Burden of disease attributable to risk factors in European countries: a scoping literature review.

OBJECTIVES: Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. METHODS: We searched multiple literature databases, including grey literature websites and targeted public health agencies websites. RESULTS: A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. CONCLUSIONS: Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates. REGISTRATION: The study protocol has been registered on PROSPERO, CRD42020177477 (available at: https://www.crd.york.ac.uk/PROSPERO/ ).

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices.

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.

Methodological considerations in injury burden of disease studies across Europe: a systematic literature review.

BACKGROUND: Calculating the disease burden due to injury is complex, as it requires many methodological choices. Until now, an overview of the methodological design choices that have been made in burden of disease (BoD) studies in injury populations is not available. The aim of this systematic literature review was to identify existing injury BoD studies undertaken across Europe and to comprehensively review the methodological design choices and assumption parameters that have been made to calculate years of life lost (YLL) and years lived with disability (YLD) in these studies. METHODS: We searched EMBASE, MEDLINE, Cochrane Central, Google Scholar, and Web of Science, and the grey literature supplemented by handsearching, for BoD studies. We included injury BoD studies that quantified the BoD expressed in YLL, YLD, and disability-adjusted life years (DALY) in countries within the European Region between early-1990 and mid-2021. RESULTS: We retrieved 2,914 results of which 48 performed an injury-specific BoD assessment. Single-country independent and Global Burden of Disease (GBD)-linked injury BoD studies were performed in 11 European countries. Approximately 79% of injury BoD studies reported the BoD by external cause-of-injury. Most independent studies used the incidence-based approach to calculate YLDs. About half of the injury disease burden studies applied disability weights (DWs) developed by the GBD study. Almost all independent injury studies have determined YLL using national life tables. CONCLUSIONS: Considerable methodological variation across independent injury BoD assessments was observed; differences were mainly apparent in the design choices and assumption parameters towards injury YLD calculations, implementation of DWs, and the choice of life table for YLL calculations. Development and use of guidelines for performing and reporting of injury BoD studies is crucial to enhance transparency and comparability of injury BoD estimates across Europe and beyond.

Burden of non-communicable disease studies in Europe: a systematic review of data sources and methodological choices.

BACKGROUND: Assessment of disability-adjusted life years (DALYs) resulting from non-communicable diseases (NCDs) requires specific calculation methods and input data. The aims of this study were to (i) identify existing NCD burden of disease (BoD) activities in Europe; (ii) collate information on data sources for mortality and morbidity; and (iii) provide an overview of NCD-specific methods for calculating NCD DALYs. METHODS: NCD BoD studies were systematically searched in international electronic literature databases and in grey literature. We included all BoD studies that used the DALY metric to quantify the health impact of one or more NCDs in countries belonging to the European Region. RESULTS: A total of 163 BoD studies were retained: 96 (59%) were single-country or sub-national studies and 67 (41%) considered more than one country. Of the single-country studies, 29 (30%) consisted of secondary analyses using existing Global Burden of Disease (GBD) results. Mortality data were mainly derived (49%) from vital statistics. Morbidity data were frequently (40%) drawn from routine administrative and survey datasets, including disease registries and hospital discharge databases. The majority (60%) of national BoD studies reported mortality corrections. Multimorbidity adjustments were performed in 18% of national BoD studies. CONCLUSION: The number of national NCD BoD assessments across Europe increased over time, driven by an increase in BoD studies that consisted of secondary data analysis of GBD study findings. Ambiguity in reporting the use of NCD-specific BoD methods underlines the need for reporting guidelines of BoD studies to enhance the transparency of NCD BoD estimates across Europe.

Genetic selection indices for growth traits in Blanco-Orejinegro cattle.

Selection indices are used in genetic improvement programs, with the purpose of selectins simultaneous for several economically important traits. The objective of this study was to construct equations for selection indices in the Blanco-Orejinegro (BON) breed and to determine the index that would generate the greatest genetic progress. The information used included birth weight (BW), body weights adjusted to 120, 240, 480, and 720 days old (W120, W240, W240, 480 and W720, respectively), age at first calving (AFC) and interval between first and second calving (IBC) estimated breeding values. Two Smith and Hazel indices were calculated using variances (I1) and literature (I2), with a part two indices designed using information from experts and breeders (I3 and I4). All the indices favored the reduction of weight at birth. The I1 focused mainly on W120 and I2, I3 and I4 focused on 720. In general, the estimated indices obtained similar reliability and expected genetic differences I1 generated a decrease in direct BW. I2 generated the largest increases in BW and AFC. I3 and I4 generated positive changes in growth and reproductive traits, with I3 generating the greatest genetic gains in the population, especially for W240.

