Consultorio de Salud Ambiental en un Hospital Privado de Comunidad de la Ciudad de Buenos Aires / Environmental Health consulting office in a Private Community Hospital of the Buenos Aires City

En los últimos años surge el concepto de Una Sola Salud que reconoce la interdependencia sistémica al observar que los cambios en la salud humana se expresan de manera sincrónica e indivisible de la salud del ambiente. Nuevas enfermedades y daños crónicos inespecíficos ocurren a la par de la pérdida de biodiversidad y vitalidad. En las últimas décadas venimos observando el surgimiento de "adaptaciones sistémicas" que requieren un abordaje desde la clínica y la toxicología a nivel individual y desde la epidemiología de la complejidad a nivel poblacional. Luego de un largo recorrido de investigaciones, el Hospital Italiano formalizó el consultorio de Salud Ambiental con la intención de brindar respuesta a la demanda de pacientes que atribuyen síntomas y signos a la polución ambiental. (AU)

In recent years, the concept of One Health has emerged, recognizing the systemic interdependence and the changes in human health that are expressed synchronously and indivisible from the environment. New diseases and nonspecific chronic damage are occuring in parallel with the loss of biodiversity and vitality.In recent decades we have observed the appearance of "systemic adaptations" that require a clinical and toxicological approach at the individual level, and address the population level from an epidemiological and complexity science paradigm. After many years of research, the Hospital Italiano de Buenos Aires formalized the Environmental Health consulting office and the measurement of glyphosate levels, giving answer to the demand of patients who associate their signs and symptoms to environmental pollution. (AU)

Cuestiones socioambientales relacionadas con el estilo de vida y salud integral de comunidades ribereñas / Socio-environmental Aspects Associated with Lifestyle and Overall Health in Riverside Communities

Introducción: El desequilibrio en la relación entre hombre y medio ambiente puede llevar a las degradaciones ambientales y como consecuencia a fuertes impactos para la salud humana. Objetivo: Comprender el significado sobre las cuestiones socioambientales relacionadas al estilo de vida y salud integral desde la perspectiva de las comunidades ribereñas. Métodos: Estudio cualitativo basado en la teoría fundamentada en los datos, referencial teórico que comprende el Interaccionismo Simbólico. La encuesta tuvo un grupo de muestras con 24 participantes. Los datos fueron recolectados a partir de la entrevista semiestructurada y observación asistemática. Se analizaron a la luz de los procedimientos adecuados al método, a saber: codificación abierta, axial e integración. Resultados: Surgieron dos categorías: relacionando positivamente las cuestiones socioambientales con el estilo de vida y repercutiendo negativamente las relaciones socioambientales con la salud integral. Conclusión: Las repercusiones socioambientales en el estilo de vida y salud integral pueden configurarse de forma positiva o negativa a depender del significado atribuido al fenómeno por el ribereño, visto la singularidad de las acciones humanas(AU)

Introduction: The imbalanced relationship between man and the environment can lead to environmental degradation and, consequently, to strong impacts on human health. Objective: To understand the meaning about the socio-environmental issues related to the lifestyle and integral health from the perspective of the riverside communities. Methods: Qualitative study based on the grounded theory based on data, a theoretical reference that includes symbolic interactionism. The survey had a group of samples with 24 respondents. The data were collected using the semi-structured interview and asystematic observation. They were analyzed in the light of the procedures appropriate to the method; namely, open coding, axial coding, and integration. Results: Two categories emerged: positively relating socio-environmental issues to lifestyle and negatively impacting socio-environmental relationships with overall health. Conclusion: Socio-environmental repercussions in the lifestyle and overall health can be configured in a positive or negative way, depending on the meaning attributed to the phenomenon by the riverside individual, given the uniqueness of human actions(AU)

Development and validation of an environmental heat strain risk assessment (EHSRA) index using structural equation modeling based on empirical relations

