[Environmental pollution, climate variability and climate change: a review of health impacts on the Peruvian population]. / Contaminación ambiental, variabilidad climática y cambio climático: una revisión del impacto en la salud de la población peruana.

This article is a review of the pollution of water, air and the effect of climate change on the health of the Peruvian population. A major air pollutant is particulate matter less than 2.5 µ (PM 2.5). In Lima, 2,300 premature deaths annually are attributable to this pollutant. Another problem is household air pollution by using stoves burning biomass fuels, where excessive indoor exposure to PM 2.5 inside the household is responsible for approximately 3,000 annual premature deaths among adults, with another unknown number of deaths among children due to respiratory infections. Water pollution is caused by sewage discharges into rivers, minerals (arsenic) from various sources, and failure of water treatment plants. In Peru, climate change may impact the frequency and severity of El Niño Southern Oscillation (ENSO), which has been associated with an increase in cases of diseases such as cholera, malaria and dengue. Climate change increases the temperature and can extend the areas affected by vector-borne diseases, have impact on the availability of water and contamination of the air. In conclusion, Peru is going through a transition of environmental risk factors, where traditional and modern risks coexist and infectious and chronic problems remain, some of which are associated with problems of pollution of water and air.

Contaminación ambiental, variabilidad climática y cambio climático: una revisión del impacto en la salud de la población peruana / Environmental pollution, climate variability and climate change: a review of health impacts on the peruvian population

El presente artículo es una revisión sobre la contaminación del agua, el aire y el efecto del cambio climático en la salud de la población peruana. Uno de los principales contaminantes del aire es el material particulado menor de 2,5 u (PM 2,5), en la ciudad de Lima, anualmente 2300 muertes prematuras son atribuibles a este contaminante. Otro problema es la contaminación del aire domiciliario por el uso de cocinas con combustible de biomasa, donde la exposición excesiva a PM 2,5 dentro de las casas es responsable de aproximadamente 3000 muertes prematuras anuales entre adultos, con otro número desconocido de muertes entre niños debido a infecciones respiratorias. La contaminación del agua tiene como principales causas los desagües vertidos directamente a los ríos, minerales (arsénico) de varias fuentes, y fallas de las plantas de tratamiento. En el Perú, el cambio climático puede impactar en la frecuencia y severidad del fenómeno de El Niño oscilación del sur (ENSO) que se ha asociado con un incremento en los casos de enfermedades como cólera, malaria y dengue. El cambio climático incrementa la temperatura y puede extender las áreas afectadas por enfermedades transmitidas por vectores, además de tener efecto en la disponibilidad del agua y en la contaminación del aire. En conclusión, el Perú, pasa por una transición de factores de riesgo ambientales, donde coexisten riesgos tradicionales y modernos, y persisten los problemas infecciosos y crónicos, algunos de los cuales se asocian con problemas de contaminación de agua y de aire...

This article is a review of the pollution of water, air and the effect of climate change on the health of the Peruvian population. A major air pollutant is particulate matter less than 2.5 u (PM 2.5). In Lima, 2,300 premature deaths annually are attributable to this pollutant. Another problem is household air pollution by using stoves burning biomass fuels, where excessive indoor exposure to PM 2.5 inside the household is responsible for approximately 3,000 annual premature deaths among adults, with another unknown number of deaths among children due to respiratory infections. Water pollution is caused by sewage discharges into rivers, minerals (arsenic) from various sources, and failure of water treatment plants. In Peru, climate change may impact the frequency and severity of El Niño Southern Oscillation (ENSO), which has been associated with an increase in cases of diseases such as cholera, malaria and dengue. Climate change increases the temperature and can extend the areas affected by vector-borne diseases, have impact on the availability of water and contamination of the air. In conclusion, Peru is going through a transition of environmental risk factors, where traditional and modern risks coexist and infectious and chronic problems remain, some of which are associated with problems of pollution of water and air...

Mercury exposure among artisanal gold miners in Madre de Dios, Peru: a cross-sectional study.

