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Article in English | WPRIM | ID: wpr-880377


BACKGROUND@#The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco.@*METHODS@#The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures.@*RESULTS@#The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies.@*CONCLUSIONS@#Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.

Biomarkers/blood , Child , Child Health , Child, Preschool , Cohort Studies , Environmental Exposure/adverse effects , Environmental Health , Environmental Pollutants/adverse effects , Female , Fetal Blood/chemistry , Follow-Up Studies , Growth/drug effects , Humans , Hypersensitivity/etiology , Infant , Japan/epidemiology , Male , Neurodevelopmental Disorders/etiology , Pregnancy , Prenatal Exposure Delayed Effects/etiology , Prevalence , Smoking/adverse effects
Article in English | WPRIM | ID: wpr-880350


BACKGROUND@#The industrial revolution has resulted in increased synthesis and the introduction of a variety of compounds into the environment and their potentially hazardous effects have been observed in the biota. The present study was aimed to evaluate the potential endocrine-disrupting effects of chronic exposure to the low concentrations of bisphenol S (BPS) in male rats.@*METHODS@#Weaning male Sprague-Dawley rats (22 days old) were either exposed to water containing 0.1% ethanol for control or different concentrations of BPS (0.5, 5, and 50 μg/L) in drinking water for 48 weeks in the chronic exposure study. After completion of the experimental period, animals were dissected and different parameters (hormone concentrations, histology of testis and epididymis, oxidative stress and level of antioxidant enzymes in the testis, daily sperm production (DSP), and sperm parameters) were determined.@*RESULTS@#Results of the present study showed a significant alteration in the gonadosomatic index (GSI) and relative reproductive organ weights. Oxidative stress in the testis was significantly elevated while sperm motility, daily sperm production, and the number of sperm in epididymis were reduced. Plasma testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) concentrations were reduced and estradiol levels were high in the 50 μg/L-exposed group. Histological observations involved a significant reduction in the epithelial height of the testis along with disrupted spermatogenesis, an empty lumen of the seminiferous tubules, and the caput region of the epididymis.@*CONCLUSION@#These results suggest that exposure to 5 and 50 μg/L of BPS for the chronic duration started from an early age can induce structural changes in testicular tissue architecture and endocrine alterations in the male reproductive system which may lead to infertility in males.

Animals , Biomarkers , Endocrine Disruptors/toxicity , Environmental Exposure/adverse effects , Environmental Pollutants/toxicity , Hypothalamo-Hypophyseal System/physiopathology , Infertility, Male/physiopathology , Male , Phenols/toxicity , Rats , Rats, Sprague-Dawley , Sulfones/toxicity , Testis/physiopathology , Toxicity Tests, Chronic
Article in English | WPRIM | ID: wpr-880339


BACKGROUND@#Mounting evidence implicates an association between ambient air pollution and impaired reproductive potential of human. Our study aimed to assess the association between air pollution and ovarian reserve in young, infertile women.@*METHODS@#Our study included 2276 Korean women who attended a single fertility center in 2016-2018. Women's exposure to air pollution was assessed using concentrations of particulate matter (PM@*RESULTS@#The mean age was 36.6 ± 4.2 years and AMH level was 3.3 ± 3.1 ng/mL in the study population. Average AMH ratio was 0.8 ± 0.7 and low AMH was observed in 10.3% of women (n=235). The average concentration of six air pollutants was not different between the normal ovarian reserve and low AMH groups for all averaging periods. In multivariable models, an interquartile range (IQR)-increase in 1 month-average PM@*CONCLUSIONS@#In a cohort of infertile Korean women, there was a suggestive evidence of the negative association between ambient PM concentration and ovarian reserve, highlighting the potential adverse impact of air pollution on women's fertility.

Adult , Air Pollutants/adverse effects , Air Pollution/adverse effects , Environmental Exposure/adverse effects , Female , Humans , Infertility, Female/etiology , Ovarian Reserve/physiology , Republic of Korea
Article in English | WPRIM | ID: wpr-880334


BACKGROUND@#Previous studies have suggested that exposure to air pollution may increase stroke risk, but the results remain inconsistent. Evidence of more recent studies is highly warranted, especially gas air pollutants.@*METHODS@#We searched PubMed, Embase, and Web of Science to identify studies till February 2020 and conducted a meta-analysis on the association between air pollution (PM@*RESULTS@#A total of 68 studies conducted from more than 23 million participants were included in our meta-analysis. Meta-analyses showed significant associations of all six air pollutants and stroke hospital admission (e.g., PM@*CONCLUSIONS@#Exposure to air pollution was positively associated with an increased risk of stroke hospital admission (PM

Air Pollutants/adverse effects , Air Pollution/adverse effects , Environmental Exposure/adverse effects , Hospitalization/statistics & numerical data , Humans , Incidence , Particle Size , Particulate Matter/adverse effects , Stroke/mortality
Article in English | WPRIM | ID: wpr-880325


BACKGROUND@#Chronic obstructive pulmonary disease (COPD) has become a severe global burden in terms of both health and the economy. Few studies, however, have thoroughly assessed the influence of air pollution on COPD-related mortality among elderly people in developing areas in the hinterland of southwestern China. This study is the first to examine the association between short-term exposure to ambient airborne pollutants and COPD-related mortality among elderly people in the central Sichuan Basin of southwestern China.@*METHODS@#Data on COPD-related mortality among elderly people aged 60 and older were obtained from the Population Death Information Registration and Management System (PDIRMS). Data on airborne pollutants comprised of particulate matter < 2.5 μm in aerodynamic diameter (PM@*RESULTS@#A total of 61,058 COPD-related deaths of people aged 60 and older were obtained. Controlling the influences of daily temperature and relative humidity, interquartile range (IQR) concentration increases of PM@*CONCLUSIONS@#Increased concentrations of ambient airborne pollutants composed of PM

