicals in the U.S., following the lead of the European Union (EU). EFSA found that two commonly used chemicals “may adversely affect the development of neurons and brain structure associated with functions such as learning and memory” particularly of children. The recommendation focuses on two chemicals ””acetamiprid and imidacloprid”” in a relatively new class of insecticide called neonicotinoids. Three chemicals in this class were recently placed under a two-year ban in the European Union (EU) for uses on flowering crops known to attract honey bees. The move stems from a recent review of research on rats which found, “Neonicotinoids may adversely affect human health, especially the developing brain.” Researchers who exposed newborn rats to one of these chemicals ””imidacloprid”” found they suffered brain shrinkage, fewer nerve signals controlling movement, and weight loss. Another study on rats found […]

(Beyond Pesticides, November 1, 2013) Insecticides commonly used in homes and schools are associated with behavioral problems in children, according to a recent study by Canadian researchers. The study investigates exposure to pyrethroid pesticides, used in more than 3,500 products, including flea and tick controls, cockroach sprays, and head lice controls. The study, Urinary metabolites of organophosphates and pyrethroid pesticides and behavioral problems in Canadian children, published in the journal Environmental Health Perspectives, raises serious concerns about the impact of pyrethroids, which are increasingly used as a replacement for organophosphates. This study uses data from the Canadian Health Measures Survey (2007-2009), a nationally representative survey, so researchers are able to apply these findings to the entire population of Canadian children. In a previous study among U.S. children, researchers at the National Health and Nutrition Examination Survey (NHANES) examined the metabolites of pyrethroids in children below the age of six. Similarly, they found pyrethroid insecticides in more than 70 percent of the samples, concluding that children had significantly higher metabolite concentrations than those of adolescents. Together these studies demonstrate that exposure is widespread, with real impacts to human health. In the recent study, researchers analyzed organophosphate and pyrethroid metabolites in the […]

(Beyond Pesticides, April 24, 2013) Using the aquatic species Daphnia, commonly referred to as “water fleas,” scientists at North Carolina State University (NC State) determined that exposure to the pesticide pyriproxyfen impacted multiple generations, ultimately resulting in more male offspring, and causing reproductive problems in female offspring. Lead author Gerald LeBlanc, PhD, notes, “This work supports the hypothesis that exposure to some environmental chemicals during sensitive periods of development can cause significant health problems for those organisms later in life —and affect their offspring and, possibly, their offspring’s offspring.” The study, published in the journal PLoS One, provides the scientific community with new information on how organisms respond to the environmental signals resulting from pesticide exposure. Environmental cues normally determine whether the Daphina offspring will be male or female, according to the researchers. This study is part of an investigation to understand the mechanisms involved with these environmental cues. The NC State team had previously identified the hormone methyl farnesoate (Mf) as an important factor in determining the sex of the organisms at the embryotic stage. The scientists exposed Daphnia to varying levels of the pesticide pyriproxyfen, an insecticide that mimics the Mf hormone. The exposure resulted in Daphnia producing […]

(Beyond Pesticides, December 10, 2012) Long-term low-level exposure to organophosphate pesticides produces lasting damage to neurological and cognitive functions, according to researchers at University College London (UCL). This research pulls data from 14 studies over the past 20 years, including more than 1,600 participants, in order to provide a quantitative analysis of the current literature on these dangerous chemicals. Lead author of the study, Sarah Mackenzie Ross, Ph.D., notes, “This is the first time anyone has analyzed the literature concerning the neurotoxicity of organophosphate pesticides, using the statistical technique of meta-analysis.” UCL’s systematic review, published in the journal Critical Reviews in Toxicology, comes to an unsettling conclusion about the hazards of constant low-level occupational exposure to organophosphates. The study notes, “The majority of well designed studies found a significant association between low-level exposure to [organophosphates] and impaired neurobehavioral function which is consistent, small to moderate in magnitude and concerned primarily with cognitive functions such as psychomotor speed, executive function, visuospatial ability, working and visual memory.” In other words, low-level exposure had significant detrimental effect on working memory and information processing. The researchers are hopeful that the results of their analysis will be used to inform governments performing reviews on the […]

(Beyond Pesticides, August 10, 2012) A new study is the first to find a difference between how boys and girls respond to prenatal exposure to the insecticide chlorpyrifos. Researchers at the Columbia Center for Children’s Environmental Health (CCCEH) at the Mailman School of Public Health found that, at age 7, boys had greater difficulty with working memory, a key component of IQ, than girls with similar exposures. On the plus side, having nurturing parents improved working memory, especially in boys, although it did not lessen the negative cognitive effects of exposure to the chemical. Results are published online in the journal Neurotoxicology and Teratology. In 2011, research led by Virginia Rauh, ScD, Co-Deputy Director of CCCEH, established a connection between prenatal exposure to chlorpyrifos and deficits in working memory and IQ at age 7. Earlier this year, a follow-up study showed evidence in MRI scans that even low to moderate levels of exposure during pregnancy may lead to long-term, potentially irreversible changes in the brain. The latest study, led by Megan Horton, PhD, explored the impact of sex differences and the home environment on these health outcomes. Dr. Horton and colleagues looked at a subset of 335 mother-child pairs enrolled […]

(Beyond Pesticides, June 15, 2012) Researchers at the Duke University School of Medicine have developed a laboratory screening system for detecting neurotoxic chemicals and successfully tested it on more than 1,400 potential toxicants. The study confirms the high toxic activity of the chemical piperonyl butoxide (PBO), a chemical “synergist” used to increase the potency of more than 700 insecticides, including synthetic pyrethroids widely used in mosquito and community spray programs and for home use. The study, entitled “The Insecticide Synergist Piperonyl Butoxide Inhibits Hedgehog Signaling: Assessing Chemical Risks,” was published in the May 2012 edition of the journal Toxicological Sciences. The testing shows that PBO disrupts a biological signaling system that is “critical in neurological development,” the researchers reported in the abstract of their paper. The study finds that the disruption of this critical pathway “may be the molecular basis for profound developmental defects in children exposed in utero to PBO.” Piperonyl butoxide is not itself classified as a pesticide, but companies combine it with insecticides to increase their potency. PBO came into widespread use when the U.S. Environmental Protection Agency (EPA) phased out chlorpyrifos and other organophosphate pesticides nearly a decade ago after determining that they posed a risk […]

(Beyond Pesticides, May 2, 1012) New research published online at the Proceedings of the National Academy of Sciences reports that babies exposed in the womb to a commonly used insecticide have brain abnormalities after birth. The insecticide, chlorpyrifos (used in agriculture, mosquito control, and golf course management) , is well documented as inducing neurodevelopmental abnormalities in infants exposed in their mother’s womb, including ADHD, cognitive deficits, and serious learning, behavioral or emotional disorders. Entitled, “Brain anomalies in children exposed prenatally to a common organophosphate pesticide,” the study investigated associations between chlorpyrifos exposure and brain morphology using magnetic resonance imaging in 40 New York City children. It found significant associations of prenatal exposure, at standard use levels, with structural changes in the developing human brain, including enlargement of superior temporal, posterior middle temporal, and enlarged superior frontal gyrus, gyrus rectus, cuneus, and precuneus along the mesial wall of the right hemisphere. These areas of the brain impacted are related to attention, language, reward systems, emotions and control may be affected by the chemical. Twenty high-exposure children (upper third of chlorpyrifos concentrations in umbilical cord blood) were compared with 20 low-exposure children. The children, ages 6-11 years, considered to have a high […]