Assessing over decadal biomass burning influence on particulate matter composition in subequatorial Amazon: literature review, remote sensing, chemical speciation and machine learning application.

A study on aerosols in the Brazilian subequatorial Amazon region, Tangará da Serra (TS) and Alta Floresta (AF) was conducted and compared to findings in an additional site with background characteristics (Manaus, AM). TS and AF counties suffer from intense biomass burning periods in the dry season, and it accounts for high levels of particles in the atmosphere. Chemical characterization of fine and coarse particulate matter (PM) was performed to quantify water-soluble ions (WSI) and black carbon (BC). The importance of explanatory variables was assessed using three machine learning techniques. Average concentrations of PM in AF and TS were similar (PM2.0, 17±10 µg m-3 (AF) and 16±11 µg m-3 (TS) and PM10-2.0, 13±5 µg m-3 (AF) and 11±7 µg m-3 (TS)), but higher than the background site. BC and SO4 2- were the prevalent components as they represented 27%-68% of particulates chemical composition. The combination of the machine learning techniques provided a further understanding of the pathways for PM concentration variability, and the results highlighted the influence of biomass burning for key sample groups and periods. PM2.0, BC, and most WSI presented higher concentrations in the dry season, providing further support for the influence of biomass burning.

Health Impact Assessment in protected areas: a proposal for urban contexts in Brazil.

The use of Health Impact Assessment (HIA) in the establishment of an urban protected area can enhance the positive impacts and mitigate the negative impacts resulting from its implementation. Brazil hosts some of the most important biodiversity hotspots in the world and the HIA may benefit biodiversity and human health. These areas are commonly created without any preceding survey to assess their impacts on health. Protected areas located in urban zones are essential to maintain environmental balance and quality of life in cities. It promotes positive impacts on health, providing ecosystem services and salutogenic benefits. However, they can generate negative impacts such as the violation of human rights, property speculation, spread of vectorial diseases, and psychosocial stress. Based on the identification of the potential impacts of urban protected areas on health and best practices, this qualitative and exploratory study justifies the use of HIA in urban protected areas, especially in the Brazil, and indicates the main elements for the construction of a methodological approach to contribute to the Sustainable Development Goals and one of its alternatives, the Buen Vivir approach.

Cerebrovascular mortality: trend and seasonality in Brazilian capitals, 2000-2019.

OBJECTIVE: To evaluate the trend and seasonality of cerebrovascular mortality rates in the adult population of Brazilian capitals from 2000 to 2019. METHODS: This is an ecological and descriptive study of a time series of mortality due to cerebrovascular causes in adults (≥ 18 years) living in Brazilian capitals from 2000 to 2019, based on the Brazilian Mortality Information System. Descriptive statistical techniques were applied in the exploratory analysis of data and in the summary of specific, standardized rates and ratios by sociodemographic characteristics. The jointpoint regression model was used to estimate the trend of cerebrovascular mortality rates by gender, age groups, and geographic regions. The seasonal variability of rates by geographic regions was estimated using the generalized additive model by smoothing cubic splines. RESULTS: People aged over 60 years comprised 77% of all cerebrovascular deaths. Women (52%), white individuals (47%), single people (59%), and those with low schooling (57%, elementary school) predominated in our sample. Recife (20/1,000 inhab.) and Vitória (16/1,000 inhab.) showed the highest crude mortality rates. Recife (49/10,000 inhab.) and Palmas (47/10,000 inhab.) prevailed after we applied standardized rates. Cerebrovascular mortality rates in Brazil show a favorable declining trend for adults of all genders. Seasonality influenced rate increase from July to August in almost all region capitals, except in the North, which rose in March, April, and May. CONCLUSIONS: Deaths due to cerebrovascular causes prevailed in older single adults with low schooling. The trend showed a tendency to decline and winter, the greatest risk. Regional differences can support decision-makers in implementing public policies to reduce cerebrovascular mortality.

The potential impact of PM2.5 on the covid-19 crisis in the Brazilian Amazon region.