Aged , Aged, 80 and over , Air Pollutants/adverse effects , China/epidemiology , Cities/epidemiology , Environmental Exposure/adverse effects , Female , Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/mortality , Time Factors
Arch. cardiol. Méx ; 90(3): 274-283, Jul.-Sep. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1131044


Resumen Objetivo: Comprobar las diferencias morfológicas y funcionales del corazón en dos poblaciones latinoamericanas con distintas características raciales y condiciones de vida. Métodos: Mediante el ecocardiograma transtorácico se obtuvieron datos de 206 personas: 103 del poblado de Atahualpa, Ecuador (nivel del mar, edad x̄ 75 ± 4.2 años, 53 mujeres) y 103 habitantes de la Ciudad de México (altitud de 2,300 m, edad x̄ 75 ± 4.2 años, 52 mujeres). Resultados: Las diferencias significativas entre Atahualpa y la Ciudad de México fueron frecuencia cardíaca, 66 vs. 80; diámetro diastólico ventricular izquierdo, 40.8 vs. 42.7; grosor del tabique, 9.8 vs. 11.6; pared posterior, 10.2 vs. 11.8; volumen-latido en centímetros cúbicos, 53.0 vs. 46.6; volumen auricular Izquierdo, 25.8 vs. 33.6; presión sistólica de la arteria pulmonar, 27.1 vs. 42.0; gasto cardíaco, 3.1 vs. 4.8; cociente E/Ea, 6.4 vs. 9.2; área mitral, 3.4 vs. 3.0. El comparativo de la función diastólica entre Atahualpa y la Ciudad de México fue: tipo 0: 2 vs. 1; tipo 1: 96 vs. 81; tipo 2: 5 vs. 20; tipo 3: 0 vs. 1. Conclusión: Las características ecocardiográficas que identifican los cambios adaptativos del corazón en Atahualpa coinciden con personas que viven a nivel del mar y con buena actividad física y en México con los habitantes de grandes altitudes y expuestos a contaminación ambiental. La función sistólica del ventrículo izquierdo fue similar en ambas poblaciones, lo que indica que los cambios adaptativos hacen posible que el corazón sea eficaz en diferentes circunstancias del ecosistema.

Abstract Objective: To compare morphological and functional differences of the heart in two Latin American populations with different ethnicity and living conditions. Methods: Using transthoracic echocardiogram we obtained data on 206 individuals: 103 from Atahualpa, Ecuador (living at sea level, mean age: 75 ± 4.2 years, 53 women) and 103 inhabitants from Mexico City (living at 2300 m above sea level, mean age: 75 ± 4.2 years, 52 women). Results: Significant differences between Atahualpa and Mexico were: Heart rate 66 versus 80 x’, left ventricular diastolic diameter 40.8 versus 42.7, septum thickness 9.8 versus 11.6, posterior wall 10.2 versus 11.8, stroke volume cc 53.0 versus 46.6, left atrial volume 25. 8 versus 33.6, systolic pressure of the pulmonary artery 27.1 versus 42.0, cardiac output 3.1 versus 4.8, E/Ea ratio 6.4 versus 9.2, and mitral area 3.4 versus 3.0. Comparison of diastolic function between Atahualpa and Mexico was: Type 0; 2 versus 1. Type 1; 96 versus 81. Type 2; 5 versus 20 and Type 3; 0 versus 1. Conclusion: Echocardiographic characteristics that identify adaptive changes of the heart in Atahualpa are coincident with people living at sea level and with good physical activity, and Mexico City, with inhabitants living at high altitudes and exposed to environmental pollution. The systolic function of the left ventricle was similar in both populations, indicating that adaptive changes allow the heart to be effective in different circumstances of the ecosystem.

Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Adaptation, Physiological/physiology , Echocardiography , Heart/diagnostic imaging , Exercise , Cross-Sectional Studies , Ecuador , Environmental Exposure/adverse effects , Environmental Pollution/adverse effects , Altitude , Mexico
Rev. chil. enferm. respir ; 36(3): 204-210, set. 2020. graf
Article in Spanish | LILACS | ID: biblio-1138553


INTRODUCCIÓN: Las placas pleurales por fibras de asbesto se caracterizan por lesiones compuestas por tejido fibroso que se ubican en la pleura parietal. Suelen aparecer hasta en un 3% a 58% de los trabajadores que estuvieron expuestos a fibras de asbesto, y en un 0,5% a 8% en población general. El OBJETIVO de este artículo es presentar dos casos clínicos de pacientes a los que se les detectó en la radiografía de tórax alteraciones pleurales posiblemente asociadas a la exposición a fibras de asbesto. CASOS CLÍNICOS: Caso 1. Paciente de sexo masculino de 49 años, trabajador de la construcción con antecedentes de exposición a fibras de asbesto. Se le realizó una radiografía de tórax con técnica OIT (Organización Internacional del Trabajo), la que evidenció alteraciones pleurales focales. Una tomografía axial computarizada de tórax, confirmó la presencia de placas pleurales. Caso 2. Paciente de sexo femenino de 79 años, jefa de hogar, sin exposición laboral conocida a fibras de asbesto. En una radiografía de tórax anteroposterior, se observó la presencia de una placa pleural focal. Se solicitó una tomografía axial computarizada de tórax, la que confirmó la presencia de placas pleurales. CONCLUSIÓN: La radiografía de tórax con técnica OIT es el instrumento básico para la identificación de enfermedades relacionadas con la exposición a fibra de asbesto. El estudio debe ser completado con una tomografía axial computarizada de tórax cuya sensibilidad es mayor permitiendo detectar tempranamente las anomalías pleurales. Es fundamental la historia ocupacional detallada ya que constituye el método más fiable y práctico para medir la exposición a fibra de asbesto.

