Association between household solid fuel use and tuberculosis: cross-sectional data from the Mongolian National Tuberculosis Prevalence Survey

BACKGROUND@#Tuberculosis (TB) and indoor air pollution (IAP) are equally critical public health issues in the developing world. Mongolia is experiencing the double burden of TB and IAP due to solid fuel combustion. However, no study has assessed the relationship between household solid fuel use and TB in Mongolia. The present study aimed to assess the association between household solid fuel use and TB based on data from the Mongolian National Tuberculosis Prevalence Survey (MNTP Survey).@*METHOD@#The MNTP Survey was a nationally representative population-based cross-sectional survey targeting households in Mongolia from 2014 to 2015, with the aim of evaluating the prevalence of TB. The survey adopted a multistage cluster sampling design in accordance with the World Health Organization prevalence survey guidelines. Clusters with at least 500 residents were selected by random sampling. A sample size of 98 clusters with 54,100 participants was estimated to be required for the survey, and 41,450 participants were included in the final analysis of the present study. A structured questionnaire was used to collect information on environmental and individual factors related to TB. Physical examination, chest X-ray, and sputum examinations were also performed to diagnose TB.@*RESULTS@#The use of solid fuels for heating (adjusted odds ratio (aOR): 1.5; 95% confidence interval (CI): 1.1-2.1), male gender (aOR: 2.2; 95% CI: 1.6-3.2), divorced or widowed (aOR: 2.6; 95% CI: 1.7-3.8), daily smoker (aOR: 1.8; 95% CI: 1.3-2.5), contact with an active TB case (aOR: 1.7; 95% CI: 1.2-2.3), being underweight (aOR: 3.7; 95% CI: 2.4-5.7), and previous history of TB (aOR: 4.3; 95% CI: 3.0-6.1) were significantly associated with bacteriologically confirmed TB after adjusting for confounding variables.@*CONCLUSION@#The use of solid fuels for heating was significantly associated with active TB in Mongolian adults. Increased public awareness is needed on the use of household solid fuels, a source of IAP.

Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveys

BACKGROUND@#Globally, over four million deaths are attributed to exposure to household air pollution (HAP) annually. Evidence of the association between exposure to HAP and under-five mortality in sub-Saharan Africa (SSA) is insufficient. We assessed the association between exposure to HAP and under-five mortality risk in 14 SSA countries.@*METHODS@#We pooled Demographic and Health Survey (DHS) data from 14 SSA countries (N = 164376) collected between 2015 and 2018. We defined exposure to HAP as the use of biomass fuel for cooking in the household. Under-five mortality was defined as deaths before age five. Data were analyzed using mixed effects logistic regression models.@*RESULTS@#Of the study population, 73% were exposed to HAP and under-five mortality was observed in 5%. HAP exposure was associated with under-five mortality, adjusted odds ratio (OR) 1.33 (95% confidence interval (CI) [1.03-1.71]). Children from households who cooked inside the home had higher risk of under-five mortality compared to households that cooked in separate buildings [0.85 (0.73-0.98)] or outside [0.75 (0.64-0.87)]. Lower risk of under-five mortality was also observed in breastfed children [0.09 (0.05-0.18)] compared to non-breastfed children.@*CONCLUSIONS@#HAP exposure may be associated with an increased risk of under-five mortality in sub-Saharan Africa. More carefully designed longitudinal studies are required to contribute to these findings. In addition, awareness campaigns on the effects of HAP exposure and interventions to reduce the use of biomass fuels are required in SSA.

Exposição ao uso da lenha para cocção no Brasil e sua relação com os agravos à saúde da população / Exposure to the use of firewood for cooking in Brazil and its relation with the health problems of the population

Resumo A poluição do ar em ambientes fechados é agravada pela queima de lenha em fogões rústicos e ambientes pouco ventilados. A exposição aos poluentes emitidos por este tipo de combustível resulta no aumento da morbidade e da mortalidade. No Brasil, os estudos e as estimativas são escassos. Visando entender esta problemática, o objetivo deste trabalho foi investigar o uso de lenha utilizando as séries de dados das agências governamentais para estimar o número de pessoas expostas. Os resultados apontam que a lenha é o segundo combustível mais usado para cozinhar, sendo utilizada por uma parcela significativa da população, em torno de 30 milhões de brasileiros. Um fator decisivo no maior uso deste combustível é o nível socioeconômico da população associada ao preço do gás liquefeito de petróleo (GLP). Os estudos realizados no país registraram concentrações altas de partículas durante a queima da lenha, excedendo os limites sugeridos pela Organização Mundial da Saúde (OMS). Também foram observadas associações entre a exposição aos poluentes gerados pela queima e o agravamento dos mais diversos problemas de saúde, dentre eles doenças respiratórias e câncer. A substituição da lenha e outros combustíveis sólidos por combustíveis mais limpos deve ser a meta do governo para minimizar custos com a saúde.

