Consultas por enfermedades respiratorias agudas en la población pediátrica y su relación con el material particulado atmosférico en Bahía Blanca: un estudio ecológico / Consultations for acute respiratory diseases in the pediatric population and their relationship with atmospheric particulate matter in Bahía Blanca: an ecological study

Introducción. El material particulado (PM) es uno de los contaminantes del aire que mayor implicación tienen en la aparición o exacerbación de cuadros respiratorios en niños. Objetivo. Describir las características de las consultas por enfermedades respiratorias agudas en menores de 15 años, los niveles de PM en el aire, y analizar la asociación existente entre ellos en un sector de Bahía Blanca entre abril de 2019 y marzo de 2020. Población y métodos. Estudio ecológico de series temporales y grupos múltiples. Análisis descriptivo de consultas totales, por área, diagnóstico, y del PM. Modelo de correlación y regresión lineal generalizado para determinar la relación entre las variables. Se utilizó el programa SPSS®. Resultados. Se recopilaron 4787 consultas. Un 38,6 % (1846) correspondieron a rinitis y un 21,1 % (1011) a broncoespasmo. El PM de 10 nm (PM10) superó su valor límite el 31 % (115) de los días de estudio y el de 2,5 nm (PM2,5) un 3 % (8). Un aumento del 10 % del PM2,5 demostró incrementos de 1,3 % en las consultas totales; el incremento llegó al 2,1 % en el área más cercana al sector industrial (p <0,05). En esta última, el aumento del 10 % de los valores de PM10 se asoció al aumento del 1,8 % de las consultas (p <0,05). Conclusión. Se demostró asociación positiva entre las consultas por enfermedad respiratoria aguda y los niveles de PM del aire, sobre todo con el PM2,5 y en el área más cercana al sector industrial.

Introduction. Particulate matter (PM) is one of the air pollutants most involved in the onset or exacerbation of respiratory conditions in children. Objective. To describe the characteristics of consultations for acute respiratory diseases in children younger than 15 years and the levels of PM in the air and to analyze their association in a sector of Bahía Blanca between April 2019 and March 2020. Population and methods. Ecological, time-series study with multiple groups. Descriptive analysis of total number of consultations, by area, diagnosis, and PM. Generalized linear correlation and regression model to determine the relationship among variables. The SPSS® software was used. Results. Data from 4787 consultations were collected. Of these, 38.6% (1846) were related to rhinitis and 21.1% (1011), to bronchospasm. PM of 10 nm (PM10) exceeded its limit value on 31% (115) of the study days, and PM of 2.5 nm (PM2.5), on 3% (8). A 10% increase in PM2.5 showed increases of 1.3% in total consultations; the increase reached 2.1% in the area closest to the industrial sector (p < 0.05). In the latter, a 10% increase in PM10 was associated with an increase of 1.8% in consultations (p < 0.05). Conclusion. A positive association was evidenced between consultations for acute respiratory diseases and PM levels in the air, especially with PM2.5 and in the area closest to the industrial sector.

Ambient Fine Particulate Matter Exposure and Blood Pressure: Evidence from a Large Chinese Multiple Follow-Up Study / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to investigate the association of ambient PM2.5 exposure with blood pressure (BP) at the population level in China.@*METHODS@#A total of 14,080 participants who had at least two valid blood pressure records were selected from the China Health and Retirement Longitudinal Survey during 2011-2015. Their long-term PM2.5 exposure was assessed at the geographical level, on the basis of a regular 0.1° × 0.1° grid over China. A mixed-effects regression model was used to assess associations.@*RESULTS@#Each decrease of 10 μg/m3 in the 1 year-mean PM2.5 concentration (FPM1Y) was associated with a decrease of 1.24 [95% confidence interval (CI): 0.84-1.64] mmHg systolic BP (SBP) and 0.50 (95% CI: 0.25-0.75) mmHg diastolic BP (DBP), respectively. A robust association was observed between the long-term decrease in PM2.5 and decreased BP in the middle-aged and older population. Using a generalized additive mixed model, we further found that SBP increased nonlinearly overall with FPM1Y but in an approximately linear range when the FPM1Y concentration was < 70 µg/m3; In contrast, DBP increased approximately linearly without a clear threshold.@*CONCLUSION@#Efficient control of PM2.5 air pollution may promote vascular health in China. Our study provides robust scientific support for making the related air pollution control policies.

Characteristics and Differences of Household Fine Particulate Matter Pollution Caused by Fuel Burning in Urban and Rural Areas in China / 中国医学科学院学报

Objective To explore the overall level,distribution characteristics,and differences in household fine particulate matter (PM2.5) pollution caused by fuel burning in urban and rural areas in China. Methods The relevant articles published from 1991 to 2021 were retrieved and included in this study.The data including the average concentration of household PM2.5 and urban and rural areas were extracted,and the stoves and fuel types were reclassified.The average concentration of PM2.5 in different areas was calculated and analyzed by nonparametric test. Results The average household PM2.5 concentration in China was (178.81±249.91) μg/m3.The mean household PM2.5 concentration was higher in rural areas than in urban areas[(206.08±279.40) μg/m3 vs. (110.63±131.16) μg/m3;Z=-5.45,P<0.001] and higher in northern areas than in southern areas[(224.27±301.66) μg/m3 vs.(130.11±140.61) μg/m3;Z=-2.38,P=0.017].The north-south difference in household PM2.5 concentration was more significant in rural areas than in urban areas[(324.19±367.94) μg/m3 vs.(141.20±151.05) μg/m3,χ2=-5.06,P<0.001].The PM2.5 pollution level showed differences between urban and rural households using different fuel types (χ2=92.85,P<0.001),stove types (χ2=74.42,P<0.001),and whether they were heating (Z=-4.43,P<0.001).Specifically,rural households mainly used solid fuels (manure,charcoal,coal) and traditional or improved stoves,while urban households mainly used clean fuels (gas) and clean stoves.The PM2.5 concentrations in heated households were higher than those in non-heated households in both rural and urban areas (Z=-4.43,P<0.001). Conclusions The household PM2.5 pollution caused by fuel combustion in China remains a high level.The PM2.5 concentration shows a significant difference between urban and rural households,and the PM2.5 pollution is more serious in rural households.The difference in the household PM2.5 concentration between urban and rural areas is more significant in northern China.PM2.5 pollution in the households using solid fuel,traditional stoves,and heating is serious,and thus targeted measures should be taken to control PM2.5 pollution in these households.

