Executive summary workshop: toward the elimination of the use of solid fuels and kerosene in urban homes in the americas

Household air pollution is one of the principal causes of disease and premature death in low and middle-income countries (LMIC) and is an avoidable health risk. In the Americas, the World Health Organization (WHO) estimated that approximately 82,000 deaths in these countries were attributale to cooking, heating, and lighting with polluting fuels and technologies in 2016. Accelerating the transition to clean energy for all is an urgent and necessary public health intervention in the region of the Americas, to reduce the health risks that primarily affect socially and economically vulnerable populations, to achieve a continent healthier, more equitable and with sustainable development, contributing to the worldwide efforts to achieve the Sustainable Development Goals (SDGs) by 2030. To achieve this result, the health sector should be involved in the design of policy interventions to reduce exposure to indoor air pollution and its effects on health, as well associal inequities. In line with the WHO Indoor Air Quality Guidelines launched in November 2014, the PAHO Strategic Plan 2014-2019 has set itself the objective of helping Member States to reduce the percentage of population by 5% that depends on solid fuels for cooking in countries with a percentage of users equal to or greater than 10% of the population (priority countries). To measure progress, one indicator is the number of countries that are implementing large-scale programs to reduce solid fuel use (SFU) in the home, and a outcome indicator measures progress in the use of energy and clean technology for cooking at home. Evaluating the progress of the countries in the indicator of the Strategic Plan, some of its member states have successfully reduced solid fuel use (SFU) in the households by 5% and have implemented large-scale programs to transition to clean fuels. Nevertheless, in other countries in the region, progress has been almost non-existent. Following the first workshop carried out in Tegucigalpa (Honduras) in 2015, where new indoor air pollution guidelines were launched by the WHO, the workshop "Toward the elimination of solid fuels and kerosene in urban homes in the Americas" was organized and carried out in Mexico City (Mexico) from September 11 to 13, 2018.

Análisis de Transmisibilidad Bacteriana a traves del conteo de UFC se S. Mutans en Binomios Madre-Niño / Análise da transmissibilidade bacteriana a través do conteio de UFC de S. Mutans em binômios mãe - filho / Analysis of Bacterial Transmissibility Through the count of CFU Of S. Mutans in Mother-Child

Objetivo: Identificar los mecanismos de transmisibilidad del S. mutans en binomios madre-hijo, a través de un conteo de Uni-dades Formadoras de Colonias (UFC). Materiales y métodos: Se evaluaron 45 binomios madre-hijo pertenecientes al centro de vacunación del Hospital Universitario de Motupe (HUM), los cuales fueron divididos en tres grupos de 15 binomios cada uno: G1 (0-6 meses); G2 (7-12 meses); G3 (13-18 meses). Obtenido el consentimiento informado, se procedió a la recolección de los datos con la aplicación de una encuesta a las madres cuyo fin fue la valoración de los mecanismos de transmisibilidad microbiana más frecuentes; seguido a esto se procedió a ejecutar la fase de recolección de muestras de saliva mediante la técni-ca de hisopado las mismas que fueron sembradas en Agar mitis salivarius y mediante una técnica semicuantitativa se procedió a evaluar y relacionar el nivel de S. mutans presentes en la madre y el hijo. Los datos fueron analizados estadísticamente con la prueba de Chi-cuadrado con un nivel de significancia del 5%. Resultados: La bacteria estuvo presente en el 93% de los niños y en el 100% de las madres. El mayor nivel de s. mutans se presentó en el grupo de 13 a 18 meses con un 33.3%; en cuanto al análisis de transmisibilidad de la madre todos presentaron un alto porcentaje; sin embargo el hábito contaminante más fre-cuente fue "besar las manos de su hijo" (93%). La relación entre el nivel de S. mutans de madre y su hijo por grupo de edad no se obtuvo diferencias significativas en ninguno de los grupos de edad (p>0,05). Al analizar la asociación entre los hábitos de transmisibilidad del S.mutans en los niños se pudo evidenciar que existe una asociación con el beso en la boca (p= 0,012). Conclusión: Existe asociación entre los factores de transmisibilidad y la presencia del s. mutans en los niños.

