(Beyond Pesticides, October 28, 2022) The Maine Congressional delegation — Senators Collins (R) and Angus King (I), and Representatives Chellie Pingree (D) and Jared Golden (D) — along with New Hampshire Senator Jeanne Shaheen (D), have introduced a bipartisan and bicameral bill — the Relief for Farmers Hit with PFAS Act — to help farmers who have been impacted by the scourge of PFAS (perfluoroalkyl and polyfluoroalkyl substances) chemicals. (The Senate version of the bill is available; the House version should be soon.) PFAS contamination has, as Beyond Pesticides documented in two Daily News Blog articles (here and here), become a huge, life-altering problem for agricultural producers in Maine and many other states. An early 2022 Safer States analysis of state-level legislation on PFAS demonstrated the extent of the problem via the response: more than 32 states have begun to act on the issue. Beyond Pesticides has covered the presence of PFAS in pesticides and pesticide containers, and in so-called “biosludge” or “biosolids”— realities that only reinforce the call for a rapid transition off of chemical-dependent agriculture and to regenerative organic agricultural practices that do not carry the enormous health and environmental risks of pesticide products and contaminated fertilizers. There […]

(Beyond Pesticides, October 21, 2022) The U.S. Environmental Protection Agency (EPA) has just made two announcements, related to the quest for improved indoor air quality in buildings, that address mitigation of disease transmission — and that of COVID-19, in particular. Related to enactment of the National COVID-19 Preparedness Plan, EPA issued guidance on the efficacy of antimicrobial products used on surfaces, and registered a new pesticide product the agency says can be used against influenza and corona viruses (some of the latter cause COVID-19 infections). In addition, EPA opened a 60-day public comment period “to solicit information and recommendations from a broad array of individuals and organizations with knowledge and expertise relating to the built environment and health, indoor air quality, epidemiology, disease transmission, social sciences and other disciplines.” Beyond Pesticides cannot help but note the irony of an intention to improve air quality that EPA couples with registration of a new, airborne pesticide for indoor use. EPA expands on its RFI (Request for Information) related to indoor air quality, saying that it is “seeking input from a diverse array of stakeholders . . . about actions, strategies, tools and approaches that support ventilation, filtration and air cleaning improvements, and […]

(Beyond Pesticides, October 17, 2022)  A recent report, Exposed and At Risk: Opportunities to Strengthen Enforcement of Pesticide Regulations for Farmworker Safety, by the Center for Agriculture and Food Systems at Vermont Law and Graduate School, in partnership with the nonprofit advocacy group, Farmworker Justice, again highlights the systemic racism of our country’s pesticide policies. Our nation depends on farmworkers, declared “essential workers” during the COVID-19 pandemic to ensure sustenance for the nation and world. Yet the occupational exposure to toxic pesticides by farmworkers is discounted by the Environmental Protection Agency (EPA), while study after study documents the disproportionate level of illness among farmworkers. While we are encouraged to see the formation of EPA’s new Office of Environmental Justice and Civil Rights, the agency has a historical bias against preventive action to ensure the protection of those disproportionately poisoned by toxic chemicals. While critically important to clean up contaminated communities, EPA must stop the flow of toxic pesticides at the front end because of the disproportionate poisoning effects of use, handling, transportation, and disposal. We live in an age of practices and products that make toxic pesticides unnecessary and their use unconscionable. Yet, EPA insists on the acceptability of harm […]

(Beyond Pesticides, September 8, 2022) A study published in Environmental Pollution finds parental exposure to real-world, sublethal concentrations of pesticide residues on grains is a major contributor to unfavorable offspring development among foraging birds. Parents’ ingestion of grains with conventional pesticide residues, whether from contaminated or pesticide-treated seeds, results in chronic exposure that adversely affects offspring health, even at low doses. The adverse effects pesticides and other environmental pollutants have on birds are amply documented and researched. Although many studies evaluate acute or chronic health implications associated with pesticide exposure in a single generation, there is a lack of information on multi-generational impacts that can provide vital information on the fundamental survivability or fitness of bird species. Considering this study emphasizes parental exposure to environmental pollutants can have adverse consequences for future generations, it is necessary that future risk assessments for birds address these implications when implementing agricultural pesticide policies. The study notes, “[S]ublethal effects of such compounds [pesticides] on non-target species should be included in the regulation. Moreover, as agroecosystem pollution is not resulting only from pesticides, there is an urgent need to analyze cocktail effects, not only between molecules of pesticides but also between pesticides and other pollutants such as […]