Genetic parameters and trends for growth traits in Blanco Orejinegro cattle.

Since 1940, efforts have been made to preserve the Blanco Orejinegro (BON) cattle breed by maintaining gene banks. Nine years ago, a BON genetic improvement program was implemented to increase genetic gain based on control of productivity and the use of performance tests, polygenic and genomic evaluations, and selection indices. The objective of this study was to estimate genetic parameters and trends for growth traits by using polygenic (PM) and genomic-polygenic (GPM) models. Productive information from the years 1980 to 2019 was used. The following data were used: 7,304 birth weight (BW) records, 1,281 records of body weight adjusted to 120 days (W120), 4,791 records of weight adjusted to 240 days (W240), 3,339 records of weight adjusted to 480 days (W480), and 1,364 records of weight adjusted to 720 days (W720). The relationship matrix included 13,612 pure animals belonging to the Colombian Corporation for Agricultural Research - AGROSAVIA and the Producer Network program. A total of 1,224 individuals were genotyped with chips of different densities and all were imputed up to 50,932 SNPs. Polygenic and genomic-polygenic models were used to estimate genetic parameters and correlations between the genetic values estimated by each model. A generalized additive model with smoothing was used to estimate trends of genetic values from 1980 to 2019. Heritabilities between 0.29 and 0.40, genetic correlations between 0.13 and 0.94, and phenotypic correlations between 0.23 and 0.72 were observed. Close-to-zero genetic growth was observed for BW and W120. Genetic trends for the other traits were positive, with higher growth in the last 7 years. The heritabilities observed in this population indicate that the traits measured would respond to selection. Greater genetic progress can be achieved in W240, W480, and W720 by continuing with genetic evaluations and developing performance tests and strategies to make genetic material readily available to producers.

Prevalence and risk factors of bovine viral diarrhea in Colombian cattle.

BACKGROUND AND AIM: Bovine viral diarrhea virus (BVDV) is present in most cattle-raising countries around the world, and it has a negative economic impact in cattle herds. In Colombia, previous studies have estimated the prevalence of BVDV in specific locations. The aim of this study was to estimate the prevalence of BVDV in cattle herds located at several municipalities across the country and to identify the associated risk and protective factors. MATERIALS AND METHODS: A cross-sectional study was carried out to investigate the prevalence of BVDV in Colombian cattle populations at farm and animal-levels. A total of 387 herds and 8110 animals located in seven different departments were included in this study. RESULTS: An animal- and farm-level prevalence of 36% and 69%, respectively, were estimated. A high variation for the farm-level prevalence was found among the municipalities studied. Moreover, seropositive cattle to the infectious bovine rhinotracheitis virus (odds ratio (OR)=2.38, p=0.0479) and Neospora caninum (OR=3.15, p=0.0122) were more likely to be seropositive for BVDV, while the practice of burning dead animals at the farm was identified as a protective factor (OR=0.17, p=0.014). CONCLUSION: The prevalence of BVDV varied more at farm-level compared to animal-level. Two risk factors and one protective factor were identified. The results of the current study are essential to understand the epidemiology of BVDV in Colombia, and to formulate strategies in the region to mitigate the impact of this virus on the productive and reproductive indicators of cattle farms at the regional level.

[Sleep quality in an adult population exposed to the noise of El Dorado Airport, Bogotá, 2012]. / Calidad del sueño en una población adulta expuesta al ruido del Aeropuerto El Dorado, Bogotá, 2012.

