Brumadinho Health Project: methodological aspects and epidemiological profile of participants in the cohort baseline.

OBJECTIVE: To present the methodological aspects of the Brumadinho Health Project and to describe the epidemiological profile of participants in the baseline cohort. METHODS: Prospective, population-based cohort study in a representative sample of residents (aged 12 and over) of Brumadinho, Minas Gerais, after a mining tailings dam failure. Information for the baseline was collected in 2021, two years after the mining tailings dam collapsed, including sociodemographic, health and service use aspects, among others. Prevalence estimates of health outcomes were described in Brumadinho, as well as in the Metropolitan Region of Belo Horizonte and Minas Gerais, using data from the 2019 National Health Survey. All analyses were performed in the software Stata 17.0, considering the sampling weights and design effect. RESULTS: 3,080 (86.4%) residents participated in the study, most of them being females (56.7%) and with a mean age of 46.1 years. The diseases more frequently reported were arterial hypertension (30.1%), high cholesterol (23.1%) and depression (22.5%), similarly to what was observed in the Metropolitan Region of Belo Horizonte and Minas Gerais, although the prevalence in Brumadinho was higher. At least one medical appointment and one hospitalization occurred in 75.2% and 9.4% of residents in the past year, respectively. CONCLUSION: It is important to monitor health, physical and mental conditions of residents after the occurrence of a disaster of this magnitude. This information can contribute with risk management of these processes, not only in the affected municipality, but also in other areas where populations are at risk of major disasters.

Prevalence of metal levels above the reference values in a municipality affected by the collapse of a mining tailings dam: Brumadinho Health Project.

OBJECTIVE: To describe the prevalence of levels of arsenic, cadmium, mercury, lead and manganese above the reference values (RV) in the population of Brumadinho, after the rupture of the mining tailings dam and to verify the factors associated with these levels. METHODS: Baseline study of a prospective cohort, in a representative sample of 3,080 residents (aged 12 and over) in Brumadinho, Minas Gerais. Exploratory variables (age, sex, skin color, household income, smoking and place of residence) were collected using a questionnaire and the levels of As, Cd and Hg in urine and Pb and Mn in blood were evaluated using the technique of inductively coupled plasma mass spectrometry. The distribution of prevalence of levels above the reference for metals was made, according to the exploratory variables. Multiple logistic regression analyzes were used to investigate the association between altered levels of metals and characteristics evaluated. RESULTS: Concentrations above RV were found in 38.08% of the population for Mn, 33.37% for As, 5.04% for Pb, 0.76% for Hg and 0.17% for Cd. There was a significant association between age group and levels of Mn and Pb; and between place of residence and As level. CONCLUSION: The results show a high prevalence of levels above the reference for Mn, As and Pb, with small differences in relation to the other variables, suggesting that it is an exposure distributed throughout the municipality.

Prenatal Exposure to Metals and Neurodevelopment in Infants at Six Months: Rio Birth Cohort Study of Environmental Exposure and Childhood Development (PIPA Project).

The PIPA Project is a prospective birth cohort study based in Rio de Janeiro, Brazil, whose pilot study was carried out between October 2017 and August 2018. Arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg) concentrations were determined in maternal (n = 49) and umbilical cord blood (n = 46). The Denver Developmental Screening Test II (DDST-II) was applied in 50 six-month-old infants. Metals were detected in 100% of the mother and newborn samples above the limits of detection. Maternal blood lead concentrations were higher in premature newborns (GM: 5.72 µg/dL; p = 0.05). One-third of the infants (n = 17-35.4%) exhibited at least one fail in the neurodevelopment evaluation (fail group). Maternal blood arsenic concentrations were significantly (p = 0.03) higher in the "fail group" (GM: 11.85 µg/L) compared to infants who did not fail (not fail group) (GM: 8.47 µg/L). Maternal and umbilical cord blood arsenic concentrations were higher in all Denver Test's domains in the "fail group", albeit non-statistically significant, showing a tendency for the gross motor domain and maternal blood (p = 0.07). These findings indicate the need to further investigate the toxic effects of prenatal exposure to metals on infant neurodevelopment.