(Beyond Pesticides, July 26, 2022) Secret meetings with industry, the elevation of unqualified individuals to decision-making roles, using an untested scientific approach, failing to conduct a simple literature review, and an overall absence of public transparency. This is how the U.S. Environmental Protection Agency’s (EPA) conducted its cancer review for the potent fumigant pesticide 1,3-Dichloropropane (1,3-D; brand name: Telone), according to a report from EPA’s Office of Inspector General (OIG). EPA’s actions allowed a product once considered to pose a 1 in 10,000 risk of cancer to Americans to increase exposure by 9,000% (from 7.7 μg/m3 to 690 μg/m3). “These departures from established standards during the cancer assessment for 1,3-D undermine the EPA’s credibility, as well as public confidence in and the transparency of the Agency’s scientific approaches, in its efforts to prevent unreasonable impacts on human health,” the OIG report states. Yet, even with the agency’s failings laid out in clear view, EPA’s lackluster response to OIG’s corrective actions in this case add insult to its injurious actions against public health. OIG initiated a review of EPA’s cancer assessment for 1,3-D after the submission of multiple complaints. 1,3-D is a highly toxic fumigant used on a variety of crops, […]

(Beyond Pesticides, June 24, 2022) As reported by the Center for Food Safety (CFS), on June 16 the Environmental Protection Agency (EPA) released final Biological Evaluations, for three neonicotinoid insecticides, that indicate that these pesticides are “likely to adversely affect” the vast majority of endangered or threatened species and/or their designated critical habitats. These evaluations for imidacloprid, clothianidin, and thiamethoxam have been a long time coming, and represent, according to the Center for Biological Diversity (CBD), the first time EPA “has completed biological evaluations of any neonicotinoids’ harms to the nation’s most imperiled plants and animals.” These evaluations evidence what CFS, CBD, Beyond Pesticides, and others have maintained for years: that neonicotinoid compounds are very serious threats to the survival and well-being of myriad organisms and habitats. A Biological Evaluation (BE) is an EPA analysis of potential harmful impacts of a registered pesticide on any species federally listed, per the Endangered Species Act, as endangered or threatened, or on their critical habitats. EPA was legally required to issue the determinations by the June 2022 deadline, per CFS litigation and a subsequent 2019 legal settlement. EPA was the defendant in 2017 litigation brought by CFS, with Beyond Pesticides, several beekeepers, and the Center for Environmental […]

(Beyond Pesticides, June 21, 2022) June 20-24 is Pollinator Week, during which we recognize—and take action to protect—this important ecosystem link. Pollinators––bees, butterflies, birds, bats, and other organisms––make a critical contribution to plant health, crop productivity, and the preservation of natural resources, but their existence is threatened by their pesticide-contaminated habitat. Pesticides have consistently been implicated as a key contributor to dramatic pollinator declines. Of the 100 crop varieties that provide 90% of the world’s food, 71 are pollinated by bees. Honey bees alone pollinate 95 kinds of fruits, nuts and vegetables, such as apples, avocados, almonds, and cranberries. Take action to protect pollinators. Providing protection for pollinators also protects the ecosystem in which they live. That protection requires eliminating harm as well as providing safe habitats where they can live and reproduce.  Provide organic habitat on your own property and encourage your town to go organic. Since plant starts in many garden centers across the country are grown from seeds coated with bee-toxic neonicotinoid pesticides, or drenched with them, Beyond Pesticides has compiled a comprehensive directory of companies and organizations that sell organic seeds and plants to the general public. Included in this directory are seeds for vegetables, flowers, and herbs, as well as […]

(Beyond Pesticides, June 19, 2022) On Juneteenth Day, we commemorate the abolition of slavery and celebrate human freedom. At the same time, we recognize that we have significant work to do to eliminate systemic racism and advance environmental justice. We strive to ensure that people of color are not disproportionately harmed by pesticides and other toxic chemicals—from production, use, to disposal—and that all people have access to sustainable and organic food and organically managed communities. Acute and chronic exposure to chemicals like pesticides cause a plethora of harmful effects, including (but not limited to) brain and nervous system disorders, birth abnormalities, cancer, developmental and learning disorders, endocrine disruption, immune disorder, and reproductive dysfunction, among others. However, people of color may experience more servere health effects from exposure, resulting in elevated rates of diseases. Communities of color and those living in low-socioeconomic conditions experience an inequitable number of hazards, including toxic waste plants, garbage dumps, and other sources of environmental pollution and odors that lower the quality of life. Therefore, these populations experience greater exposure to harmful chemicals and suffer from health outcomes that affect their ability to work and learn. When discussing health disparities and environmental justice, we need to […]