Abstract Indoor air pollution is exacerbated by the burning of firewood in rustic stoves and poorly ventilated environments. Exposure to the pollutants emitted by this type of fuel results in increased morbidity and mortality. In Brazil, studies and estimates regarding these conditions are scarce. In order to understand this problem, the objective of this work was to investigate the use of firewood using the data series of government agencies to estimate the number of exposed people. The results indicated that firewood is the second most used fuel for cooking, being used by a significant portion of the population, more than 30 million Brazilians. A decisive factor in the increased use of this fuel is the socioeconomic level of the population associated with the price of liquefied petroleum gas (LPG). The studies carried out in the country recorded high concentrations of particles during firewood burning, exceeding the limits suggested by the World Health Organization (WHO). Associations were also observed between the exposure to the pollutants generated by the burning and the aggravation of health problems, among them respiratory diseases and cancer. Replacing fuelwood and other solid fuels with cleaner fuels should be the government's goal to minimize health costs.

Pollution in the Americas: a leading cause of disease burden and an opportunity for cancer prevention / Contaminación en las Américas: causa principal de carga de la enfermedad y una oportunidad para prevención del cáncer

Abstract: Objective: Environmental and occupational agents are causes of cancer and disease worldwide while their control and the reduction of the associated disease burden remains complex. Materials and methods: This paper summarizes the current status of the burden of environmental and occupational causes of disease in the Americas based on presentations from a panel on environment, occupation and other environmental risk factors for cancer in the Americas, delivered in Panama, at the international conference Promoting Health Equity and Transnational Collaborations for the Prevention and Control of Cancer in the Americas. Results: Three case studies are presented to illustrate the impact of specific environmental and occupational agents and the challenge of control. Conclusions: There are still fully avoidable exposures to carcinogens, as well documented in the case of asbestos in Brazil. Thus, there are abundant targets for intervention to reduce cancer in the Americas.

Resumen: Objetivo: Los agentes ambientales y ocupacionales son causas de cáncer y enfermedades en todo el mundo, mientras que su control y reducción de la carga de enfermedad asociada siguen siendo puntos complejos. Material y métodos: Este documento resume el estado actual de la carga de las causas ambientales y ocupacionales de las enfermedades en las Américas a partir de las presentaciones de un panel sobre medio ambiente, ocupación y otros factores de riesgo ambientales para el cáncer en las Américas, realizado en Panamá, en la conferencia internacional Promoviendo la Equidad en Salud y las Colaboraciones Transnacionales para la Prevención y el Control del Cáncer en las Américas. Resultados: Se presentan tres estudios de caso para ilustrar el impacto de agentes ambientales y ocupacionales específicos y el desafío del control. Conclusiones: Todavía hay exposiciones totalmente evitables a los carcinógenos, como está bien documentado en el caso del asbesto en Brasil. Hay abundantes puntos estratégicos de intervención para reducir el cáncer en las Américas.

Effects on the female reproductive system of air pollution produced by the use of wood combustion for residential heating: challenges and perspectives of morphological studies / Efectos sobre el sistema reproductivo femenino de la contaminación del aire producido por el uso de la combustión de madera para calefacción residencial: retos y perspectivas de los estudios morfológicos

Previous studies have shown that air pollution affects cardio-respiratory function, but its role regarding reproductive processes is unknown. There are few experimental background studies on its effects on the morpho-function in the reproductive system. The use of wood combustion for residential heating (WCRH) in the cities of south-central Chile has increased significantly. As a result, it has become a source of significant emissions of particulate matter suspended (PM) in the air. The possible association between exposure to PM and reproductive problems has been suggested only on the basis of epidemiological studies, most of them carried out in environments where the main source of PM emission is the combustion of oil by motorized vehicles and industries, ignoring the effects produced by the smoke of WCRH. For example, in the city of Temuco-Padre Las Casas, Chile, 93 % of PM emissions correspond to WCRH smoke, thus being considered an urban area with a single PM emission source and the factors that contribute to this type of contamination are reasonably representative of most of the cities in south-central Chile. We therefore suggest this as an adequate setting to evaluate the real effect of the environmental contamination produced by the smoke of WCRH in the reproductive system. The limited number of studies reported on the effects of this type of emission on the female reproductive system, present a challenge for the morphological sciences and also for those who make decisions that affect public health.

