Background: Women living in agricultural areas may experience high pesticide exposures compared with women in urban or suburban areas because of their proximity to farm activities.

Objective: Our objective was to review the evidence in the published literature for the contribution of nonoccupational pathways of pesticide exposure in women living in North American agricultural areas.

Methods: We evaluated the following nonoccupational exposure pathways: paraoccupational (i.e., take-home or bystander exposure), agricultural drift, residential pesticide use, and dietary ingestion. We also evaluated the role of hygiene factors (e.g., house cleaning, shoe removal).

Results: Among 35 publications identified (published 1995–2013), several reported significant or suggestive ( p < 0.1) associations between paraoccupational ( n = 19) and agricultural drift ( n = 10) pathways and pesticide dust or biomarker levels, and 3 observed that residential use was associated with pesticide concentrations in dust. The 4 studies related to ingestion reported low detection rates of most pesticides in water; additional studies are needed to draw conclusions about the importance of this pathway. Hygiene factors were not consistently linked to exposure among the 18 relevant publications identified.

Conclusions: Evidence supported the importance of paraoccupational, drift, and residential use pathways. Disentangling exposure pathways was difficult because agricultural populations are concurrently exposed to pesticides via multiple pathways. Most evidence was based on measurements of pesticides in residential dust, which are applicable to any household member and are not specific to women. An improved understanding of nonoccupational pesticide exposure pathways in women living in agricultural areas is critical for studying health effects in women and for designing effective exposure-reduction strategies.

Citation: Deziel NC, Friesen MC, Hoppin JA, Hines CJ, Thomas K, Beane Freeman LE. 2015. A review of nonoccupational pathways for pesticide exposure in women living in agricultural areas. Environ Health Perspect 123:515–524;  http://dx.doi.org/10.1289/ehp.1408273

Address correspondence to N.C. Deziel, Yale School of Public Health, 60 College St., New Haven, CT 06510 USA. Telephone: (203) 785-6062. E-mail: nicole.deziel@yale.edu

This work was supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics (Z01CP010119).

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health. The U.S. Environmental Protection Agency through its Office of Research and Development collaborated in the research described here. It has been subjected to agency review and approved for publication.

The authors declare they have no actual or potential competing financial interests.

Received: 13 February 2014 Accepted: 28 January 2015 Advance Publication: 30 January 2015 Final Publication: 1 June 2015