Objetive: To identify the mechanisms transmissibility of S. mutans in mother-child binomials, through a count of colonies forming units (CFU). Materials and Methods: we assessed 45 couples mother-child belonging to the Centre of vaccination of The University Hospital of Motupe, which were divided into three groups: G1 (0-6 months); G2 (7-12 months); G3 (13-18 months). Obtained informed consent it was proceeded the collection of data, with the application of a survey to the mothers whose purpose was the assessment of the mechanisms of microbial transmissibility more frequent, following this, the saliva sampling phase was carried out using the swab technique, which were seeded in Salivarius Agar and through a semi quantita-tive technique, proceeded to evaluate and related the level of S. mutans present in mother and child. The data were analysed statistically with the chi-square test with a significance level of 5%. Results: the bacterium was present in 93% of the children and 100% of the mothers. The highest level of S. mutans was presented in the group of 13 to 18 months with a 33.3%; in the analysis of transmissibility of the mother all presented a high percentage; However, the most frequent polluting habit was "kissing the hands of your child" (93%). The relationship between the level of S. mutans of mother and her child by age group did not show significant differences in any of the age groups (p> 0.05). When analyzing the association between the trans-missibility habits of S. mutans in children, it was possible to show that there is an association with kissing in the mouth (p = 0.012). Conclusion: There is an association between the factors of transmissibility and the presence of s. Mutans in children.

Objetivo: Identificar os mecanismos de transmissibilidade de S. mutans em binômios mãe-filho, através do conteio de Unidades Formadoras de Colonias (UFC). Materiais e métodos: Foram avaliadas 45 binômios mãe-filho pertencentes ao centro de vaci-nação do Hospital Universitário de Motupe (HUM), os quais foram divididos em grupos de 15 binômios cada um: G1 (0-6 me-ses); G2 (7-12 meses); G3 (13-18 meses). Obtido o termo de consentimento livre esclarecido, se procedeu à recolecção dos dados mediante um inquérito às mães cujo objetivo foi valorar os mecanismos de transmissibilidade microbiana mais frequentes; depois procedeu-se a executar a fase de coleta de amostras de saliva através usando um cotonete nas mucosas da criança, as mesmas que foram cultivadas em Ágar mitis salivarius e mediante a técnica semi-quantitativa procedeu-se a avaliar e relacionar os níveis de S. mutans presentes na mãe e o filho. Os dados foram analisados com o teste de Qui-quadrado com um nível de significância de 5%. Resultados: A bactéria esteve presente em 93% das crianças e em 100% das mães. O maior nível de S. Mutans apresentou-se no grupo de 13 a 18 meses em um 33,3%; enquanto ao método de transmissibilidade da mãe todos apresentaram uma alta por-centagem; no entanto, o hábito contaminante mais frequente foi "beijar as mãos do seu filho" (93%). A relação entre o nível de S. mutans da mãe e seu filho por faixa etária não foi observada em nenhum dos grupos de idade (p> 0,05). Ao analisar a associação entre os hábitos de transmissibilidade do S. mutans nas crianças podia-se comprovar que existe uma associação com o beijo na boca (p = 0,012). Conclusão: Existe uma associação entre os fatores de transmissibilidade e a presença do s. mutans nas crianças.

Medición de los niveles de ruido ambiental en la ciudad de Santiago de Chile / Environmental noise levels measurement of the city of Santiago, Chile

