Exposure to chemical mixtures in Mexican children: high-risk scenarios.

In developing countries, the management of environmental toxicants is inadequate, thus, humans may be exposed to levels higher than normal levels (background levels). Therefore, the aim of this study was to evaluate the exposure level of Mexican children to dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), lead, and polycyclic aromatic hydrocarbons [using 1-hydroxypyrene (1-OHP) as exposure biomarker] and to assess the percentage of children exposed to these four compounds at concentrations higher than normal in each community studied. We performed random sampling in eight communities in Mexico (five communities in Chiapas State and three communities in San Luis Potosi State). DDT and DDE were analyzed by gas chromatography/mass spectrometry, the quantification of lead in blood was performed using atomic absorption spectrophotometry, and 1-OHP analyses were performed using HPLC with a fluorescence detector. Elevated DDT, DDE, and 1-OHP levels were found in children living in the indigenous communities of Chiapas State, while higher blood lead levels were found in two communities in San Luis Potosí. Approximately 30 % of children living in Chiapas were exposed to all four compounds at concentrations above the guidelines for each compound, whereas 48 % of children studied were exposed to all four contaminants at concentrations higher than normal in a community in San Luis Potosí State. As expected, our results showed that in hot spots, children are exposed to levels higher than normal. Therefore, child environmental health programs are urgently needed.

[Community clinical toxicology]. / Toxicología clínica comunitaria.

In some Latin American countries acute intoxication is professionally managed by specialized physicians qualified in the area. Something similar occurs with work-related chronic intoxication in the formal sector. However, a different reality prevails for the assessment of chronic intoxication of environmental origin, since it is by definition more difficult to diagnose. For treatment of acute intoxication, Toxicological Information and Care Centers have been set up, though similar bodies have not been created for chronic environmental intoxication. Therefore, in this study a model of chronic intoxication care is proposed, using multidisciplinary teams adopting a new approach, namely Community Clinical Toxicology, the goal of which would be the simultaneous care of acute intoxication which is generally treated in hospital, and environmental intoxication that is normal dealt with at community level. The ultimate goal is to take advantage of the expertise that exists in the Region in terms of Clinical Toxicology to organize community work.

Toxicología clínica comunitaria / Community Clinical Toxicology

En algunos países de América Latina las intoxicaciones agudas se manejan de manera profesional por médicos especialistas en la mate-ria. Algo similar ocurre con las intoxicaciones crónicas de origen laboral en el sector formal. No obstante, una realidad diferente ocurre en cuanto a la evaluación de las intoxicaciones crónicas de origen ambiental, dado que éstas por su naturaleza, son más difíciles de diagnosticar. Para el tratamiento de las intoxicaciones agudas se han organizado Centros de Información y Atención Toxicológica, pero para las intoxicaciones crónicas ambientales no se ha generado organismos semejantes. Por consiguiente, en este trabajo sugerimos un modelo de atención de la intoxicaciones crónicas a través de grupos multidisciplinarios bajo el esquema de una nueva disciplina: la Toxicología Clínica Comunitaria, cuyo objetivo sería la atención simultánea de las intoxicaciones agudas que generalmente se atienden en un ámbito hospitalario y de las intoxicaciones ambientales que por lo normal se presentan a nivel comunitario. El objetivo final es aprovechar la experiencia que existe en la Región en cuanto a Toxicología Clínica para organizar el trabajo comunitario.

In some Latin American countries acute intoxication is professionally managed by specialized physicians qualified in the area. Something similar occurs with work-related chronic intoxication in the formal sector. However, a different reality prevails for the assessment of chronic intoxication of environmental origin, since it is by definition more difficult to diagnose. For treatment of acute intoxication, Toxicological Information and Care Centers have been set up, though similar bodies have not been created for chronic environmental intoxication. Therefore, in this study a model of chronic intoxication care is proposed, using multidisciplinary teams adopting a new approach, namely Community Clinical Toxicology, the goal of which would be the simultaneous care of acute intoxication which is generally treated in hospital, and environmental intoxication that is normal dealt with at community level. The ultimate goal is to take advantage of the expertise that exists in the Region in terms of Clinical Toxicology to organize community work.