Estudios previos han demostrado que la polución del aire afecta la función cardio-respiratoria, pero el rol que tiene ésta respecto a los procesos reproductivos es desconocida. Existen escasos antecedentes experimentales sobre sus efectos sobre la morfo-función en el sistema reproductivo. El uso de la combustión de madera para calefacción residencial (WCRH) en las ciudades del centro-sur de Chile ha aumentado significativamente. Como resultado, se ha convertido en una fuente de emisión importante de material particulado en suspensión (PM) en el aire ambiental. La posible asociación entre exposición a PM y problemas reproductivos ha sido sugerida solo en base a estudios epidemiológicos, la mayoría de ellos realizados en ambientes donde la principal fuente de emisión de PM es la combustión del petróleo por vehículos motorizados e industrias, ignorando los efectos producidos por el humo de WCRH. Por ejemplo, en la ciudad de Temuco-Padre Las Casas, Chile, el 93 % de las emisiones de PM corresponden al humo de WCRH, por lo tanto, es considerada como un área urbana con una fuente de emisión de PM única y los factores que contribuyen a este tipo de contaminación son razonablemente representativos a la mayoría de las ciudades en el centro-sur de Chile, lo que permite sugerirla como un ambiente adecuado para evaluar el efecto de la contaminación ambiental producida por el humo de la WCRH en el sistema reproductivo. Los escasos estudios reportados sobre los efectos de este tipo de emisión sobre el sistema reproductivo femenino constituyen un desafío no tan solo para las ciencias morfológicas, sino que además, para quienes toman decisiones que afectan la salud pública.

Occupational hazards, DNA damage, and oxidative stress on exposure to waste anesthetic gases / Riscos ocupacionais, danos no material genético e estresse oxidativo frente à exposição aos resíduos de gases anestésicos

Abstract Background and objectives The waste anesthetic gases (WAGs) present in the ambient air of operating rooms (OR), are associated with various occupational hazards. This paper intends to discuss occupational exposure to WAGs and its impact on exposed professionals, with emphasis on genetic damage and oxidative stress. Content Despite the emergence of safer inhaled anesthetics, occupational exposure to WAGs remains a current concern. Factors related to anesthetic techniques and anesthesia workstations, in addition to the absence of a scavenging system in the OR, contribute to anesthetic pollution. In order to minimize the health risks of exposed professionals, several countries have recommended legislation with maximum exposure limits. However, developing countries still require measurement of WAGs and regulation for occupational exposure to WAGs. WAGs are capable of inducing damage to the genetic material, such as DNA damage assessed using the comet assay and increased frequency of micronucleus in professionals with long-term exposure. Oxidative stress is also associated with WAGs exposure, as it induces lipid peroxidation, oxidative damage in DNA, and impairment of the antioxidant defense system in exposed professionals. Conclusions The occupational hazards related to WAGs including genotoxicity, mutagenicity and oxidative stress, stand as a public health issue and must be acknowledged by exposed personnel and responsible authorities, especially in developing countries. Thus, it is urgent to stablish maximum safe limits of concentration of WAGs in ORs and educational practices and protocols for exposed professionals.

Resumo Justificativa e objetivos Os Resíduos de Gases Anestésicos (RGA) presentes no ar ambiente das Salas de Operação (SO) são associados a riscos ocupacionais diversos. O presente artigo propõe-se a discorrer sobre exposição ocupacional aos RGA e seu impacto em profissionais expostos, com ênfase em danos genéticos e estresse oxidativo. Conteúdo Apesar do surgimento de anestésicos inalatórios mais seguros, a exposição ocupacional aos RGA ainda é preocupação atual. Fatores relacionados às técnicas anestésicas e estação de anestesia, além da ausência de sistema de exaustão de gases em SO, contribuem para poluição anestésica. Para minimizar os riscos à saúde em profissionais expostos, recomendam-se limites máximos de exposição. Entretanto, em países em desenvolvimento, ainda carece a mensuração de RGA e de regulamentação frente à exposição ocupacional aos RGA. Os RGA são capazes de induzir danos no material genético, como danos no DNA avaliados pelo teste do cometa e aumento na frequência de micronúcleos em profissionais com exposição prolongada. O estresse oxidativo também é associado à exposição aos RGA por induzir lipoperoxidação, danos oxidativos no DNA e comprometimento do sistema antioxidante em profissionais expostos. Conclusões Por tratar-se de questão de saúde pública, é imprescindível reconhecer os riscos ocupacionais relacionados aos RGA, inclusive genotoxicidade, mutagenicidade e estresse oxidativo. Urge a necessidade de mensuração dos RGA para conhecimento desses valores nas SO, especialmente em países em desenvolvimento, de normatização das concentrações máximas seguras de RGA nas SO, além de se adotarem práticas de educação com conscientização dos profissionais expostos.