INTRODUCTION: Asbestos fiber pleural plaque is characterized by lesions composed of fibrous tissue that are located in the parietal pleura. They usually appear in up to 3 to 58% of workers who were exposed to asbestos fiber, and 0.5 to 8% in the general population. The OBJECTIVE of this article is to present two clinical cases of patients who were detected in the chest radiograph pleural alterations associated with exposure to asbestos fibers. CLINICAL CASES: First case: 49-year-old male patient, building worker with a history of exposure to asbestos fibers. Focal pleural alterations were detected by a chest x-ray performed according ILO (International Labour Organization) technique. The presence of pleural plaques was confirmed in a computed tomography of the chest. Second case: Holder, without occupational exposure to asbestos fibers. An anteroposterior chest radiography showed the presence of focal pleural plaque in a CT scan of the chest. CONCLUSION: Chest x-ray with ILO technique is the basic instrument for the identification of diseases related to asbestos fiber exposure. The study should be completed with a CT scan of the chest whose sensitivity is greater, allowing early detection of pleural abnormalities. Detailed occupational history is essential, as it is the most reliable and practical method to measure asbestos fiber exposure.

Humans , Male , Female , Middle Aged , Aged , Pleural Diseases/etiology , Pleural Diseases/diagnostic imaging , Asbestos/adverse effects , Pleura/pathology , Radiography, Thoracic , Tomography, X-Ray Computed , Inhalation Exposure , Environmental Exposure/adverse effects
Arch. argent. pediatr ; 118(1): e48-e52, 2020-02-00. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1095869


El síndrome de Guillain-Barré constituye una entidad de etiología diversa, que se caracteriza por debilidad muscular aguda, simétrica, ascendente y progresiva, y es una de las polineuropatías adquiridas más frecuentes en la infancia. Entre los diagnósticos diferenciales, deben considerarse las neuropatías producidas por metales pesados, mercurio y plomo, y metaloides, como el arsénico, plaguicidas organofosforados y el tetracloruro de carbono.Se presenta a un paciente de 14 años con diagnóstico de síndrome de Guillain-Barré sin respuesta al tratamiento convencional con gammaglobulina. Considerando otras etiologías, se sospechó neuropatía producida por metales pesados, y se confirmó intoxicación por mercurio.El objetivo de esta presentación es concientizar a los pediatras acerca del impacto de los tóxicos ambientales en la salud infantil para realizar un diagnóstico precoz pesquisando datos clave a través de la historia clínica ambiental

Guillain-Barré syndrome is an entity of diverse etiology, characterized by acute, symmetric, ascending and progressive muscle weakness, being one of the most frequent acquired polyneuropathies in childhood. Neuropathies produced by heavy metals, mercury and lead, and metalloids, such as arsenic, organophosphorus pesticides and carbon tetrachloride, should be considered among the differential diagnoses.We present a 14-year-old patient with a presumptive diagnosis of Guillain-Barré syndrome without response to conventional treatment with gamma globulin. Considering other etiologies, heavy metal neuropathy was suspected, and mercury poisoning was confirmed.The aim of this presentation is to make pediatricians aware about the impact of environmental toxic agents on children's health in order to make an early diagnosis by researching key data through the environmental clinical history.

Humans , Male , Adolescent , Mercury Poisoning, Nervous System/diagnosis , Polyneuropathies , Heavy Metal Poisoning, Nervous System/drug therapy , Environmental Exposure/adverse effects
Rev. Paul. Pediatr. (Ed. Port., Online) ; 38: e2018177, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057227


ABSTRACT Objective: To investigate context of overweight adolescents from the semiarid and rural areas of Pernambuco, considering the multifactorial nature of the determinants of being overweight, and the food and nutritional insecurity conditions of the region. Methods: A population based cross-sectional study was conducted from September to October 2015. The nutritional status of adolescents was assessed by body mass index (BMI) and classified by the BMI/Age indicator, according to sex. To analyze the factors associated with being overweight, the variables were grouped into: socioeconomic, demographic, environmental, lifestyle, psychological, biological and food and nutritional security. Poisson regression was used to verify the association between being overweight and independent variables. Results: The prevalence of excessive weight found was 20.1%, namely: 13.4% overweight and 6.7% obese. After adjusting for the confounding variables, the variables: occupancy situation (rented house), alcohol consumption, food security and light food insecurity, body perception (overweight and obese) and age range (10 to 14 years), were associated with being overweight. High food and nutritional insecurity was identified in 80.4% of the population. The moderate and severe forms were more frequent, and precarious social conditions were still prevalent in the region. Conclusions: The prevalence of being overweight was high, exceeding the expected for a population with better living conditions. The determinants of being overweight were: alcohol consumption, occupancy situation, self-perceived weight, age and food security/mild food insecurity.

