Tasas de suicidio y concentración de litio en agua corriente en Rocha y Montevideo: primer estudio en Uruguay, período 2019-2020 / Suicide rates and lithium concentration in tap water in Rocha and Montevideo: first study in Uruguay, period 2019-2020 / Taxas de suicídio e concentração de lítio na água encanada em Rocha e Montevidéu: primeiro estudo no Uruguai, período 2019-2020

El suicidio es un fenómeno que además de las pérdidas humanas que involucra, repercute negativamente en familiares y allegados, produciendo a su vez enormes gastos en el sistema sanitario. En Uruguay, la tasa de suicidio no solo ha experimentado un aumento sostenido, representando una preocupación constante para las autoridades, sino que suele ser una de la más altas de Latinoamérica, en 2022 fue de 23,08 cada 100.000 habitantes. Reconociendo que el suicidio es un fenómeno multifactorial grave, diversos estudios han indagado sobre la posible correlación entre la presencia de litio en agua corriente y tasas de suicidio, habiéndose observado una relación inversa, lo que permitiría considerar el litio como eventualmente protector de la conducta suicida. El presente estudio pretende abordar dicha correlación en los departamentos de Rocha y Montevideo, de Uruguay. Los resultados obtenidos no son concluyentes. En cuanto a las concentraciones de litio presentes en agua corriente, en general son menores a las señaladas en otros estudios como protectoras (30 µ/L). Es necesario profundizar en este eje de discusión, como en otros, para obtener un diagnóstico más detallado de este complejo y sentido fenómeno.

Suicide is a phenomenon that, in addition to the human losses it involves, has a negative impact on family members and acquaintances, leading to enormous costs in the healthcare system. In Uruguay, the suicide rate has not only experienced a sustained increase, representing a constant concern for authorities, but it also tends to be one of the highest in Latin America, reaching 23.08 per 100,000 inhabitants in 2022. Recognizing that suicide is a serious multifactorial phenomenon, several studies have investigated the possible correlation between the presence of lithium in tap water and suicide rates, noting an inverse relationship. This suggests that lithium could potentially be considered protective against suicidal behavior. This study aims to address this correlation in the departments of Rocha and Montevideo, Uruguay. The results obtained are inconclusive. Regarding the concentrations of lithium present in tap water, they are generally lower than those indicated in other studies as protective (30 µg/L). It is necessary to delve deeper into this axis of discussion, as in others, to obtain a more detailed diagnosis of this complex and profound phenomenon.

O suicídio é um fenómeno que, além das perdas humanas que envolve, tem um impacto negativo nos familiares e amigos, produzindo enormes gastos no sistema de saúde. No Uruguai, a taxa de suicídio não só tem registado um aumento sustentado, representando uma preocupação constante para as autoridades, mas geralmente é uma das mais altas da América Latina, sendo de 23,08 por 100.000 habitantes em 2022. Reconhecendo que o suicídio é um fenómeno multifatorial grave, vários estudos têm investigado a possível correlação entre a presença de lítio na água encanada e as taxas de suicídio; observa-se uma relação inversa, o que permitiria considerá-lo como um possível protetor do comportamento suicida. O presente estudo visa abordar esta correlação nos departamentos de Rocha e Montevidéu no Uruguai. Os resultados obtidos não são conclusivos. Quanto às concentrações de litio presentes na água corrente, são geralmente inferiores às indicadas em outros estudos como protetoras (30 µ/L). É necessário aprofundar esta área de discussão como em outras linhas de pesquisa, e obter um diagnóstico mais detalhado deste fenômeno complexo e significativo.

Utilização da Microscopia Eletrônica de Varredura na detecção de matérias estranhas em águas envasadas / Scanning Electron Microscopy as a tool to detect and quantify microscopic physical hazards in bottled mineral waters