INTRODUCTION: The airport of Bogotá lies within the city and its expansion could produce an increase in adverse effects on the health of the inhabitants of Fontibón and Engativá districts due to the noise it generates. OBJECTIVE: To determine the prevalence of sleep disturbances and associated factors among residents of Fontibón exposed to this noise. MATERIALS AND METHODS: A cross-sectional study design was used, involving a sample of 205 people aged 18 to 65, selected by means of stratified random sampling. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Descriptive statistics were carried out, as well as correlation tests between the different scales. RESULTS: A total of 60% of the residents reported poor quality sleep (PSQI>5), with a mean PSQI of 7.19 (SD=3.931), and the following pathological interruptions were found: subjective sleep quality, 27%; sleep latency, 39%; sleep duration, 33%; habitual sleep efficiency, 37%; sleep alterations, 30%; diurnal dysfunction, 40%, and use of sleeping medication, 5%. According to the Epworth Sleepiness Scale (ESS>10), 28% of residents reported daytime somnolence. Regarding the prevalence of poor quality sleep according to the Pittsburgh Sleep Quality Index, 17% of those who reported not being able to sleep because of noise associated this with air traffic. A correlation was observed between the index and the scale ( r =0.329, CI 95%: 0.20-0.44). CONCLUSIONS: Inhabitants of the district reported poor sleep quality due to exposure to noise, airport operations being one of the main generating sources. Noise mitigation strategies in the district need to be reviewed and the public health implications of the El Dorado Airport expansion should be considered.

[Influence of the climate variability on acute respiratory infections in the city of Bogotá]. / Influencia de la variabilidad climática en las enfermedades respiratorias agudas en Bogotá.

INTRODUCTION: Acute respiratory infection is one of the most significant causes of morbidity in Bogota, and its burden of disease has increased in association with climate variability . OBJECTIVE: The aim of the study was to evaluate weekly trends of acute respiratory infection in relation to meteorological variables (temperature, relative humidity and cumulative rainfall) in Bogota during 2011 and 2012. MATERIALS AND METHODS: Epidemiological and meteorological data from 104 weeks were gathered. Temporal variability was taken into account including previous weeks and spatial variability was considered by studying each zone of the city separately (north, south, east, west). Statistical analysis was performed through Poisson dynamic regression models. RESULTS: The relative humidity had the greater impact on acute respiratory infection and its effects lasted between 8 to 10 weeks. Cumulative rainfall had effects only in the east zone, while the temperature presented mild effects across the four different zones of the city. CONCLUSION: Such results are the first step for the design of health-related early warning systems associated with climate variability.

[Respiratory symptoms associated with air pollution in five localities of Bogotá, 2008-2011, a dynamic cohort study]. / Síntomas respiratorios asociados con la exposición a la contaminación del aire en cinco localidades de Bogotá, 2008-2011, estudio en una cohorte dinámica.

INTRODUCTION: High levels of air pollution increase respiratory morbidity in children under five years of age. OBJECTIVE: To know the incidence of respiratory symptoms and its associated factors in five localities of Bogota. MATERIALS AND METHODS: A dynamic cohort study was undertaken with a sample size of 3,278 children from five localities split into two groups according to the degree of exposure to particulate matter. Monitoring was conducted at the outbreak of ten respiratory symptoms through a diary of those symptoms. Statistical analysis included incidence rate ratio (IRR) calculations and Poisson regression models for each assessed symptom. RESULTS: Cough was more frequent in the highly exposed group (lRR=1.23, Cl 95% 1.13-1.34). The most exposed group had higher incidence of expectoration (lRR=1.64, Cl= 95% 1.47-1.84). Wheezing was associated with high exposure to particulate matter (RR=2.29, Cl 95% 1.78-3.00), cottage industries (RR=1.29, Cl 95% 1.01-1.68) and age (RR=0.95, Cl 95% 0.94-0.96). Risk attributable to air pollution exposure fluctuated according to symptoms from 37% for nocturnal wheezing (Cl 95% 26-47.8) to 10.6 for cough (Cl 95% 6.3-15%). CONCLUSION: Extradomiciliary air pollution effects are potentiated by socioeconomic living and working conditions of people in Bogota. A broader conceptual public health approach and the strengthening of intersector actions are required to reduce health effects of air pollution.

