RESUMO
Environmental pollution is a growing problem that negatively impacts health with social and economic high costs. In this sense, coordinated surveillance of conditions, risks, exposures and health effects related to pollution is a useful tool to guide decision-making processes. The objective of this essay was to describe a surveillance system for environmental contaminants in Colombia and its design background. Using the technical guidelines proposed by the Pan American Health Organization, a literature review was conducted to identify the key elements to be included in such surveillance system and to establish which of these elements were already present in the Colombian context. Moreover, these findings were compared with successful experiences in Latin America. The surveillance system includes five components: Epidemiological, environmental and biological surveillance, clinical monitoring and recommendations to guide policies or interventions. The key factors for a successful surveillance system are: interdisciplinary and inter-sector work, clear definition of functions, activities, data sources and information flow. The implementation of the system will be efficient if the structures and tools existing in each country are taken into account. The most important stakeholders are inter-sector public health and environmental commissions and government institutions working in research and surveillance issues related to health, sanitation, environment, drugs and food regulation and control. In conclusion, Colombia has the technical resources and a normative framework to design and implement the surveillance system. However, stakeholders´ coordination is essential to ensure the efficacy of the system so it may guide the implementation of cost-effective actions in environmental health.
Assuntos
Monitoramento Ambiental/métodos , Poluição Ambiental/prevenção & controle , Colômbia , HumanosRESUMO
La contaminación ambiental es un problema creciente que afecta negativamente la salud y tiene un alto costo social y económico, lo que exige una vigilancia articulada de las condiciones y los riesgos ambientales de la exposición y sus efectos en la salud, con el fin de orientar la adopción de decisiones. El objetivo de este ensayo fue describir un eventual sistema de vigilancia de contaminantes ambientales para Colombia y los antecedentes de su diseño. Con base en los lineamientos técnicos de la Organización Panamerica de la Salud, se hizo una revisión bibliográfica y normativa para detectar los elementos clave necesarios y ya existentes en el contexto colombiano, orientados a la formulación de tal sistema. Además, se compararon los elementos estructurales de experiencias exitosas en Latinoamérica. El sistema de vigilancia requiere cinco componentes: la vigilancia epidemiológica, la vigilancia ambiental, la vigilancia biológica-sanitaria, la vigilancia clínica, y la orientación de políticas e intervenciones en salud ambiental. Los factores críticos de éxito son el trabajo interdisciplinario y entre los sectores involucrados y el establecimiento de funciones, actividades, fuentes de datos y flujos de información. La implementación del sistema será eficiente si se aprovechan las iniciativas regionales y las estructuras o herramientas existentes en el país. Las principales entidades implicadas en la creación del sistema, son las comisiones intersectoriales para la salud ambiental y la salud pública, y las instituciones técnicas gubernamentales relacionadas con la investigación y la vigilancia en salud, saneamiento, ambiente, regulación de medicamentos y alimentos. En conclusión, Colombia cuenta con los recursos técnicos y normativos para desarrollar el sistema de vigilancia en salud ambiental. La acción articulada de los diferentes sectores asegura la idoneidad del sistema para orientar acciones costo-efectivas en salud ambiental.
Environmental pollution is a growing problem that negatively impacts health with social and economic high costs. In this sense, coordinated surveillance of conditions, risks, exposures and health effects related to pollution is a useful tool to guide decision-making processes. The objective of this essay was to describe a surveillance system for environmental contaminants in Colombia and its design background. Using the technical guidelines proposed by the Pan American Health Organization, a literature review was conducted to identify the key elements to be included in such surveillance system and to establish which of these elements were already present in the Colombian context. Moreover, these findings were compared with successful experiences in Latin America. The surveillance system includes five components: Epidemiological, environmental and biological surveillance, clinical monitoring and recommendations to guide policies or interventions. The key factors for a successful surveillance system are: interdisciplinary and inter-sector work, clear definition of functions, activities, data sources and information flow. The implementation of the system will be efficient if the structures and tools existing in each country are taken into account. The most important stakeholders are inter-sector public health and environmental commissions and government institutions working in research and surveillance issues related to health, sanitation, environment, drugs and food regulation and control. In conclusion, Colombia has the technical resources and a normative framework to design and implement the surveillance system. However, stakeholders´ coordination is essential to ensure the efficacy of the system so it may guide the implementation of cost-effective actions in environmental health.