Este trabalho objetiva averiguar a presença de matérias estranhas presentes em águas minerais envasadas e sugerir a utilização da Microscopia Eletrônica de Varredura (MEV), como técnica adequada para detecção e contagem. Oito amostras de água mineral foram obtidas e subamostras de 100 mL foram filtradas em membranas, que foram secas e recobertas com platina e observadas em MEV. Áreas de 21.025 µm2 foram focalizadas e as partículas contadas. Realizaram-se análise de variância e o teste de Regwq para a comparação das médias das contagens. Diferentes partículas visualizadas foram registradas sob distintas magnificações. A análise de variância revelou alta significância entre a quantidade de matérias estranhas das amostras, indicando que as amostras diferiram bastante quanto a essa característica. As médias obtidas obedeceram a uma estratificação, mas foram estimadas com grande precisão, sugerindo-se que a subdivisão em 10 grupos de contagem e a extrapolação para o volume de 100 mL é uma estimativa confiável para a contagem de partículas filtradas nesse volume de água. Foi mostrado que o MEV se apresentou como instrumento auxiliar adequado para a contagem de matérias estranhas em amostras de águas minerais envasadas, especialmente quando suas dimensões não permitem sua identificação convencionalmente. (AU)

This work aims to investigate the presence of microscopic foreign materials in bottled mineral waters and suggest the use of Scanning Electron Microscopy (SEM) as a suitable technique for counting foreign matter. Eight samples of mineral water were obtained, and 100 mL subsamples were filtered through membranes, which were then dried, coated with platinum, and observed under SEM. Areas of 21,025 µm2 were analysed, and the particles present were counted. Variance analysis was carried out, and the Regwq test was applied to compare the counting averages. Samples of the dirt particles were imaged at different magnifications. The analysis of variance revealed high significance among the samples, indicating substantial differences between them. The averages followed a stratification pattern and were estimated with great precision, suggesting that the subdivision into 10 count groups and the extrapolation to 100 mL volume is a reliable estimate for the count of particles filtered in this volume of water. It was shown that SEM was a suitable instrument for counting and observing foreign matter and dirt in samples of bottled natural mineral waters, especially when their dimensions are too small to be detected by conventional methods. (AU)

Drinking water quality of various sources in Peshawar, Mardan, Kohat and Swat districts of Khyber Pakhtunkhwa province, Pakistan / Qualidade de água potável de váris fontes dos distritos de Peshawar, Mardan, Kohat e Swat da província de Khyber Pakhtunkhwa, Paquistão

Abstract The present study involves the chemical and bacteriological analysis of water from different sources i.e., bore, wells, bottle, and tap, from Peshawar, Mardan, Swat and Kohat districts of Khyber Pakhtunkhwa (KP) province, Pakistan. From each district, 50 water samples (10 samples from each source), regardless of urban and rural status, were collected from these sources and analysed for sulphates, nitrates, nitrites, chlorides, total soluble solids and coliforms (E. coli). Results indicated that majority of the water sources had unacceptable E. coli count i.e.> 34 CFU/100mL. E. coli positive samples were high in Mardan District, followed by Kohat, Swat and Peshawar district. Besides this, the some water sources were also chemically contaminated by different inorganic fertilizers (nitrates/nitrites of sodium, potassium) but under safe levels whereas agricultural and industrial wastes (chloride and sulphate compounds) were in unsafe range. Among all districts, the water quality was found comparatively more deteriorated in Kohat and Mardan districts than Peshawar and Swat districts. Such chemically and bacteriologically unfit water sources for drinking and can cause human health problems.

Resumo O presente estudo envolve a análise química e bacteriológica de água de diferentes fontes, ou seja, furo, poços, garrafa e torneira, dos distritos de Peshawar, Mardan, Swat e Kohat da província de Khyber Pakhtunkhwa (KP), Paquistão. De cada distrito, 50 amostras de água (10 amostras de cada fonte), independentemente do status urbano e rural, foram coletadas dessas fontes e analisadas para sulfatos, nitratos, nitritos, cloretos, sólidos solúveis totais e coliformes (E. coli). Os resultados indicaram que a maioria das fontes de água tinha uma contagem inaceitável de E. coli, ou seja, > 34 UFC / 100 mL. As amostras positivas para E. coli foram elevadas no distrito de Mardan, seguido por Kohat, Swat e distrito de Peshawar. Além disso, algumas fontes de água também foram contaminadas quimicamente por diferentes fertilizantes inorgânicos (nitratos/nitritos de sódio, potássio), mas em níveis seguros, enquanto os resíduos agrícolas e industriais (compostos de cloreto e sulfato) estavam em níveis inseguros. Entre todos os distritos, a qualidade da água foi considerada comparativamente mais deteriorada nos distritos de Kohat e Mardan do que nos distritos de Peshawar e Swat. Essas fontes de água química e bacteriologicamente impróprias para beber podem causar problemas à saúde humana.

