Microbial and potentially toxic elements risk assessment in high Andean river water based on Monte Carlo simulation, Peru.

The study evaluated microbial and Potentially Toxic Elements-PTEs risks in high Andean river water in Peru using Monte Carlo simulation. A total of 144 water samples were collected from four rivers and evaluated for physicochemical parameters, PTEs and bacterial pathogens. The microbial risk analysis for exposure to pathogens present in the water was based on the probability of occurrence of diseases associated with Escherichia coli, Pseudomonas aeruginosa and enterococci. PTEs risk analysis was performed using a Monte Carlo simulation approach. The results showed that the highest microbial risk due to exposure to water contaminated by E. coli, P. aeruginosa and enterococci was recorded in the Miraflores and Chia rivers. Meanwhile, the analysis of carcinogenic and non-carcinogenic risk by PTEs in adults and children revealed that the Chia river presents a high risk of contamination by PTEs, especially the carcinogenic risk for children. The Monte Carlo simulation indicated a 56.16% and 94.85% probability of exceeding the limit value of 0.0001 for carcinogenic risk in adults and children, respectively. It can be concluded that children consuming the waters of the Chia river are potentially at risk of As toxicity.

Human Health Risk Assessment for Exposure to Heavy Metals via Dietary Intake of Rainbow Trout in the Influence Area of a Smelting Facility Located in Peru.

Abandoned mining-metallurgical sites can significantly impact the environment and human health by accumulating heavy metals in aquatic ecosystems. The water in the sub-basin near an abandoned smelting facility in the city of La Oroya, Peru, is primarily used for pisciculture. The objective of this study was to assess the risk to human health from exposure to heavy metals via dietary intake of rainbow trout (Oncorhynchus mykiss) in the influence area of a smelting facility located in the central Andean region of Peru. The bioconcentration factor, biosediment accumulation factor, and consumption risks were evaluated using the Monte Carlo method. The results showed that the concentrations of elements (Zn > Pb > Cu > As) in rainbow trout muscle did not exceed the maximum limit (ML). However, the water significantly exceeded the ML for Pb in all sectors and As in the lower and middle parts of the river. The concentration of Pb in sediments also significantly exceeded the ML in the upper and lower parts of the river. Consequently, rainbow trout consumption in the study area presents risks to human health due to the bioaccumulation of heavy metals, with a 1.27% carcinogenic risk in samples from the lower part of the river.

Assessment of toxic metal contamination, distribution and risk in the sediments from lagoons used for fish farming in the central region of Peru.

Toxic metal contamination, distribution and risk were evaluated in the sediments of three lagoons used for fish farming in the central region of Peru. The distribution of toxic metals in the sediment was in the following descending order of Zn > V > Ni > Cu > Pb > As > Cr > Co > Cd > Sb. Contamination factor (Cf) and geoaccumulation index (Igeo) values for Co, Cr, Cu, Ni, Pb, Sb, V and Zn indicated low contamination and for Cd moderate contamination. The pollution load index (PLI) ranged from 0.3856 to 0.5622; indicating no appreciable contamination and the modified degree of contamination (mCd) corroborated this result. The potential ecological risk (Ri) in the Tranca Grande and Pomacocha lagoons revealed a low potential ecological risk and in Tipicocha a moderate potential ecological risk. HI values < 1 indicated that non-carcinogenic adverse effects were negligible. In adults, the Total carcinogenic risk (TCR) values for As, Cd, Cr, Ni and Pb were less than 1.00E-04, indicating no significant carcinogenic risk. In children, TCR values showed similar behavior with the exception of As. Therefore, considering that fish production for domestic consumption and export is carried out in these lagoons, it is important to continue monitoring toxic metals to protect the health of these ecosystems and human health.

Data on the concentration of heavy metals and metalloids in lotic water of the Mantaro river watershed and human risk assessment, Peru.

This article contains data on the concentration of heavy metals and metalloids in the water of seven rivers in the Mantaro river watershed in the central Andes of Peru, collected during the autumn of 2019. The concentrations of Cu, Fe, Pb, Zn and As were determined by flame atomic absorption spectrophotometry to assess human risk. The concentration of heavy metals and arsenic varied according to the sector of the rivers evaluated. The cluster analysis identified four different groups among the observation sectors. The risk assessment for humans was conducted on the basis of exposure doses to heavy metals and arsenic in water by ingestion and dermal pathways, using standard methods established by USEPA. These data can be reused as a basis for estimating the cancer risk or as a comparison group for future risk studies. They can also be useful to public health policy makers when proposing surveillance and control programmes using remedial technologies.

Physician Acceptance of a Physician-Pharmacist Collaborative Treatment Model for Hypertension Management in Primary Care.

Physician-pharmacist collaborative care (PPCC) is effective in improving blood pressure (BP) control, but primary care provider (PCP) engagement in such models has not been well-studied. The authors analyzed data from PPCC referrals to 108 PCPs, for patients with uncontrolled hypertension, assessing the proportion of referral requests approved, disapproved, and not responded to, and reasons for disapproval. Of 2232 persons with uncontrolled hypertension, PPCC referral requests were sent for 1516 (67.9%): 950 (62.7%) were approved, 406 (26.8%) were disapproved, and 160 (10.6%) received no response. Approval rates differed widely by PCP with a median approval rate of 75% (interquartile range, 41%-100%). The most common reasons for disapproval were: PCP prefers to manage hypertension (19%), and BP controlled per PCP (18%); 8% of cases were considered too complex for PPCC. Provider acceptance of a PPCC hypertension clinic was generally high and sustained but varied widely among PCPs. No single reason for disapproval predominated.