BACKGROUND@#Need to a simple, available, accurate, comprehensive, and valid indicator is felt to assess thermal effects. Therefore, the present study was aimed to develop and validate the environmental heat strain risk assessment (EHSRA) index using structural equation modeling (SEM) based on empirical relations.@*METHODS@#This cross-sectional study was performed on 201 male workers in environments with various climatic conditions. The heart rate and tympanic temperature of the individuals were monitored at times of 30, 60, and 90 min after beginning the work. At these times, values of dry temperature, wet temperature, globe temperature, and air velocity were also measured and metabolism rate and clothing thermal insulation value were estimated. At the end, a theoretical model was depicted in AMOS software and obtained coefficients were applied to develop a novel index. The scores of this indicator were categorized into four risk levels via ROC curves and validate using linear regression analysis.@*RESULTS@#Indirect effect coefficients of the globe temperature, dry temperature, wet temperature, air velocity, metabolism, and clothing thermal insulation variables on the tympanic temperature were computed by 0.77, 0.75, 0.69, 0.24, 0.49, and 0.39, respectively. These coefficients were applied to develop the index. Optimal cut-off points of boundaries between risk levels included 12.02, 15.88, and 17.56. The results showed that the EHSRA index justified 75% of the variations of the tympanic temperature (R@*CONCLUSIONS@#The novel index possesses appropriate validity. It was suggested that this indicator is applied and validated in various environments in the next studies.

Aplicación de la bioética ambiental en el ejercicio profesional de la enfermería / Application of Environmental Bioethics to Professional Nursing Practice

RESUMEN Introducción: Los profesionales de enfermería, como parte del equipo de salud, deben participar activamente en las actividades de prevención de factores de riesgo ambiental, teniendo en cuenta el ejercicio ético de la profesión. Objetivo: Identificar cómo se aplica la bioética ambiental en el ejercicio profesional de la enfermería. Métodos: Revisión sistemática de artículos publicados de 2006 a 2016 en bases de datos electrónicas Academic Search Complete, CINAHL, GREENFILE, MEDLINE, SciELO y Redalyc, utilizando los descriptores "bioética", "ética", "enfermería", "medio ambiente" y "salud ambiental", en español, inglés y portugués, así como la consulta de los códigos de ética de enfermería del Comité Internacional de Enfermería y de las Asociaciones Nacionales de Enfermería de América. El análisis de datos se realizó en una base de datos en Excel. Conclusiones: La bioética ambiental es un tema que ha sido considerado por las organizaciones internacionales y nacionales de enfermería y por tanto debe estar inmerso en el ejercicio profesional de enfermería(AU)

ABSTRACT Introduction: Nursing professionals, as part of the health team, must actively participate in activities for preventing environmental risk factors, taking into account the ethical practice of the profession. Objective: To identify how environmental bioethics is applied in the professional practice of nursing. Methods: Systematic review of articles published from 2006 to 2016 in electronic databases such as Academic Search Complete, CINAHL, GREENFILE, MEDLINE, SciELO and Redalyc, using the descriptors bioética ["bioethics"], ética ["ethics"], enfermería ["nursing"], medio ambiente ["environment"], and salud ambiental ["environmental health"], in Spanish, English and Portuguese, as well as the consultation of the codes of ethics of nursing of the International Council of Nurses and the American Nurses Association. The data analysis was carried out in an Excel database. Conclusions: Environmental bioethics is an issue that has been considered by international and national nursing organizations and, therefore, must be included in the professional practice of nursing(AU)

Environmental and demographic determinants of dengue incidence in Brazil / Determinantes ambientales y demográficos asociados con la incidencia del dengue en Brasil

ABSTRACT Objective To analyze the spatial distribution of dengue fever cases within an urban area of the São Paulo State, southeast Brazil. Methods Based on a methodology created by the authors, it was possible to organize the Brazilian Census data of 2010 into a regular grid of 250x250 meters each cell. This cell was the unit of analysis. Then, the 1 688 residential addresses of autochthonous dengue cases reported in 2013 in Caraguatatuba city were geocoded to calculate the incidence rate by cell. The dependent variable was the dengue incidence rate and the independent variables were classified into two types: environmental and sociodemographic. Finally, a Zero-Inflated Negative Binomial Regression was performed using the software R. Results The statistical analysis showed an association between dengue incidence rate and the environmental variable "proximity to strategic points (junk yards, tire repair shops and deposits of recyclable materials)." Dengue was also associated to the sociodemographic variables "proportion of households with per capita income up to 3 minimum wages", "proportion of nonwhite people" and "proportion of not owned households". Conclusion Dengue is associated to several factors related to its epidemic outbreak. In this complex context, results suggest that this infectious disease is socially conditioned, since it is more likely to reach population groups with specific characteristics, notably those with low socioeconomic status.(AU)