(Beyond Pesticides, June 7, 2022) Bumblebee colonies exposed to low levels of the weed killer glyphosate are unable to adequately regulate nest temperature, imperiling the next generation of bumblebees and long-term colony growth and survival. This latest finding, published this month in the journal Science, is a stark reminder that a pesticide does not have to kill an animal outright in order to create effects that ultimately result in death and population declines. “Sublethal effects, i.e. effects on organisms that are not lethal but can be seen, for example, in the animals’ physiology or behaviour, can have a significant negative impact and should be taken into account when pesticides are approved in future,” said Anja Weidenmüller, PhD, of the University of Konstanz, Germany. With regulators at the U.S. Environmental Protection Agency (EPA) refusing to adequately account for sublethal impacts, and myopically focused on the acute effects of pesticide exposure, bumblebee populations in the United States are in free fall and require urgent protective action. To better understand how glyphosate exposure affects bumblebee colony growth and brood (young larval bee) development, researchers first split colonies in two. One side of the colony was fed sugar water containing 5mg/liter of glyphosate, while […]

(Beyond Pesticides, May 20, 2022) Beyond Pesticides has long covered the various ways in which corruption related to pesticides, agriculture, and food — whether in industry or government — can result in harm to human and environmental health, including to a multiplicity of organisms, and their ecosystems and habitats. In this Daily News Blog entry, we will review the landscape of U.S. pesticide regulation, examples of corruption, and what can be done to counter it. A look at some recent instances provides unfortunate assurance that problems of corruption at EPA persist. A serious flaw in EPA’s registration (and periodic pesticide registration review) processes is their reliance on industry-provided data and research on safety of pesticide products, which does not reliably represent actual risks of harms. Agrochemical companies sometimes purchase research that yields biased or distorted findings, cherry pick results in their submissions to EPA, or try to suppress research findings. USRTK recently covered an instance in which Bayer (and other companies) funded a study on the impacts — of use of their neonicotinoid (neonic) corn seed treatments — on bees during planting season. Neonics have been widely implicated in the plummeting health, function, and populations of pollinators and in the so-called […]

(Beyond Pesticides, May 13, 2022) The Midwest Center for Investigative Reporting has covered a report, released days ago by the U.S. Environmental Protection Agency (EPA), that acknowledges the agency’s failures to meet its responsibilities under the Endangered Species Act (ESA) and sets out a plan for improving its performance and meeting its obligations. The report, Balancing Wildlife Protection and Responsible Pesticide Use: How EPA’s Pesticide Program Will Meet Its Endangered Species Act Obligations, 2022, notes that these failures have resulted “not only in inadequate protections for listed species, but also, litigation against the Agency that has increased in frequency in recent years” — to the tune of more than 20 lawsuits covering 1,000+ pesticide products. Beyond Pesticides has covered the many chemical assaults on ESA species, as well as a number of lawsuits brought on their behalf — most recently, the Center for Biological Diversity’s (CBD’s) suit about the threats of synthetic pyrethroid insecticides to fragile species. Beyond Pesticides reported on a 2019 CBD lawsuit seeking to force the National Marine Fisheries Service (NMFS) and the U.S. Fish and Wildlife Service (FWS) to initiate rulemaking to prevent most pesticide use in critical habitat for endangered species — an aspect of the […]

