HCH contamination from former pesticide production in Brazil--a challenge for the Stockholm Convention implementation.

Hexachlorocyclohexane (HCH) isomers (α-, ß- and γ- HCH [lindane]) were recently added to the list of persistent organic pollutants regulated by the Stockholm Convention, and therefore, the legacy of HCH and lindane production has become an issue of global relevance. The production of lindane with the much larger quantities of associated waste isomers has generated large waste deposits and contaminated sites. This article presents an overview of HCH-polluted sites in Brazil as a basis for further activities related to the Stockholm Convention. The locations of HCH stockpiles and contaminated sites in Brazil arising from production and formulation have been compiled and mapped. This shows that the measures taken over the past 25 years have not resulted in remediation of the HCH pollution. An exposure risk study has been summarised for one major site and is included to demonstrate the contemporary relevance of the contamination. Major site remediation efforts are planned at one site but people live close to several other sites, and there is an urgent need of further assessments and remediation to ensure the protection of human health and the environment. The Stockholm Convention requires a systematic approach and should be adopted for the assessment of all sites and appropriate isolation/remediation measures should be facilitated. The appropriate planning of these activities for the production site in Rio de Janeiro could be a positive contribution for Rio+20 highlighting that green economy and sustainable production also include the appropriate management of legacies of historic production of an industrial sector (here the organochlorine industry).

Chronic amiodarone use decreases implantable cardioverter defibrillator shock efficacy

To evaluate the effect of amiodarone on implantable cardioverter defibrillator efficacy, we compared first shock conversion rates for ventricular fibrillation in 113 patients who received amiodarone to those in 641 patients who did not receive the drug. All patients received a CPI VENTAK P2 implantable cardioverter defibrillator. The first shock conversion rate for spontaneous ventricular fibrillation was lower for patients taking amiodarone (62 por cento vs 88 por cento. p < 0.01). Multivariate anysis selected amiodarone use (odds ratio 5.3) and lower first shock energy (odds ratio 0.9) as predictors of first shock failure. Conclusions: amiodarone use was associated with decreased implantable cardioverter defibrillator shock efficacy.