Environmental exposure to cadmium but not lead is associated with decreased semen quality parameters: quality regionalism of sperm properties / 亚洲男科学杂志(英文版)

Environmental factors may negatively contribute to a progressive worsening of semen quality, and differences in semen quality may result from different environmental exposures (regional differences) or lifestyle differences. Heavy metals are factors with a confirmed negative influence on male fertility. Among them, lead and cadmium are commonly found in human surroundings. Thus, we analyzed semen parameters (according to the World Health Organization 2010 recommendations) and semen lead and cadmium concentrations in 188 men from two different regions in Poland, a typical agricultural area and an industrial area, in couples that had been diagnosed with infertility. The assays were performed using flameless electrothermal atomic absorption spectrometry. In the statistical analysis, regional comparisons and then taxonomic comparisons based on three parameters (age, semen concentration, and sperm morphology) were applied. We showed that more cadmium than lead accumulated in semen, a higher cadmium concentration was observed in semen obtained from men from the agricultural region, and better semen quality and lower cadmium concentrations were found in the semen of men from the industrial, more polluted region. We thus showed an existing regionalism in the sperm quality properties. However, semen parameters such as morphology and progressive and nonprogressive motility followed the same trends, regardless of the patient's age, region, or class. We could conclude that the environment has a minor impact on sperm morphology and progressive and nonprogressive motility and that other existing factors could have an indirect influence on semen quality.

Association between short-term exposure to ambient nitrogen dioxide and the risk of heart failure hospitalization / 中华预防医学杂志

Objective: To assess the association between short-term exposure level of nitrogen dioxide and the hospitalization risk of heart failure. Methods: Based on China-PEACE Retrospective Heart Failure Study, 117 364 hospitalized patients with heart failure were recruited from 92 hospitals in 62 cities throughout China between January 1, 2015 and December 31, 2015. The daily exposure level of nitrogen dioxide, temperature, and humidity in the same cities during the same period were also collected. We applied the generalized additive model and Bayesian hierarchical model to quantify the lagged effect and cumulative effect of short-term (0-3 days) exposure to ambient nitrogen dioxide on the hospitalization risk of heart failure. We further conducted stratified analyses by age, region, and season to identify any difference in the associations between short-term nitrogen dioxide exposure and heart failure among subgroups. Results: The mean age for participants in the analysis was (70.32±12.22) years. The median, minimum and maximum of daily nitrogen dioxide concentration in 62 cities from January 1, 2015 to December 31, 2015 was 26.4 μg/m3, 2.33 μg/m3 and 150.25 μg/m3, respectively. The exposure level of nitrogen dioxide at the same day was associated with the hospitalization risk of heart failure (OR=1.022, 95%CI: 1.012, 1.031). Significant effects were also observed in the moving average concentrations from lag 0-1 to lag 0-3 day (OR=1.020, 95%CI: 1.009, 1.030; OR=1.016, 95%CI: 1.004, 1.028; OR=1.013, 95%CI: 1.001, 1.026). Moreover, all of the associations between short-term exposure to nitrogen dioxide and the risk of heart failure hospitalization were statistically significant, with no significant difference in all subgroups stratified by age, region, and season. Conclusion: A higher level of short-term exposure to nitrogen dioxide could trigger more hospitalizations with heart failure.

A panel study on the acute respiratory effects of ambient particles of different sizes on children in Shanghai / 中华预防医学杂志

Objective: To explore the association between size-fractionated particle number concentrations (PNC) and respiratory health in children. Methods: From November 2018 to June 2019, there were 65 children aged 6-9 years from an elementary school in shanghai recruited in this panel study with three rounds of follow-up. The forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and exhaled nitric oxide (FeNO) levels were measured and buccal mucosa samples of children were collected at each follow-up visit. The level of PNC, temperature and humidity of the elementary school was monitored from 3 days before each physical examination to the end of the physical examination. The linear mixed effects model was used to analyze the association between PNC and indicators of respiratory health in children. Results: Linear mixed effects model analysis revealed that, at lag 2 day, an interquartile range increase in PNC for particles measuring 0.25-0.40 μm was associated with the absolute changes in FVC, FEV1 and abundance-based coverage estimator (ACE) about -60.15 ml (95%CI:-88.97 ml, -31.32 ml), -34.26 ml (95%CI:-63.22 ml, -5.31 ml), -6.00 (95%CI:-9.15, -2.84) and percentage change in FeNO about 12.10% (95%CI: 3.05%, 21.95%), respectively. These adverse health effects increased with the decrease of particle size. Conclusion: The short-term exposure to particulate matter is associated with reduced lung function, buccal microbe diversity and higher airway inflammation level among children. These adverse health effects may increase with the decrease of particle size.