Calidad del sueño en una población adulta expuesta al ruido del Aeropuerto El Dorado, Bogotá, 2012 / Sleep quality in an adult population exposed to the noise of El Dorado Airport, Bogotá, 2012

Introducción. El Aeropuerto de Bogotá está dentro de la ciudad y su ampliación podría representar un aumento de los efectos adversos del ruido sobre la salud de los habitantes de las localidades de Fontibón y Engativá. Objetivo. Conocer la prevalencia de los trastornos del sueño y los factores asociados en residentes de Fontibón expuestos al ruido del Aeropuerto El Dorado. Materiales y métodos. Se hizo un estudio de corte transversal con una muestra de 205 personas de 18 a 65 años de edad, seleccionada mediante muestreo aleatorio estratificado. La calidad del sueño se evaluó mediante el índice de calidad del sueño de Pittsburgh (ICSP) y la escala de somnolencia de Epworth (ESE). Se hicieron análisis estadísticos descriptivos y pruebas de correlación entre estos instrumentos. Resultados. El 60 % de los residentes informaron mala calidad del sueño según el índice de calidad del sueño de Pittsburgh (ICSP>5), con una media de 7,19 (desviación estándar, DE=3,931), y se encontraron puntuaciones patológicas así: calidad subjetiva del sueño, 27 %; latencia del sueño, 39 %; duración del sueño, 33 %; eficiencia habitual del sueño, 37 %; alteraciones del sueño, 30 %; disfunción diurna, 40 %, y uso de hipnóticos, 5 %. Según la escala de somnolencia de Epworth (ESE>10), se reportó 28 % de somnolencia diurna. Con relación a la prevalencia de la mala calidad del sueño según el índice, 17 % de quienes reportaron no dormir debido al ruido lo asoció al tráfico aéreo. Se encontró correlación entre el índice y la escala ( r =0,329, IC 95% 0,20-0,44). Conclusiones. Los habitantes de la localidad presentaron mala calidad del sueño por exposición al ruido, siendo la operación aeroportuaria una de las principales fuentes generadoras. Es necesario revisar las estrategias de mitigación de ruido en la localidad y considerar las implicaciones de la ampliación del Aeropuerto El Dorado para la salud pública.

Introduction: The airport of Bogotá lies within the city and its expansion could produce an increase in adverse effects on the health of the inhabitants of Fontibón and Engativá districts due to the noise it generates. Objective: To determine the prevalence of sleep disturbances and associated factors among residents of Fontibón exposed to this noise. Materials and methods: A cross-sectional study design was used, involving a sample of 205 people aged 18 to 65, selected by means of stratified random sampling. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Descriptive statistics were carried out, as well as correlation tests between the different scales. Results: A total of 60% of the residents reported poor quality sleep (PSQI>5), with a mean PSQI of 7.19 (SD=3.931), and the following pathological interruptions were found: subjective sleep quality, 27%; sleep latency, 39%; sleep duration, 33%; habitual sleep efficiency, 37%; sleep alterations, 30%; diurnal dysfunction, 40%, and use of sleeping medication, 5%. According to the Epworth Sleepiness Scale (ESS>10), 28% of residents reported daytime somnolence. Regarding the prevalence of poor quality sleep according to the Pittsburgh Sleep Quality Index, 17% of those who reported not being able to sleep because of noise associated this with air traffic. A correlation was observed between the index and the scale ( r =0.329, CI 95%: 0.20-0.44). Conclusions: Inhabitants of the district reported poor sleep quality due to exposure to noise, airport operations being one of the main generating sources. Noise mitigation strategies in the district need to be reviewed and the public health implications of the El Dorado Airport expansion should be considered.

Influencia de la variabilidad climática en las enfermedades respiratorias agudas en Bogotá / Influence of the climate variability on acute respiratory infections in the city of Bogotá