OBJECTIVE: This study aims to assess covid-19 morbidity, mortality, and severity from 2020 to 2021 in five Brazilian Amazon states with the highest records of wildfires. METHODS: A distributed lag non-linear model was applied to estimate the potential exposure risk association with particulate matter smaller than 2.5-µm in diameter (PM2.5). Daily mean temperature, relative humidity, percentual of community mobility, number of hospital beds, days of the week, and holidays were considered in the final models for controlling the confounding factors. RESULTS: The states of Para, Mato Grosso, and Amazonas have reported the highest values of overall cases, deaths, and severe cases of covid-19. The worrying growth in the percentual rates in 2020/2021 for the incidence, severity, and mortality were highlighted in Rondônia and Mato Grosso. The growth in 2020/2021 in the estimations of PM2.5 concentrations was higher in Mato Grosso, with an increase of 24.4%, followed by Rondônia (14.9%). CONCLUSION: This study establishes an association between wildfire-generated PM2.5 and increasing covid-19 incidence, mortality, and severity within the studied area. The findings showed that the risk of covid-19 morbidity and mortality is nearly two times higher among individuals exposed to high concentrations of PM2.5. The attributable fraction to PM2.5 in the studied area represents an important role in the risk associated with covid-19 in the Brazilian Amazon region.

Chronic Mercury Exposure and GSTP1 Polymorphism in Munduruku Indigenous from Brazilian Amazon.

Genetic polymorphisms may be involved with mercury levels and signs and symptoms of intoxication from this exposure. Therefore, the aims were to describe the frequency of the GSTP1 polymorphism and to evaluate its effects on mercury levels and neurological signs in three Munduruku indigenous villages in the Brazilian Amazon. One-hundred-and-seven indigenous (over 12 years old) were included and genotyped (rs1695) using a TaqMan validated assay. Then, associations were evaluated by binary logistic regression, using odds ratios (OR) and 95% confidence intervals (CI). Mean age was 27.4 ± 13.9 years old, 52.3% were male, mean hair mercury concentration was 8.5 ± 4.3, exceeding the reference limit (≥6.0 µg/g), and were different among the three villages: 13.5 ± 4.6 µg/g in Sawré Aboy, 7.4 ± 2.3 µg/g in Poxo Muybu and 6.9 ± 3.5 µg/g in Sawré Muybu. The minor allele frequency of GSTP1 G was significantly different among the villages: 57% Sawré Muybu, 21% Poxo Muybu and 15% Sawré Aboy. Finally, after adjustment, GSTP1 GG and GA genotypes were associated with lower levels of Hg (OR = 0.13; CI95% = 0.03-0.49) and abnormal somatosensory signs (OR = 3.7; 95%IC = 1.5-9.3), respectively. In conclusion, monitoring this population is imperative to identify individuals at higher risk of developing signs of chronic mercury exposure based on the genetic profile.

Cerebrovascular mortality: trend and seasonality in Brazilian capitals, 2000-2019 / Mortalidade cerebrovascular: tendência e sazonalidade nas capitais brasileiras, 2000-2019

ABSTRACT OBJECTIVE To evaluate the trend and seasonality of cerebrovascular mortality rates in the adult population of Brazilian capitals from 2000 to 2019. METHODS This is an ecological and descriptive study of a time series of mortality due to cerebrovascular causes in adults (≥ 18 years) living in Brazilian capitals from 2000 to 2019, based on the Brazilian Mortality Information System. Descriptive statistical techniques were applied in the exploratory analysis of data and in the summary of specific, standardized rates and ratios by sociodemographic characteristics. The jointpoint regression model was used to estimate the trend of cerebrovascular mortality rates by gender, age groups, and geographic regions. The seasonal variability of rates by geographic regions was estimated using the generalized additive model by smoothing cubic splines. RESULTS People aged over 60 years comprised 77% of all cerebrovascular deaths. Women (52%), white individuals (47%), single people (59%), and those with low schooling (57%, elementary school) predominated in our sample. Recife (20/1,000 inhab.) and Vitória (16/1,000 inhab.) showed the highest crude mortality rates. Recife (49/10,000 inhab.) and Palmas (47/10,000 inhab.) prevailed after we applied standardized rates. Cerebrovascular mortality rates in Brazil show a favorable declining trend for adults of all genders. Seasonality influenced rate increase from July to August in almost all region capitals, except in the North, which rose in March, April, and May. CONCLUSIONS Deaths due to cerebrovascular causes prevailed in older single adults with low schooling. The trend showed a tendency to decline and winter, the greatest risk. Regional differences can support decision-makers in implementing public policies to reduce cerebrovascular mortality.