RESUMEN Objetivo Analizar la distribución espacial de los casos de dengue dentro de un área urbana en el estado de Sao Paulo, sudeste de Brasil. Métodos Basados en una metodología creada por los autores, se organizaron los datos del censo brasileño de 2010 en una malla regular de 250x250 metros cada célula. Esta célula fue la unidad de análisis. En seguida, fueran gecodificadas todas las 1 688 residencias de los casos de dengue registrados en 2013 en la ciudad de Caraguatatuba para calcular la tasa de incidencia por célula. La variable dependiente fue la tasa de incidencia del dengue y las variables independientes fueron clasificadas en dos tipos: ambientales y sociodemográficas. Finalmente se realizó una Regresión Binomial Negativa Inflada con Ceros utilizando el software R. Resultados El análisis estadístico mostró una asociación entre la tasa de incidencia del dengue y la variable ambiental proximidad de puntos estratégicos (depósitos de chatarra, talleres de reparación de neumáticos y depósitos de materiales reciclables). El dengue también se asoció a las variables sociodemográficas proporción de hogares con ingreso per cápita de hasta 3 salarios mínimos, proporción de personas no blancas y de hogares que no sean propiedad. Conclusión Se concluyó que el dengue tiene un conjunto múltiple de factores relacionados con la aparición de sus epidemias. En el contexto de esta complejidad, los resultados sugieren que esta enfermedad infecciosa está condicionada socialmente, ya que es más probable que llegue a grupos de población con características específicas, especialmente aquellos con un nivel socioeconómico bajo.(AU)

Experimentações estéticas: o cuidado de si, do outro e do ambiente em que vivemos / Apropiaciones sociopoéticas: experimentaciones estéticas del cuidado sociopoetics / Aesthetic trials: taking care of oneself, of the other and of the environment in which we live

Objective: To present intervention research developed by the authors in the form of artistic and educational activities, called aesthetic experiments, analyzing them and their effects as a practical-theoretical set directed themselves, each other and the environment. Methods: It was built from the authors’ experience with research practices inspired by studies of The Three Ecologies and socialpoetics methodology, being used in the analysis face-to-face writing of the participants during the workshop and the answers to the questions sent by e-mail. Results: They point to the overcoming of inner fears and the discovery of personal potential to face challenges. The sensibility of the gaze and the involvement with the other as a fundamental element in the exercise of confidence in daily relationships. Conclusion: The experimentation process indicates that there is a power of the meeting, the exchange and sensibility when we privilege knowledge that is learned with the body in motion, relating to the other and the world.

Objetivo: apresentar a pesquisa-intervenção desenvolvida pelos autores em forma de atividades artísticopedagógicas, denominadas experimentações estéticas, analisando-as e seus efeitos enquanto conjunto práticoteórico voltado ao cuidado de si, do outro e do ambiente. Métodos: Construído a partir da experiência dos autores com práticas de pesquisa inspiradas nos estudos sobre as três ecologias e na metodologia sociopoética, sendo utilizada na análise a escrita presencial dos participantes durante as oficinas e as respostas deles às questões enviadas por e-mail. Resultados: Apontam para a superação dos medos internos e a descoberta das potencialidades pessoais para enfrentar desafios. A sensibilidade do olhar e o envolvimento com o outro como elemento fundamental no exercício de confiança das relações cotidianas. Conclusão: O processo de experimentação indica que existe uma potência do encontro, dos intercâmbios e da sensibilidade quando privilegiamos um conhecimento que se apreende com o corpo em movimento, relacionando-se com o outro e o mundo.

Objetivo: presentar la investigación-intervención desarrollada por los autores en forma de actividades artísticas y educativas, llamadas experimentos estéticos, analizandolos y a sus efectos enquanto um conjunto práctico-teórico dirigido al cuidado de sí, de los demás y de El medio ambiente. Métodos: Construido a partir de la experiencia de lós autores con las prácticas de investigación inspirados en los estudios sobre los tres ecologías y en metodología Sociopoética, siendo utilizados em el análisis los registros por escrito de los participantes durante el taller y las respuestas a las preguntas enviadas por e-mail. Resultados: indica la superación de los miedos internos y el descubrimiento del potencial personal para enfrentar los desafíos. La sensibilidad del ojo y la implicación con el otro como un elemento fundamental en el ejercicio de la confianza de las relaciones cotidianas. Conclusión: El proceso de experimentación indica que hay una potencia de lo encuentro, de lo intercambio y de La sensibilidad cuándo es privilegiado un conocimiento que se aprende com el cuerpo en movimiento, en relación con los demás y el mundo.