Introducción. La enfermedad respiratoria es una de las principales causas de morbilidad en Bogotá y los efectos de la variabilidad climática se han reflejado en un aumento del número de casos. Objetivo. En el presente estudio se analizó el comportamiento semanal de la enfermedad respiratoria aguda en Bogotá y se asoció con las variables climatológicas de temperatura, humedad relativa y precipitación, analizando su impacto en la aparición de casos en la ciudad. Materiales y métodos. El análisis se llevó a cabo mediante la estimación de modelos de regresión de Poisson, con datos epidemiológicos de 104 semanas correspondientes a los años 2011 y 2012. La variabilidad climática temporal se analizó considerando los efectos de las variables en semanas anteriores y, para el análisis de la variabilidad espacial, la ciudad se dividió en cuatro zonas: norte, sur, oriente y occidente. Resultados. Los resultados de las correlaciones cruzadas demostraron que en tres de las cuatro zonas la humedad relativa tenía un mayor impacto sobre los casos de enfermedad respiratoria aguda y su efecto persistía hasta por ocho y diez semanas. La precipitación, por el contrario, tuvo impacto únicamente en la zona oriente, mientras que la temperatura tuvo efectos moderados en todas las zonas. Conclusión. Debido al componente dinámico de estos modelos, los resultados son un primer paso para el diseño de un sistema de alerta temprana en salud que tome en cuenta la variabilidad climática.

Introduction: Acute respiratory infection is one of the most significant causes of morbidity in Bogota, and its burden of disease has increased in association with climate variability . Objective: The aim of the study was to evaluate weekly trends of acute respiratory infection in relation to meteorological variables (temperature, relative humidity and cumulative rainfall) in Bogota during 2011 and 2012. Materials and methods: Epidemiological and meteorological data from 104 weeks were gathered. Temporal variability was taken into account including previous weeks and spatial variability was considered by studying each zone of the city separately (north, south, east, west). Statistical analysis was performed through Poisson dynamic regression models. Results: The relative humidity had the greater impact on acute respiratory infection and its effects lasted between 8 to 10 weeks. Cumulative rainfall had effects only in the east zone, while the temperature presented mild effects across the four different zones of the city. Conclusion: Such results are the first step for the design of health-related early warning systems associated with climate variability.

Síntomas respiratorios asociados con la exposición a la contaminación del aire en cinco localidades de Bogotá, 2008-2011, estudio en una cohorte dinámica / Respiratory symptoms associated with air pollution in five localities of Bogotá, 2008-2011, a dynamic cohort study

Introducción. En Bogotá, la morbilidad por enfermedad respiratoria en menores de cinco años aumenta a medida que lo hace la contaminación del aire. Objetivo. El objetivo de este estudio fue conocer la incidencia de los síntomas respiratorios en cinco localidades de Bogotá y su asociación con otros factores, entre 2008 y 2011. Materiales y métodos. Se hizo un estudio de cohorte dinámica. El tamaño de la muestra fue de 3.278 niños de cinco localidades, divididos en dos grupos de acuerdo con la exposición a material en partículas. Se hizo el seguimiento de la aparición de diez síntomas respiratorios mediante un diario de registro. El análisis estadístico incluyó el cálculo de la razón de tasas de incidencia (RTI) y la regresión de Poisson para cada síntoma evaluado. Resultados. La tos se presentó con mayor frecuencia en los niños más expuestos (RTI=1,23; IC 95% 1,13-1,34) y la incidencia de expectoración fue mayor en ellos (RTI=1,64; IC 95% 1,47-1,84). En cuanto a las sibilancias, se observó una asociación con la exposición a material en partículas (RR=2,29; IC 95% 1,78-3,00), la presencia de fábricas en la vivienda (RR=1,29; IC 95% 1,01-1,68) y la edad (RR=0,95; IC 95% 0,94-0,96). La proporción de riesgo atribuible a la exposición a la contaminación del aire, fluctuó según los síntomas entre 37 % para las sibilancias nocturnas (IC 95% 26-47,8) y 10,6 % para la tos (IC 95% 6,3-15). Conclusión. Los efectos de la contaminación del aire extramuros se vieron potenciados por las condiciones socioeconómicas en las que vive y trabaja la población de Bogotá. Es necesario adoptar una aproximación conceptual más amplia desde la perspectiva de la salud pública y fortalecer la acción intersectorial para reducir los efectos de la contaminación del aire en la salud de la población.