Entorno alimentario: disponibilidad de agua potable y presencia de kioscos en escuelas públicas de la provincia de Buenos Aires / Food environment: drinking water availability and kiosks access at public schools in Buenos Aires province

INTRODUCCIÓN: El entorno escolar juega un rol importante para prevenir la malnutrición en la infancia. El objetivo fue evaluar la disponibilidad de agua potable en la cocina, la oferta durante el almuerzo y la jornada escolar y la presencia de kioscos en escuelas públicas de la provincia de Buenos Aires según prestación alimentaria y necesidades básicas insatisfechas (NBI). MÉTODOS: Se realizó un análisis post hoc de la Encuesta del Servicio Alimentario Escolar 2016-2019 de una muestra de 3342 escuelas iniciales, primarias y secundarias. Se evaluó el suministro de agua en la cocina, las fuentes de agua potable para los alumnos, la bebida en el almuerzo y la disponibilidad de kiosco. Las variables se analizaron por nivel educativo y se estratificaron según la prestación alimentaria. Se realizó un análisis estadístico descriptivo. RESULTADOS: Alrededor del 1% (n=30) de las escuelas no contaban con agua potable en la cocina, y no se observaron diferencias porcentuales por prestación ni tertil de NBI. El 10% de las escuelas no ofrecía bebida en el almuerzo, y 7 de cada 10 no disponía de fuente de agua potable accesible; 4 de cada 10 primarias y secundarias presentaron kiosco. Al evaluar según NBI, la proporción de escuelas con kiosco decrecía a medida que aumentaba el tertil. DISCUSIÓN: Es fundamental generar políticas de regulación del entorno escolar con un enfoque integral y sistémico para prevenir la malnutrición en la población infantil más vulnerable.

Contemporary slave labor and subjectivity: psychosocial perspectives on the enslaved's narratives / Trabalho escravo contemporâneo e subjetividade: considerações psicossociais sobre narrativas de escravizado(a)s / Trabajo esclavo contemporáneo y subjetividad: consideraciones psicosociales sobre narrativas de personas esclavizadas

This study addresses the relation between subjectivity and contemporary enslaved labor from the enslaved workers' narratives in Brazil. A qualitative social research was carried out based on a constructionist perspective. We sought interaction with rescued workers and used (a) participant observation of workers' routine in an institutional project that supports them and a field diary, (b) semi-structured and open individual interviews with workers and a member of the team project. The fieldwork lasted a year and a half and the analysis followed Content Analysis. Freudian theory and Foucault's thought were used for interpretation, which managed to understand aspects of workers' experiences, exploitation characteristics, parental abandonment, as well as the tensions in self-classification as enslaved. The narratives pointed to a dramatic reality manifested in body exploitation, authoritarian abuses, violence, and negligence. At the same time, these narratives showed forms of worker resistance that calls for further investigations to increase knowledge on the subjective experiences of those who were enslaved.(AU)

O artigo aborda as relações entre subjetividade e trabalho escravo contemporâneo a partir da narrativa de trabalhadores(as) escravazados(as). Foi realizada uma pesquisa social qualitativa em uma perspectiva construcionista. Buscamos a interação com trabalhadores resgatados e realizamos a observação participante da rotina de trabalhadores atendidos em um projeto institucional, com diário de campo, e entrevistas individuais (semiestruturadas e abertas) com trabalhadores(as) e equipe do projeto institucional. O trabalho de campo durou um ano e meio, e a pesquisa foi realizada com o suporte da Análise de Conteúdo. Para a interpretação utilizamos aportes da teoria freudiana e do pensamento de Foucault, com os quais foi possível compreender aspectos das vivências dos trabalhadores, características da exploração, abandonos parentais e tensões em torno da autoclassificação como "escravo". As narrativas apontaram uma realidade dramática manifesta na exploração do corpo, em abusos autoritários, na violência e negligência. Ao mesmo tempo, as narrativas evidenciaram formas de resistência dos trabalhadores que convocam mais investigações para adensar o conhecimento sobre as experiências subjetivas desses que estão num lugar de escravizado(a).(AU)