Simultaneous quantification of pyrethroid metabolites in urine of non-toilet-trained children in Japan

BACKGROUND@#Pyrethroid (PYR) insecticides are widely used for controlling various pests. There are two types that differ in terms of usage: agricultural-purpose PYR (agriculture-PYR) and hygiene purpose PYR (hygiene-PYRs). Few studies exist on the exposure to these chemicals in small children. In this study, we conducted biomonitoring of urinary pyrethroid metabolites in 1.5-year-old children throughout the year.@*METHODS@#Study subjects were 1075 children participating in an Aichi regional sub-cohort of the Japan Environment and Children's Study as of 18-month health check-up. The concentrations of four specific hygiene-PYR metabolites including 2,3,5,6-tetrafluoro-1,4-benzenedimethanol (HOCH2-FB-Al), and five common metabolites of hygiene- and agriculture-PYRs including 3-phenoxybenzoic acid (3PBA) and cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (DCCA), were measured in urine samples extracted from soiled diapers using a triple quadrupole gas chromatograph-mass spectrometer.@*RESULTS@#The highest detection frequencies were for 3PBA, followed by DCCA, 1R-trans-chrysanthemum dicarboxylic acid, and HOCH2-FB-Al. Among the six metabolites, urinary concentrations were seasonally varied. However, this variation was not observed in the most studied PYR metabolite, 3PBA. Spearman's correlation analysis demonstrated a significant positive correlation between FB-Al and DCCA (r = 0.56) and HOCH2-FB-Al and 4-methoxymethyl-2,3,5,6-tetrafluorobenzyl alcohol (r = 0.60).@*CONCLUSIONS@#This biomonitoring survey found widespread and seasonally specific exposure to multiple hygiene- and agriculture-PYRs in 1.5-year-old Japanese children.

Cardiovascular and Cerebrovascular Diseases Induced by Air Pollution / 中国医学科学院学报

Air pollution has severe detrimental effects on public health.A substantial number of studies have demonstrated that air pollution exposure is a risk factor for the occurrence of cardiovascular and cerebrovascular diseases and a cause of non-communicable diseases.Both long-term and short-term exposure to air pollution are associated with respiratory diseases,stroke,coronary artery disease,and diabetes.Aiming to better understand the association,we reviewed the latest studies about the association of air pollution with cardiovascular and cerebrovascular diseases,especially stroke,coronary heart disease,arrhythmia,hypertension,and heart failure,and summarized the underlying mechanisms of the health damage caused by long-term and short-term exposure to air pollution.

Impact of birth season on the years of life lost from respiratory diseases in the elderly related to ambient PM

BACKGROUND@#Ambient fine particle (PM@*METHODS@#A time-stratified case-crossover design was used to analyze YLL from respiratory diseases in the elderly related to ambient PM@*RESULTS@#Each 10 μg/m@*CONCLUSIONS@#Birth season which reflects the early-life PM

Exposição ao uso da lenha para cocção no Brasil e sua relação com os agravos à saúde da população / Exposure to the use of firewood for cooking in Brazil and its relation with the health problems of the population

Resumo A poluição do ar em ambientes fechados é agravada pela queima de lenha em fogões rústicos e ambientes pouco ventilados. A exposição aos poluentes emitidos por este tipo de combustível resulta no aumento da morbidade e da mortalidade. No Brasil, os estudos e as estimativas são escassos. Visando entender esta problemática, o objetivo deste trabalho foi investigar o uso de lenha utilizando as séries de dados das agências governamentais para estimar o número de pessoas expostas. Os resultados apontam que a lenha é o segundo combustível mais usado para cozinhar, sendo utilizada por uma parcela significativa da população, em torno de 30 milhões de brasileiros. Um fator decisivo no maior uso deste combustível é o nível socioeconômico da população associada ao preço do gás liquefeito de petróleo (GLP). Os estudos realizados no país registraram concentrações altas de partículas durante a queima da lenha, excedendo os limites sugeridos pela Organização Mundial da Saúde (OMS). Também foram observadas associações entre a exposição aos poluentes gerados pela queima e o agravamento dos mais diversos problemas de saúde, dentre eles doenças respiratórias e câncer. A substituição da lenha e outros combustíveis sólidos por combustíveis mais limpos deve ser a meta do governo para minimizar custos com a saúde.

Abstract Indoor air pollution is exacerbated by the burning of firewood in rustic stoves and poorly ventilated environments. Exposure to the pollutants emitted by this type of fuel results in increased morbidity and mortality. In Brazil, studies and estimates regarding these conditions are scarce. In order to understand this problem, the objective of this work was to investigate the use of firewood using the data series of government agencies to estimate the number of exposed people. The results indicated that firewood is the second most used fuel for cooking, being used by a significant portion of the population, more than 30 million Brazilians. A decisive factor in the increased use of this fuel is the socioeconomic level of the population associated with the price of liquefied petroleum gas (LPG). The studies carried out in the country recorded high concentrations of particles during firewood burning, exceeding the limits suggested by the World Health Organization (WHO). Associations were also observed between the exposure to the pollutants generated by the burning and the aggravation of health problems, among them respiratory diseases and cancer. Replacing fuelwood and other solid fuels with cleaner fuels should be the government's goal to minimize health costs.

Valores de referencia pediátricos de cromo y mercurio en orina del área de la Ciudad de Buenos Aires y alrededores / Pediatric reference values for chromium and mercury in urine in the City of Buenos Aires and Greater Buenos Aires

Introducción. Debido a la fuerte industrialización de la Ciudad de Buenos Aires y alrededores, la población podría estar expuesta a metales. Para poder evaluar el nivel de exposición de los niños al cromo y al mercurio, es fundamental tener valores de referencia (VR) propios. El objetivo fue determinar los VR pediátricos para cromo y mercurio en la muestra aislada de orina. Población y métodos: Se incluyeron niños y niñas no expuestos a los contaminantes evaluados que concurrieron al Servicio de Bajo Riesgo y al Consultorio del Jardín Maternal del Hospital de Pediatría S.A.M.I.C. "Prof. Dr. Juan P. Garrahan". Se cuantificó cromo (UCr), mercurio (UHg) y creatinina urinarios. Se calcularon los p95 con su intervalo de confianza del 95 % [IC 95 %] según el concepto para VR de la German Human Biomonitoring Commission. Resultados: Se incluyeron 160 pacientes en el estudio. Se obtuvieron 144 muestras de niños y niñas de entre 1 y 17 años (mediana: 7 años). Se cuantificó UCr a 137 muestras y UHg a 129. La mediana y rango de cromo fue 0,54 (indetectable -3,06) µg/g de creatinina y la de mercurio fue 0,49 (indetectable -7,57) µg/g de creatinina.Conclusiones: Los VR fueron, para UCr, hasta 1,5 µg/l [1,2-2,8] y hasta 2,2 µg/g de creatinina [1,8-3,0] y para UHg, hasta 2,5 µg/l [1,8-4,8] y 3,2 µg/g de creatinina [2,5-4,7