RESUMO Objetivo: Investigar o excesso de peso em adolescentes do Sertão e Agreste de Pernambuco, considerando a multifatoriedade dos determinantes do excesso de peso e as condições de insegurança alimentar e nutricional da região. Métodos: Estudo transversal, de base populacional, realizado no período de setembro a outubro de 2015. O estado nutricional dos adolescentes foi avaliado pelo índice de massa corpórea (IMC) e classificado pelo indicador IMC/idade, segundo o sexo. Para analisar os fatores associados ao excesso de peso, as variáveis foram agrupadas em: socioeconômicas, demográficas, ambientais, de estilo de vida, psicológicas, biológicas e segurança alimentar e nutricional. A regressão de Poisson foi utilizada para verificar a associação entre o excesso de peso e as variáveis independentes. Resultados: A prevalência de excesso de peso encontrada foi de 20,1%, sendo 13,4% de sobrepeso e 6,7% de obesidade. Após o ajuste para as variáveis de confusão, as variáveis regime de ocupação (casa cedida, alugada), consumo de álcool, segurança alimentar, insegurança alimentar leve, percepção corporal (sobrepeso e obesidade) e faixa etária (10 a 14 anos) mostraram-se associadas ao excesso de peso. Destaca-se a elevada insegurança alimentar e nutricional, em 80,4% da população, sendo as formas moderadas e graves as mais frequentes, como também as precárias condições sociais ainda prevalentes na região. Conclusões: A prevalência de excesso de peso foi elevada, superando o esperado para uma população com melhores condições de vida. Os determinantes do excesso de peso foram: consumo de álcool, regime de ocupação, autopercepção do peso, faixa etária e segurança alimentar/insegurança alimentar leve.

Humans , Male , Female , Child , Adolescent , Nutritional Status/physiology , Overweight/epidemiology , Food Supply/standards , Self Concept , Socioeconomic Factors , Brazil/epidemiology , Body Mass Index , Demography/trends , Prevalence , Cross-Sectional Studies , Environmental Exposure/adverse effects , Overweight/psychology , Underage Drinking/psychology , Food Supply/statistics & numerical data , Life Style , Obesity/epidemiology
Article in English | WPRIM | ID: wpr-880305


BACKGROUND@#Particulate matter (PM) < 2.5 μm (PM@*METHODS@#We obtained DNA methylation and exercise data of 496 participants (aged between 30 and 70 years) from the Taiwan Biobank (TWB) database. We also extracted PM@*RESULTS@#DLEC1 methylation and PM@*CONCLUSIONS@#We found significant positive associations between PM

Adult , Aged , Air Pollutants/adverse effects , DNA Methylation/drug effects , Environmental Exposure/adverse effects , Exercise , Female , Humans , Male , Middle Aged , Particulate Matter/adverse effects , Taiwan , Tumor Suppressor Proteins/metabolism
Ciênc. Saúde Colet ; 25(supl.2): 4225-4230, Mar. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1133185


Abstract There is credible evidence that the 1984-Bhopal-methyl isocyanate (MIC)-gas-exposed long-term survivors and their offspring born post-exposure are susceptible to infectious/communicable and non-communicable diseases. Bhopal's COVID-19 fatality rate suggests that the MIC-gas tragedy survivors are at higher risk, owing to a weakened immune system and co-morbidities. This situation emboldened us to ponder over what we know, what we don't, and what we should know about their susceptibility to COVID-19. This article aims at answering these three questions that emerge in the minds of public health officials concerning prevention strategies against COVID-19 and health promotion in the Bhopal MIC-affected population (BMAP). Our views and opinions presented in this article will draw attention to prevent and reduce the consequences of COVID-19 in BMAP. From the perspective of COVID-19 prophylaxis, the high-risk individuals from BMAP with co-morbidities need to be identified through a door-to-door visit to the severely gas-affected regions and advised to maintain good respiratory hygiene, regular intake of immune-boosting diet, and follow healthy lifestyle practices.

Resumo Há evidências plausíveis de que os sobreviventes a longo prazo da exposição a gás de 1984 e isocianato de metila (CIM), em Bhopal, e seus filhos nascidos após esse fato estão suscetíveis a doenças infecciosas/transmissíveis e não transmissíveis. A taxa de fatalidade COVID-19 de Bhopal sugere que os sobreviventes da tragédia do gás MIC estão em maior risco, devido a um sistema imunológico enfraquecido e comorbidades. Essa situação nos encorajou a refletir sobre o que sabemos, o que não sabemos e o que devemos saber sobre a suscetibilidade deles ao COVID-19. Este artigo objetiva responder a essas três perguntas que surgem na mente dos funcionários de saúde pública sobre estratégias de prevenção contra o COVID-19 e promoção da saúde na população afetada pelo Bhopal MIC (BMAP). Nossas visões e opiniões apresentadas neste artigo chamam a atenção para prevenir e reduzir as consequências do COVID-19 no BMAP. Da perspectiva da profilaxia com COVID-19, os indivíduos de alto risco do BMAP com condições comórbidas precisam ser identificados por meio de uma visita de porta em porta nas regiões severamente afetadas por gases e aconselhados a manter uma boa higiene respiratória, ingestão regular de dieta que estimule o sistema imunológico e seguir práticas de estilo de vida saudáveis.

Humans , Pneumonia, Viral/prevention & control , Survivors , Isocyanates/toxicity , Coronavirus Infections/prevention & control , Disease Susceptibility , Environmental Exposure/adverse effects , Pandemics/prevention & control , Pneumonia, Viral/transmission , Pneumonia, Viral/epidemiology , Self Care , Communicable Disease Control , Immunocompromised Host , Coronavirus Infections , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Vulnerable Populations , Disasters , Betacoronavirus , India/epidemiology
Rev. saúde pública (Online) ; 54: 71, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1127243


