[Epidemiological characterization of bites on people, as emergency care record: Province of Los Andes, Chile]. / Caracterización epidemiológica de mordeduras en personas, según registro de atención de urgencia: Provincia de Los Andes, Chile.

BACKGROUND: Bites constitute a public health problem worldwide. AIM: To characterize epidemiologically bites by animals happened in the province of Los Andes (2005-2007). METHOD: Descriptive, retrospective epidemiological study. Studied variables: Bitten person (BP), accident by bite, biting animal and bite. It was not feasible to obtain more updated information by law of patient protection. RESULTS: 2,360 BP were assisted in the emergency unit of San Juan de Dios Hospital and Rio Blanco clinic. An annual average rate of 729 BP/100,000 inhabitants and 1.99 daily average was recorded. The male gender was most affected (53.5%) and the age group from 6 to 10 years old. (Rate: .521/100,000). Most frequent topographic location was the lower limb, except in children under 5 year olds in whom predominated head and neck. The biting animal according to frequency was: the dog (67.1%) spider (7.1%) and cat (3.9%). The animal property was 35.6% known and 30.7% own. The most frequent problems were: nonspecific allergy; toxic effect by spider bites and among the infections, the disease made by cat’s scratch stands out. Regarding the record system, the biting animal complaint was applied to 47.6% of the BP and the 92.8% of the recorded information was incomplete. CONCLUSIONS: Bites reported higher rates in the province of Los Andes than the average of the country (729 versus 188/100,000), standing out the higher magnitude in 6 to 10 year-old-children. It is noticed that the record is low and incomplete. In this province, no bite control programs or updated studies have been carried out.

Caracterización epidemiológica de mordeduras en personas, según registro de atención de urgencia: Provincia de Los Andes, Chile / Epidemiological characterization of bites on people, as emergency care record: Province of Los Andes, Chile

Background: Bites constitute a public health problem worldwide. Aim: To characterize epidemiologically bites by animals happened in the province of Los Andes (2005-2007). Method: Descriptive, retrospective epidemiological study. Studied variables: Bitten person (BP), accident by bite, biting animal and bite. It was not feasible to obtain more updated information by law of patient protection. Results: 2,360 BP were assisted in the emergency unit of San Juan de Dios Hospital and Rio Blanco clinic. An annual average rate of 729 BP/100,000 inhabitants and 1.99 daily average was recorded. The male gender was most affected (53.5%) and the age group from 6 to 10 years old. (Rate: .521/100,000). Most frequent topographic location was the lower limb, except in children under 5 year olds in whom predominated head and neck. The biting animal according to frequency was: the dog (67.1%) spider (7.1%) and cat (3.9%). The animal property was 35.6% known and 30.7% own. The most frequent problems were: nonspecific allergy; toxic effect by spider bites and among the infections, the disease made by cat’s scratch stands out. Regarding the record system, the biting animal complaint was applied to 47.6% of the BP and the 92.8% of the recorded information was incomplete. Conclusions: Bites reported higher rates in the province of Los Andes than the average of the country (729 versus 188/100,000), standing out the higher magnitude in 6 to 10 year-old-children. It is noticed that the record is low and incomplete. In this province, no bite control programs or updated studies have been carried out.

Introducción: Las mordeduras constituyen un problema de salud pública mundial. Objetivo: Caracterizar epidemiológicamente las mordeduras por animales ocurridos en la provincia de Los Andes (2005-2007). Método: Estudio epidemiológico descriptivo retrospectivo. Variables estudiadas: Persona mordida (PM), accidente por mordedura, animal mordedor y mordedura. No fue factible obtener información más actualizada por ley de protección del paciente. Resultados: Se atendieron 2.360 PM en los Servicios de Urgencia del Hospital San Juan de Dios y Clínica Río Blanco. Se registró una tasa anual promedio de 729 PM/100.000 hbts. y promedio diario 1,99. El género más afectado fue el masculino (53,5%), y el grupo etario de 6 a 10 años (tasa:1.521/100.000). La ubicación topográfica más frecuente fue extremidad inferior, excepto en niños bajo 5 años de edad en quienes predominó cabeza-cuello. El animal mordedor según frecuencia fue: perro (67,1%) araña (7,1%) y gato (3,9%). La propiedad del animal fue 35,6% conocida y 30,7% propios. Las complicaciones más frecuentes fueron alergia no específica, efecto tóxico por mordedura de arañas y entre las infecciones destaca la enfermedad por rasguño de gato. La notificación de animal mordedor se aplicó a 47,6% de las PM; 92,8% de la información contenida estaba incompleta. Conclusiones: Las mordeduras en la Provincia de Los Andes presentaron tasas mayores que el promedio país (729 versus 188/100.000), destacando la mayor magnitud en niños de 6 a10 años. En la provincia no se han realizado programas de control de mordeduras o estudios actualizados.

Increased lung and bladder cancer incidence in adults after in utero and early-life arsenic exposure.

BACKGROUND: From 1958 to 1970, >100,000 people in northern Chile were exposed to a well-documented, distinct period of high drinking water arsenic concentrations. We previously reported ecological evidence suggesting that early-life exposure in this population resulted in increased mortality in adults from several outcomes, including lung and bladder cancer. METHODS: We have now completed the first study ever assessing incident cancer cases after early-life arsenic exposure, and the first study on this topic with individual participant exposure and confounding factor data. Subjects included 221 lung and 160 bladder cancer cases diagnosed in northern Chile from 2007 to 2010, and 508 age and gender-matched controls. RESULTS: ORs adjusted for age, sex, and smoking in those only exposed in early life to arsenic water concentrations of ≤110, 110 to 800, and >800 µg/L were 1.00, 1.88 [95% confidence interval (CI), 0.96-3.71], and 5.24 (3.05-9.00; P(trend) < 0.001) for lung cancer, and 1.00, 2.94 (1.29-6.70), and 8.11 (4.31-15.25; P(trend) < 0.001) for bladder cancer. ORs were lower in those not exposed until adulthood. The highest category (>800 µg/L) involved exposures that started 49 to 52 years before, and ended 37 to 40 years before the cancer cases were diagnosed. CONCLUSION: Lung and bladder cancer incidence in adults was markedly increased following exposure to arsenic in early life, even up to 40 years after high exposures ceased. Such findings have not been identified before for any environmental exposure, and suggest that humans are extraordinarily susceptible to early-life arsenic exposure. IMPACT: Policies aimed at reducing early-life exposure may help reduce the long-term risks of arsenic-related disease.