RESUMO OBJETIVO Avaliar a tendência e a sazonalidade das taxas de mortalidade cerebrovascular na população adulta das capitais brasileiras de 2000 a 2019. MÉTODOS Estudo ecológico e descritivo de séries temporais de mortalidade por causas cerebrovasculares em adultos (≥ 18 anos) residentes nas capitais do Brasil no período 2000-2019, obtidas do Sistema de Informações sobre Mortalidade. Técnicas de estatística descritiva foram aplicadas na análise exploratória dos dados e no resumo de taxas específicas, padronizadas e razões por características sociodemográficas. A regressão de pontos de junção (jointpoint regression model) estimou a tendência das taxas de mortalidade cerebrovascular por sexo, grupos etários e regiões geográficas. A variabilidade sazonal por regiões geográficas das taxas foi estimada utilizando o modelo aditivo generalizado por meio de splines de suavização cúbica. RESULTADOS As pessoas maiores de 60 anos representaram 77% dos óbitos cerebrovasculares. Predominaram o sexo feminino (52%), a raça branca (47%), os solteiros (59%) e a baixa escolaridade (57%, ensino fundamental). As capitais Recife (20/1.000 hab.) e Vitória (16/1.000 hab.) apresentaram as maiores taxas brutas de mortalidade. Aplicando as taxas padronizadas Recife (49/10.000 hab.) e Palmas (47/10.000 hab.) prevaleceram. As taxas de mortalidade cerebrovascular no Brasil apresentam uma tendência favorável ao declínio em ambos os sexos e em adultos. A sazonalidade mostrou influenciar na elevação das taxas entre os meses de julho a agosto em quase todas as capitais das regiões, exceto na Norte, que se elevaram nos meses de março, abril e maio. CONCLUSÕES Os óbitos por causa cerebrovascular prevaleceram em pessoas idosas, solteiras e com baixa escolaridade. A tendência foi favorável ao declínio, sendo o inverno o período de maior risco. As diferenças regionais permitem subsidiar os tomadores de decisões em relação à implementação de políticas públicas para reduzir a mortalidade cerebrovascular.

The potential impact of PM2.5 on the covid-19 crisis in the Brazilian Amazon region

ABSTRACT OBJECTIVE This study aims to assess covid-19 morbidity, mortality, and severity from 2020 to 2021 in five Brazilian Amazon states with the highest records of wildfires. METHODS A distributed lag non-linear model was applied to estimate the potential exposure risk association with particulate matter smaller than 2.5-µm in diameter (PM2.5). Daily mean temperature, relative humidity, percentual of community mobility, number of hospital beds, days of the week, and holidays were considered in the final models for controlling the confounding factors. RESULTS The states of Para, Mato Grosso, and Amazonas have reported the highest values of overall cases, deaths, and severe cases of covid-19. The worrying growth in the percentual rates in 2020/2021 for the incidence, severity, and mortality were highlighted in Rondônia and Mato Grosso. The growth in 2020/2021 in the estimations of PM2.5 concentrations was higher in Mato Grosso, with an increase of 24.4%, followed by Rondônia (14.9%). CONCLUSION This study establishes an association between wildfire-generated PM2.5 and increasing covid-19 incidence, mortality, and severity within the studied area. The findings showed that the risk of covid-19 morbidity and mortality is nearly two times higher among individuals exposed to high concentrations of PM2.5. The attributable fraction to PM2.5 in the studied area represents an important role in the risk associated with covid-19 in the Brazilian Amazon region.

Health Impact Assessment in protected areas: a proposal for urban contexts in Brazil / Avaliação de Impacto à Saúde em áreas protegidas: uma proposta para contextos urbanos no Brasil / Evaluación del Impacto en la Salud en áreas protegidas: una propuesta para contextos urbanos en Brasil

Abstract: The use of Health Impact Assessment (HIA) in the establishment of an urban protected area can enhance the positive impacts and mitigate the negative impacts resulting from its implementation. Brazil hosts some of the most important biodiversity hotspots in the world and the HIA may benefit biodiversity and human health. These areas are commonly created without any preceding survey to assess their impacts on health. Protected areas located in urban zones are essential to maintain environmental balance and quality of life in cities. It promotes positive impacts on health, providing ecosystem services and salutogenic benefits. However, they can generate negative impacts such as the violation of human rights, property speculation, spread of vectorial diseases, and psychosocial stress. Based on the identification of the potential impacts of urban protected areas on health and best practices, this qualitative and exploratory study justifies the use of HIA in urban protected areas, especially in the Brazil, and indicates the main elements for the construction of a methodological approach to contribute to the Sustainable Development Goals and one of its alternatives, the Buen Vivir approach.

