Risk of asthmatic episodes in children exposed to sulfur dioxide stack emissions from a refinery point source in Montreal, Canada.

BACKGROUND: Little is known about the respiratory effects of short-term exposures to petroleum refinery emissions in young children. This study is an extension of an ecologic study that found an increased rate of hospitalizations for respiratory conditions among children living near petroleum refineries in Montreal (Canada). METHODS: We used a time-stratified case-crossover design to assess the risk of asthma episodes in relation to short-term variations in sulfur dioxide levels among children 2-4 years of age living within 0.5-7.5 km of the refinery stacks. Health data used to measure asthma episodes included emergency department (ED) visits and hospital admissions from 1996 to 2004. We estimated daily levels of SO2 at the residence of children using a) two fixed-site SO2 monitors located near the refineries and b) the AERMOD (American Meteorological Society/Environmental Protection Agency Regulatory Model) atmospheric dispersion model. We used conditional logistic regression to estimate odds ratios associated with an increase in the interquartile range of daily SO2 mean and peak exposures (31.2 ppb for AERMOD peaks). We adjusted for temperature, relative humidity, and regional/urban background air pollutant levels. RESULTS: The risks of asthma ED visits and hospitalizations were more pronounced for same-day (lag 0) SO2 peak levels than for mean levels on the same day, or for other lags: the adjusted odds ratios estimated for same-day SO2 peak levels from AERMOD were 1.10 [95% confidence interval (CI), 1.00-1.22] and 1.42 (95% CI, 1.10-1.82), over the interquartile range, for ED visits and hospital admissions, respectively. CONCLUSIONS: Short-term episodes of increased SO2 exposures from refinery stack emissions were associated with a higher number of asthma episodes in nearby children.

Preventing neural tube defects in Europe: a missed opportunity.

Each year, more than 4500 pregnancies in the European Union are affected by neural tube defects (NTD). Unambiguous evidence of the effectiveness of periconceptional folic acid in preventing the majority of neural tube defects has been available since 1991. We report on trends in the total prevalence of neural tube defects up to 2002, in the context of a survey in 18 European countries of periconceptional folic acid supplementation (PFAS) policies and their implementation. EUROCAT is a network of population-based registries in Europe collaborating in the epidemiological surveillance of congenital anomalies. Representatives from 18 participating countries provided information about policy, health education campaigns and surveys of PFAS uptake. The yearly total prevalence of neural tube defects including livebirths, stillbirths and terminations of pregnancy was calculated from 1980 to 2002 for 34 registries, with UK and Ireland estimated separately from the rest of Europe. A meta-analysis of changes in NTD total prevalence between 1989-1991 and 2000-2002 according to PFAS policy was undertaken for 24 registries. By 2005, 13 countries had a government recommendation that women planning a pregnancy should take 0.4mg folic acid supplement daily, accompanied in 7 countries by government-led health education initiatives. In the UK and Ireland, countries with PFAS policy, there was a 30% decline in NTD total prevalence (95% CI 16-42%) but it was difficult to distinguish this from the pre-existing strong decline. In other European countries with PFAS policy, there was virtually no decline in NTD total prevalence whether a policy was in place by 1999 (2%, 95% CI 28% reduction to 32% increase) or not (8%, 95% CI 26% reduction to 16% increase). The potential for preventing NTDs by periconceptional folic acid supplementation is still far from being fulfilled in Europe. Only a public health policy including folic acid fortification of staple foods is likely to result in large-scale prevention of NTDs.

Outcomes of pregnancy among women living in the proximity of oil fields in the Amazon basin of Ecuador.

Oil companies have released billions of gallons of untreated wastes and oil directly into the environment of the Ecuadorian Amazon. This cross-sectional study investigated the environmental conditions and reproductive health of women living in rural communities surrounded by oil fields in the Amazon basin and in unexposed communities. Water from local streams was analyzed for total petroleum hydrocarbons (TPH). The women, aged 17 to 45 years, had resided for at least three years in the study communities. Socioeconomic and reproductive histories of the last three pregnancies were obtained from interviews. Information from the questionnaire was available for 365 exposed and 283 non-exposed women. The study was conducted from November 1998 to April 1999. Streams of exposed communities had TPH concentrations above the allowable limit. After adjustment for potential confounders, the pregnancies of women in exposed communities were more likely to end in spontaneous abortion (OR: 2.47; 95% CI: 1.61-3.79; p < 0.01). No association was found between stillbirth and exposure. An environmental system to control and eliminate the sources of pollution in the area is needed.