Este artículo aborda la relación entre la subjetividad y el trabajo esclavo contemporáneo desde la narrativa de trabajadores esclavizados. Se realizó una investigación social cualitativa desde una perspectiva construccionista. Buscamos la interacción con los trabajadores liberados y utilizamos la observación participante de la rutina de los trabajadores atendidos en un proyecto institucional, diario de campo y entrevistas individuales (semiestructuradas y abiertas) con trabajadores y miembros del equipo del proyecto institucional. El trabajo de campo duró un año y medio, y se utilizó como apoyo el análisis de contenido. Para la interpretación se utilizaron aportes de la teoría freudiana y el pensamiento de Foucault, con lo que fue posible comprender aspectos de las vivencias de los trabajadores, características del escenario de explotación, abandono parental y las tensiones relacionadas con la autoclasificación "esclavo". Las narrativas apuntan a una realidad dramática manifestada en la explotación del cuerpo, abuso autoritario, violencia y abandono. Al mismo tiempo, evidenciaron formas de resistencia por parte de los trabajadores, que reclaman más investigaciones para profundizar en el conocimiento sobre las vivencias subjetivas de quienes se encuentran en esclavitud.(AU)

Fluoride in Bottled Waters Consumed in Northeastern Brazil

ABSTRACT Objective: To assess the fluoride concentration of bottled waters from municipalities in northeastern Brazil. Material and Methods: Bottled mineral waters were purchased in two periods at different commercial places of four large municipalities (João Pessoa, Campina Grande, Patos, and Cajazeiras) in the Paraíba state. The municipalities selected to present the following annual average temperature: João Pessoa 26.5 °C, Campina Grande 23.3 °C, Patos and Cajazeiras 27.5 °C. Fluoride concentration was determined using a combined ion-specific electrode. Readings (in mV) were conducted in triplicates for each standard solution and converted into fluoride concentration (mg F/L) using the Excel® software. Results: A total of 72 samples from six brands of bottled water were analyzed. The fluoride concentrations of all samples were low (0.11-0.21mg/L) but higher than those reported on the label and varied among different batches of the same brand. Conclusion: The fluoride levels in bottled water vary among brands, and these actual values are not stated in the labels.

Water consumption in 0-6-month-old healthy infants and effective factors: A systematic review / Consumo de agua en lactantes sanos de cero a seis meses y factores efectivos: una revisión sistemática

Introduction: Early introduction of fluids and water affects the duration of breastfeeding, the infant immune system, and possibly causes infants to consume less breast milk, which may, in turn, affect their nutritional and immune status. Objective: This study was carried out to determine water consumption in 0-6-month-old infants and the factors affecting this consumption. Materials and methods: A literature review was conducted in seven electronic databases (Medline, Web of Science, PubMed, ScienceDirect, Scopus, Cochrane Library, and TÜBITAK) for studies published until April 25, 2022, using the keywords: drinking water, infant, and breastfeeding. Results: The systematic review included 13 studies. Five studies were crosssectional, three were descriptive and quasi-experimental, and the others were case-control and cohort studies. It was reported in the examined studies that 86.2% of the infants were around 6 weeks old, 44 % of the infants were 1 month old, 77% were 3 months old, 2.5% were 4 months old, and 2.5 to 85% of the infants were around 6 months old when they first consumed water. The prominent reasons for making the infants drink water are the thought that they need it and cultural reasons. Conclusions: The exclusive breastfeeding of 0-6-month-old infants is the recommendation of reliable health authorities. Nurses play a key role in implementing this practice. In this systematic review, it was seen that families gave their infants water at varying rates in the 0-6-month period, and the factors affecting this situation were revealed. If nurses determine which factors affect families in terms of the early introduction of fluids, they could be able to plan the necessary education and interventions.

Introducción. La introducción temprana de líquidos y agua afecta la duración de la lactancia, el sistema inmune del lactante y posiblemente hace que los lactantes consuman menos leche materna, lo que a su vez puede afectar su estado nutricional e inmunitario. Objetivo. Este estudio se realizó para determinar el consumo de agua en bebés de cero a seis meses y los factores que inciden en este consumo. Materiales y métodos. Se hizo una revisión de la literatura en siete bases de dato electrónicas (Medline, Web of Science, PubMed, ScienceDirect, Scopus, Cochrane Library y TÜBITAK) para estudios publicados hasta el 25 de abril de 2022, utilizando las palabras clave: agua potable, lactante y lactancia. Resultados. La revisión sistemática incluyó 13 estudios. Cinco fueron estudios transversales, tres fueron descriptivos, cuasiexperimentales y los restantes fueron estudios de casos y controles, y de cohortes. En los estudios examinados se informó que le dieron agua al 86,2 % de los lactantes de seis semanas, al 44 % de los lactantes de un mes, al 77 % de los lactantes de tres meses, al 2,5 % de los lactantes de cuatro meses y al 2,5 % a 85 % de los lactantes de seis meses. Las razones principales para dar agua a los bebés son la idea de que los bebés necesitan agua y razones culturales. Conclusiones. La lactancia materna exclusiva es la recomendación de las autoridades sanitarias para los bebés de cero a seis meses. Las enfermeras juegan un papel clave en la implementación de esta práctica. En esta revisión sistemática se observó que las familias daban agua a sus bebés en proporciones variables durante el período de cero a seis meses y se revelaron los factores que inciden en esta situación. Si las enfermeras determinan qué factores afectan a las familias en cuanto a la introducción temprana de líquidos, podrían planificar las medidas educativas y las intervenciones necesarias.