El uso de estufas eficientes y su impacto en la promoción de la salud en el contexto colombiano / The use of efficient stoves and its impact on the promotion of health in context Colombian

La contaminación del aire intramural, asociada a uso de combustibles de biomasa y carbón para la preparación de alimentos se asocia en Colombia con 1000 muertes cada año (Ministerio de Ambiente y Desarrollo Sostenible (MADS), 2015) y se estima que el 42% de los casos de Enfermedad Pulmonar Obstructiva Crónica (EPOC) se relacionan con factores ambientales. Según la OPS/OMS, el uso de combustibles sólidos para cocinar es un problema de salud pública y el principal riesgo ambiental en las Américas, afectando a casi 90 millones de personas. La Organización Mundial de la Salud (OMS) estima 81424 muertes en las Américas en el 2012 como consecuencia del uso de combustibles sólidos (UCS) para cocinar y calentarse y más de 2.5 millones de años de vida ajustados por discapacidad (DALYs por su sigla en inglés) (WHO, 2015). Las Directrices de la OMS sobre la Calidad del Aire de Interiores: Quema de Combustibles en los Hogares alertan del peligro del UCS y establecen metas para reducir las emisiones de contaminantes nocivos para la salud procedente de fogones, estufas y lámparas de mecha de uso doméstico (Organización Mundial de la Salud (OMS) , 2006). Este documento contiene un aporte de información para la discusión sobre el impacto potencial del uso de estufas eficientes en la salud de las poblaciones expuestas a contaminantes del aire, generados por el uso de combustibles sólidos para cocinar. Así mismo presenta las recomendaciones sobre las opciones que ofrecen los mayores beneficios para proteger la salud de quienes no tienen acceso a fuentes de energía más limpia.

Thirdhand smoke: when the danger is more than you can see or smell / Thirdhand smoke: cuando el peligro va más allá de lo que se ve o se siente / Thirdhand smoke: quando o perigo vai além do que se vê ou sente

Recent discussion has focused on another form of exposure to tobacco - thirdhand smoke (THS) - consisting of residual pollutants from cigarette smoke that remain in environments. The main concern with THS is based on the presence and persistence of many toxic compounds, some specific nitrosamines from tobacco that have carcinogenic activity. Little is known about THS, and few people are aware of its existence and potential health repercussions, thus highlighting the need to shed light on the subject and incorporate it into the public health debate, as was done with passive smoking several years ago. THS is a form of passive smoking, together with secondary or involuntary exposure to cigarette smoke.

Recientemente comenzó a ser discutida otra forma de exposición al tabaco -thirdhand smoke (THS)- que consta de contaminantes residuales de humo de cigarrillo que permanecen en el medio ambiente. La principal preocupación con la THS se basa en la presencia y larga persistencia de muchos compuestos tóxicos, como algunas nitrosaminas específicas que tienen actividad cancerígena. Pocos saben de la existencia de los THS y su impacto preocupante en la salud. Se plantea la necesidad de sacarlo a la luz e incluirlo en las discusiones, como se hizo con el tabaquismo pasivo hace unos años, incluso porque el THS se caracteriza como una forma de tabaquismo pasivo por la exposición secundaria o involuntaria de humo de cigarrillo.

Recentemente, passou a ser discutida mais uma forma de exposição ao tabaco - thirdhand smoke (THS) - que consiste nos poluentes residuais da fumaça de cigarro que permanecem nos ambientes. A principal preocupação com o THS é embasada na presença e longa persistência de muitos compostos tóxicos, algumas nitrosaminas específicas do tabaco que têm atividade carcinogênica. Além de se saber pouco sobre o THS, poucos sabem de sua existência e preocupante repercussão na saúde. Coloca-se em destaque a necessidade de trazê-lo à luz e incluí-lo nas discussões, assim como foi feito com o tabagismo passivo alguns anos atrás, até mesmo porque o THS se caracteriza como uma forma de tabagismo passivo junto à exposição secundária ou involuntária da fumaça de cigarro.