Resumo: O uso da Avaliação de Impacto à Saúde (AIS) na criação de uma área protegida urbana pode potencializar os impactos positivos e mitigar os impactos negativos resultantes de sua implementação. O Brasil abriga alguns dos mais importantes hotspots de biodiversidade do mundo e a implementação da AIS pode beneficiar tanto estas áreas como a saúde humana. As áreas protegidas urbanas são comumente estabelecidas sem qualquer avaliação prévia de seus impactos na saúde e são essenciais para manter o equilíbrio ambiental e a qualidade de vida nas cidades. Além disso, as áreas protegidas impactam positivamente a saúde, fornecendo serviços ecossistêmicos e benefícios salutogênicos. Contudo, podem gerar impactos negativos, como violação de direitos humanos, especulação imobiliária, disseminação de doenças vetoriais e estresse psicossocial. Com base na identificação dos impactos potenciais das áreas protegidas urbanas na saúde e nas melhores práticas para aplicá-las, este estudo qualitativo e exploratório justifica o uso da AIS em áreas protegidas urbanas, especialmente no Brasil, e indica os principais elementos para a construção de uma abordagem metodológica que contribua com os Objetivos de Desenvolvimento Sustentável e uma de suas alternativas, a abordagem Buen Vivir.

Resumen: Usar la Evaluación del Impacto en la Salud (EIS) para crear un área protegida urbana puede potenciar los impactos positivos y mitigar los impactos negativos resultantes de su implementación. En Brasil se pueden encontrar algunos de los hotspots de biodiversidad más importantes del mundo e implementar la EIS puede beneficiar tanto estas áreas como la salud humana. Las áreas protegidas urbanas, en general, se establecen sin cualquier evaluación previa de sus impactos en la salud y son esenciales para mantener el equilibrio ambiental y la calidad de vida en las ciudades. Además, las áreas protegidas tienen un impacto positivo en la salud, proporcionando servicios ecosistémicos y beneficios salutogénicos. Sin embargo, pueden generar impactos negativos, como la violación de los derechos humanos, la especulación inmobiliaria, la propagación de enfermedades vectoriales y el estrés psicosocial. Con base en la identificación de los posibles impactos de las áreas protegidas urbanas en la salud y en las mejores prácticas para aplicarlas, este estudio cualitativo y exploratorio justifica el uso de la EIS en áreas protegidas urbanas, sobre todo en Brasil, e indica los elementos principales para construir un enfoque metodológico que contribuya a los Objetivos de Desarrollo Sostenible y una de sus alternativas, el enfoque Buen Vivir.

Human risk assessment of ash soil after 2020 wildfires in Pantanal biome (Brazil).

Wildfires have increased in the last years and, when caused by intentional illegal burnings, are frequently run out of control. Wildfire has been pointed out as an important source of polycyclic aromatic hydrocarbons (PAHs) and trace elements (TEs) - such as, As, Ni, and Pb - to environmental compartments, and thus may pose a risk to human health and to the ecosystem. In 2020, the Brazilian biome, Pantanal, faced the largest losses by wildfires in the last 22 years. Ashes from the topsoil layer in Pantanal were collected after these wildfires at 20 sites divided into the sediment, forest, PF, PS, and degraded sites. Toxicity and associated risks for human health were also evaluated. The areas highly impacted by wildfires and by artisanal gold mining activities showed higher concentrations for TEs and PAHs than the protected areas. Pb varied from 8 ± 4 to 224 ± 81 mg kg-1, and total PAH concentration ranged between 880 ± 314 and 1350 ± 70 ng g-1, at sites impacted by anthropogenic activities. Moreover, health risk assessments for TE and PAH indicated a potentially great risk for children and adults, via ingestion, inhalation, and dermal pathway. The carcinogenic risks exceeded reference values, for both TE and PAH, suggesting harmful conditions, especially for vulnerable groups, such as children and the elderly. Supplementary Information: The online version contains supplementary material available at 10.1007/s11869-022-01248-2.

Mercury Contamination: A Growing Threat to Riverine and Urban Communities in the Brazilian Amazon.