Introduction. Due to the heavy industrialization of the Autonomous City of Buenos Aires and Greater Buenos Aires, the population may have become exposed to metals.To assess the level of exposure to chromium and mercury in children, it is critical to have local reference values (RVs). Our objective was to determine pediatric RVs for chromium and mercury in a single urine sample.Population and methods: Children who were not exposed to the studied contaminants and who attended the Department of Low Risk Conditions and the Daycare Center Office of Hospital de Pediatría S.A.M.I.C. "Prof. Dr. Juan P. Garrahan" were included. Urinary chromium (UCr), urinary mercury (UHg), and urinary creatinine were measured. The p95 and its corresponding 95 % confidence interval (CI) were estimated based on the RV concept proposed by the German Human Biomonitoring Commission.Results: The study included 160 patients. A total of 144 samples from children aged 1-17 years (median: 7 years) were collected. UCr was measured in 137 samples and UHg, in 129 samples. The median value of chromium was 0.54 µg/g of creatinine (range, undetectable to 3.06), while that of mercury was 0.49 µg/g of creatinine (range, undetectable to 7.57). Conclusions: The RVs for UCr were up to 1.5 µg/L [1.2-2.8] and up to 2.2 µg/g of creatinine [1.8-3.0], and for UHg, up to 2.5 µg/L [1.8-4.8] and 3.2 µg/g of creatinine [2.5-4.7]

Impacto del Material Particulado aéreo (MP 2, 5 ) sobre las hospitalizaciones por enfermedades respiratorias en niños: estudio caso-control alterno / Impact of Particulate Matter (PM 2, 5 ) and children's hospitalizations for respiratory diseases: a case cross-over study

INTRODUCCIÓN: Santiago de Chile con 7 millones de habitantes alcanza elevados niveles de contaminación atmosférica en invierno, el material particulado habitualmente excede los estándares de la OMS. OBJETIVO: Evaluar la influencia de la contaminación atmosférica por material particulado en las hospitalizaciones por enfermedades respiratorias en niños, entre 2001 y 2005 en la Región Metropolitana de Chile, independientemente de la presencia ambiental de virus sincicial respiratorio (VRS). MATERIAL Y MÉTODO: 72.479 hospitalizaciones públicas y privadas por enfermedades respiratorias de niños menores de 15 años residentes en la región del estudio se analizaron con un diseño de caso control alternante, con estratificación temporal. Se evaluó principalmente: hospitalizaciones por enfermedades respiratorias (J00-J99), neumonía (J12-J18); asma (J21.0 - J21.9) y bronquiolitis (J45 - J46). Recopilándose diariamente temperatura, MP10, MP2,5, ozono, virus respiratorios (VRS) y humedad ambientales. RESULTADOS: Los promedios de MP10 y MP2,5 fueron 81,5 y 41,2 pg/m3 respectivamente. El promedio de temperatura fue 12,8 °C y de la humedad del aire 72,6 %. Un aumento de 10 pg/m3 de MP25 con 1 y 2 días de rezago se asoció con un incremento de las hospitalizaciones por enfermedades respiratorias cercano a 2%, este porcentaje aumentó a 5% cuando la exposición fue con 8 días de rezago, reflejando sinergismo entre material particulado y virus respiratorio (VRS). CONCLUSIÓN: La exposición breve a contaminación atmosférica puede provocar hospitalizaciones por enfermedades respiratorias en niños.

INTRODUCTION: With seven million inhabitants, Santiago de Chile reaches high levels of air pollution in winter, the particulate matter usually exceeds WHO standards. OBJECTIVE: To assess the influence of air pollution caused by particulate matter on children's hospitalizations due to respiratory diseases between 2001 and 2005 in the Metropolitan Region of Chile, independently from the environmental presence of respiratory syncytial virus (RSV). MATERIAL AND METHOD: 72,479 public and private hospitalizations due to respiratory diseases of children under 15 years of age residing in the study region were analyzed using a time-stratified alternating case-control design. The main evaluations were: hospitalizations due to respiratory diseases (J00-J99), pneumonia (J12-J18); asthma (J21.0 - J21.9), and bronchiolitis (J45 - J46). Daily compilation of temperature data, PM10, PM2,5, ozone, respiratory virus (RSV), and environmental humidity. RESULTS: Mean values of PM10 and PM2.5 were 81.5 and 41.2 pg/m3 respec tively. The average temperature was 12.8 °C and air humidity 72.6%. An increase of 10 pg/m3 of PM25 with one and two days of lag was associated with an hospitalizations increase due to respiratory diseases close to 2%, this percentage increased to 5% when the exposure was with eight days of lag, reflecting synergism between particulate matter and respiratory viruses (RSV). CONCLUSION: Short air pollution exposure can lead to children's hospitalizations due to respiratory diseases.