INTRODUCTION: Exposure to mercury, a toxic metal, occurs primarily from inhaling mercury vapors or consuming methylmercury-contaminated fish. One third of all anthropogenic mercury emissions worldwide are from artisanal gold mining, which uses mercury to extract gold. Although recent reports suggest that the Madre de Dios region in Peru (with >30,000 artisanal miners) has extensive mercury contamination, residents had never been assessed for mercury exposure. Thus, our objective was to quantify mercury exposure among residents of an artisanal mining town in Madre de Dios and to assess risk factors for exposure. METHODS: We conducted a cross-sectional assessment of 103 residents of an artisanal gold mining town in July 2010. Each participant provided a urine and blood sample and completed a questionnaire assessing potential exposures and health outcomes. We calculated geometric mean (GM) urine total mercury and blood methylmercury concentrations and compared log-transformed concentrations between subgroups using linear regression. RESULTS: One third (34.0 %) of participants were gold miners. All participants had detectable urine total mercury (GM, 5.5 µg/g creatinine; range, 0.7-151 µg/g creatinine) and 91 % had detectable blood methylmercury (GM, 2.7 µg/L; range, 0.6-10 µg/L); 13 participants (13 %) reported having kidney dysfunction or a neurological disorder. Urine total mercury concentrations were higher among people who heated gold-mercury amalgams compared with people who never heated amalgams (p < 0.05); methylmercury concentrations were higher among fish consumers compared with nonfish consumers (p < 0.05). CONCLUSION: Our findings suggest that mercury exposure may be widespread in Huaypetue.

Blood lead levels among police officers in Lima and Callao, 2004.

Lead contamination is a public health problem of world-wide scope that negatively affects the health of especially women and children. Nevertheless, studies on lead contamination and its impact on health in Peru are limited. The objective of the present study was to determine blood lead levels (BLL) of traffic police officers in Lima and Callao compared with values in police officers working indoors and with data obtained in 1992. The study was performed in May-June 2004 and included 52 traffic officers and 50 officers working in police stations in the north, center and east of Lima and Callao, Peru. Both groups were of similar age. The dependent variables were arterial blood pressure and BLL obtained in each officer. In addition a questionnaire was applied to evaluate risk factors for lead exposure. In 2004, the average BLL in traffic police officers was higher (44.7+/-6.1microg/l) than that of indoor police officers (39.3+/-8.2microg/l) (p=0.0001). However, none of the police officers had BLL of over 100microg/l. No differences were observed in the location of the residences of the participants and the respective traffic density. Those over 30 years of age had a higher risk of having a BLL over 42microg/l than younger officers (odds ratio (OR)=4.45). Traffic police officers had a higher risk of BLL >42microg/l (OR=4.80). Compared with data from 1992 obtained from the literature, an important reduction has been observed in 2004. This may be a consequence of the policy to eliminate leaded gasoline in Peru. However, it is still necessary to monitor this policy to ensure the elimination of lead in gasoline.

Use of isotope ratios to identify sources contributing to pediatric lead poisoning in Peru.

In 1998, a school-based blood lead level (BLL) survey of 2,510 children, conducted in Lima and Callao, Peru, revealed elevated BLLs in children from 2 Callao schools (mean BLL = 25.6 microg/dl; n = 314) and in children from Callao overall (mean BLL = 15.2 microg/dl; n = 898), compared with children from Lima (mean BLL = 7.1 microg/dl; n = 1,612). Public health officials at Peru's Direccion General de Salud Ambiental (DIGESA) hypothesized that a possible source of the elevated pediatric BLLs observed in Callao was a large depository near the port where mineral concentrates are stored prior to shipment. The U.S. Centers for Disease Control and Prevention worked with DIGESA to identify source(s) that contributed to the pediatric lead poisonings by comparing isotopic profiles of lead in blood, mineral, gasoline, and air filter samples. The lead isotope ratio (IR) observed in mineral samples from the depository in Callao differed from those in gasoline samples from Lima and Callao. The blood lead IRs of children living near the depository were similar to the IRs of the mineral samples and different from the IRs of the gasoline samples, suggesting that lead from the depository-and not gasoline-was the primary source of lead in these children. Lead IR analysis of regional air filter samples supported these findings.