In recent decades, widespread and uncontrolled use of mercury (Hg) in artisanal small-scale gold mining has released thousands of tons of mercury-contaminated waste in the Amazon biome, endangering the largest tropical rainforest worldwide. In this study, we assessed and compared blood Hg levels in individuals living in urban and riverine areas in the lower Tapajós basin and examined the association between Hg exposure and specific biochemical parameters. In total, 462 adults from eight riverine communities and one urban area were assessed. Overall, 75.6% of the participants exhibited Hg concentrations exceeding the safe limit (10 µg/L). Hg exposure was higher in the riverine population (90%) than in urban areas (57.1%). Mean Hg levels were 21.8 ± 30.9 µg/L and 50.6 µg/L in urban and riverine residents, respectively. The mean Hg level was higher in those aged 41-60 years in both urban and riparian areas, with riparian residents exhibiting a mean double that of urban residents. The highest glucose and hepatic biomarker levels were detected in the urban area, whereas the highest levels of renal biomarker occurred in the riverine population. Our results indicate that Hg contamination remains a persistent challenge for the urban population of Santarém, a major city in the Brazilian Amazon.

Impactos da cadeia do etanol: subsídios para uma proposta integrada de vigilância ambiental e de saúde do trabalhador / Impacts of the ethanol chain: subsidies for an integrated proposition on environmental and worker's health surveillance

Resumo Objetivos: analisar os impactos positivos e negativos da cadeia produtiva do etanol em municípios do polo agroindustrial do estado de Mato Grosso como subsídio à formulação de uma proposta de vigilância integrada e participativa em Saúde e Meio Ambiente. Métodos: estudo de caso no campo da Vigilância em Saúde Ambiental desenvolvido no perímetro de abrangência de uma usina de etanol. Utilizou-se o método de Diagnóstico Rápido e Participativo com uso de dados secundários, análise documental e entrevistas. Resultados: a análise de conteúdo propiciou quatro temáticas: impactos positivos e negativos da cadeia produtiva do etanol na área de influência direta e indireta do empreendimento; riscos socioambientais em território inserido no polo agroindustrial do etanol; condições e relações de trabalho dos (ex-)trabalhadores inseridos na cadeia do agronegócio; vigilância em Saúde e Meio Ambiente para um empreendimento de médio porte em polo agroindustrial de etanol no Cerrado. Conclusão: os impactos usualmente percebidos como positivos não promoveram melhorias sociais e econômicas permanentes para os trabalhadores e a população local. Verificou-se que a vigilância ao meio ambiente e à saúde dos trabalhadores inexiste, mas a vigilância participativa contribui para o empoderamento dos atores sociais nas discussões dos direitos dos trabalhadores e para a percepção socioambiental local.

Abstract Objective: to analyze the negative and positive impacts of the ethanol production chain in municipalities from the agro-industrial complex of the State of Mato Grosso, Brazil, as a subsidy to elaborate a proposal for integrated and participative surveillance on Health and Environment. Methods: case study based on Environmental Health Surveillance developed in the impact area of an ethanol plant. We used Rapid and Participatory Diagnosis with secondary data, document analysis and interviews. Results: content analysis provided four themes: positive and negative impacts of the ethanol production chain in the direct and indirect enterprise influence area; socio-environmental risks in the territories within the ethanol agro-industrial complex; working conditions and labor relations of (former) workers within the agribusiness chain; Health and Environmental surveillance for medium-sized enterprises in ethanol agro-industrial complexes in the Cerrado region. Conclusion: impacts usually perceived as positive had no permanent social and economic improvements for workers and the local population. Although environmental and occupational health surveillance is non-existent, participatory surveillance contributes to empowering social actors in discussions on labor rights and local social-environmental awareness.

Intergenerational Association of Short Maternal Stature with Stunting in Yanomami Indigenous Children from the Brazilian Amazon.

To describe the factors associated to stunting in <5-year-old Yanomami Brazilian children, and to evaluate the association of short maternal stature to their offspring's stunting. A cross-sectional study carried out in three villages in the Yanomami territory. We performed a census, in which all households with children < 5-years-old were included. The length/height-for-age z-score <-2 standard deviations was used to classify the children as stunted. Short maternal height was defined as <145 cm for adult women, and <-2 standard deviations of the height-for-age z-score for adolescent women. We used adjusted Poisson regression models to estimate prevalence ratios (PR) along the 90% confidence interval. We evaluated 298 children. 81.2% of children suffered from stunting and 71.9% of the mothers from short stature. In the bivariate analysis, a significant association of stunting with short maternal stature, gestational malaria and child's place of birth were observed. Considering the variables of the children under five years of age, there were significant associations with age group, the child's caregiver, history of malaria, pneumonia, and malnutrition treatment. In the adjusted hierarchical model, stunting was 1.22 times greater in the offspring of women with a short stature (90% CI: 1.07-1.38) compared to their counterparts. Brazilian Amazonian indigenous children living in a remote area displayed an alarming prevalence of stunting, and this was associated with short maternal height, reinforcing the hypothesis of intergenerational chronic malnutrition transmission in this population. In addition, children above 24 months of age, who were born in the village healthcare units and who had had previous treatment in the past for stunting presented higher rates of stunting in this study.