Spatial pattern of the environmental exposure to tin in the vicinity of an alloy industry in Volta Redonda, Rio de Janeiro State, Brazil / Padrão espacial da exposição ambiental ao estanho nos arredores de uma indústria de ligas metálicas em Volta Redonda, Estado do Rio de Janeiro, Brasil / Patrón espacial de exposición ambiental al estaño en las proximidades de una industria de aleación en Volta Redonda, estado de Río de Janeiro, Brasil

Abstract: Despite being widely used in industry, the literature on tin and its effects in humans is scarce, especially regarding reference values in biological indicators such as blood and urine. Similarly, environmental limits are also rare. This study sought to assess the spatial distribution of hotspots in the environmental exposure to tin in the vicinity of an alloy industry in the south region of the state of Rio de Janeiro, Brazil. The study population consisted of 74 adults. Graphite furnace atomic absorption spectrometry determined tin in all samples. Households and points around the industry were georeferenced with the use of GPS to identify the most intense tin sites. Results of the first and second campaigns ranged from 0.022 to 0.153 and 0.003 to 0.445µg m-3 for the atmospheric air, whereas such ranges were 0.64 to 1.61 and 1.97 to 8.54µg m-2 for household dust, respectively. The mean tin concentration found in the blood of the population was 3.85 ± 1.57µg L-1. In urine the value was 3.56 ± 1.88µg L-1. The kernel map showed the highest spatial concentrations of tin in household dust in the eastern region of the industry. In the first sampling, atmospheric air samples presented the most elevated concentrations in the southwest and southeast. Although the direction of the wind was northwest, potentially high risks were concentrated in the central area in the second collection. The largest hotspots were in the north, south and southeast regions; however, urine samples showed medium to high levels in the west and east regions. Regarding blood samples, the greatest difference was the absence of hotspot areas in the west. Environmental monitoring becomes necessary to better assess the exposure to tin.

Resumo: O estanho é amplamente utilizado na indústria. A literatura sobre seus efeitos em humanos é escassa, principalmente quanto aos valores de referência em indicadores biológicos como sangue e urina. Também são raros os estudos sobre os limites do estanho no meio ambiente. O estudo teve como objetivo avaliar os pontos críticos da distribuição espacial da exposição ambiental ao estanho nos arredores de uma indústria de ligas metálicas na região sul do Estado do Rio de Janeiro, Brasil. A população do estudo consistiu em 74 adultos. O estanho foi medido em todas as amostras com a espectrometria de absorção atômica em forno de grafite. As residências e outros pontos em torno da indústria foram georreferenciados com GPS para identificar os locais com maior concentração de estanho. Os resultados da primeira e segunda campanhas variaram entre 0,022 e 0,153 e entre 0,003 e 0,445µg m-3 para o ar atmosférico, enquanto para a poeira doméstica as faixas foram 0,64-1,61 e 1,97-8,54µg m-2, respectivamente. A concentração sanguínea média de estanho na população foi 385 ± 1,57µg L-1 e na urina foi 3,56 ± 1,88µg L-1. O mapa kernel mostrou as concentrações mais elevadas de estanho na poeira doméstica nos arredores ao leste da indústria. Na primeira amostragem, o ar atmosférico apresentou as concentrações ao sudoeste e sudeste da fábrica. Entretanto, riscos potencialmente altos estiveram concentrados na área central, embora a direção do vento tenha sido noroeste na segunda coleta de amostras. Os maiores pontos críticos foram ao norte, sul e sudeste da indústria, mas as amostras de urina mostraram níveis moderados a altos ao oeste a ao leste. Nas amostras de sangue, a maior diferença foi a ausência de pontos críticos ao oeste da indústria. O monitoramento ambiental é necessário para melhor avaliar a exposição ao estanho.

Resumen: El uso del estaño está muy generalizado en la industria. La literatura sobre sus efectos en humanos es escasa, especialmente en lo que concierne a los valores de referencia en indicadores biológicos como sangre y orina. Igualmente, los límites ambientales también son raros. El objetivo de este estudio fue evaluar los puntos calientes de la distribución espacial de exposición ambiental al estaño, en las proximidades de una industria de aleación, en el sur del estado de Río de Janeiro, Brasil. El estudio poblacional contó con 74 adultos. La espectrometría de absorción atómica por horno de grafito halló estaño en todas las muestras. Asimismo, las residencias se georreferenciaron con puntos alrededor de la industria mediante GPS para identificar los lugares con mayor intensidad de estaño. Los resultados de la primera y segunda campaña oscilaron de 0,022 a 0,153 y 0,003 a 0,445µg m-3 en aire atmosférico, aunque tales rangos fueron de 0,64 a 1,61 y de 1,97 a 8,54µg m-2 en el caso de polvo doméstico, respectivamente. El promedio de concentración de estaño encontrado en la sangre de la población fue 3.85 ± 1.57µg L-1. Respecto a la orina, este valor fue 3.56 ± 1.88µg L-1. El mapa de kernel expuso que las concentraciones espaciales más altas de estaño en el polvo doméstico de las casas se encontraron en la región oriental de la industria. En la primera muestra, las muestras de aire atmosférico presentaron las concentraciones más elevadas en el suroeste y sureste. No obstante, los riesgos potencialmente altos se concentraron en el área central, a pesar de que la dirección del viento era noroeste en la segunda recogida de muestras. Los puntos calientes más grandes estuvieron en el norte, sur, y sureste. Sin embargo, las muestras de orina mostraron niveles de medios a altos en el oeste y este. Respecto a las muestras de sangre, la diferencia más grande fue la ausencia de áreas calientes en el oeste. El monitoreo ambiental se hace necesario para evaluar mejor la exposición al estaño.