Relationship between pulmonary function and indoor air pollution from coal combustion among adult residents in an inner-city area of southwest China

Few studies evaluate the amount of particulate matter less than 2.5 mm in diameter (PM2.5) in relation to a change in lung function among adults in a population. The aim of this study was to assess the association of coal as a domestic energy source to pulmonary function in an adult population in inner-city areas of Zunyi city in China where coal use is common. In a cross-sectional study of 104 households, pulmonary function measurements were assessed and compared in 110 coal users and 121 non-coal users (≥18 years old) who were all nonsmokers. Several sociodemographic factors were assessed by questionnaire, and ventilatory function measurements including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were compared between the 2 groups. The amount of PM2.5 was also measured in all residences. There was a significant increase in the relative concentration of PM2.5 in the indoor kitchens and living rooms of the coal-exposed group compared to the non-coal-exposed group. In multivariate analysis, current exposure to coal smoke was associated with a 31.7% decrease in FVC, a 42.0% decrease in FEV1, a 7.46% decrease in the FEV1/FVC ratio, and a 23.1% decrease in PEFR in adult residents. The slope of lung function decrease for Chinese adults is approximately a 2-L decrease in FVC, a 3-L decrease in FEV1, and an 8 L/s decrease in PEFR per count per minute of PM2.5 exposure. These results demonstrate the harmful effects of indoor air pollution from coal smoke on the lung function of adult residents and emphasize the need for public health efforts to decrease exposure to coal smoke.

Indoor air quality and health in schools / Qualidade do ar interno e saúde em escolas

Objective: To determine whether indoor air quality in schools is associated with the prevalence of allergic and respiratory diseases in children. Methods: We evaluated 1,019 students at 51 elementary schools in the city of Coimbra, Portugal. We applied a questionnaire that included questions regarding the demographic, social, and behavioral characteristics of students, as well as the presence of smoking in the family. We also evaluated the indoor air quality in the schools. Results: In the indoor air of the schools evaluated, we identified mean concentrations of carbon dioxide (CO2) above the maximum reference value, especially during the fall and winter. The CO2 concentration was sometimes as high as 1,942 ppm, implying a considerable health risk for the children. The most prevalent symptoms and respiratory diseases identified in the children were sneezing, rales, wheezing, rhinitis, and asthma. Other signs and symptoms, such as poor concentration, cough, headache, and irritation of mucous membranes, were identified. Lack of concentration was associated with CO2 concentrations above the maximum recommended level in indoor air (p = 0.002). There were no other significant associations. Conclusions: Most of the schools evaluated presented with reasonable air quality and thermal comfort. However, the concentrations of various pollutants, especially CO2, suggest the need for corrective interventions, such as reducing air pollutant sources and improving ventilation. There was a statistically significant association between lack of concentration in the children and exposure to high levels of CO2. The overall low level of pollution in the city of Coimbra might explain the lack of other significant associations. .

Objetivo: Determinar se há uma associação entre a qualidade do ar interno em escolas e a prevalência de patologias alérgicas e respiratórias nas crianças que as frequentam. Métodos: Foram avaliados 1.019 alunos de 51 escolas de ensino básico na cidade de Coimbra, Portugal. A avaliação foi realizada através de um questionário com questões referentes a características demográficas, sociais e comportamentais dos alunos, assim como presença de hábitos tabágicos na família. Foi ainda avaliada a qualidade do ar interno nas escolas. Resultados: Foram identificadas concentrações médias de dióxido de carbono (CO2) no interior das salas de aula acima da concentração máxima de referência, principalmente no período de outono/inverno, chegando a valores de 1.942 ppm, o que implica elevado risco potencial para a saúde das crianças. Os sintomas/patologias respiratórias mais prevalentes nas crianças foram crises de espirros, rinite alérgica, estertores/sibilos e asma. Outros sinais e sintomas verificados foram falta de concentração, tosse, dores de cabeça e irritação das mucosas. A falta de concentração das crianças foi associada ao ar interno das salas de aula com valores acima do máximo recomendado para CO2 (p = 0,002). Não houve outras associações significativas. Conclusões: A maioria das escolas estudadas apresentava razoável qualidade do ar e conforto térmico, embora a concentração de vários poluentes, sobretudo CO2, sugere a necessidade de intervenções corretivas, como redução de fontes emissoras de poluentes e melhorias da ventilação. Houve uma associação estatisticamente significativa entre a falta de concentração nas crianças ...

A Study on the Prevalence of Indoor Mycoflora in Air Conditioned Buses.