Mercury Exposure in Munduruku Indigenous Communities from Brazilian Amazon: Methodological Background and an Overview of the Principal Results.

The Amazonian indigenous peoples depend on natural resources to live, but human activities' growing impacts threaten their health and livelihoods. Our objectives were to present the principal results of an integrated and multidisciplinary analysis of the health parameters and assess the mercury (Hg) exposure levels in indigenous populations in the Brazilian Amazon. We carried out a cross-sectional study based on a census of three Munduruku indigenous villages (Sawré Muybu, Poxo Muybu, and Sawré Aboy), located in the Sawré Muybu Indigenous Land, between 29 October and 9 November 2019. The investigation included: (i) sociodemographic characterization of the participants; (ii) health assessment; (iii) genetic polymorphism analysis; (iv) hair mercury determination; and (v) fish mercury determination. We used the logistic regression model with conditional Prevalence Ratio (PR), with the respective 95% confidence intervals (CI95%) to explore factors associated with mercury exposure levels ≥6.0 µg/g. A total of 200 participants were interviewed. Mercury levels (197 hair samples) ranged from 1.4 to 23.9 µg/g, with significant differences between the villages (Kruskal-Wallis test: 19.9; p-value < 0.001). On average, the general prevalence of Hg exposure ≥ 6.0 µg/g was 57.9%. For participants ≥12 years old, the Hg exposure ≥6.0 µg/g showed associated with no regular income (PR: 1.3; CI95%: 1.0-1.8), high blood pressure (PR: 1.6; CI95%: 1.3-2.1) and was more prominent in Sawré Aboy village (PR: 1.8; CI95%: 1.3-2.3). For women of childbearing age, the Hg exposure ≥6.0 µg/g was associated with high blood pressure (PR: 1.9; CI95%: 1.2-2.3), with pregnancy (PR: 1.5; CI95%: 1.0-2.1) and was more prominent among residents in Poxo Muybu (PR: 1.9; CI95%: 1.0-3.4) and Sawré Aboy (PR: 2.5; CI95%: 1.4-4.4) villages. Our findings suggest that chronic mercury exposure causes harmful effects to the studied indigenous communities, especially considering vulnerable groups of the population, such as women of childbearing age. Lastly, we propose to stop the illegal mining in these areas and develop a risk management plan that aims to ensure the health, livelihoods, and human rights of the indigenous people from Amazon Basin.

Health Risk Assessment of Mercury Exposure from Fish Consumption in Munduruku Indigenous Communities in the Brazilian Amazon.

Fish serves as the principal source of animal protein for the indigenous people of the Amazon, ensuring their food and nutritional security. However, gold mining causes mercury (Hg) contamination in fish, and consequently increases health risks associated with fish consumption. The aim of this study was to assess the health risk attributed to the consumption of mercury-contaminated fish by Munduruku indigenous communities in the Middle-Tapajós Region. Different fish species were collected in the Sawré Muybu Indigenous Land to determine mercury levels. The health risk assessment was carried out according to the World Health Organization (WHO 2008) methodology and different scenarios were built for counterfactual analysis. Eighty-eight fish specimens from 17 species and four trophic levels were analyzed. Estimates of Hg ingestion indicated that the methylmercury daily intake exceeds the U.S. EPA (United States Environmental Protection Agency) (2000) reference dose from 3 to 25-fold, and up to 11 times the FAO (Food and Agriculture Organization)/WHO (2003) dose recommendation. In all situations analyzed, the risk ratio estimates were above 1.0, meaning that the investigated Munduruku communities are at serious risk of harm as a result of ingestion of mercury-contaminated fish. These results indicate that, at present, fish consumption is not safe for this Munduruku population. This hazardous situation threatens the survival of this indigenous population, their food security, and their culture.

Genetic Polymorphism of Delta Aminolevulinic Acid Dehydratase (ALAD) Gene and Symptoms of Chronic Mercury Exposure in Munduruku Indigenous Children within the Brazilian Amazon.