Nivel de ruido ambiental en 2 unidades de cuidados críticos de un centro de tercer nivel de atención / Environmental noise levels in 2 intensive care units in a tertiary care centre

Resumen Introducción: La Organización Mundial de la Salud establece como nivel máximo de ruido 40 decibelios (dB) para una unidad de cuidados críticos. El objetivo de este estudio fue comparar la intensidad del nivel de ruido ambiental en 2 unidades de cuidados críticos de un hospital de tercer nivel de atención. Métodos: En un diseño observacional, descriptivo y transversal se comparó el nivel máximo de ruido dentro de la unidad de cuidados intensivos metabólicos y coronarios con un medidor digital. La medición en 4 puntos diferentes de cada habitación con intervalos de 5 min durante un período de 60 min se llevó a cabo a las 7:30, 14:30 y 20:30. El promedio de las observaciones se comparó con estadística descriptiva y U de Mann-Whitney. Un análisis con la prueba de Kruskal-Wallis se realizó para comparar los promedios de ruido en las diferentes lecturas. Resultados: Se observó que el ruido en la unidad de cuidados intensivos tuvo un promedio de 64.77 ± 3.33 dB (p = 0.08); algo similar sucedió en la unidad de cuidados intensivos metabólicos coronarios con un promedio de 60.20 ± 1.58 dB (p = 0.129). El 25% o más de las mediciones superaron hasta por 20 puntos lo recomendado por la Organización Mundial de la Salud. Conclusiones: El nivel de ruido que se encontró en las unidades de cuidados intensivos estudiadas sobrepasan el nivel máximo recomendado para un hospital. Es necesario diseñar y aplicar acciones para una mayor participación del personal de salud en la disminución del ruido ambiental.

Abstract Introduction: The World Health Organisation (WHO) has established a maximum noise level of 40 decibels (dB) for an intensive care unit. The aim of this study was to compare the noise levels in 2 different intensive care units at a tertiary care centre. Methods: Using a cross-sectional design study, an analysis was made of the maximum noise level was within the intensive coronary care unit and intensive care unit using a digital meter. A measurement was made in 4 different points of each room, with 5 minute intervals, for a period of 60 minutes 7:30, 14:30, and 20:30. The means of the observations were compared with descriptive statistics and Mann-Whitney U. An analysis with Kruskal-Wallis test was performed to the mean noise level. Results: The noise observed in the intensive care unit had a mean of 64.77 ± 3.33 dB (P = .08), which was similar to that in the intensive coronary care unit, with a mean of 60.20 ± 1.58 dB (P = .129). Around 25% or more of the measurements exceeded the level recommended by the WHO by up to 20 points. Conclusions: Noise levels measured in intensive care wards exceed the maximum recommended level for a hospital. It is necessary to design and implement actions for greater participation of health personnel in the reduction of environmental noise.

Analysis of the association between bladder carcinoma and arsenic concentration in soil and water in southeast Brazil

ABSTRACT In approximately 50% of cases of bladder carcinoma, an associated predisposing factor can be established. The main factors are exposure to tobacco, arsenic (As) ore and aromatic compounds. Arsenic is a metalloid with a low average concentration in the earth's crust, and one of the most dangerous substances for human health. The present study aims to evaluate the incidence of hospitalization and mortality from bladder neoplasia and its possible association with As concentration in water and soil in two of the most critical regions of Brazil: the states of São Paulo and Minas Gerais. We have investigated bladder cancer hospitalization and mortality in the states of Sao Paulo and Minas Gerais during 2010-2014. Water and soil samples were analyzed and As concentrations were established. Data were obtained through the Department of Informatics of the Brazilian Unified Health System. Correlation was made with water samples from São Paulo and with data on soil analysis from Minas Gerais. The results revealed no direct association in the distinctive municipalities. Areas with high environmental As concentration had a low bladder cancer rate, while areas with normal as levels had similar cancer rates. The quantitative variables did not present a normal distribution (p < 0.05). In conclusion, we did not observe a correlation between as concentration in water or soil and bladder cancer's hospitalization and mortality rates in the states of São Paulo and Minas Gerais.

Exposure to NO2 and children hospitalization due to respiratory diseases in Ribeirão Preto, SP, Brazil / Exposição ao NO2 e internações por doenças respiratórias em crianças em Ribeirão Preto, SP, Brasil

Abstract The effects of exposure to air pollutants on human health are mainly reflected in respiratory diseases in children and elderly ones. An ecological time series study was carried out in Ribeirão Preto/SP data to examine the role of exposure to air pollutants and hospital admissions due to respiratory diseases in children under 10 years old. The study period was between January, 2011 and December, 2013. Particulate Matter (PM10), Nitrogen dioxide (NO2), and ozone (O3), temperature and air relative humidity, were analyzed to estimate the association with hospital admissions using a generalized linear model of Poisson's regression with lags of zero up to seven days after exposure to pollutants, adjusted by the day of the week, seasonality and effective temperature. The significance level adopted was p < 0.05. NO2, when analyzed in single pollutant model shown to be significant at lag 2 and 3 and when analyzed in the multi-pollutant model it shown to be significant at lags 2 up to 5, and lag 7 with relative risk between 1.05 and 1.09 per 10 μg/m3 increase in NO2 concentration, with an excess of 150 hospital admission and substantial increase in costs to Public Health System. The data enable the local health managers can take action to minimize these effects.

Resumo Os efeitos da exposição aos poluentes do ar sobre a saúde humana são principalmente refletidos nas doenças respiratórias, em crianças e idosos. Este estudo, do tipo ecológico de séries temporais, foi realizado em Ribeirão Preto/SP para examinar o papel da exposição a poluentes do ar e internações hospitalares por doenças respiratórias em crianças de até 10 anos de idade. O período de estudo foi entre 01.01.2011 e 31.12.2013. Material partículado (PM10), dióxido de nitrogênio (NO2) e ozônio (O3), temperatura e umidade relativa do ar foram analisadas para estimar a associação com internações hospitalares usando um modelo linear generalizado da regressão de Poisson com defasagens de zero até sete dias após a exposição, ajustado pelo dia da semana, sazonalidade e temperatura efetiva. Foi adotado alfa = 0,05. NO2 quando analisado no modelo unipoluente mostrou significância nos lags 2 e 3 e quando avaliado no modelo multi-poluente foi significativo nos lags 2 até 5, e lag 7, com risco relativo entre 1,05 e 1,09 por 10 μg/m3 de aumento em sua concentração, com excesso de 150 internações e aumento substancial dos custos para o sistema de saúde pública. Os dados permitem que o gestor local de saúde possa tomar medidas para minimizar estes efeitos.