Prevalence of metal levels above the reference values in a municipality affected by the collapse of a mining tailings dam: Brumadinho Health Project / Prevalência dos níveis de metais acima dos valores de referência em município atingido pelo rompimento de barragem de rejeitos da mineração: Projeto Saúde Brumadinho

ABSTRACT Objective: To describe the prevalence of levels of arsenic, cadmium, mercury, lead and manganese above the reference values (RV) in the population of Brumadinho, after the rupture of the mining tailings dam and to verify the factors associated with these levels. Methods: Baseline study of a prospective cohort, in a representative sample of 3,080 residents (aged 12 and over) in Brumadinho, Minas Gerais. Exploratory variables (age, sex, skin color, household income, smoking and place of residence) were collected using a questionnaire and the levels of As, Cd and Hg in urine and Pb and Mn in blood were evaluated using the technique of inductively coupled plasma mass spectrometry. The distribution of prevalence of levels above the reference for metals was made, according to the exploratory variables. Multiple logistic regression analyzes were used to investigate the association between altered levels of metals and characteristics evaluated. Results: Concentrations above RV were found in 38.08% of the population for Mn, 33.37% for As, 5.04% for Pb, 0.76% for Hg and 0.17% for Cd. There was a significant association between age group and levels of Mn and Pb; and between place of residence and As level. Conclusion: The results show a high prevalence of levels above the reference for Mn, As and Pb, with small differences in relation to the other variables, suggesting that it is an exposure distributed throughout the municipality.

RESUMO Objetivo: Descrever a prevalência dos níveis dos metais arsênio, cádmio, mercúrio, chumbo e manganês acima dos valores de referência (VR) na população de Brumadinho, após o rompimento da barragem de rejeitos de mineração, e verificar os fatores associados a esses níveis. Métodos: Estudo da linha de base de uma coorte prospectiva, em amostra representativa de 3.080 residentes (12 anos ou mais de idade) de Brumadinho, Minas Gerais. As variáveis exploratórias (idade, sexo, cor de pele, renda domiciliar, tabagismo e local de residência) foram coletadas por questionário, e os níveis de As, Cd e Hg na urina e de Pb e Mn no sangue foram avaliados pela técnica de espectrometria de massa com plasma indutivamente acoplado. Fez-se a distribuição das prevalências de níveis acima da referência para os metais, segundo as variáveis exploratórias. Análises de regressão logística múltipla foram utilizadas para averiguar associação entre os níveis alterados de metais e as características avaliadas. Resultados: Encontraram-se concentrações acima do VR em 38,08% da população para Mn, 33,37% para As, 5,04% para Pb, 0,76% para Hg e 0,17% para Cd. Houve associação significativa entre a faixa etária e os níveis de Mn e Pb; e entre o local de residência e o nível de As. Conclusão: Os resultados demonstram elevada prevalência de níveis acima da referência para Mn, As e Pb, com pequenas diferenças em relação às demais variáveis, sugerindo se tratar de uma exposição distribuída em todo o município.

Brumadinho Health Project: methodological aspects and epidemiological profile of participants in the cohort baseline / Projeto Saúde Brumadinho: aspectos metodológicos e perfil epidemiológico dos participantes da linha de base da coorte

ABSTRACT: Objective: To present the methodological aspects of the Brumadinho Health Project and to describe the epidemiological profile of participants in the baseline cohort. Methods: Prospective, population-based cohort study in a representative sample of residents (aged 12 and over) of Brumadinho, Minas Gerais, after a mining tailings dam failure. Information for the baseline was collected in 2021, two years after the mining tailings dam collapsed, including sociodemographic, health and service use aspects, among others. Prevalence estimates of health outcomes were described in Brumadinho, as well as in the Metropolitan Region of Belo Horizonte and Minas Gerais, using data from the 2019 National Health Survey. All analyses were performed in the software Stata 17.0, considering the sampling weights and design effect. Results: 3,080 (86.4%) residents participated in the study, most of them being females (56.7%) and with a mean age of 46.1 years. The diseases more frequently reported were arterial hypertension (30.1%), high cholesterol (23.1%) and depression (22.5%), similarly to what was observed in the Metropolitan Region of Belo Horizonte and Minas Gerais, although the prevalence in Brumadinho was higher. At least one medical appointment and one hospitalization occurred in 75.2% and 9.4% of residents in the past year, respectively. Conclusion: It is important to monitor health, physical and mental conditions of residents after the occurrence of a disaster of this magnitude. This information can contribute with risk management of these processes, not only in the affected municipality, but also in other areas where populations are at risk of major disasters.