(Beyond Pesticides, May 9, 2022) While the U.S. Environmental Protection Agency (EPA) updated its guidelines for pollinator risk assessments in 2014, the agency continues to either fail to conduct full assessments, or dismiss concerning data it receives. EPA appears to discount threats like the insect apocalypse, evidenced by a 75% decline in insect abundance, which threatens not only global ecosystems, but also food production that depends on animal pollination. As pesticides move through the food web, birds are also at risk. Bird numbers are down 29% since Rachel Carson wrote Silent Spring in 1962. Tell EPA To Protect Against Other Threats to Pollinators. Tell Congress To Insist that EPA Does Its Job. The problem is highlighted by EPA’s recent Interim Decision on fenbuconazole, in which the agency notes that, “For larval bees, RQs (risk quotients) exceed the LOC (level of concern) for all pollinator attractive uses including when assessed at the lowest application rate of 0.0938 lb a.i./Acre (RQ = 1.1).” Yet in the same document, the agency declares that “…the benefits of fenbuconazole (e.g., efficacy in management of fungal pathogens) outweigh any remaining risk and that continuing to register fenbuconazole provides significant benefits, including its ability to increase crop […]

(Beyond Pesticides, May 3, 2022) Exposure to a commonly used fungicide considered to be ‘slightly toxic or nontoxic’ to pollinators makes male mason bees less likely to find a mate, jeopardizing future generations of critically important pollinators. This determination comes from research recently published in the Journal of Applied Ecology by scientists at Germany’s University of Würzburg. The timing of these findings comes after the U.S. Environmental Protection Agency (EPA) reapproved uses of fenbuconazole, the fungicide in question, late last year without completing all required studies on pollinator health effects. Horned mason bees (Osmia cornuta), a solitary bee species, have a complex mating process that includes a range of “pre-copulatory behaviors” used by male bees attract females. Males create thoracic vibrations with their flight muscles, rub the eyes of female bees with their antennae, and emit a distinct odor from their body. If the female likes the presentation, she will mate with the male. Otherwise, she will move him to the side and wait for another male to try to win her affection. To see how this process was influenced by pesticide exposure, researchers conducted a range of different experiments. For the first, newly emerged male and female bees were […]

(Beyond Pesticides, April 28, 2022) A study in Environmental Research finds that glyphosate’s primary metabolite (breakdown product), aminomethylphosphonic acid (AMPA), induces DNA damage through oxidative stress among subpopulations of primary school children. Although pyrethroid and chlorpyrifos metabolites can induce oxidative stress, this study is the first to investigate AMPA’s association with adverse health effects, rather than solely the effects of the active ingredient, glyphosate, in Roundup and other formulations. Glyphosate is the most commonly used active ingredient worldwide, appearing in many herbicide formulations, readily contaminating soil, water, food, and other resources. Chemical use has been increasing since the inception of crops genetically modified to tolerate glyphosate. However, studies demonstrate glyphosate is among the most prevalent pesticide contributors to human, biotic, and ecosystem harm. According to research, herbicide toxicity to invertebrates has doubled since 2004. Although research links glyphosate exposure to cancer, specifically non-Hodgkin lymphoma, much less research considers the effects that metabolites have on children who are more vulnerable to chemical exposure. Ecological and health risk assessments primarily focus on active ingredients in pesticide products, overlooking the potential impacts of metabolites. Thus, studies like these highlight the need to assess the implications of metabolite exposure to protect human, animal, and environmental health. The study notes, “Our […]

(Beyond Pesticides, April 22, 2022) A study published on April 18 finds that people in U.S. BIPOC (Black, Indigenous and People of Color) communities, as well as those living in low-income communities, endure a very disproportionate rate of exposure to pesticides, and of subsequent risks of harm. It finds that such disparities exist in both urban and rural communities, and at all points in the pesticide “life cycle,” from manufacture to application. A section of Beyond Pesticides’ recent mega-issue of Pesticides and You, “Retrospective 2021: A Call to Urgent Action,” is devoted to such inequities. Section IV, “Disproportionate Pesticide Harm Is Racial Injustice: Documenting Victimization: Structural Racism,” reprises Beyond Pesticides’ 2021 coverage of environmental injustices. It also calls for urgent action re: federal and state “evaluations that go into toxic chemical regulation . . . to reform and replace the current regulatory decision-making process, which is empirically racist, with one that acknowledges and cares for those with the highest real-world vulnerabilities and exposure[s].” The first comprehensive assessment of disparities in pesticide protections and oversight in the U.S., the study paper appeared in the journal BMC Public Health. The authors set out the broad history of how humanity moved from “Traditional Ecological […]