La salud de mujeres que viven cerca de pozos y estaciones de petróleo en la Amazonía ecuatoriana / The health of women who live near oil wells and oil production stations in the Amazon region of Ecuador

OBJETIVOS: Investigar las condiciones ambientales y el estado de salud de las mujeres que viven en comunidades rurales rodeadas por pozos y estaciones de petróleo en la Amazonía del Ecuador. METODO: Se aplicó un diseño transversal comparativo, asignándose la exposición según la localización geográfica de las comunidades respecto a los pozos y estaciones de petróleo. Se analizaron muestras de agua de los ríos locales para determinar el contenido de hidrocarburos totales de petróleo y se proporcionó un cuestrionario estructurado a cada cabeza de familia. El estudio se localizó en comunidades campesinas del nordeste del Ecuador y duró desde noviembre de 1998 hasta abril de 1999. Se incluyenron en el estudio nueve comunidades en el área expuesta (368 participantes) y 14 en el área no expuesta (291 participantes). RESULTADOS: Los ríos de las comunidades expuestas presentaron niveles de contaminación muy superiores al límite aceptado para el uso humano. Se encontraron diferencias significativas en las razones de prevalencia de hongos en la piel (RP 1,37; IC951,01 a 1,86) en las dos semanas previas al estudio y de irritación de la nariz (RP 2,18; IC951,64 a 2,91) y garganta (RP 1,68; IC951,02 a 2,75) en los 12 meses aneriores. También se encontraron asociados con la exposición en las dos semanas previas el cansancio y "otros síntomas", y en los 12 meses anteriores, el dolor de cabeza, irritqación ocular, dolor de oídos, diarrea y gastritis. CONCLUSIONES: Los síntomas observados en las participantes de las comunidades expuestas concuerdan con los sítomas de toxicidad causados por el petróleo. Hay una necesidad urgente de establecer un adecuado programa de control y remediación ambiental que evite este innecesario e inaceptable reisgo para la salud de estas poblaciones

La salud de mujeres que viven cerca de pozos y estaciones de petróleo en la Amazonía ecuatoriana / The health of women who live near oil wells and oil production stations in the Amazon region of Ecuador

OBJETIVOS: Investigar las condiciones ambientales y el estado de salud de las mujeres que viven en comunidades rurales rodeadas por pozos y estaciones de petróleo en la Amazonía del Ecuador. METODO: Se aplicó un diseño transversal comparativo, asignándose la exposición según la localización geográfica de las comunidades respecto a los pozos y estaciones de petróleo. Se analizaron muestras de agua de los ríos locales para determinar el contenido de hidrocarburos totales de petróleo y se proporcionó un cuestrionario estructurado a cada cabeza de familia. El estudio se localizó en comunidades campesinas del nordeste del Ecuador y duró desde noviembre de 1998 hasta abril de 1999. Se incluyenron en el estudio nueve comunidades en el área expuesta (368 participantes) y 14 en el área no expuesta (291 participantes). RESULTADOS: Los ríos de las comunidades expuestas presentaron niveles de contaminación muy superiores al límite aceptado para el uso humano. Se encontraron diferencias significativas en las razones de prevalencia de hongos en la piel (RP 1,37; IC951,01 a 1,86) en las dos semanas previas al estudio y de irritación de la nariz (RP 2,18; IC951,64 a 2,91) y garganta (RP 1,68; IC951,02 a 2,75) en los 12 meses aneriores. También se encontraron asociados con la exposición en las dos semanas previas el cansancio y "otros síntomas", y en los 12 meses anteriores, el dolor de cabeza, irritqación ocular, dolor de oídos, diarrea y gastritis. CONCLUSIONES: Los síntomas observados en las participantes de las comunidades expuestas concuerdan con los sítomas de toxicidad causados por el petróleo. Hay una necesidad urgente de establecer un adecuado programa de control y remediación ambiental que evite este innecesario e inaceptable reisgo para la salud de estas poblaciones

Objective. Investigate the environmental conditions in and the state of health of women who live in rural communities surrounded by oil wells and oil production stations in the Amazon region of Ecuador. Method. We used a comparative cross-sectional design, classifying exposure according to the location of the communities with respect to the oil wells and production stations. Water samples from the local rivers were analyzed to determine total petroleum hydrocarbons, and a structured questionnaire was used with the head of each family in the study. The study was performed in rural communities in northeastern Ecuador from November 1998 through April 1999. The study included 9 communities in the exposed area (368 participants) and 14 communities in the unexposed area (291 participants). Results. The rivers of the exposed communities showed contamination levels much above the limits acceptable for human use. Statistically significant differences between the exposed communities and the unexposed communities were found for the prevalence of skin fungi for the two weeks prior to the study (odds ratio (OR) = 1.37; 95% confidence interval (CI) = 1.01­1.86) as well as for nasal irritation (OR = 2.18, 95% CI = 1.64­2.91) and for throat irritation (OR = 1.68, 95% CI = 1.02­2.75) in the preceding 12 months. Also associated with exposure in the two preceding weeks were fatigue and the category of "other symptoms"; similarly associated with exposure in the preceding 12 months were headaches, eye irritation, earaches, diarrhea, and gastritis. Conclusions. The symptoms found among the participants in the exposed communities match the toxicity symptoms caused by oil. There is an urgent need to establish an adequate environmental control and remediation program in order to prevent unnecessary and unacceptable health hazards for these populations