Revision and prospect of the "Standards for Drinking Water Quality (GB5749-2022)" in China / 中华预防医学杂志

The revision of the national standards for drinking water quality is an important, rigorous and delicate endeavor. The paper introduced the revision of this standard, emphasizing the revision principle, overall technical considerations, and revision contents. Recommendations were also proposed for the implementation of this standard.

Research on the establishment of standard limits for perfluorooctanoic acid and perfluorooctane sulfonate in the "Standards for Drinking Water Quality（GB5749-2022）"in China / 中华预防医学杂志

Perfluorinated compounds, especially Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are widely detected in water environments in China. Considering the potential health risks of drinking water exposure routes, PFOA and PFOS have been added to the water quality reference index of the newly issued "Standards for Drinking Water Quality (GB5749-2022)", with limit values of 40 and 80 ng/L, respectively. This study analyzed and discussed the relevant technical contents for determining the limits of the hygiene standard, including the environmental existence level and exposure status of PFOA and PFOS, health effects, derivation of safety reference values, and determination of hygiene standard limits. It also proposed prospects for the future direction of formulating drinking water standards.

Research on the determination of the limit value of perchlorate in the "Standards for Drinking Water Quality（GB5749-2022）" in China / 中华预防医学杂志

Perchlorate is an environmental pollutant that has been a focus of attention in recent years. It has been detected in many environmental water bodies and drinking water in China, with a high level of presence in some areas of the Yangtze River Basin. The human body may ingest perchlorate through exposure pathways such as drinking water and food, and its main health effect is to affect the thyroid's absorption of iodine. The "Standards for Drinking Water Quality" (GB5749-2022) includes perchlorate as an expanded indicator of water quality, with a limit value of 0.07 mg/L. This article analyzes the technical content related to the determination of hygiene standard limits for perchlorate in drinking water, including the environmental presence level and exposure status of perchlorate, main health effects, derivation of safety reference values, and determination of hygiene standard limits.

Research on the formulation and revision of radiological parameters in the "Standards for Drinking Water Quality（GB5749-2022）" in China / 中华预防医学杂志

The radioactive safety of drinking water has attracted increasing public concern. The newly issued Standards for Drinking Water Quality (GB5749-2022) in China has revised the radiological parameters. This article provides an overview of the main sources, levels of radionuclides in drinking water, and summarized the individual doses criterion and adverse health effects associated with exposure of the public to radionuclides from drinking-water. It analyzes and discusses the relevant revision content of radiological parameters, including the guidance values for screening gross α and gross β, subtracting the contribution of potassium-40 from gross β activity when the gross β activity concentration exceeds the screening level, and the basis for establishing the limit values of reference indices uranium and radium-226. Specific implementation and evaluation suggestions are also proposed.

Research on the formulation and revision of standard limits for antimony,boron and vanadium in the "Standards for Drinking Water Quality (GB5749-2022)" in China / 中华预防医学杂志

China is rich in antimony, boron, and vanadium mineral resources, which have been detected in environmental water bodies and drinking water. During the revision process of the "Standards for Drinking Water Quality (GB5749-2006)", research and evaluation are focused on three indicators: antimony, boron and vanadium. Vanadium is added and the limit value of boron is adjusted. This study reviews and discusses the technical contents related to the revision of the antimony, boron and vanadium, including the environmental presence levels, exposure status, health effects, and the revision of the standard limits of these three indicators. Suggestions are also made for the implementation of this standard.