Genetic polymorphisms involved in mercury toxicokinetics and toxicodynamics may be associated with severe mercury toxicity. This study aimed to investigate the impact of an ALAD polymorphism on chronic mercury exposure and the health situation of indigenous children from the Brazilian Amazon. One-hundred-and-three indigenous children (under 15 years old) were included and genotyped (rs1800435) using a TaqMan validated assay. The mean age was 6.6 ± 4.5 years old, 60% were female, 49% presented with anemia, and the mean hair mercury concentration was 7.0 ± 4.5 (1.4-23.9) µg/g, with 49% exceeding the reference limit (≥6.0 µg/g). Only two children were heterozygous ALAD, while the others were all wild type. Minor allele frequency (ALAD G) and heterozygous genotype (ALAD CG) were 1% and 2%, respectively. The two children (12 and 14 years old) with the ALAD polymorphism had mercury levels above the average as well as had neurological symptoms related to chronic mercury exposure, such as visual field alterations, memory deficit, distal neuropathy, and toe amyotrophy. Both children also reported frequent consumption of fish in the diet, at least three times a week. In conclusion, our data confirm that an ALAD polymorphism can contribute to mercury half-life time, harmful effects, and neuropsychological disorders in indigenous children with chronic mercury exposure to gold mining activity.

The effect of ambient temperature on blood pressure of patients undergoing hemodialysis in the Pantanal-Brazil.

The objective was to analyze the association of changes in pre-dialysis systolic and diastolic blood pressure with air temperature in a municipality in the Brazilian Pantanal, a tropical climate area. Longitudinal panel study, with analysis of mixed effects models of 133 hemodialysis patients in the city of Cáceres-Mato Grosso in 2014. Air temperature showed an inverse association with pre-dialysis systolic and diastolic blood pressure. With each increase of 1 °C in the mean air temperature, the pre-dialysis systolic blood pressure decreases -0.730mmHg (p ≤ 0.000) and the pre-dialysis diastolic blood pressure decreases -0.280mmHg (p ≤ 0.000). The estimated effect was greater for systolic blood pressure, but both pre-dialysis blood pressure measures are reduced with an increase in lag (up to two days), even when adjusted for relative air humidity. Air temperature is determinant for changes in pre-dialysis systolic and diastolic blood pressure in hemodialysis patients. The temperature effect was greater for systolic blood pressure than for diastolic blood pressure.

Port and industrial compound of Pecém: an epidemiological survey. / Complexo industrial e portuário do Pecém: um inquérito epidemiológico.

This research aimed to analyze the dwellers' knowledge of the territories, Pecém Port and Industrial Compound (CIPP), the quality of life of the communities living in the vicinity of the enterprises, and the prevalence of hypertension and overweight. This is a home-based, epidemiological survey of four areas of the Family Health Strategy (ESF) in São Gonçalo do Amarante and one area of the ESF in Caucaia, Ceará, Brazil. The study was carried out between 10/2017 and 03/2018. Anthropometric and blood pressure measurements were performed, and sociodemographic data and knowledge about community, the CIPP, and quality of life were collected. A total of 69.8% of the 503 adults interviewed were female, and the mean age was 44 years. Parada was the area reporting the highest percentage of problems related to air particles (51.1%), the worst concept regarding the CIPP (40.1% bad), the highest percentage of worse quality of life (29, 1%), and greater desire to move to another place (31.5%). Pecém had the highest percentage of community problems related to violence, consumption of illicit drugs, and prostitution. We concluded that there are signs of impact on local populations' health and quality of life without more significant direct work/income benefits.

Esta pesquisa busca analisar o conhecimento dos moradores sobre o território, Complexo Industrial e Portuário do Pecém (CIPP), qualidade de vida das comunidades que vivem no entorno dos empreendimentos, além da prevalência de hipertensão e excesso de peso. Trata-se de um inquérito epidemiológico, de base domiciliar, envolvendo quatro áreas da Estratégia de Saúde da Família (ESF) do Município de São Gonçalo do Amarante e uma de Caucaia, Ceará, Brasil. O estudo foi realizado entre 10/2017 e 03/2018, em que foram realizadas aferições antropométricas e pressão arterial e coletados dados sociodemográficos e o conhecimento sobre comunidade, CIPP e qualidade de vida. Dos 503 adultos entrevistados, 69,8% eram do sexo feminino e a média de idade foi 44 anos. Parada foi a área que relatou o maior percentual de problemas relacionados às partículas aéreas (51,1%), pior conceito em relação ao CIPP (40,1% ruim), maior percentual de piora da qualidade de vida (29,1%) e maior desejo de mudar (31,5%). Pecém apresentou maior percentual de problemas na comunidade relacionados à violência, consumo de drogas ilícitas e prostituição. Conclui-se que se apresenta indícios de impacto na saúde e qualidade de vida das populações locais sem maiores benefícios diretos no trabalho/renda.