Identificación de capacidades en salud ambiental de las autoridades ambientales en Colombia / Identification of capacities in environmental health from environmental authorities in Colombia

Objetivos Elaborar un diagnóstico rápido de capacidades de las autoridades ambientales y el Ministerio de Ambiente y Desarrollo Sostenible para asumir su rol en salud ambiental con base en el modelo de capacidades del Programa de las Naciones Unidas para el Desarrollo-PNUD. Método Se utilizaron los métodos de revisión documental, entrevista dirigida en aspectos clave y una encuesta comentada. Se seleccionaron 84 entidades a las cuales se les aplicó la encuesta de manera personalizada. Se obtuvo información completa de 76 instituciones. Resultados La valoración de favorabilidad del entorno se encontró entre las categorías aceptable y poco favorable, las capacidades en gestión del conocimiento se observaron precarias y la valoración de capacidades funcionales se reportó entre adecuadas o aceptables. La valoración de capacidades específicas tuvo una valoración de deficientes o apenas aceptables. Conclusión Se apreciaron dos problemas importantes: a. Las autoridades ambientales no conciben ni ponen en práctica estas capacidades desde el modelo del PNUD, sino desde el modelo convencional del Ministerio de Ambiente y Desarrollo Sostenible, y; b. Las autoridades ambientales muestran un nivel bajo de incorporación de las políticas de salud ambiental en su campo de acción específico.(AU)

Objectives To diagnose the capabilities that environmental authorities and the Ministry of Environment and Sustainable Development have to assume their role in environmental health, based on the capacity model of the United Nations Program for Development UNDP. Method Document review, interviews on key issues and a commented survey were conducted. 84 entities were selected for a tailored survey; complete information was obtained from 76 institutions. Results The valuation of environment favorability was within the acceptable and unfavorable categories; knowledge management capabilities were found to be precarious and assessment of functional capabilities ranged between appropriate and acceptable. The assessment of specific capabilities had a rating of poor or barely acceptable. Conclusions Two major problems were found: a. The environmental authorities do not conceive or implement these capabilities based on the UNDP model but on the conventional model of the Ministry of Environment, Housing and Territorial Development; b. Environmental authorities show an incipient level of incorporation of environmental health policies in their field of action.(AU)

Dialogue summary: improving the healthiness of food environments in the Caribbean

The evidence brief on Improving the Healthiness of Food Environments was used as the starting point for the deliberations during the stakeholder dialogue. The evidence brief recognized that the relationship between environmental factors and dietary choices was complex and multifaceted, however, it positioned four issues as the most important to understanding the problem in the Caribbean:Firstly, Caribbean States were identified as net food importing countries with heavy reliance on imports as the main source of food, and this resulted in wide availability and affordability of highly-processed unhealthy foods on the domestic market;Secondly, the surrounding environment faced by some groups, including children, urban populations and the poor made them more susceptible to poor dietary choices.Thirdly, the food choices made in response to macro and micro environmental influences led to a high prevalence of diet-related NCDs which placed heavy direct and indirect cost burdens on Caribbean countries;Finally, the brief noted that despite the range of cost-effective evidence-based policy interventions available to address the various issues related to unhealthy food environments, Caribbean countries faced a number of implementation challenges that constrained their ability to mount a comprehensive response.

Los procesos sociales y medioambientales en la salud de niños asmáticos: desafíos para la ciencia y la tecnología en Cuba / Social and environmental processes in the health of asthmatic children: challenges for science and technology in Cuba

Introducción: la importancia del asma, como problema de salud, no sólo radica en que afecta a muchas personas, por su índice de mortalidad, sino por el impacto socioeconómico en todas las edades. Objetivo: realizar un análisis de los procesos sociales y medioambientales en la salud de niños asmáticos como desafíos para la ciencia y la tecnología en general y en particular para Cuba. Método: investigación documental con varios momentos: la revisión bibliográfica y documental sobre este tema y el análisis del contenido de los mismos, buscando formular inferencias a partir de la identificación de sus características en cuanto a procesos sociales y medioambientales en la salud de niños asmáticos. Conclusiones: el asma es una enfermedad crónica, cuyo curso poblacional es modificable si se actúa sobre los determinantes estructurales de la enfermedad y se generan procesos saludables medioambientales y nutricionales desde la estructura social(AU)