Research on the standard limits for vinyl chloride and trichloroethylene in the "Standards for Drinking Water Quality（GB5749-2022）" in China / 中华预防医学杂志

The usage of vinyl chloride and trichloroethylene in China has been increasing year by year, and they have been detected in both drinking water and environmental water, making them important environmental pollutants. Based on the latest research results on the health effects of vinyl chloride and trichloroethylene, the newly issued, "Standards for Drinking Water Quality (GB5749-2022)" in China has adjusted the standard limit of vinyl chloride from 0.005 mg/L to 0.001 mg/L and the standard limit of trichloroethylene from 0.07 mg/L to 0.02 mg/L. This article analyzed and discussed the relevant technical contents for determining the above standard limits, including the levels and exposure conditions of vinyl chloride and trichloroethylene in the water environment, health effects, derivation of safety reference values, and determination of hygiene standard limits. Suggestions were also made for the implementation of this standard.

Methodological study on the establishment of limit values in the Standards of Drinking Water Quality / 中华预防医学杂志

The establishment of limit values for standards of drinking water quality is an important and complex process. This study systematically introduced the methodology of the establishment of standard limit values for drinking water quality and elaborated on the workflow of setting limit values of water quality indicators, principles and methods of selecting water quality indicators, derivation of safety reference values, and establishment of limit values. It also aimed to provide reference and support for the future revision of relevant standards.

Interpretation of the limit values of iodide in the "Standards for Drinking Water Quality（GB5749-2022）" in China / 中华预防医学杂志

The Drinking Water Sanitation Standard (GB 5749-2022) has been officially promulgated and implemented, with the iodide listed as a new reference indicator for water quality. This study interprets the distribution of iodine in environmental media, the impact of water iodine on health, the significance of establishing iodide standard limits, and the use of iodide standard limits, in order to provide a scientific basis for the application of iodide standard limits in this revised standard.

Spatial correlation between the prevalence of dental fluorosis and the chemical elemental composition of drinking water sources in a typical coal-fired pollution fluorosis area / 中华流行病学杂志

Objective: To investigate the spatial distribution characteristics and correlation between the prevalence of dental fluorosis and the chemical elemental composition of drinking water sources in coal-fired fluorosis areas. Methods: Based on the survey data on the prevalence of dental fluorosis at CDC in Guizhou Province in 2022, 274 original surface drinking water sources were collected in typical coal-fired fluorosis areas, and fluoride (F), calcium (Ca), magnesium (Mg), aluminum (Al), titanium (Ti), chromium (Cr), manganese (Mn), iron (Fe), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), barium (Ba), lead (Pb) 17 elements; apply Moran's I index, Getis-Ord Gi* hotspot analysis of the global spatial autocorrelation of chemical elements in drinking water and the degree of aggregation of each element on the local area, and correlation analysis with the prevalence of dental fluorosis in the region. Results: Except for Cu, Zn, and Cd, global spatial autocorrelation Moran's I was negative, and all other elements were positive. F, Ca, Al, Ti, As, Mo, Cd, and Cu elements showed high values of aggregation in the southeastern low-altitude area; Mg, Ba, Pb, Cr, Mn, and Fe elements were mainly aggregated in the central altitude terrain transition area, Zn and Se elements in water sources are significantly positively correlated with the prevalence of dental fluorosis (P<0.05). In contrast, F, Mg, Al, Ti, As, Mo, Cd, Ba, and Pb elements negatively correlate (P<0.05). Elements in the central region were high-high aggregation, as a hot spot aggregation area with high disease incidence, while F, Al, Mn, Mo, Cd, and Ba elements in the western region were low-low aggregation, as a cold spot aggregation area with a low incidence of fluorosis. Conclusions: The risk of population fluoride exposure in surface drinking water sources is shallow. However, the chemical element content of drinking water sources in coal-fired polluted endemic fluorosis areas has prominent spatial geographical distribution characteristics. There is a significant spatial aggregation effect with the prevalence of dental fluorosis, which may play a synergistic or antagonistic effect on the occurrence and prevalence of dental fluorosis.

