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Challenges and Opportunities for Urban Environmental Health and Sustainability: the HEALTHY-POLIS initiative.

Vardoulakis, Sotiris; Dear, Keith; Wilkinson, Paul
| Idioma(s): Inglés
Cities around the world face many environmental health challenges including contamination of air, water and soil, traffic congestion and noise, and poor housing conditions exacerbated by unsustainable urban development and climate change. Integrated assessment of these risks offers opportunities for holistic, low carbon solutions in the urban environment that can bring multiple benefits for public health. The Healthy-Polis consortium aims to protect and promote urban health through multi-disciplinary, policy-relevant research on urban environmental health and sustainability. We are doing this by promoting improved methods of health risk assessment, facilitating international collaboration, contributing to the training of research scientists and students, and engaging with key stakeholders in government, local authorities, international organisations, industry and academia. A major focus of the consortium is to promote and support international research projects coordinated between two or more countries. The disciplinary areas represented in the consortium are many and varied, including environmental epidemiology, modelling and exposure assessment, system dynamics, health impact assessment, multi-criteria decision analysis, and other quantitative and qualitative approaches. This Healthy-Polis special issue presents a range of case studies and reviews that illustrate the need for a systems-based understanding of the urban environment.
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Diagnóstico da disposição final dos resíduos sólidos urbanos na região da Associação dos Municípios do Alto Irani (AMAI), Santa Catarina/ Diagnosis of the final disposal of urban solid wastes in the region of the Association of the Cities at Alto Irani (AMAI), Santa Catarina State

França, Rosiléa Garcia; Ruaro, Édina Cristina Rodrigues
| Idioma(s): Portugués
O objetivo desse estudo foi diagnosticar o destino dos resíduos sólidos urbanos na região da AMAI (SC), composta por catorze municípios. Foram aplicados questionários às prefeituras e realizadas visitas nos municípios para mapear tanto lixões ativos e desativados como aterros controlados e sanitários. Os parâmetros utilizados foram: existência de cercas; tipo de cobertura; retirada dos resíduos antes da cobertura; proximidades com águas superficiais; presença de catadores ou animais; monitoramento e coleta de chorume e gás; distância de moradias e existência de coleta seletiva. A partir da pesquisa, foram localizados vinte e sete lixões desativados, sendo que dezoito deles receberam algum tipo de remediação; porém, em nenhum deles ocorreu de forma padrão. Detectou-se precariedade na remediação nos lixões desativados, pois a simples cobertura com terra não é suficiente, já que o material ali depositado continua poluindo através do chorume produzido. Atualmente, todos os municípios depositam os seus resíduos sólidos urbanos em aterros sanitários localizados em Xanxerê e Xaxim. Dos quatorze municípios, somente um possui coleta seletiva e ainda de forma precária. Atualmente, coleta-se 54,15 ton/dia de resíduos, totalizando-se uma média de 0,610 g/hab.dia de lixo, a um custo de R$ 1,78/hab para os cofres públicos mensalmente. The aim of this study was to carry out diagnosis about the destination given to the urban solid wastes in AMAI-SC region, which has fourteen cities. It was applied questionnaires to the city halls, and visits to map active and inactive dumps, controlled and sanitary landfill. It was investigated: the existence of fences, monitoring and collecting of gas and leachate, if they were next to the superficial waters, the presence of animals or collectors. It was considered, also, the distance of houses and/or urban mass and information about selective collection. It was found twenty and seven inactive dumps, where eighteen had received treatment. It was detected precariousness in remediation of all inactive dumps, because a single covering with land is not enough, therefore the material put there, keeps polluting through the production of lard and methane gas. Nowadays, all AMAI cities put their urban solid wastes in sanitary landfill found in Xanxerê and Xaxim. Among the fourteen cities, only one has selective collection, and in a precarious way, what reduces the useful life time of landfill, beyond being harmful to the environment. It is collected 54.15 tons/day of wastes, which sums 0.610 g/ of waste, costing R$ 1.78 to the public coffers monthly.
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Changes in population susceptibility to heat and cold over time: assessing adaptation to climate change.