Aim: To study the presence of indoor mycoflora in A/c Buses to know the commuters risk of exposure to fungal spores. Place and Duration: Chennai Mofussil Bus Terminus (CMBT), Koyambedu, Chennai, India. Study was conducted from November 2011 to April 2012. Methodology: Airborne fungi from 50 A/c buses were studied using Reuter Centrifugal Sampler (Biotest, Germany), fungi from the surfaces of air vents through swab sample and bus seats by rubbing sterile petridishes on the seats. Sabourauds Dextrose Agar (SDA) was used for the isolation of fungi from different buses. The collected data were statistically analyzed. Results: A total of 38 species classified in 21 genera were recorded. Among which, Zygomycetes was represented by 4 species, Ascomycetes and Coelomycetes by single species each and the remaining belongs to Hyphomycetes. The genus, Aspergillus was represented by maximum number of species (11 species) followed by Penicillium (5 species). A total average of 713 CFU/m3 of air was recorded within the buses. Aspergillus niger was the first dominant fungi in the order of dominance followed by Chrysonilia sitophila, Alternaria alternata and Aspergillus flavus in that order. From the surface of bus seats, Aspergillus niger, A. flavus, Rhizopus stolonifer and A. japonicus were recorded as dominant. However, different mycofloral composition was recorded from air vents. Cladosporium chlorocephalum and Curvularia lunata dominated the surface of air vents. Conclusion: The study demonstrates the presence of potential fungal species which pose exposure risk to the immune compromised commuters.

Assessment of surface ozone over residential environments

Surface ozone [O[3]] has become one of the most important topic of air quality and climate change researches. This is because of causing harmful effects on human health, climate, vegetation and materials. For these reasons, understanding the processes which control the origin, trends, distribution and effects surface O[3] are important. In this paper, the surface O[3] concentration was investigated experimentally and numerically over residential environment. Surface O[3] was measured using Visible blind Ultraviolet sensors [UV Ozone Analyzer] over the period of 2008-2010 in Kuwait international airport. A back trajectory method based on HYbrid Single-Particle Lagrangian Integrated Trajectory [HYSPLIT] model was used for assessing the surface O[3] over residential environment. The diurnal, and seasonal variations of surface O[3] were analyzed and discussed. Furthermore, the effect of meteorological conditions on the surface O[3] was also analyzed. Diurnal variation shows that maximum O[3] concentration was at the noon and about minimum in the evening. Seasonal variation showed that February was a highest rate of O[3] concentration. Power stations are a major point source for O[3] precursors. The surface O[3] shows a medium correlation with temperature and a week correlation with wind speed

Is ambient air pollution another risk factor of tuberculosis?

No abstract available.

Impact of outdoor air pollution on the incidence of tuberculosis in the Seoul metropolitan area, South Korea

BACKGROUND/AIMS: Although indoor air pollution is a well-known risk factor for tuberculosis (TB), the possible link between outdoor air pollution and TB development has not been examined fully. We assessed the impact of outdoor air pollution on TB development in the Seoul metropolitan area, South Korea. METHODS: The mean concentrations of ambient particulate matter (PM) with an aerodynamic diameter < or = 10 microm (PM10), O3, CO, NO2, and SO2 levels in Seoul, between January 1, 1997 and December 31, 2006, were determined. Furthermore, their association with the risk of developing TB after adjusting for socioeconomic status, between January 1, 2002 and December 31, 2006, was investigated. RESULTS: Between January 1, 2002 and December 31, 2006, a total of 41,185 TB cases were reported in Seoul. Concentrations of PM10, O3, CO, and NO2 were not associated with TB incidence in males or females. However, the interquartile increase in SO2 concentration was associated with a 7% increment in TB incidence (relative risk [RR], 1.07; 95% credible interval [CrI], 1.03 to 1.12) in males but not in females (RR, 1.02; 95% CrI, 0.98 to 1.07). CONCLUSIONS: Long-term exposure to ambient SO2 increased the risk of TB in males.