ABSTRACT OBJECTIVE To analyze the many factors regarding socioeconomic and healthcare-related variables linked to maternal diseases and the possible impact of the environmental disaster of Mariana, given the prenatal exposure to different water sources for human consumption that were associated with low birthweight in full-term live births in the Municipal Hospital of Governador Valadares, Minas Gerais. METHODS Case-control study, carried out with live births at the Municipal Hospital of Governador Valadares, from May 2017 to July 2018. The case group consisted of full-term live births and low birthweight, and the control group consisted of full-term live births with adequate weight, matched by gender and date of birth. For each case, two controls were selected. Data collection was performed through interviews with the puerperal women, and complementary information was obtained by analyzing the prenatal card and medical records. For data analysis, logistic regression was performed. RESULTS The study included 65 live births from the case group and 130 from the control group. After the analysis was adjusted for other factors under study, we found that the higher risks of low birthweight are associated with the first childbirth (OR = 2.033; 95%CI = 1.047-3.948; p = 0.036), smoking during pregnancy (OR = 2.850; 95%CI = 1.013-8.021; p = 0.047) and consumption of water supplied by the municipalities affected by the tailings from the Fundão dam failure (RC = 2.444; 95%CI = 1.203-4.965; p = 0.013). CONCLUSIONS The variables "water consumed during pregnancy," "previous pregnancies" and "maternal smoking" were associated with low birthweight in the population studied. The importance of epidemiological studies that assess water quality and its adverse health effects is reinforced, as well as greater prenatal control of first-time pregnant women and greater support of policies against smoking, especially during pregnancy.

RESUMO OBJETIVO Analisar os fatores socioeconômicos, demográficos, ambientais, reprodutivos, comportamentais, de assistência à saúde, doenças maternas e, sobretudo, o possível impacto do desastre ambiental ocorrido em Mariana, pela exposição pré-natal a diferentes fontes de água para consumo humano, associados ao baixo peso ao nascer em nascidos vivos a termo no Hospital Municipal de Governador Valadares, Minas Gerais. MÉTODOS Estudo caso-controle, realizado com nascidos vivos no Hospital Municipal de Governador Valadares, no período de maio de 2017 a julho de 2018. O grupo caso foi composto por nascidos vivos a termo e baixo peso ao nascer e o grupo controle, por nascidos vivos a termo e com peso adequado, pareados por sexo e data de nascimento. Para cada caso foram selecionados dois controles. A coleta de dados foi realizada por meio de entrevista com as puérperas e informações complementares foram obtidas pela análise do cartão de pré-natal e prontuários. Para análise dos dados, foi realizada regressão logística. RESULTADOS Participaram do estudo 65 nascidos vivos pertencentes ao grupo caso e 130 ao grupo controle. Após a análise ajustada para os demais fatores em estudo, verificou-se que os riscos mais elevados de baixo peso ao nascer estão associados aos primeiros filhos (RC = 2,033; IC95% = 1,047-3,948; p = 0,036) e aos nascidos vivos cujas mães utilizaram cigarro durante a gestação (RC = 2,850; IC95% = 1,013-8,021; p = 0,047) e consumiram a água fornecida pelos serviços de abastecimento dos municípios atingidos pelos rejeitos provenientes do rompimento da barragem de Fundão (RC = 2,444; IC95% = 1,203-4,965; p = 0,013). CONCLUSÕES A água consumida na gestação, primiparidade e tabagismo materno apresentaram associação com baixo peso ao nascer na população estudada. Reforça-se a importância de estudos epidemiológicos, que avaliem a qualidade da água e seus efeitos adversos na saúde, assim como maior controle no pré-natal das gestantes que terão o primeiro filho e maior apoio das políticas contra o tabagismo, especialmente durante a gravidez.

Humans , Female , Pregnancy , Infant, Newborn , Birth Weight , Infant, Low Birth Weight , Pregnancy Complications/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Case-Control Studies , Cities , Environmental Exposure/adverse effects
Rev. argent. microbiol ; 51(4): 324-333, dic. 2019. tab
Article in English | LILACS, BNUY, UY-BNMED | ID: biblio-1057396


Abstract Leptospirosis is important in Uruguay due to the economic loss caused by the diseases of production animals, mainly bovines, and also due to frequent human infection. We decided to study anti-Leptospira antibodies in the sera of dairy workers, rice laborers, veterinarians, suburban slum dwellers and garbage recyclers. Our aims were to estimate the seroprevalence of infection by Leptospira spp. in these people at risk, the relative importance of the known risk factors associated with infection, and the impact of human infections in each setting. Groups at risk were identified and 35 visits to their locations were made, conducting field surveys and exchange talks for information and education. Simple epidemiological questionnaires were administered and sera samples were taken from 308 persons. The microagglutination Technique (MAT) and the IgM Indirect Immunofluorescence (IIF) assay were employed to detect antibodies. Environmental water samples, canine and equine sera were also examined. More than 45% of human sera were reactive and the studied groups were confirmed to be widely exposed to infection. Female sera were frequently reactive, though most illnesses occur in men, and the most severe cases in elderly males; the emergence and evolution of the disease may strongly depend on the host condition and functions. Animal contact and unsafe water usage were the main identified risk factors to be considered in prevention. Fifty per cent of the studied horses showed a positive MAT reaction. The underdiagnosis of the illness and its long-term symptoms require further study, as well as greater health and social attention efforts.