Ações para a melhoria do conforto acústico em instituições de educação infantil / Noise in early childhood education institutions

Resumo Elevados níveis de pressão sonora têm sido observados em escolas e, por sua interferência na saúde das crianças e professores, teve-se por objetivo analisar esses níveis em centros de educação infantil que atendem crianças com idades entre zero e seis anos, investigar a percepção dos funcionários quanto à exposição ao ruído e identificar a audição desses trabalhadores. O estudo foi realizado em dez instituições que empregam 320 trabalhadores. Os níveis de pressão sonora foram medidos segundo as normas técnicas, os funcionários preencheram questionário sobre a percepção do ruído e passaram por avaliação auditiva. Observou-se elevado nível de pressão sonora e diferenças entre as instituições, situações e locais. A maioria dos funcionários se considerou exposta ao ruído com dificuldades de atenção e concentração, ansiedade e dor de cabeça. Cerca de 30% dos funcionários apresentaram perda auditiva neurossensorial bilateral em frequências específicas. Os níveis de pressão sonora encontrados podem comprometer a aprendizagem das crianças e a saúde de todos. Os funcionários percebem o ruído e indicam prejuízos em sua rotina de trabalho. Ações para melhorar o conforto acústico nessas instituições foram discutidas e estão sendo implementadas.

Abstract High sound pressure levels have been observed in schools, and its interference in the health of children and teachers it was taken to analyze these levels in childhood education centers serving children aged zero to six years, investigate the staff's perceptions concerning noise exposure and identify the auditory conditions of these workers and the occurrence of diseases. The study was conducted in ten institutions employing 320 workers. Sound pressure levels were measured according to the technical norms; employees completed a questionnaire on the perception of noise and underwent auditory evaluation. There was high sound pressure level and differences between institutions, situations and places. Most employees are considered exposed to noise with attention and concentration difficulties, anxiety and headache. About 30% of employees had bilateral sensorineural hearing loss in specific frequency. The sound pressure levels found can affect children's learning and the health of all. The employees also perceived elevated levels of noise and indicated some possible negative aspects in their work routine. Actions to improve the acoustic comfort in these institutions will be discussed with the management teams.

Green spaces and mortality due to cardiovascular diseases in the city of Rio de Janeiro / Espaços verdes e mortalidade por doenças cardiovasculares no município do Rio de Janeiro

ABSTRACT OBJECTIVE Investigate the association between exposure to green spaces and mortality from ischemic heart and cerebrovascular diseases, and the role of socioeconomic status in this relationship, in the city of Rio de Janeiro, Brazil. METHODS Ecological study, with the census tracts as unit of analysis. This study used data from deaths due to ischemic heart and cerebrovascular diseases among residents aged over 30 years, from 2010 to 2012. Exposure to green was estimated using the Normalized Difference Vegetation Index based on satellite images. The associations between exposure to green spaces and mortality rates due to ischemic heart and cerebrovascular diseases, standardized by gender and age, were analyzed using conditional autoregressive models, adjusted for the density of light and heavy traffic routes, pollution proxy, and by the socioeconomic situation, measured by the Social Development Index. Analyzes stratified by socioeconomic levels were also carried out, given by the tertiles of the Social Development Index. RESULTS Among the greener sectors, with a Normalized Difference Vegetation Index above the third quartile, the reduction in mortality due to ischemic heart disease was 6.7% (95%CI 3.5-9.8) and cerebrovascular was 4.7% (95%CI 1.2-8.0). In the stratified analysis, the protective effect of green spaces on ischemic heart disease mortality was observed among the greenest sectors of all strata, and it was higher for those with a lower socioeconomic level (8.6%, 95%CI 1.8-15.0). In the case of mortality due to cerebrovascular diseases, the protective effect was verified only for the greenest sectors of the lowest socioeconomic level (9.6%, 95%CI 2.3-16.5). CONCLUSIONS Mortality rates for ischemic heart and cerebrovascular diseases are inversely associated with exposure to green spaces when controlling socioeconomic status and air pollution. The protective effect of green spaces is greater among the tracts of lower socioeconomic level.

RESUMO OBJETIVO Investigar a associação entre a exposição aos espaços verdes e a mortalidade por doenças isquêmicas do coração e cerebrovasculares, e o papel do nível socioeconômico nessa relação, no município do Rio de Janeiro, Brasil. MÉTODOS Estudo ecológico, tendo os setores censitários como unidade de análise. Foram utilizados os dados de óbitos por doenças isquêmicas do coração e cerebrovasculares, entre residentes com idade acima de 30 anos, ocorridos de 2010 a 2012. A exposição ao verde foi estimada por meio do Índice de Vegetação por Diferença Normalizada, baseado em imagens de satélite. As associações entre a exposição aos espaços verdes e a taxas de mortalidade por doenças isquêmicas do coração e cerebrovasculares, padronizadas por sexo e idade, foram analisadas por meio de modelos condicionais autorregressivos, ajustados pelas densidades de vias de tráfego leve e pesado, proxy de poluição, e pela situação socioeconômica, mensurada pelo Índice de Desenvolvimento Social. Também foram realizadas análises estratificadas por níveis socioeconômicos, dados pelos tercis do Índice de Desenvolvimento Social. RESULTADOS Entre os setores mais verdes, com Índice de Vegetação por Diferença Normalizada acima do terceiro quartil, a redução da mortalidade por doenças isquêmicas do coração foi de 6,7% (IC95% 3,5-9,8) e por cerebrovascular foi de 4,7% (IC95% 1,2-8,0). Na análise estratificada, o efeito protetor dos espaços verdes na mortalidade por doenças isquêmicas do coração foi observado entre os setores mais verdes de todos os estratos, sendo maior para os de menor nível socioeconômico (8,6%; IC95% 1,8-15,0). No caso da mortalidade por doenças cerebrovasculares, o efeito protetor foi verificado apenas para os setores mais verdes do nível socioeconômico mais baixo (9,6%; IC95% 2,3-16,5). CONCLUSÕES As taxas de mortalidade por doenças isquêmicas do coração e cerebrovasculares são inversamente associadas à exposição aos espaços verdes, controlando o nível socioeconômico e a poluição do ar. O efeito protetor dos espaços verdes é maior entre os setores de nível socioeconômico mais baixo.