Contaminación del aire de interiores en hogares en situación de pobreza extrema en Colombia / Indoor air pollution in extremely poor Colombian households

Objetivo Caracterizar la exposición a la contaminación del aire interior por uso de combustibles sólidos en hogares en situación de pobreza extrema en Colombia. Métodos A partir de la información gubernamental oficial de hogares en situación de pobreza extrema (encuesta Red Unidos de septiembre 2012, n=1,3 millones de hogares y >5 millones de individuos) se estructuraron dos modelos de regresión logística: (i) Factores asociados al uso de combustibles sólidos para cocinar a nivel hogar, (ii) Asociación entre el uso de combustibles sólidos en el hogar y prevalencia de limitaciones de la salud a nivel individuo. Resultados Un total de 530 mil hogares en situación de pobreza extrema donde habitan 2,1 millones de colombianos, enfrentan el factor de riesgo (uso de combustibles fósiles en el hogar). La presencia del factor de riesgo está asociada a la zona rural (odds ratio-OR=19,4; intervalo de confianza al 95 %-IC95 %: 19,2-19,6), la etnia indígena (OR=2,9; IC95 %:2,9-3,0) y, de manera inversa, a la situación de desplazamiento (OR=0,6;IC95 %:0,6-0,6). La prevalencia de limitación cardiovascular y/o respiratoria, así como de limitación en visión se asociaron con la exposición. Discusión Las iniciativas que busquen mejorar la salud ambiental y calidad de vida de la población rural de mayor vulnerabilidad socio-económica del país cuentan con información de caracterización e impacto para priorizar programas tendientes a disminuir la exposición al uso de combustibles sólidos.

Objective Characterising exposure to indoor air pollution arising from solid-fuel use in extremely poor Colombian households. Methods Data from the September 2012 survey by Red Unidos (literally United Network, the Colombian government's official instrument for identifying extremely poor households: n=1.3 million households and >5 million people) was used for two logistic regression models: factors associated with solid fuel used in cooking within households and an association between exposure to solid fuel use in households and the prevalence of limitations regarding individual health. Results According to the Red Unidos data-based models, 2.1 million people living in 530,000 extremely poor households were exposed to environmental health risk (i.e. household air pollution caused by solid fuel use). Such risk was found to be related to living in rural areas (odds ratio (OR)=19.4 95 % confidence interval (95 %CI): 19.2-19.6 %), having an Indian background (OR=2.9: 2.9-3.0 95 %CI) and, inversely (i.e. when living in towns), internal displacement (OR=0.6: 0.6-0.695 %CI). The prevalence of permanent cardiovascular and respiratory limitations and limited vision were associated with exposure to indoor air pollution arising from solid fuel use. Discussion Initiatives for improving environmental health and the quality of life for extremely poor rural households in Colombia must make full use of the available characterisation data and its impact for prioritising programmes aimed at reducing exposure to solid fuel use.

Contaminación ambiental por PM10 dentro y fuera del domicilio y capacidad respiratoria en Puerto Nare, Colombia / PM10 environmental pollution in and around housing and respiratory capacity in Puerto Nare, Colombia

Objetivo Explorar la relación entre niveles de PM10 intra y extradomiciliario y la función pulmonar de los habitantes, corregimiento La Sierra, Puerto Nare, Antioquia-Colombia. Materiales y Métodos Mediante encuesta y observación, se determinaron condiciones ambientales y del entorno inmediato de viviendas correspondientes a 124 habitantes a los cuales se había realizado el examen espirométrico; se monitorearon condiciones meteorológicas: temperatura, humedad relativa, precipitación, velocidad del viento y PM10 (24 horas) al interior y exterior de las casas. Resultados En el 50 % de las viviendas el PM10 interior (0,05mg/m³) fue

Objective Exploring the relationship between PM10 intra- and extra-domiciliary levels and the lung function of people living in La Sierra, Antioquia, Colombia. Materials and Methods A survey and field observations were used for determining the environmental conditions and the immediate household environment of 124 people who had taken a spirometric test. Meteorological conditions were monitored: temperature, relative humidity, rainfall, wind speed and PM10 (24 hours) within and outside the houses. Results Indoor PM10 (0.05 mg/m³) in 50 % of the houses was

A poluição do ar em ambientes internos e a síndrome dos edifícios doentes / Air pollution in internal environments and sick building syndrome

A Qualidade do Ar Interno (QAI) surgiu como ciência a partir da década de 70 com a crise energética e a consequente construção dos edifícios selados (desprovidos de ventilação natural), principalmente nos países desenvolvidos, e se destacou após a descoberta de que a diminuição das taxas de troca de ar nesses ambientes era a grande responsável pelo aumento da concentração de poluentes no ar interno. Admite-se que a ventilação seja um dos principais fatores que interferem na qualidade do ar interno e que os próprios ocupantes dos edifícios contribuem substancialmente com a poluição destes ambientes através de suas atividades. Sabe-se ainda que a má qualidade do ar interno está associada a doenças (como tosse, rinite, alergia, etc.) e à Síndrome dos Edifícios Doentes (SED). Para amostragem de substâncias gasosas no ar de ambientes internos dispõe-se de diversas metodologias, sendo as principais: sistemas passivos de monitoramento, sistemas ativos e automáticos. Para a efetiva promoção de um ambiente saudável, deve-se conciliar a aplicação de legislações específicas com pesquisas e conscientização dos ocupantes dos edifícios. Essa revisão objetiva relacionar os diferentes contaminantes encontrados em ambientes internos, seus efeitos à saúde humana e suas metodologias de amostragem.