Introduction: The importance of asthma, as a health problem, not only concerns that it affects many people, for it mortality rate, but for the socioeconomic impact at all ages. Objective: To carry out an analysis of the social and environmental processes in the health of asthmatic children as challenges for science and technology in general and in particular in Cuba. Method: Document research with several moments: bibliographic and document review about this topic and their content analysis, aiming at formulating inferences starting from the identification of their characteristics regarding social and environmental processes on the health of asthmatic children. Conclusions: Asthma is a chronic disease, whose population course is modifiable if action is taken over the disease's structural determinants and environmental and nutritional healthy processes are generated from the social structure(AU)

Análisis preliminar de un cuestionario de evaluación de la percepción social de la contaminación atmosférica / Preliminary analysis of a questionnaire for assessing the social perception of air pollution

Objetivo Analizar las propiedades psicométricas y la organización estructural de un cuestionario diseñado para evaluar la percepción social de la contaminación del aire y de sus riesgos para la salud en el Valle de Aburrá, área geográfica donde se ha identificado una problemática ambiental asociada a la polución. Métodos Estudio descriptivo en el que se diseñó y validó un cuestionario que recogía tres dimensiones de la percepción social de la contaminación del aire (socio-territorial, socio-cognitiva y comportamental) y algunas variables sociodemográficas. Tras el estudio piloto, las dimensiones de análisis fueron organizadas en 12 categorías, conformadas por 111 ítems con escalas tipo Likert de cuatro o cinco opciones de respuesta. El instrumento fue aplicado a una muestra no probabilística de 318 participantes, los cuales eran residentes de Medellín y del municipio de Girardota. Resultados Tras el análisis factorial exploratorio (rotación varimax), el cuestionario se redujo a 68 ítems que evalúan siete dimensiones de la percepción social de la contaminación atmosférica y de sus riesgos para la salud. La varianza total explicada es del 75 % y la confiabilidad alpha de Cronbach de la prueba fue 0,9. Discusión Las dimensiones encontradas permiten aproximarse a la organización estructural de la percepción social de la polución y de sus riesgos sanitarios en el contexto de estudio. Aunque algunas dimensiones socio-cognitivas y comportamentales fueron confirmadas, la dimensión socio-territorial y la implicación personal no se configuraron como componentes estructurales y requieren ser reelaboradas conceptualmente. Resulta necesario realizar un análisis estructural confirmatorio de las dimensiones del cuestionario.

Objective To analyze the psychometric properties and the structural organization of a questionnaire designed to assess the social perception of air pollution and its health risks in the Valle de Aburrá (Colombia), a geographical area where environmental problems associated with air pollution have been identified. Methods A descriptive study was carried out, in which a questionnaire was designed and validated to determine three dimensions of social perception of air pollution: the socio-territorial dimension, the socio-cognitive dimension and the behavioral dimension. Some socio-demographical variables were also included. After the pilot study, the dimensions of the analysis were organized into 12 categories, made up of 111 items with Likert scales of four or five response options. The instrument was applied to a non-random sample of 318 participants, who were residents of Medellin city and Girardota town. Results After exploratory factor analysis (varimax rotation), the questionnaire was reduced to 68 items assessing seven dimensions of social perception of air pollution and its health risks. The total variance explained is 75 %, and the overall Cronbach's alpha reliability was 0.9. Discussion The dimensions found allow us to develop an approach to the structural organization of the social perception of air pollution in the context of study. Although some socio-cognitive and behavioral dimensions were confirmed, the socio-territorial dimension and the personal involvement variable were not configured as structural components and, conceptually, they need to be reworked. Confirmatory structural analysis of the dimensions of the questionnaire is required.

Evaluación sanitaria de factores de riesgos físicos en viviendas Petrocasas bajo un cambio de cubierta / Health evaluation of physical risk factors in petrohouses after roof replacement