Arbuthnott, Katherine; Hajat, Shakoor; Heaviside, Clare; Vardoulakis, Sotiris
| Idioma(s): Inglés
BACKGROUND: In the context of a warming climate and increasing urbanisation (with the associated urban heat island effect), interest in understanding temperature related health effects is growing. Previous reviews have examined how the temperature-mortality relationship varies by geographical location. There have been no reviews examining the empirical evidence for changes in population susceptibility to the effects of heat and/or cold over time. The objective of this paper is to review studies which have specifically examined variations in temperature related mortality risks over the 20(th) and 21(st) centuries and determine whether population adaptation to heat and/or cold has occurred. METHODS: We searched five electronic databases combining search terms for three main concepts: temperature, health outcomes and changes in vulnerability or adaptation. Studies included were those which quantified the risk of heat related mortality with changing ambient temperature in a specific location over time, or those which compared mortality outcomes between two different extreme temperature events (heatwaves) in one location. RESULTS: The electronic searches returned 9183 titles and abstracts, of which eleven studies examining the effects of ambient temperature over time were included and six studies comparing the effect of different heatwaves at discrete time points were included. Of the eleven papers that quantified the risk of, or absolute heat related mortality over time, ten found a decrease in susceptibility over time of which five found the decrease to be significant. The magnitude of the decrease varied by location. Only two studies attempted to quantitatively attribute changes in susceptibility to specific adaptive measures and found no significant association between the risk of heat related mortality and air conditioning prevalence within or between cities over time. Four of the six papers examining effects of heatwaves found a decrease in expected mortality in later years. Five studies examined the risk of cold. In contrast to the changes in heat related mortality observed, only one found a significant decrease in cold related mortality in later time periods. CONCLUSIONS: There is evidence that across a number of different settings, population susceptibility to heat and heatwaves has been decreasing. These changes in heat related susceptibility have important implications for health impact assessments of future heat related risk. A similar decrease in cold related mortality was not shown. Adaptation to heat has implications for future planning, particularly in urban areas, with anticipated increases in temperature due to climate change.
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An effective public health program to reduce urban heat islands in Québec, Canada/ Programa eficaz de salud pública para reducir las islas de calor urbano en Québec, Canada

Beaudoin, Mélanie; Gosselin, Pierre
| Idioma(s): Inglés
In 2005, the Government of the Province of Québec, Canada, adopted the Climate Change Action Plan for 2006 – 2012. The Institut national de santé publique du Québec (National Institute of Public Health of Québec), charged with implementing the health adaptation component of the Plan, worked to mitigate urban heat islands (UHI) by funding and evaluating 40 pilot projects. These projects explored different methods of fighting UHIs by greening cities in a participative and mobilizing approach led mainly by non-governmental organizations and municipalities. An assessment of temperatures before and after implementing various methods demonstrated that some actions enabled significant gains of coolness and more efficiently mitigated heat (reduction of concrete/asphalt surfaces, increasing vegetation, etc.). An assessment of quality of life showed that projects were positively received by users, especially by those living in vulnerable situations. A lifecycle analysis showed that from the environmental perspective, UHI mitigation measures that do not require fertilization or maintenance are preferable. Finally, communication efforts that raise awareness of UHI and mitigation are of significant importance to program success. En el 2005, el Gobierno de la provincia de Québec, Canadá, adoptó un plan de acción sobre el cambio climático para el período del 2006 al 2012. El Instituto Nacional de Salud Pública de Québec (Institut national de santé publique du Québec), encargado de la adaptación del plan para proteger la salud humana, dio un paso para mitigar las islas de calor urbanas (ICU) mediante el financiamiento y la evaluación de 40 proyectos piloto. En estos proyectos se exploraron diferentes métodos para combatir las ICU a base de aumentar las áreas verdes con arreglo a un enfoque participativo y movilizador impulsado principalmente por las organizaciones no gubernamentales y los municipios. Cuando se examinaron las temperaturas antes y después de aplicar distintos métodos, se observó que algunos habían llevado a un enfriamiento ambiental apreciable y que eran más eficientes para aliviar el calor (reducir las superficies de concreto y asfalto, plantar vegetación, y demás). Una evaluación enfocada en la calidad de vida indicó que los proyectos tuvieron buena acogida entre los usuarios, sobre todo los que vivían en situaciones de vulnerabilidad. Un análisis basado en el ciclo vital demostró que, desde el punto de vista ambiental, las medidas para la mitigación de las ICU que no requieren abono ni mantenimiento son las más aconsejables. Por último, las iniciativas de comunicación orientadas a sensibilizar al público en torno a las ICU y su mitigación son muy importantes para lograr que los programas rindan buenos resultados.
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Política de mudança do clima no município de São Paulo, Brasil: reflexividade e permeabilidade do Setor Saúde/ The climate change policy of the city of São Paulo, Brazil: reflexivity and permeability of the health sector