Avaliação dos níveis de chumbo e mercúrio em população exposta ambientalmente na Região Centro-oeste do Brasil / Evaluación de los niveles de plomo y mercurio en población expuesta ambientalmente en la región centro-oeste de Brasil / Lead and mercury levels in an environmentally exposed population in the Central Brazil

O objetivo foi avaliar o nível de exposição ao chumbo e mercúrio em população do Pantanal Mato-grossense, Brasil. Chumbo no sangue (Pb-S) (n = 119) e mercúrio na urina (Hg-U) (n = 109) de moradores da região foram determinados por espectrometria de absorção atômica. A comparação de médias e correlação entre as variáveis utilizaram o teste ANOVA e a regressão linear, respectivamente, com 95% de confiança. Pb-S médio foi 2,82 ± 1,53µg dL-1. A comparação de Pb-S estratificado por local de coleta (p ≤ 0,01), atividade laboral (p ≤ 0,01) e consumo de leite produzido na região (p ≤ 0,05) mostrou diferenças estatisticamente significativas. Também houve associações positivas entre Pb-S e local de coleta (p ≤ 0,01), profissão dos participantes (p ≤ 0,05), consumo de leite da região (p ≤ 0,01) e origem da água de consumo (p ≤ 0,01). A média de Hg-U foi 1,41 ± 0,98µg L-1. Os teores mostraram diferenças significativas apenas quanto à profissão dos participantes (p ≤ 0,01), e associações positivas surgiram entre Hg-U e atividade profissional (p ≤ 0,01) assim como índice de massa corporal dos sujeitos de estudo (p ≤ 0,01). As amostras apresentaram baixos níveis de chumbo e mercúrio, semelhantes àqueles encontrados em populações também expostas ambientalmente. Apesar dessas baixas concentrações, o conhecimento atual sobre toxicidade desses metais mostra que efeitos à saúde já podem ser sentidos em níveis antes considerados seguros, o que caracteriza o perigo.

El objetivo fue evaluar el nivel de exposición al plomo y mercurio en una población del Pantanal Mato-grossense, Brasil. El plomo en sangre (Pb-S) (n = 119) y mercurio en la orina (Hg-U) (n = 109) de los habitantes de esa región se determinó por espectrometría de absorción atómica. La comparación de medias y la correlación entre las variables utilizaron el test ANOVA y la regresión lineal, respectivamente, con un 95% de confianza. Pb-S medio fue 2,82 ± 1,53µg dL-1. La comparación de Pb-S estratificado por lugar de recogida (p ≤ 0,01), actividad laboral (p ≤ 0,01) y consumo de leche que se produjo en la región (p ≤ 0,05) mostró diferencias estadísticamente significativas. También hubo asociaciones positivas entre Pb-S y el lugar de recogida (p ≤ 0,01), profesión de los participantes (p ≤ 0,05), consumo de leche de la región (p ≤ 0,01) y origen del agua de consumo (p ≤ 0,01). La media de Hg-U fue 1,41 ± 0,98µg L-1. Los porcentajes mostraron diferencias significativas sólo respecto a la profesión de los participantes (p ≤ 0,01), y las asociaciones positivas surgieron entre Hg-U y la actividad profesional (p ≤ 0,01), así como índice de masa corporal de los sujetos de estudio (p ≤ 0,01). Las muestras presentaron bajos niveles de plomo y mercurio, semejantes a aquellos encontrados en poblaciones también expuestas ambientalmente. A pesar de esas bajas concentraciones, el conocimiento actual sobre toxicidad de estos metales muestra que los efectos sobre la salud, ya pueden ser apreciados en niveles antes considerados seguros, lo que caracteriza el peligro.

The objective was to assess the level of exposure to lead and mercury in a population in the Pantanal region in Mato Grosso State, Brazil. Blood lead (PbB) (n = 119) and urinary mercury (HgU) (n = 109) in local residents were measured by atomic absorption spectrometry. Comparison of means and correlations between variables used analysis of variance (ANOVA) and linear regression, respectively, with 95% confidence intervals. Mean PbB was 2.82 ± 1.53µg dL-1. The comparison of PbB stratified by collection site (p ≤ 0.01), work activity (p ≤ 0.01), and consumption of locally produced cow's milk (p ≤ 0.05) showed statistically significant differences. There were also positive associations between PbB and collection site (p ≤ 0.01), participants' profession (p ≤ 0.05), local milk (p ≤ 0.01), and source of drinking water (p ≤ 0.01). Mean HgU was 1.41 ± 0.98µg L-1. The levels only showed significant differences for participants' profession (p ≤ 0.01), and positive associations emerged between HgU and work activity (p ≤ 0.01) and body mass index (p ≤ 0.01). The samples showed low lead and mercury levels, similar to those found in other environmentally exposed populations. Despite these low concentrations, current knowledge on the toxicity of these metals shows that health effects can already be felt at levels that were previously considered safe, thus characterizing a health hazard.