Introduction: High levels of air pollution increase respiratory morbidity in children under five years of age. Objective: To know the incidence of respiratory symptoms and its associated factors in five localities of Bogota. Materials and methods: A dynamic cohort study was undertaken with a sample size of 3,278 children from five localities split into two groups according to the degree of exposure to particulate matter. Monitoring was conducted at the outbreak of ten respiratory symptoms through a diary of those symptoms. Statistical analysis included incidence rate ratio (IRR) calculations and Poisson regression models for each assessed symptom. Results: Cough was more frequent in the highly exposed group (lRR=1.23, Cl 95% 1.13-1.34). The most exposed group had higher incidence of expectoration (lRR=1.64, Cl= 95% 1.47-1.84). Wheezing was associated with high exposure to particulate matter (RR=2.29, Cl 95% 1.78-3.00), cottage industries (RR=1.29, Cl 95% 1.01-1.68) and age (RR=0.95, Cl 95% 0.94-0.96). Risk attributable to air pollution exposure fluctuated according to symptoms from 37% for nocturnal wheezing (Cl 95% 26-47.8) to 10.6 for cough (Cl 95% 6.3-15%). Conclusion: Extradomiciliary air pollution effects are potentiated by socioeconomic living and working conditions of people in Bogota. A broader conceptual public health approach and the strengthening of intersector actions are required to reduce health effects of air pollution.

Urban environment interventions linked to the promotion of physical activity: a mixed methods study applied to the urban context of Latin America.

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential.

Efectos auditivos y extraauditivos por exposición al ruido ambiental en docentes de las localidades de Fontibón y Engativá. Bogotá, D. C., 2010 / Auditory Effects and Extraauditivos Exposure to Environmental Noise in Teachers of the localities of Fontibón and Engativá. Bogotá, D. C., 2010 / Efeitos auditivos e extraauditivos pela exposição ao ruído ambiental em professores das localidades de Fontibón e Engativá. Bogotá, D. C., 2010

Introducción: El ruido es una de las principales causas de preocupación para muchas poblaciones, ya que incide en la calidad de vida y, además, puede provocar efectos nocivos sobre la salud. Uno de sus efectos es la pérdida de la audición (hipoacusia), que puede ser reversible o permanente, pues progresa con lentitud, de forma proporcional con la exposición. Objetivos: Implementar un estudio de monitorización de los efectos auditivos y no auditivosen la salud determinando los niveles de ruido poblacional y ambiental en docentes de las localidades de Fontibón y Engativá, que contribuya en la construcción del sistema de vigilancia epidemiológica. Métodos: Estudio observacional de tipo transversal. La población sujeto de estudio fue constituida por 147 docentes que laboran en las instituciones educativas distritales (IED) definidas como de mayor exposición (> 65 dB) y de menor exposición (< 65 dB), según el mapa de ruido ambiental de cada localidad (clasificación revisada con mediciones de ruido ambiental y poblacional realizadas en los centros educativos). Se hizo una encuesta de antecedentes de salud y de percepción de ruido indagando sobre antecedentes familiares, personales y hábitos relacionados con la salud auditiva y una audiometría tonal liminal y otoscopia. Para la calificación del grado de severidad, se estimó lo recomendado en la guía GATI­HNIR. Resultados: El 27,7 % de los docentes (40 de los participantes) presentaron hipoacusia en algún grado de severidad, resultado asociado al promedio mayor de respuesta del umbral de los docentes de los colegios de mayor exposición. La exposición fue asociada, a su vez, a acúfenos y a la sensación de ruido en el entorno; las fuentes generadoras identificadas con mayor frecuencia son el tráfico aéreo y el terrestre, concordante ello con la ubicación de las instituciones educativas. La hipoacusia fue más común en los docentes de la localidad de Engativá (p < 0,001), en docentes de edades ≥ 45 años (p < 0,001) y quienes presentan hipertensión arterial (HTA) (p = 0,041). Los umbrales auditivos son más altos en los colegios altamente expuestos para todas las frecuencias, excepto las de 500 y 6000 Hz para ambos oídos (p < 0,05) Los síntomas otológicos se asociaron a la exposición > 65 dB (p = 0,007), al igual que diversos síntomas neurológicos (p = 0,002). No se encontró relación con síntomas psicológicos. Conclusión: Los docentes vinculados a instituciones de alta exposición presentan mayores efectos auditivos y extraauditivos, en comparación con quienes laboran en colegios menos expuestos, lo que puede estar afectando el proceso de enseñanza. El diseño y la ubicación de colegios deben tener en cuenta estos impactos, para evitar futuras afectaciones.