Indoor Air Quality (IAQ) emerged as a science from the 1970s onwards with the energy crisis and the subsequent construction of sealed buildings (without natural ventilation). This mainly occurred in developed countries and it soon came to public attention that lower levels of air exchange in these environments was the main culprit for the increase in concentration of indoor air pollutants. It is common knowledge that ventilation is one of the principal factors that interfere with air quality in indoor environments and that the occupants contribute to the pollution of these environments with their activities. Furthermore, poor indoor air quality is associated with some diseases (cough, rhinitis, allergy, etc.) and with Sick Building Syndrome (SBS). For sampling of the indoor contaminants there are several methodologies, available including passive monitoring systems, active and automatic systems. To ensure a healthy indoor environment, the application of specific legislation needs to be reconciled with research and fostering awareness among the occupants of such buildings. This survey seeks to identify the different contaminants found in internal environments, their effects on human health and the methodologies available for sampling them.

Repercussão de uma intervenção educativa com agentes comunitários de saúde nas condições ambientais de domicílios de crianças asmáticas / Impact that an educational intervention carried out by community health agents has on environmental conditions in the households of children with asthma

OBJETIVO: Verificar o impacto de uma intervenção educativa problematizadora sobre o controle ambiental para aeroalérgenos, conduzida por agentes comunitários de saúde, nos domicílios de crianças com asma. MÉTODOS: Estudo prospectivo de intervenção. Foram visitados 95 domicílios com crianças (faixa etária de 2-10 anos) com episódios recorrentes de dispneia e sibilância no município de Iguatu (CE). A intervenção educativa envolveu grupos focais com agentes comunitários de saúde com a problematização sobre medidas educativas a serem implementadas. Após a intervenção, 84 domicílios foram revisitados e reavaliados. RESULTADOS: Após a intervenção, houve uma redução significativa na limpeza do piso com vassoura (p = 0,02), no uso de fogão a carvão (p = 0,001) e no número de bichos de pelúcia no domicílio (p = 0,05). Houve uma melhoria significativa no controle ambiental para aeroalérgenos nos quartos das crianças após a intervenção (p = 0,003). CONCLUSÕES: A intervenção educativa mostrou ser uma importante ferramenta junto à população estudada, minimizando os aspectos negativos das condições ambientais dos domicílios das crianças asmáticas.

OBJECTIVE: To determine the impact that an educational intervention employing problem-solving strategies for the environmental control of aeroallergens has on environmental conditions in the households of children with asthma. The intervention was carried out by community health agents. METHODS: This was a prospective intervention study. The community health agents visited 95 households in which there were children (2-10 years of age) who had recurrent episodes of wheezing and dyspnea. All of the households investigated were in the city of Iguatu, Brazil. The educational interventions involved focus groups and community health agents. The focus groups were asked to brainstorm the educational measures to be implemented, in order to devise problem-solving strategies. After the intervention, 84 households were revisited and reevaluated. RESULTS: After the intervention, there was a significant decrease in the use of brooms for cleaning the floor (p = 0.02), in the use of coal-burning stoves (p = 0.001), and in the number of stuffed toys (p = 0.05). There was also a significant post-intervention improvement in the environmental control of aeroallergens in the bedrooms of the children (p = 0.003). Conclusions: The educational intervention applied in this study proved to be an important tool for the target population, improving environmental conditions in the households of children with asthma.

Efectos clínicos de la exposición directa e indirecta a tabaco en los niños / Health effects of passive smoking exposure on children

El tabaquismo es fuente importante de contaminación intra domiciliaria. La prevención de la exposición al humo de tabaco tiene un impacto significativo en morbilidad y mortalidad en aquellos expuestos en forma indirecta, especialmente cuando se trata de un individuo en desarrollo activo como ocurre en la vida intrauterina y durante los primeros años de vida. La evidencia es contundente respecto del riesgo que existe en la disminución de la función pulmonar, aparición de sibilancias recurrentes, asma, neumonía y muerte súbita. La exposición al humo de tabaco en los niños debe recibir mayor atención de parte del equipo de salud, especialmente del pediatra.