Endemic dental fluorosis in children from a brazilian slave-descendent community: a cross-sectional study / Fluorose dentária endêmica em crianças de uma comunidade quilombola brasileira: um estudo transversal

Although fluoride (F) is required for the normal growth and development of several human organs and tissues, excessive exposure to it may be potentially toxic. Groundwater may present ranging levels of F; however, the appearance, taste, and smell are not altered. Thus, the present study aimed to evaluate dental fluorosis in children from a Brazilian slave-descendent community, as well as to assess F levels in the drinking water supplies available in that area. For that, 21 children aged from 6 to 14 years living in Rincão dos Martimianos were invited to participate. Thylstrup and Fejerskov index (a 0­9 scale) was used to assess dental fluorosis on permanent teeth. Furthermore, the F concentration of two water samples (from the artesian well and a tank) was determined by using a potentiometric method. All children presented dental fluorosis to some degree, ranging from score 2 to 9. About 81% of them had dental fluorosis scores equal to or over 5. Scores lower than 5 were observed only in children younger than 8 years; on the other hand, all children older than 8 years presented scores higher than 5. Moreover, artesian well water had an F concentration of 5 mg/L and tank water 0.8 mg/L. It is suggested that the F-rich groundwater supply was most probably responsible for dental fluorosis in that area. Brazilian slave-descendent communities, therefore, should receive constant attention from their local authorities in order to guarantee a proper water supply for consumption, as well as to provide public health education(AU)

Embora o flúor (F) seja necessário para o crescimento e desenvolvimento normal de vários órgãos e tecidos humanos, a exposição excessiva pode ser potencialmente tóxica. As águas subterrâneas podem apresentar níveis variados de F; no entanto, a aparência, o sabor e o cheiro não são alterados. Desta forma, o presente estudo teve como objetivo avaliar a fluorose dentária em crianças de uma comunidade brasileira descendente de escravos, bem como avaliar os níveis de F na água potável disponível nessa área. Para isso, 21 crianças de 6 a 14 anos residentes no Rincão dos Martimianos foram convidadas a participar da pesquisa. O índice de Thylstrup e Fejerskov (uma escala de 0 a 9) foi usado para avaliar a fluorose dentária em dentes permanentes. Além disso, a concentração de F de duas amostras de água (do poço artesiano e de um tanque) foi determinada pelo método potenciométrico. Todas as crianças apresentaram algum grau de fluorose dentária, variando de 2 a 9. Cerca de 81% delas apresentaram escores de fluorose dentária iguais ou superiores a 5. Escores inferiores a 5 foram observados apenas em crianças menores de 8 anos; por outro lado, todas as crianças maiores de 8 anos apresentaram escores superiores a 5. Além disso, a água do poço artesiano tinha concentração de F de 5 mg/L e a água do tanque 0,8 mg/L. Desta forma, acredita-se que a fonte de água subterrânea rica em F foi provavelmente responsável pela fluorose dentária na região avaliada. As comunidades quilombolas brasileiras, portanto, devem receber atenção constante de suas autoridades locais, a fim de garantir o abastecimento adequado de água para consumo, bem como proporcionar educação em saúde pública(AU)

Processo de construção do Programa Nacional de Acesso à Água Potável em Terras Indígenas (PNATI) / Construction process of the National Program for Access to Potable Water in Indigenous Lands (PNATI) / Proceso de construcción del Programa Nacional de Acceso a Agua Potable en Tierras Indígenas (PNATI)

Objetivo: compreender o processo de construção do Programa Nacional de Acesso à Água Potável em Terras Indígenas (PNATI), por meio de fatores socioepidemiológicos que impulsionaram sua institucionalização. Método: estudo descritivo e socioepidemiológico, baseado em dados secundários da Secretaria Especial de Saúde Indígena (SESAI), com recorte temporal pré-pandêmico e pandêmico. Aanálise dos dados seguiu os fundamentos da teoria do sistema político de David Easton. Resultados: o processo de construção do programa considerou o volume de notificações de doenças de veiculação hídrica, o baixo acesso à água potável e a dificuldade no controle da qualidade desta nas aldeias atendidas pela SESAI. Após a construção do PNATI, verificou-se a importância desse instrumento para planejamento, gerência e controle social na garantia do abastecimento de água potável nas terras indígenas e mudanças na realidade sanitária dos povos indígenas do Brasil.Conclusão: o PNATI preenche uma lacuna existente quanto ao amparo legal, com a oportunidade de reverter o panorama de insuficiências de saneamento ambiental, com vistas a universalizar o acesso à água, em quantidade e qualidade nas comunidades indígenas, e contribuir para a melhoria da saúde dessa população.