(Beyond Pesticides, April 21, 2022) A literature review published in Royal Society finds that ‘inert’ ingredients’ in pesticide formulations adversely affect the health of bees and other wild pollinators. Inert ingredients, also known as “other” ingredients, and not disclosed by name on pesticide product labels, facilitate the action of active ingredients targeting a specific pest. Although both ingredients have chemical and biological activity, most studies on agricultural chemical toxicity focus on the active ingredient, assuming that inert ingredients are “nontoxic.” The U.S. Environmental Protection Agency (EPA), in regulating pesticides, assesses the toxicity of individual active ingredients on bees through various testing methods. However, there are no requirements for EPA to test inert ingredients to the same degree, despite evidence demonstrating these chemicals harm pollinators. Moreover, EPA does not require pesticide manufacturers to disclose the inert ingredients used in any product as the information is confidential. Both wild and commercial bees and other pollinators encounter multiple stressors, including pesticides, parasites, and poor nutrition, that act together to increase the risk of bee mortality. Therefore, reviews like these highlight the need for pesticide testing to consider the effects of all product ingredients, regardless of perceived toxicity. The researchers caution, “We argue that ‘inert’ ingredients […]

(Beyond Pesticides, April 14, 2022) Over the last century, cities across the world have engaged in a “war on rats” that has failed to achieve meaningful results, and should consider a new paradigm for rodent management, according to a review of relevant literature published in Frontiers in Ecology and Evolution last month. As awareness regarding the widespread dangers of commonly used rodenticides increases, and states like California begin to rein in their use, the importance of alternative management approaches has grown. Reviewing over 100 studies on municipal rat management, the authors outline a path forward that embraces a systems approach and calls for a change in public expectations. Since the early 1900s, municipal rat management has primarily focused on killing rats and removing their food, water and harborage, but data available on the efficacy of this approach is sparse. Successful programs, according to the literature, are often grant funded and time limited, or employ such substantial amounts of rodenticide that it carries significant risks regarding secondary poisoning of people and nontarget species. Failures consistently note the ephemeral nature of rodent reductions. A 1909 study referenced in the review, from which the authors indicate much of present-day rodent management is based, […]

(Beyond Pesticides, April 12, 2022) A recent study published in Scientific Reports warns that parasitic salmon lice (Lepeophtheirus salmonis) in Pacific Ocean open-net fish farming operations are becoming resistant to emamectin benzoate (EMB), an active ingredient used to control salmon lice population in North America, both in the U.S. and British Columbia, Canada. Previously, researchers believed parasitic salmon lice only had high rates of chemical resistance in the Atlantic region due to the mixing of farmed and wild salmon. However, Pacific salmon lice are exhibiting similar rates of decreased sensitivity to EMB from various sources, including a decrease in the wild Pacific salmon population, overuse of chemical treatments, and reliance on single chemical treatments. The aquaculture industry (e.g., farmed seafood/fish) repeatedly faces sustainability issues, failing to adhere to environmental regulations and threatening marine health. Extensive use of pesticides to rid the parasite has led to widespread resistance to multiple pesticides, prompting increasing infection rates among North Atlantic salmon populations. These parasites endanger both farmed salmon and wild salmon, in addition to other local species of fish. In this context, pesticide treatments contributes to resistance among lethal pest populations, especially in ecologically vulnerable and interconnected ecosystems like ocean basins. The researchers caution, “Salmon […]

(Beyond Pesticides, March 25, 2022) Recent coverage by The Guardian of the U.S. Environmental Protection Agency’s (EPA’s) plan — to extend the registration of several demonstrably harmful neonicotinoid insecticides — compels Beyond Pesticides to identify, once again, the agency’s failures to enact its core mission. That mission is “to protect human health and the environment,” and to ensure that “national efforts to reduce environmental risks are based on the best available scientific information.” EPA has undertaken a review of the registration of several members of the neonicotinoid (neonic) family of pesticides and, despite the agency’s own findings of evidence of serious threats to pollinators, aquatic invertebrates, and other wildlife, it issued interim decisions on these neonics in January 2020 that disregard the science on the pesticides’ impacts. EPA appears to be prepared to finalize these registrations late in 2022; this would, barring further action, extend the use of these harmful compounds for 15 years. Neonics are used widely in the U.S., both on crops to kill sucking insects, and as seed treatments with the same goal for the developing plant. These insecticides are systemic compounds, meaning that once applied, they travel to all parts of a plant through the vascular […]