Introducción: el problema de la vivienda tiene un alcance mundial. La solución del déficit cualitativo y cuantitativo de la vivienda en Cuba transita a través de diferentes soluciones. Varios asentamientos del país se han erigido con vivienda industrial prefabricada de cloruro de polivinil ­PVC- conocidas por Petrocasas. Algunos estudios reportan estrés térmico en estas viviendas, vinculado a débil ventilación y calentamiento de cierres expuestos al sol. Objetivo: realizar una evaluación de salud ambiental en factores de riesgos físicos en el ambiente interior de las viviendas relativo a la intemperie, tras un cambio del material de cubierta. Método: se plantea un estudio experimental evaluativo de factores de riesgos físicos en el ambiente interior de las viviendas petrocasas a partir de una propuesta de modificación del material de la cubierta con la intención de reducir el estrés térmico de las mismas. Fueron edificadas con este propósito dos viviendas petrocasas con igual orientación de fachada principal y diferente cubierta; ;una fue sustituida por poliestireno expandido y la otra mantiene cubierta original (aluminio y papel de asfalto).Se evaluaron comparativamente factores de riesgos físicos: ruido, componente magnético del campo electromagnético de baja frecuencia, iluminación natural, artificial, ventilación y, principalmente, microclima para valorar la eficacia del cambio introducido. La evaluación estadística se efectuó por descriptores, modelos de regresión y espectro de potencia bivariado con los paquetes estadísticos SPSS v. 17.0 y Statistica 8.0. Resultados: la vivienda Petrocasa con cubierta de aluminio ­ asfalto presenta un clima interior algo más desfavorable al bienestar térmico que aquella de poliestireno; la ventilación en ambas resulta deficiente. Conclusiones: el cambio de material de la cubierta ligera de la vivienda Petrocasa proporciona un clima interior algo más favorable al bienestar de sus residentes(AU)

Introduction: the housing problem is global in scope. Solution to qualitative and quantitative housing deficit in Cuba has been addressed from various different perspectives. Several settlements in the country have been built with prefabricated industrial houses made of polyvinyl chloride (PVC). These are known as petrohouses. Some studies have reported thermal stress inside these houses, resulting from insufficient ventilation and the heating of roofs exposed to the sun. Objective: carry out an environmental health evaluation of physical risk factors present in the indoor environment of petrohouses as compared with the outside environment after roof replacement. Method: an experimental evaluative study was conducted of physical risk factors present in the indoor environment of petrohouses based on a proposal of modification of the roof material with the purpose of reducing thermal stress. For this purpose, two petrohouses were built with the same orientation of their main facade, but different roof material. One was roofed with expanded polystyrene, while the other retained its original roof (aluminum sheets and asphalt paper). The following physical risk factors were evaluated comparatively: noise, magnetic component of the low frequency electromagnetic field, natural and artificial lighting, ventilation, and mainly microclimate, to evaluate the efficacy of the change made. Statistical evaluation was conducted with descriptors, regression models and bivariate power spectrum, using the statistical software packages SPSS v. 17.0 and Statistica v. 8.0. Results: indoor environment in the petrohouse with an aluminum-asphalt roof is somewhat more unfavorable in terms of thermal welfare than in the polystyrene-roofed house. Ventilation is deficient in both. Conclusions: roof replacement in petrohouses provides an indoor environment somewhat more favorable to the welfare of dwellers(AU)

Uma tipologia em saúde ambiental para a Região Metropolitana de São Paulo: analisando dimensões de sustentabilidade / A typology in environmental health for Metropolitan Area of São Paulo (MRSP) analysis of sustainability dimensions

A Região Metropolitana de São Paulo (RMSP) apresenta heterogênea divisão funcional entre os seus municípios em termos de atividades econômicas e demanda por serviços ambientais. Essas divisões corroboram com diferentes condições econômicas, sociais, e de saúde nos municípios desse conjunto. Neste contexto, indicadores estratégicos podem ser utilizados para qualificar as localidades municipais. Este trabalho tem como objetivo estabelecer por meio de indicadores de sustentabilidade uma tipologia em saúde ambiental para os municípios que compõem a RMSP. O estudo foi iniciado por meio do levantamento de dados secundários fornecidos por instituições públicas. Para a seleção dos indicadores foi considerada a matriz de indicadores para a saúde ambiental desenvolvida em conjunto com o PNUMA, a OMS e a USEPA, denominada de FPSEEA. Os indicadores selecionados foram submetidos à análise estatística de agrupamentos utilizando-se o software PAST. A análise empregada neste estudo foi a de Agrupamento Hierárquico (UPGMA), que possibilitou definir quatro agrupamentos principais de municípios. Os resultados obtidos apresentaram uma variedade de condições ambientais e sociais na RMSP.