Objective:to understand the construction process of the National Program for Access to Potable Water in Indigenous Lands, through socio-epidemiological factors that drove its institutionalization. Method:descriptive and socioepidemiological study, based on secondary data from the Special Secretariat for Indigenous Health (SESAI), with a pre-pandemic and pandemic time frame. Data analysis followed the foundations of David Easton's political system theory. Results:the program's construction process considered the volume of notifications of waterborne diseases, the low access to potable water and the difficulty in controlling its quality in the villages served by SESAI. After the construction of the PNATI, the importance of this instrument for planning, management and social control in guaranteeing the supply of potable water in indigenous lands and changes in the health reality of the indigenous peoples of Brazil was verified. Conclusion:PNATI fills an existing gap in terms of legal support, with the opportunity to reverse the scenario of insufficient environmental sanitation, with a view to universalizing access to water, in quantity and quality in indigenous communities, and contributing to the improvement of the health of this population.

Objetivo:comprender el proceso de construcción del Programa Nacional de Acceso a Agua Potable en Tierras Indígenas, a través de los factores socioepidemiológicos que impulsaron su institucionalización. Método:estudio descriptivo y socioepidemiológico, con base en datos secundarios de la Secretaría Especial de Salud Indígena (SESAI), con marco temporal antes y durante la pandemia. El análisis de datos siguió los fundamentos de la teoría del sistema político de David Easton. Resultados:el proceso de construcción del programa consideró el volumen de notificaciones de enfermedades hídricas, el bajo acceso al agua potable y la dificultad para controlar su calidad en las localidades atendidas por SESAI. Luego de la construcción del PNATI, se constató la importancia de este instrumento de planificación, gestión y control social en la garantía del abastecimiento de agua potable en tierras indígenas y cambios en la realidad sanitaria de los pueblos indígenas de Brasil. Conclusión:el PNATI llena un vacío existente en materia de respaldo legal, con la oportunidad de revertir el escenario de insuficiente saneamiento ambiental, con miras a universalizar el acceso al agua, en cantidad y calidad en las comunidades indígenas, y contribuir al mejoramiento de la salud de estas población.

Fluoruros en agua de consumo al norte y occidente de México / Fluorides in water for consumption in northern and western Mexico

La cantidad de fluoruros en el agua en algunas regiones de México representa un problema de salud pública. El objetivo de este trabajo fue realizar una revisión sistemática de estudios originales que reportaran niveles de fluoruros en agua corriente y embotellada de la región norte y occidente de México. Esta revisión sistemática se elaboró utilizando el sistema PRISMA en las bases de datos de PubMed, Scopus, Medigraphic y Scielo. Se implementaron las palabras clave de fluoride OR fluorosis AND water AND Mexico, y se incluyeron y excluyeron registros de acuerdo con los criterios previamente establecidos. Fueron revisados aquellos artículos publicados entre el 1 de enero del 2010 y el 30 de marzo del 2021. Se identificaron 36 registros en total. La mayoría mostraban datos encontrados en la región occidente del país (n = 23) mientras que los restantes fueron realizados al norte. Ambas regiones se mostraron con rangos máximos y medias muestrales por encima de lo sugerido por la Organización Mundial de la Salud y los organismos reguladores nacionales. De acuerdo con los estudios aquí analizados en México, las regiones Norte y Occidente del país muestran una situación preocupante por los elevados niveles de fluoruros que reportan los autores en agua corriente y embotellada, los niveles se encuentran casi en su totalidad por encima de los recomendados a nivel nacional e internacional lo cual significa un problema de salud pública que requiere de atención.

The amount of fluoride in water in some regions of Mexico represents a public health problem. The aim of this study was to conduct a systematic review of original studies that report fluoride levels in tap and bottled water from the northern and western regions of Mexico. A systematic review was conducted using the PRISMA method in PubMed, Scopus, Medigraphic and Scielo databases. The keywords fluoride OR fluorosis AND water AND Mexico were used for the search and the records found were included and excluded according to the previous established criteria. We reviewed data in articles published between January 1st, 2010 and March 30th, 2021. We identified a total of 36 records. Most showed data found in the western region (n = 23), while the rest reported data found in the north. Both regions reported maximum and mean sample ranges above those suggested by the World Health Organization and national regulations. According to the analyzed data, in Mexico, the northern and western regions of the country show a concerning situation due to the high levels of fluoride reported by many authors in tap and bottled water. Almost all authors reported data above those recommended for national and international regulations, which represent an important public health problem that requires attention.