Introducción. Un estudio realizado en Santiago en 1989, estimó que 1.300.000 personas estaban sometidas a niveles de ruido inaceptables por las normas internacionales. Considerando que no existen publicaciones sobre ruido ambiental realizadas por otorrinolaringólogos, y que el tema no ha sido revisado en los últimos 15 años, quisimos actualizar la información al respecto. Material y método. Se evaluó el ruido en lugares que afectan la rutina del ciudadano común, independiente de su profesión: Barrio residencial, parques, discotecas, bar-discoteque, calles principales, buses de transporte urbano habituales, buses de transporte urbano del proyecto transantiago y Metro. Las mediciones se realizaron con un sonómetro integrador, según lo establecido por la normas de la Comisión Nacional del Medio Ambiente (CONAMA), durante los meses de julio a septiembre del 2006. Resultados. Las discotecas son el lugar con mayor contaminación acústica. En relación a la Avda . Bernardo O'Higgins (Alameda), el nivel de ruido: 80.5 dB(A), se mantiene constante en diferentes puntos de medición. Entre el transporte público, el metro tiene los niveles de ruido más altos: 87 dB (A). No existen diferencias entre los buses antiguos o micros amarillas y los del proyecto transantiago. Conclusiones. Nuestros resultados ponen una nota de alerta mostrando que el nivel de ruido en Santiago, para la gran mayoría de los parámetros, son superiores a las normas establecidas.

Introduction. A study carried out in Santiago in 1989 estimated that 1,300,000 people were exposed to noise levels unacceptable by international standards. Considering that there are no reports of environmental noise evaluations performed by otorhinolaryngologists, and that the subject has not been reviewed in the past 15 years, in this paper we present up-to-date information on the topic. Materials and methods. Noise levels were evaluated in several places that are part of the common citizen life, disregarding their profession: Residential neighborhoods, parks, discos, pubs, main streets, city buses (old and new system), and subway. Measurements were taken using an integrating sound level meter, according to CONAMA standards, between the months of July and September, 2006. Results. The highest noise pollution was found in discos. With regard to the main avenue in Santiago, Libertador B. O'Higgins, noise levels (80 dB (A)) remained constant in different measured points. As of public transportation, the subway had the higher noise levels (87 dB (A)). There were no differences between the old and new public transit buses. Conclusions. Our results raise an environmental alert, showing that the noise level in Santiago, for most parameters, is above international standards.

Aplicação do método da carga máxima total diária (CMTD) para a amônia no Rio Atibaia, região de Campinas/Paulínia - SP / Application of ammonia total maximum daily load (TMDL) to Atibaia River, Campinas/Paulínia region - São Paulo state

Neste estudo foram avaliadas a capacidade de suporte e o estado de degradação do Rio Atibaia, considerando a ameaça para a vida aquática pela presença da Amônia, a qual representa um dos principais riscos às comunidades aquáticas no Rio Atibaia. Com este objetivo foi aplicado o método da Carga Máxima Total Diária (CMTD), da Agência de Proteção Ambiental dos Estados Unidos (EPA). Os resultados revelaram que as cargas de Amônia aumentavam progressivamente ao longo do Rio Atibaia, principalmente devido às fontes pontuais. As cargas de Amônia diárias assumiram valores de 30 a 5000 kg NH3. A capacidade de suporte das águas Rio Atibaia, para proteger a vida aquática contra os efeitos tóxicos da Amônia, tem sido violadas em trechos próximos à sua foz. A degradação dessas águas foi mais intensa na estação seca. Este trabalho mostrou que o esgoto doméstico não-tratado de uma população aproximada de 250 mil habitantes da cidade de Campinas, via Ribeirão Anhumas, é a principal fonte de Amônia na bacia do Rio Atibaia, apesar do grande número de indústrias ali presentes.

This study evaluated the tolerance capacity and the impairment state of the Atibaia River, considering the threat to aquatic life by the presence of Ammonia, which represents one of the main risks to the aquatic communities in the Atibaia River. With this aim, the method Total Maximum Daily Load (TMDL), from the United States Environmental Protection Agency (EPA), was applied. The results revealed that the Ammonia loads increased progressively through the Atibaia River, especially due to the point sources. The daily Ammonia loads assumed values that ranged from 30 to 5000 kg NH3. The tolerance capacity of the waters of the Atibaia River, to protect aquatic life against the toxic effects of the Ammonia, has been violated in reaches near its mouth. The impairment of these waters was more intense during the dry season. This study showed that the domestic sewer not treated of an approximate population of 250 thousand inhabitants in the city of Campinas is the main source of Ammonia in the Atibaia River Basin, despite the number of industries present there.