The São Paulo Metropolitan Area (SPMA) shows heterogeneous functional division among its municipalities in terms of economic activities and demand for environmental services.Those divisions corroborate with economic conditions, social and health, in the municipalities as a whole. Strategic indicators can be used in the context to qualify the municipal localities. The aim of the work is to establish through sustainability indicators an environmental health typology for the ones that make the SPMA. The study was initiated by means of secondary survey supplied by public institutions. For the selection of indicators was considered the matrix of ones for environmental health developed together with the United Nations Program for the Environment PNUMA, WHO and USEPA called FPSEEA. The indicators selected were submitted to statistical cluster analysis using the software PAST. The analysis used in this study was the Hierarchical (UPGMA) that enabled to define four main municipalities clusters. The results obtained showed a variety of environmental and social conditions in the SPMA.

Características ambientais e ocupacionais do trabalho docente da rede estadual de um município brasileiro / Características ambientales y ocupacionales de la enseñanza de trabajo de la red estadual de un municipio de Brasil / Environmental and occupational characteristics of the teaching practice of the state net of a brazilian municipality

ntrodução: estudos realizados nas últimas décadas apontam uma grave situação no que diz respeito ao ambiente de trabalho docente. Objetivo: descrever as características ambientais e ocupacionais do trabalho docente da rede estadual do município de Jequié ­ BA. Métodos: estudo seccional com amostra de 300 professores da rede estadual de ensino. Para coleta de dados utilizou-se questionário padronizado, com informações sobre características sociodemográficas e referentes ao ambiente de trabalho físico e organizacional. Os dados foram analisados utilizando procedimentos da estatística descritiva como média, desvio padrão e frequência simples e relativa. Resultados: a média de idade dos entrevistados foi de 39 (DP=10,18) anos, sendo a maioria do sexo feminino.Com relação às características ambientais as queixas predominantes foram nos aspectos referentes à luminosidade inadequada (84,8 porcento), seguida pela temperatura (77,4 porcento), mobiliário (68,3 porcento) e acústica (61,7 porcento). O desgaste na relação professor-aluno foi o aspecto mais referido dentro das questões organizacionais do trabalho (55,7 porcento). A insatisfação com a profissão chega a atingir 40 porcento dos entrevistados.Conclusões: o ambiente laboral insalubre pode comprometer a qualidade do trabalho prestado e desencadear patologias temporárias ou definitivas. Os dados mostram necessidade de maior atenção por parte dos gestores públicos para adequação do ambiente de trabalho dos professores às necessidades aqui apontadas a fim de oferecer segurança e bem-estar no trabalho, além prevenir complicações de saúde e absenteísmo(AU)

Introducción: estudios realizados en las últimas décadas apuntan a una grave situación de irrespeto en el ambiente del trabajo docente. Objetivo: describir las características ambientales y ocupacionales del trabajo docente el la red estadual del município de Jequié ­ BA. Métodos: estudio seccional con una muestra de 300 profesores de la red estadual. Para la colecta de datos se utilizó un cuestionario estandarizado con informaciones sobre características sociodemográficas y referentes al ambiente de trabajo físico y organizacional. Los datos fueron analizados utilizando procedimentos de estatística descriptiva como media, desviación estándar y frecuencias simple y relativa. Resultados: la media de edad de los entrevistados fue de 39 (DP=10,18) años, siendo la mayoría del sexo femenino. Con relación a las características ambientales, las quejas predominantes fueron en los aspectos referentes a la iluminación inadequada (84,8 por ciento), seguida por la temperatura (77,4 por ciento), mobiliario (68,3 por ciento) y acústica (61,7 por ciento). El deterioro en la relación profesor-alumno fue el aspecto más referido dentro de las cuestiones organizacionales del trabajo (55,7 por ciento). La insatisfacción con la profesión llegó a alcanzar 40 por ciento de los entrevistados. Conclusiones: el ambiente laboral insalubre puede comprometer la calidad del trabajo que se proporciona y desencadenar patologías temporales o definitivas. Los datos muestran la necesidad de una mayor atención por parte de los gestores públicos para la adecuación del ambiente de trabajo de los profesores con las necesidades aquí apuntadas, a fin de ofrecer seguridad y bienestar en el trabajo y prevenir complicaciones de salud y ausentismo(AU)