Landin, Rubens; Giatti, Leandro Luiz
| Idioma(s): Portugués
São Paulo é hoje uma metrópole insustentável, em que as vulnerabilidades sociais e ambientais se deparam com as incertezas das mudanças climáticas. Para o enfrentamento deste contexto o Município criou, em 2009, a Política Municipal de Mudança do Clima. O objetivo deste artigo é analisar como se articula o setor saúde na implantação dessa Política até o ano de 2012. O método adotado foi a Análise de Conteúdo e as evidências, os documentos oficiais e as entrevistas semiestruturadas. Em um contexto de transformação da sociedade, afetado por degradação ambiental e agravos socioambientais, a problemática necessita de rupturas a inércias rotineiras e de novos sistemas de conhecimentos. Os resultados demonstraram uma relação dialética intersetorial positiva, pois a hipótese da pesquisa era de que ao setor saúde caberia dar suporte a ações de monitoramento da qualidade do ar e sua verificabilidade constatou abrangência, introduzindo prevenção e promoção da saúde como focos determinantes, sobretudo, influenciando outras políticas. O processo em estudo ganha, assim, reflexividade ao avançar com medidas interativas, rompendo com a tradicionalização do modelo de política setorial reducionista e demonstra intersetorialidade e importância nas questões relacionadas à saúde pública local. São Paulo is today an unsustainable city in which social and environmental vulnerabilities are obliged to tackle the uncertainties of climate change. To face up to this situation, in 2009 the city unveiled its Climate Change Policy. The scope of this paper is to analyze how the health sector is preparing to contribute to the implementation of this policy by 2012. Content analysis was the method adopted by examining official documents and conducting semi-structured interviews. In a context of social transformation affected by environmental degradation and socio-environmental consequences there is a need for the cessation of inertia and a demand for new knowledge systems. The outcomes of the study showed a positive intersectorial dialectic relationship, since the research hypothesis was that the health sector would be called upon to back actions on air quality monitoring. Its verification showed a broad scope introducing health promotion and preventive actions as the determinant focus, especially influencing other public policies. Thus, the process under scrutiny acquired reflexivity when evolving with interactive measures breaking with the traditional sectorial and reductionist policy model. It shows an intersectorial perspective based on the importance of issues related to local public health.
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Saúde coletiva, resíduos sólidos urbanos e os catadores de lixo/ Urban solid residues, garbage collectors and public health