Mortality Risk from Respiratory Diseases Due to Non-Optimal Temperature among Brazilian Elderlies.

Over the past decade, Brazil has experienced and continues to be impacted by extreme climate events. This study aims to evaluate the association between daily average temperature and mortality from respiratory disease among Brazilian elderlies. A daily time-series study between 2000 and 2017 in 27 Brazilian cities was conducted. Data outcomes were daily counts of deaths due to respiratory diseases in the elderly aged 60 or more. The exposure variable was the daily mean temperature from Copernicus ERA5-Land reanalysis. The association was estimated from a two-stage time series analysis method. We also calculated deaths attributable to heat and cold. The pooled exposure-response curve presented a J-shaped format. The exposure to extreme heat increased the risk of mortality by 27% (95% CI: 15-39%), while the exposure to extreme cold increased the risk of mortality by 16% (95% CI: 8-24%). The heterogeneity between cities was explained by city-specific mean temperature and temperature range. The fractions of deaths attributable to cold and heat were 4.7% (95% CI: 2.94-6.17%) and 2.8% (95% CI: 1.45-3.95%), respectively. Our results show a significant impact of non-optimal temperature on the respiratory health of elderlies living in Brazil. It may support proactive action implementation in cities that have critical temperature variations.

[Estimate of mean daily concentration of fine particulate matter in the Industrial and Port Complex area of Pecém, Ceará, Brazil]. / Estimativa da concentração média diária de material particulado fino na região do Complexo Industrial e Portuário do Pecém, Ceará, Brasil.

Exposure to fine particulate matter (PM2.5) is associated with numerous negative health outcomes. Thus, monitoring the environmental concentration of PM2.5 is important, especially in heavily industrialized areas, since they harbor potential emitters of PM2.5 and substances with the potential to increase the toxicity of already suspended particles. This study aims to estimate daily concentrations of PM2.5 in three areas under the influence of the Industrial and Port Complex of Pecém (CIPP), Ceará State, Brazil. A nonlinear regression model was applied to estimate PM2.5, using satellite-monitored optical depth data. Estimates were performed in three areas of influence (Ai) of the CIPP (São Gonçalo do Amarante - AiI, Paracuru and Paraipaba - AiII, and Caucaia - AiIII), from 2006 to 2017. Estimated mean annual concentrations were lower than established by Brazil's national legislation in all three Ai (8µg m-³). In all the Ai, the months of the dry season (September to February) showed the highest concentrations and a predominance of east winds, while the months of the rainy season (March to August) showed the lowest concentrations and less defined winds Weather conditions can play an important role in the removal, dispersal, or maintenance of concentrations of particulate matter in the region. Even at low estimated concentrations, it is important to assess the composition of fine participles in this region and their possible association with adverse health outcomes in the local population.

Mercury Exposure through Fish Consumption in Traditional Communities in the Brazilian Northern Amazon.

Artisanal small-scale gold mining (ASGM) is the main source of anthropogenic mercury emissions and contamination in Latin America. In the Brazilian northern Amazon, ASGM has contaminated the environment and people over the past century. The main contamination route is through fish consumption, which endangers the food security and livelihoods of traditional communities. Our study aims to assess the potential toxicological health risks caused by the consumption of Hg-contaminated fish across five regions in Amapá State. We sampled 428 fish from 18 sites across inland and coastal aquatic systems. We measured the total mercury content in fish samples, and the results were applied to a mercury exposure risk assessment targeting three distinct groups (adults, women of childbearing age, and children). Mercury contamination was found to exceed the World Health Organization's safe limit in 28.7% of all fish samples, with higher prevalence in inland zones. Moreover, the local preference for carnivorous fish species presents a serious health risk, particularly for communities near inland rivers in the region. This is the first study to provide clear recommendations for reducing the mercury exposure through fish consumption in Amapá State. It builds scientific evidence that helps decision-makers to implement effective policies for protecting the health of riverine communities.