Objective: To describe the environmental and occupational characteristics of the teaching practice of the state net from Jequié - BA. Methods: Sectional study with sample of 300 teachers of the teaching state net. To data collection used a standardized questionnaire, questions about sociodemographic characteristics and regarding environment of physical and organizational work. The data were analyzed using descriptive statistics procedures as mean, standard deviation and simple and relative frequency. Results: The average age of respondents was 39 (DP = 10.8) years With relation to environmental characteristics the predominant complaints were in the aspects regarding to inadequate luminosity (84.8 percent), followed by temperature (77.4 percent), furniture (68.3 percent) and acoustics (61.7 percent). Other aspects drawbacks to physical environmental of teaching practice were reported in smallest proportion. The wear on the teacher-student relationship was the most referred aspects within the organizational questions of the work (55.7 percent). The dissatisfaction with the occupation arrives to reaches 40 percent of respondents. Conclusions: The unhealthy labor environment can compromise the quality of the provided work and initiate temporary or definitive pathology. The data show necessity of greater attention by part of public managers to suitability the workplace of teachers to needs pointed here in order to offer security and well-being at work, beyond prevent health complications and absenteeism(AU)

La Maestría en Salud Ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología y las principales experiencias / Master's Degree in Environmental Health conducted at the National Institute of Hygiene, Epidemiology and Microbiology and the main lessons learned

Objetivo: presentar las principales experiencias acumuladas en la Maestría en Salud Ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología. Métodos: se realizó un estudio descriptivo de las 17 ediciones en el período comprendido desde 1990 hasta 2009. Se aplicaron técnicas cuantitativas de análisis documental, en las que se tomaron en consideración la edad, el sexo, el lugar de residencia, la profesión y la procedencia laboral de los egresados. Resultados: Se han graduado 235 estudiantes desde 1990 hasta 2009, con mayor participación de la provincia de La Habana. El sexo femenino fue el más representativo con el 59,1 por ciento y una edad promedio de 40 años. Se concibió un mejor enfoque en la evaluación y manejo de riesgos. Recibió del Ministerio de Educación Superior el aval de Maestría Certificada. La Maestría en Salud Ambiental contó con la asesoría del Centro Panamericano de Ecología Humana y Salud, y fue reconocida como curso de excelencia de la Red de Formación Ambiental para América Latina y el Caribe. Conclusión: Se han incorporado nuevos enfoques en las asignaturas con una visión integradora, multidisciplinaria e intersectorial, lo que ha contribuido al desarrollo de competencias, conocimientos y habilidades investigativas en los egresados

Objective: to present the main lessons learned from the Master's Degree in Environmental Health program conducted at the National Institute of Hygiene, Epidemiology and Microbiology. Methods: A descriptive study was performed of the 17 cycles of the Master's Degree program held between 1990 and 2009. Quantitative document analysis techniques were applied to the variables age, sex, place of residence, profession and workplace of graduates. Results: 235 students graduated from 1990 to 2009, with a predominance of graduates from the province of Havana. Female sex was the best represented with 59.1 percent and a mean age of 40. A better approach was devised for risk evaluation and management. The Ministry of Higher Education awarded the program the category of Certified Master's Degree.The Master's Degree in Environmental Health program was advised by the Pan American Center for Human Ecology and Health, and the academic excellence of the course was recognized by the Network of Environmental Education for Latin America and the Caribbean. Conclusions: The subjects taught have been enhanced with new approaches based on a comprehensive, multidisciplinary and intersectoral view, which has contributed to the development of graduates' competencies, knowledge and research skills

Evaluación de riesgo para la salud pública: nuevo instrumento de gestión ambiental para Chile / Evaluation of public health risk: A new instrument for environmental management in Chile

One of the main challenges in environmental management is to prevent the public health impact of projects that can cause pollution. To tackle this problem, the new Chilean bill on environmental management has defined the need to determine the potential health risks of a given Project. This paper gives a summary of the method used for risk evaluation and its evolution. Its incorporation in the Environmental Impact Evaluation System is proposed, to guarantee an effective prevention of the potential risks on health of new projects.

Climate change and health: methodological issues and introduction to climate epidemiology.

Climate change is a major threat to the health of current and future generations. This paper assesses the current estimations of adverse health outcomes of climate change and explores methodological issues. The study is essentially based on literature review. The estimation of disease burden does not portray an accurate picture of the problem due to methodological constraints on account of de-linking several non-climatic factors. In particular, the developing nations face greater challenges due to poor infrastructure, and lack of institutions and health services. The concept of climate epidemiology can minimize the existing research gap by adapting trans-disciplinary approach and it can establish as a new frontier for health advocacy in the larger context of global environmental change.