Siqueira, Mônica Maria; Moraes, Maria Silvia de
| Idioma(s): Portugués
O artigo aborda a problemática ambiental da produção e da geração de resíduos sólidos urbanos, destacando o conceito de saúde e de ambiente enquanto representação social. A partir de uma revisão bibliográfica, discute a incorporação da temática saúde e ambiente no campo de conhecimento e práticas de interconexão com a saúde coletiva. Associa nesse contexto a questão da exclusão social gerada pela forma de produção e de consumo da sociedade pós-moderna, introduzindo os catadores de lixo, grupo populacional vulnerável. The article approaches the issues of environmental production and the generation of urban solid residues, in particular the environment and health concept while social representation. From a bibliographical revision it argues the incorporation of the themes of health and environment in the practical field of knowledge and of interconnection with the Public Health. In this context it associates the question of the social exclusion generated by the form of production and consumption of the after-modern society, introducing the garbage collectors as a vulnerable population group.
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Contaminaçäo ambiental por ovos e larvas de helmintos em fezes de cäes na área central do Balneário Cassino, Rio Grande do Sul/ Environmental contamination by helminth eggs and larvae in dog feces from central area of Cassino beach, Rio Grande do Sul

Scaini, Carlos James; Toledo, Ricardo Navarrete de; Lovatel, Raquel; Dionello, Maria Alix; Gatti, Fabiane dos Anjos; Susin, Lulie; Signorini, Vera Regina Mendonça
| Idioma(s): Portugués
Para investigar a presença de helmintos, agentes de zoonoses parasitárias, foram examinadas 237 amostras fecais de cäes, na área central do principal balneário do litoral sul do Rio Grande do Sul. As principais contaminaçöes foram: ovos e larvas do gênero Ancylostoma (71,3 por cento), ovos de Trichuris (32,5 por cento) e Toxocara (9,3 por cento)
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Influencia de la variabilidad climática en las enfermedades respiratorias agudas en Bogotá/ Influence of the climate variability on acute respiratory infections in the city of Bogotá

Correal, María Elsa; Marthá, Juan Esteban; Sarmiento, Rodrigo
| Idioma(s): Español
Introducción. La enfermedad respiratoria es una de las principales causas de morbilidad en Bogotá y los efectos de la variabilidad climática se han reflejado en un aumento del número de casos. Objetivo. En el presente estudio se analizó el comportamiento semanal de la enfermedad respiratoria aguda en Bogotá y se asoció con las variables climatológicas de temperatura, humedad relativa y precipitación, analizando su impacto en la aparición de casos en la ciudad. Materiales y métodos. El análisis se llevó a cabo mediante la estimación de modelos de regresión de Poisson, con datos epidemiológicos de 104 semanas correspondientes a los años 2011 y 2012. La variabilidad climática temporal se analizó considerando los efectos de las variables en semanas anteriores y, para el análisis de la variabilidad espacial, la ciudad se dividió en cuatro zonas: norte, sur, oriente y occidente. Resultados. Los resultados de las correlaciones cruzadas demostraron que en tres de las cuatro zonas la humedad relativa tenía un mayor impacto sobre los casos de enfermedad respiratoria aguda y su efecto persistía hasta por ocho y diez semanas. La precipitación, por el contrario, tuvo impacto únicamente en la zona oriente, mientras que la temperatura tuvo efectos moderados en todas las zonas. Conclusión. Debido al componente dinámico de estos modelos, los resultados son un primer paso para el diseño de un sistema de alerta temprana en salud que tome en cuenta la variabilidad climática. Introduction: Acute respiratory infection is one of the most significant causes of morbidity in Bogota, and its burden of disease has increased in association with climate variability . Objective: The aim of the study was to evaluate weekly trends of acute respiratory infection in relation to meteorological variables (temperature, relative humidity and cumulative rainfall) in Bogota during 2011 and 2012. Materials and methods: Epidemiological and meteorological data from 104 weeks were gathered. Temporal variability was taken into account including previous weeks and spatial variability was considered by studying each zone of the city separately (north, south, east, west). Statistical analysis was performed through Poisson dynamic regression models. Results: The relative humidity had the greater impact on acute respiratory infection and its effects lasted between 8 to 10 weeks. Cumulative rainfall had effects only in the east zone, while the temperature presented mild effects across the four different zones of the city. Conclusion: Such results are the first step for the design of health-related early warning systems associated with climate variability.
Resultados  1-10 de 346