Resumen La leptospirosis es importante en Uruguay por las pérdidas económicas que ocasionan las enfermedades en los animales de producción, principalmente en los bovinos, y a causa de la frecuente infección humana. Decidimos estudiar anticuerpos anti -Leptospira en trabajadores de tambo y de plantaciones de arroz, así como en veterinarios, habitantes de asentamientos y recicladores de residuos. Buscamos evaluar la importancia de distintos factores de riesgo conocidos asociados con la infección por Leptospira spp., y estimar la frecuencia y el impacto de las infecciones humanas en la población expuesta. Se efectuaron 35 visitas a colectivos de riesgo, realizando relevamientos de campo e intercambios educativos, llenando formularios epidemiológicos sencillos y tomando muestras de sangre a 308 personas. Se investigaron anticuerpos séricos con técnicas de microaglutinación (MAT) e inmunofluorescencia indirecta para IgM. Se examinaron también, muestras de agua ambiental, y sueros caninos y equinos. Más del 45% de los sueros humanos fueron reactivos y se confirmó que los grupos estudiados estaban ampliamente expuestos a la infección. Los sueros de mujeres fueron frecuentemente reactivos, aunque la mayoría de las enfermedades ocurren en varones, y los casos más graves en varones añosos. La emergencia y la evolución de la afección pueden depender fuertemente del estado del huésped y su respuesta. El contacto con animales y el uso de agua insegura fueron los principales factores de riesgo identificados para considerar en la prevención. El 50% de los sueros equinos fueron reactivos por MAT. Es necesario incrementar los esfuerzos de atención social y sanitaria en estos sectores, superar el subdiagnóstico y estudiar la evolución y la sintomatología a largo plazo de los pacientes.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Leptospira/immunology , Leptospirosis/prevention & control , Leptospirosis/blood , Leptospirosis/epidemiology , Antibodies, Bacterial/blood , Social Conditions , Uruguay/epidemiology , Seroepidemiologic Studies , Risk Factors , Occupational Exposure/adverse effects , Environmental Exposure/adverse effects , Leptospirosis/etiology
Ciênc. Saúde Colet ; 24(11): 4133-4140, nov. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1039528


Resumo O objetivo deste artigo é avaliar o impacto das emissões da queima da cana-de-açúcar sobre o número de internações hospitalares por doenças respiratórias em uma região canavieira. Registros de internações hospitalares por doenças respiratórias foram adquiridas a partir da base de dados referentes ao sistema de informações hospitalares do sistema único de saúde (SIH-SUS), no período de 28 de março de 2011 a 28 de dezembro de 2012. Níveis de MP10, NO2, O3, temperatura e umidade relativa foram registradas. Modelos de regressão logística foram construídos para analisar a associação entre o número total de internações, poluentes atmosféricos e variáveis meteorológicas. Foram registradas 1.179 internações, dentre elas a pneumonia mostrou aumento significativo no período de queima (p = 0,005). Neste mesmo período observou-se que o cluster MP10 e NO2 influenciou 67,9% (IC95%: 11,111-2,537), seguido do cluster MP10, NO2, O3 e temperatura que influenciou 91,1% (IC95%: 1,116; 3,271) no número total de internações. Durante o período de queima houve maior número de internações por doenças respiratórias, principalmente de pneumonia, quando foi observada a influência dos poluentes e temperatura no processo de adoecimento da população.

Abstract The scope of this article is to evaluate the impact of emissions from sugarcane burning on hospital admission numbers for respiratory diseases in a sugarcane region. Hospital admission records for respiratory diseases were acquired from the database of the Hospital Information System of the Unified Health System (SIH-SUS) in the period from March 28, 2011 to December 28, 2012. Levels of PM10, NO2, O3, Temperature and Relative Humidity were recorded. Logistic regression models were created to analyze the association between the total number of hospitalizations, atmospheric pollutants and meteorological variables. A total of 1,179 hospitalization admissions were recorded, with a significant increase in cases of pneumonia in the burning period (p = 0.005). Likewise, it was observed that the cluster of PM10 and NO2 was influenced 67.9% (95% CI: 11.111-2.537) followed by cluster PM10, NO2, O3 and Temperature that influenced 91.1% (95% CI: 1.116; 3.271) in the total number of hospitalization admissions. During the sugarcane burning period there were more hospitalization admissions due to respiratory tract diseases, mainly pneumonia, where the influence of air pollutants and temperature in the process of illness in the population was detected.

Humans , Pneumonia/epidemiology , Respiratory Tract Diseases/epidemiology , Saccharum , Environmental Exposure/adverse effects , Temperature , Brazil , Databases, Factual , Air Pollutants/toxicity , Particulate Matter/toxicity , Fires , Hospitalization/statistics & numerical data , Humidity , National Health Programs
Salud pública Méx ; 61(5): 692-697, sep.-oct. 2019.
Article in English | LILACS | ID: biblio-1127333


Abstract: Bisphenol A (BPA), found in plastics and epoxy resins, is one of the most studied chemicals. BPA is regarded as an endocrine disruptor and has been related to adverse health effects in humans. However, some regulatory agencies around the world have concluded that BPA is safe at current human exposure levels. As the scientific community attempts to settle the debate on BPA's health effects, regulatory agencies have been put into a challenging public health policy situation. The United States has implemented no regulatory actions due to safety concerns, while Europe has used the precautionary principle to guide its regulation in the face of scientific uncertainty. In this paper, we explore the debate surrounding BPA regulation and the possibility for countries to introduce guidelines, using Mexico as an example. Policy change determinants analysis suggest that countries can and should impose regulations on BPA.

Resumen: El bisfenol A (BPA), presente en plásticos y resinas epoxi, es uno de los químicos más estudiados. Se considera un disruptor endocrino y se ha relacionado con efectos adversos para la salud humana. Algunas agencias regulatorias en el mundo han concluido que el BPA es seguro a los niveles de exposición humana actuales. Mientas la comunidad científica intenta resolver el debate sobre dichos efectos, las agencias regulatorias enfrentan una difícil situación de política pública. Los Estados Unidos de América no han implementado acciones reglamentarias por razones precautorias, mientras que Europa ha utilizado el principio precautorio para guiar su regulación ante la incertidumbre científica. En este documento exploramos el debate que rodea la regulación del BPA y la posibilidad de que los países introduzcan directrices, usando a México como ejemplo. El análisis de los determinantes del cambio de políticas sugiere que los países pueden y deben regular el BPA.