RESUMO: Objetivo: Apresentar os aspectos metodológicos do Projeto Saúde Brumadinho e descrever o perfil epidemiológico dos participantes da linha de base da coorte. Métodos: Coorte prospectiva, de base populacional, em amostra representativa dos residentes (12 anos ou mais de idade) de Brumadinho, Minas Gerais, após rompimento de barragem de rejeitos de mineração. As informações para a linha de base foram coletadas em 2021, dois anos após o rompimento da barragem de rejeitos de mineração, incluindo aspectos sociodemográficos, de saúde, uso de serviços, entre outros. Foram descritas prevalências de desfechos em saúde em Brumadinho, bem como na região metropolitana de Belo Horizonte e em Minas Gerais, utilizando os dados da Pesquisa Nacional de Saúde de 2019. Todas as análises foram realizadas no Stata 17.0, considerando-se os pesos amostrais e o efeito de delineamento. Resultados: Participaram 3.080 (86,4%) moradores, sendo a maioria do sexo feminino (56,7%) e com média de idade de 46,1 anos. As doenças referidas mais frequentes foram hipertensão arterial (30,1%), colesterol alto (23,1%) e depressão (22,5%). Pelo menos uma consulta médica e uma hospitalização no último ano ocorreram em 75,2% e 9,4% dos entrevistados, respectivamente. Conclusão: É importante o monitoramento das condições de saúde, físicas e mentais, após ocorrência de um desastre dessa magnitude. Esse conhecimento poderá contribuir para a gestão de risco desses processos não só no município atingido, mas em outras áreas nas quais as populações estão sob risco de grandes desastres.

Food consumption according to the degree of processing, dietary diversity and socio-demographic factors among pregnant women in Rio de Janeiro, Brazil: The Rio Birth Cohort Study of Environmental Exposure and Childhood Development (PIPA project).

BACKGROUND: Relevant evidence has addressed the negative impact of food processing on health. However, maternal ultra-processed food consumption is poorly investigated. AIM: To analyze food consumption according to the degree of food processing, dietary diversity, and associated socio-demographic factors during pregnancy. METHODS: Cross-sectional data was taken from a birth cohort in Rio de Janeiro, Brazil, with 142 pregnant women. We assessed diet using a qualitative food frequency questionnaire and classified food items according to the NOVA classification system as non-ultra-processed-foods and ultra-processed-foods. Non-ultra-processed-food and ultra-processed-food scores were calculated, reflecting weekly intake of more than one subgroup. Dietary diversity of the non-ultra-processed-food diet fraction was described according to the Food and Agriculture Organization guidelines. The association between food consumption and socio-demographic factors were investigated using logistic regression models. RESULTS: Over 60% of the pregnant women reported consumption of at least three non-ultra-processed-food groups. However, only 25% had adequate dietary diversity. The level of education (Complete high school: odds ratio, 5.36; 95% confidence interval, 1.73-16.65) was associated with regular intake of "meat and eggs." Among the ultra-processed-food score, 27% of the participants described a weekly consumption of at least two ultra-processed-food subgroups. White women (odds ratio, 2.63; 95% confidence interval, 1.05-6.63) had a higher chance of reporting "packaged ready meals" consumption. CONCLUSIONS: This study shows a high weekly consumption of ultra-processed-food subgroups and low dietary diversity of the non-ultra-processed-food fraction of the diet of pregnant women in Brazil. Our results elucidate the influence of socio-demographic characteristics on diet quality during pregnancy.