(Beyond Pesticides, March 21, 2022) With a history of unenforceable and impractical pesticide label restrictions resulting in U.S. Environmental Protection Agency (EPA) findings of ludicrously small or no risk, the agency is at it again with its latest announcement that spins its approval of the continued use of the deadly organophosphate insecticide malathion as “protecting threatened and endangered species.” This just the latest example of an irresponsible federal agency falling far short, as the nation and world sit on the brink of biodiversity collapse and deadly pesticide-induced diseases. Tell EPA to protect endangered species. Tell Congress to make sure the Biden administration protects endangered species.  The announcement follows the release of a final biological opinion by U.S. Fish and Wildlife Service (FWS), which, according to the Center for Biological Diversity (CBD), “relies on scientifically unfounded assessment methods imposed during the Trump administration [and] stands in sharp contrast to the agency’s 2017 conclusion that 1,284 species would likely be jeopardized by malathion.” Meanwhile, the National Marine Fisheries Service, a sister agency to the U.S. Fish and Wildlife Service, released an updated biological opinion that determined malathion and two other toxic organophosphate pesticides are causing jeopardy to virtually every endangered U.S. salmon, sturgeon, […]

(Beyond Pesticides, March 18, 2022) A 2020 lawsuit related to pesticide drift was resolved on March 8, 2022 in San Joaquin (California) Superior Court with the finding that Alpine Helicopter Services, which specializes in pesticide applications for government and tourism entities, had violated pesticide drift laws and endangered public health and safety. The court further found Alpine liable for damage related to its actions, though penalties in the case, brought by California state prosecutors and the California Department of Pesticide Regulation (DPR), have yet to be determined. The case exposes a handful of the many instances of pesticide drift, also known as “chemical trespass,” that occur every year in the U.S. In 2004, Beyond Pesticides covered the issue with Getting the Drift on Chemical Trespass; its monitoring of drift issues is ongoing, as can be seen in its “Pesticide Drift” archives. The long history of nontarget exposure, contamination, and poisoning teaches that drift is a function of pesticide use, but not considered adequately by regulators who allow the marketing of poisons that are known to move through the environment uncontrolled. Cases like the Alpine case highlight a relentless problem associated with the daily use of pesticides. Pesticide drift is any airborne […]

(Beyond Pesticides, March 11, 2022) With a history of unenforceable and impractical pesticide label restrictions resulting in U.S. Environmental Protection Agency (EPA) findings of ludicrously small or no risk, the agency is at it again with its latest announcement that allows the continued use of the deadly organophosphate insecticide malathion. This just the latest example of what advocates see as an irresponsible federal agency falling far short, as the nation and world sit on the brink of biodiversity collapse and deadly pesticide-induced diseases.   In a head-spinning development, the U.S. Fish and Wildlife Service (FWS) announced on March 8 its final Biological Opinion (BiOp) on malathion, which opinion claims that the commonly used insecticide poses no extinction risk to any protected animal or plant. The FWS review and BiOp are part of EPA’s evaluation of whether malathion — an organophosphate insecticide that causes serious damage to many organisms — should retain its registration. The Executive Summary of the BiOp concludes: “Our findings suggest that no proposed species or candidate species would experience species-level effects from the action [i.e., registration and thus, permitted use of malathion], and, therefore, are not likely to be jeopardized. We also conclude the proposed action is not […]

(Beyond Pesticides, February 9, 2022) Insecticide use during pregnancy significantly increases the occurrence of Otitis Media (OM) in infants, according to research published in Scientific Reports from a team of Japanese researchers late last month. Otitis Media, an infection of the space behind the ear drum, is a common disease among children. While most infections go away on their own, some children experience pain, fever, and in some cases complications that result in hearing loss. This research underscores the myriad of dangers and diseases that pesticide use can precipitate, which are not considered under risk assessments conducted by the U.S. Environmental Protection Agency (EPA). Scientists collected their initial data from the ongoing Japan Environment and Children’s Study, a national birth cohort study that evaluates environmental factors affecting children’s health in Japan. Data recorded include factors such as maternal age, birth weight, and gestation weeks, and mothers provided answers to a range of questionnaires, including one relating to exposure to insecticides during pregnancy. Study authors utilized a range of other covariates to control for further risk factors, such as family history of OM, living with other siblings, nursery attendance, parental smoking habits, and others. The study determined that OM during an […]