Humans , Phenols/toxicity , Benzhydryl Compounds/toxicity , Environmental Exposure/adverse effects , Endocrine Disruptors/toxicity , Legislation, Drug , Public Policy/legislation & jurisprudence , United States , Europe , Mexico
Ciênc. Saúde Colet ; 24(8): 3079-3088, ago. 2019. graf
Article in Portuguese | LILACS | ID: biblio-1011896


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.

Humans , Environmental Monitoring/methods , Air Pollution, Indoor/analysis , Cooking/statistics & numerical data , Environmental Exposure/analysis , Respiratory Tract Diseases/etiology , Respiratory Tract Diseases/epidemiology , Socioeconomic Factors , Ventilation/standards , Wood , Brazil/epidemiology , Air Pollution, Indoor/adverse effects , Environmental Exposure/adverse effects , Neoplasms/etiology , Neoplasms/epidemiology
Rev. chil. infectol ; 36(2): 145-166, abr. 2019. tab
Article in Spanish | LILACS | ID: biblio-1003664


Resumen El enfrentamiento del diagnóstico diferencial y etiológico de las enfermedades infecciosas de los pacientes con cáncer, incluyendo los receptores de trasplante de precursores hematopoyéticos (TPH), debe corresponder a una decisión informada, oportuna y que repercuta directamente en una conducta médica que determine una mejor sobrevida y calidad de vida de los pacientes. El objetivo de este trabajo fue aportar en el manejo de estos pacientes desarrollando una herramienta útil al médico clínico para tomar estas decisiones. Para ello se agruparon las infecciones por sistemas comprometidos diferenciando los posibles agentes etiológicos en bacterias, virus, hongos y parásitos, explicitando los exámenes diagnósticos más relevantes, mencionando la o las técnicas recomendadas, junto con el tipo de muestra óptima para su adecuado procesamiento. De manera adicional, se incorporó el ítem "nivel de requerimiento" para sugerir lo que, a juicio de los autores y la evidencia existente, debe estar presente obligatoriamente en el centro o puede ser derivable a otro laboratorio.

The confrontation of the differential and etiological diagnosis of the infectious diseases of cancer patients, including hematopoietic stem cells transplant (HSCT) recipients, must correspond to an informed, timely decision that directly affects medical behavior that determines a better survival and quality of life for patients. The main goal of this work was to contribute to the management of these patients developing a useful tool for the clinician to make these decisions. For that, infections were grouped by compromised systems, differentiating the possible etiological agents in bacteria, viruses, fungi and parasites, highlighting the relevant diagnostic tests, mentioning the recommended techniques together with the optimal sample type for proper processing. In addition, under each group of techniques we added the item "level of requirement" to suggest what, in the opinion of the authors and the existing evidence, must be mandatory to have at local level or can be derivable to another laboratory.

Humans , Laboratories, Hospital/standards , Cross Infection/diagnosis , Cross Infection/microbiology , Hematopoietic Stem Cell Transplantation/adverse effects , Neoplasms/complications , Biopsy/standards , Cross Infection/therapy , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/standards , Environmental Exposure/adverse effects , Immunocompetence , Neoplasms/therapy
Rev. chil. infectol ; 36(2): 126-138, abr. 2019. graf
Article in Spanish | LILACS | ID: biblio-1003663


Resumen El ambiente hospitalario es una fuente potencial de exposición a patógenos como bacterias, hongos y parásitos, que pueden provocar infecciones en pacientes con cáncer incluyendo receptores de trasplante de precursores hematopoyéticos. Para aminorar este riesgo, se deben tener en cuenta los elementos de diseño, construcción y emplazamiento del área de atención de pacientes. Se entregan recomendaciones para proveer ambientes seguros, incluyendo características y uso de ambiente protegido, la definición de procesos críticos, equipos clínicos destinados a la atención de pacientes, sugerencias de ámbitos a supervisar y aspectos relativos a la calidad microbiológica del aire y agua.

The hospital environment is a potential source of exposure to pathogens such as bacteria, fungi and parasites that can cause infections in patients with cancer including transplanted hematopoietic precursors. To mitigate this risk, the design, construction and location elements of the patient care area must be taken into account. Recommendations are given to provide safe environments, including aspects related to characteristics and use of a protected environment, the definition of critical processes, clinical teams dedicated to the care of patients, suggestions of areas to be monitored, the microbiological quality of air and water.

Humans , Cross Infection/microbiology , Cross Infection/prevention & control , Hematopoietic Stem Cell Transplantation/adverse effects , Equipment and Supplies, Hospital/microbiology , Hospital Design and Construction/methods , Neoplasms/complications , Water Microbiology , Risk Factors , Infection Control/methods , Risk Assessment , Air Microbiology , Environmental Exposure/adverse effects , Immunocompetence , Neoplasms/therapy
Medicina (B.Aires) ; 79(2): 123-136, abr. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1002618


En los últimos años hubo un aumento significativo en la prevalencia de las enfermedades alérgicas pese a los avances en la comprensión de la patogénesis, la divulgación de guías para su control y tratamiento y la aparición de nuevos fármacos. La raz ón para este aumento no está totalmente estable cida, pero se considera que múltiples factores ambientales podrían estar involucrados en ello. El aire inspirado contiene numerosos agentes nocivos además de alérgenos ambientales; el asma y la rinitis alérgica son las principales expresiones clínicas respiratorias inmediatas posteriores a su inhalación. En la antropósfera, el entorno de la superficie terrestre habitada por los humanos, se han alterado los equilibrios naturales por la emisión de múltiples sustancias y se ha producido un creciente cambio climático. Este fenómeno global influye en la calidad del aire y consecuentemente en el desarrollo de enfermedades respiratorias. Dado que la bibliografía sobre el tema del control ambiental es muy amplia, y en ocasiones difícil de interpretar para poder realizar indicaciones precisas, válidas y sencillas de cumplir por parte de los pacientes, cuatro sociedades científicas de la República Argentina, dedicadas a este tipo de enfermedades, elaboraron un documento con información de fácil acceso a todo profesional médico que trate asma y/o rinitis, que expone medidas prácticas para los enfermos y alerta a los distintos actores involucrados en la salud pública acerca de las necesidades insatisfechas en este tema tan complejo, a fin de poder elaborar una agenda para su posible resolución.

In recent years there has been a significant increase in the prevalence of allergic diseases despite advances in the understanding of the pathogenesis, the dissemination of guidelines for its management and the emergence of new drugs. The reasons for this increase are not fully established, but it is suggested that multiple environmental factors may be involved. Inhaled air contains numerous harmful agents in addition to environmental allergens. The main immediate respiratory clinical expression after inhaling this contaminated air is asthma and rhinitis. The activity of human beings has altered the outdoor environment by the emission of multiple pollutants and has produced an increasing climate change. It also has a notable impact on the development of respiratory pathology and the modification of air quality. The bibliography on the subject of environmental control is very broad and sometimes difficult to interpret. In order to be able to make precise, valid and simple indications for patients to accomplish with, four scientific societies of the Argentine Republic that deal with this type of diseases, have elaborated a document that contains information of easy access to all medical personal involved in the treatment of patients with asthma and / or rhinitis, that provides practical measures for the patients and the different public health systems about unmet needs in this complex issue.

Humans , Respiratory Tract Diseases/etiology , Allergens/adverse effects , Environmental Exposure/adverse effects , Asthma/etiology , Climate Change , Risk Factors , Air Pollutants/adverse effects
Rev. chil. pediatr ; 90(2): 166-174, abr. 2019. tab
Article in Spanish | LILACS | ID: biblio-1003734


INTRODUCCIÓN: Santiago de Chile con 7 millones de habitantes alcanza elevados niveles de contaminación atmosférica en invierno, el material particulado habitualmente excede los estándares de la OMS. OBJETIVO: Evaluar la influencia de la contaminación atmosférica por material particulado en las hospitalizaciones por enfermedades respiratorias en niños, entre 2001 y 2005 en la Región Metropolitana de Chile, independientemente de la presencia ambiental de virus sincicial respiratorio (VRS). MATERIAL Y MÉTODO: 72.479 hospitalizaciones públicas y privadas por enfermedades respiratorias de niños menores de 15 años residentes en la región del estudio se analizaron con un diseño de caso control alternante, con estratificación temporal. Se evaluó principalmente: hospitalizaciones por enfermedades respiratorias (J00-J99), neumonía (J12-J18); asma (J21.0 - J21.9) y bronquiolitis (J45 - J46). Recopilándose diariamente temperatura, MP10, MP2,5, ozono, virus respiratorios (VRS) y humedad ambientales. RESULTADOS: Los promedios de MP10 y MP2,5 fueron 81,5 y 41,2 pg/m3 respectivamente. El promedio de temperatura fue 12,8 °C y de la humedad del aire 72,6 %. Un aumento de 10 pg/m3 de MP25 con 1 y 2 días de rezago se asoció con un incremento de las hospitalizaciones por enfermedades respiratorias cercano a 2%, este porcentaje aumentó a 5% cuando la exposición fue con 8 días de rezago, reflejando sinergismo entre material particulado y virus respiratorio (VRS). CONCLUSIÓN: La exposición breve a contaminación atmosférica puede provocar hospitalizaciones por enfermedades respiratorias en niños.

INTRODUCTION: With seven million inhabitants, Santiago de Chile reaches high levels of air pollution in winter, the particulate matter usually exceeds WHO standards. OBJECTIVE: To assess the influence of air pollution caused by particulate matter on children's hospitalizations due to respiratory diseases between 2001 and 2005 in the Metropolitan Region of Chile, independently from the environmental presence of respiratory syncytial virus (RSV). MATERIAL AND METHOD: 72,479 public and private hospitalizations due to respiratory diseases of children under 15 years of age residing in the study region were analyzed using a time-stratified alternating case-control design. The main evaluations were: hospitalizations due to respiratory diseases (J00-J99), pneumonia (J12-J18); asthma (J21.0 - J21.9), and bronchiolitis (J45 - J46). Daily compilation of temperature data, PM10, PM2,5, ozone, respiratory virus (RSV), and environmental humidity. RESULTS: Mean values of PM10 and PM2.5 were 81.5 and 41.2 pg/m3 respec tively. The average temperature was 12.8 °C and air humidity 72.6%. An increase of 10 pg/m3 of PM25 with one and two days of lag was associated with an hospitalizations increase due to respiratory diseases close to 2%, this percentage increased to 5% when the exposure was with eight days of lag, reflecting synergism between particulate matter and respiratory viruses (RSV). CONCLUSION: Short air pollution exposure can lead to children's hospitalizations due to respiratory diseases.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Respiratory Tract Diseases/etiology , Air Pollutants/toxicity , Air Pollution/adverse effects , Environmental Exposure/adverse effects , Particulate Matter/toxicity , Hospitalization/statistics & numerical data , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/epidemiology , Logistic Models , Chile/epidemiology , Risk Factors , Cross-Over Studies , Air Pollutants/analysis , Air Pollution/analysis , Air Pollution/statistics & numerical data , Environmental Exposure/analysis , Environmental Exposure/statistics & numerical data , Particulate Matter/analysis