Introduction: Noise is one of the main causes of concern within populations, as it affects negatively the quality of life and health of individuals. One of its effects is hearing loss (hypoacusis) that may be reversible or permanent as it slowly progresses proportionally to exposure. Objectives: To implement a monitoring study of the hearing and non-auditory health effects, to determine the levels of population and environmental noise for teachers in Fontibon and Engativa, that contributes to the construction of an epidemiological surveillance system. Methods: Transversal observational study. The population for this study was constituted by 147 teachers belonging to district educational institutions, divided into high exposure (> 65 dB) and low exposure (< 65 dB), according to the environmental noise maps of each district, revised classification with population and environmental noise measurements performed in educational centers. A survey of health history and noise perception was conducted, asking about family and personal backgrounds, habits related to hearing health, and a liminal tone audiometry and otoscopy. To classify the degree of severity, it was estimated according to the guide GATI-HNIR. Results: 27.7 % of teachers (40 people) presented hearing loss in some severity degree. This result is associated to the higher response average of the threshold of teachers of schools with high exposure. Exposure was associated with tinnitus and the sensation of noise in the environment. The identified generating sources with higher frequency are air and ground traffic, in accordance with the location of schools. Hearing loss was more frequent within teachers in Engativá (p < 0.001), of age ≥ 45 years (p < 0.001), and those who present HTN (p = 0,041). The hearing thresholds are higher for schools with high exposure for all frequencies, except those of 500 and 6000 Hz for both ears (p < 0.05). Otologic symptoms were associated to the exposure > 65 dBA (p = 0.007), as well as neurological symptoms (p = 0.002). No relation was found with psychological symptoms. Conclusion: Teachers from schools exposed to high levels presented higher auditory and extra-auditory effects, in comparison to those exposed to lower levels of noise. This could affect the teaching process. The design and location of the schools must take into account these type of impacts to avoid future damag

Introdução: O ruído é uma das principais causas de preocupação para muitas populações, uma vez que afeta a qualidade de vida e também pode causar efeitos adversos à saúde. Um efeito é a perda de audição (Hipoacusia), que pode ser reversível ou permanente e progride lentamente de forma proporcional com a exposição. Objetivos: O objetivo do estudo foi implementar um estudo de monitorização dos efeitos na saúde auditiva e não auditiva, determinando os níveis de ruído da população e do ambiente em professores das localidades de Fontibón e Engativá, que contribuíam na construção de um sistema de monitoramento epidemiológica. Métodos: Estudo observacional do tipo transversal. A população de estudo foi constituída de 147 professores das Instituições Educacionais do Distrito definidos como maior exposição (> 65 dB) e exposição menor (< 65 dB), de acordo com o mapa de ruído ambiente de cada localidade, classificação revista por medições de ruído ambiental e populacional realizado nos centros de educação. Foi realizado um questionário sobre o histórico de saúde e percepção de ruído indagando os antecedentes familiares, pessoais e hábitos relacionados com a saúde auditiva, audiometria tonal liminar e otoscopia. Para determinar o grau de severidade foi apreciada a recomendação da guia GATI-HNIR. Resultados: 27,7 % dos profesores (40) apresentaram hipoacusia em algum grau gravidade, resultado associado ao promédio maior de resposta no limiar de professores de colégios com maior exposição. A exposição foi associada a zumbido e sensação de ruído no ambiente, as fontes identificadas com mais frequência são de tráfego aéreo e rodoviário, de forma compatível com a localização das instituições de ensino. A hipoacusia foi mais frequente em professores da localidade de Engativá (p < 0,001), em professores com idade ≥ 45 anos (p < 0,001) e com HTA (p = 0,041). Os limiares auditivos são mais elevados em escolas altamente expostas para todas as frequências, exceto as de 500 e 6000 Hz para ambas as orelhas (p < 0,05). Ossintomas otológicos associados à exposição > 65dBA (p = 0,007), igual aos sintomas neurológicos (p = 0,002). Não foi encontrada relação com sintomas psicológicos. Conclusão: Os professores vinculados às instituições com maior exposição, apresentam maiores efeitos auditivos e extra-auditivos em comparação com os pertencentes aos colégios menos expostos, o que pode estar afetando o processo de ensino. O modelo e a localização das escolas devem considerar estes impactos para evitar danos futuros.

Prevalencia de mercurio y plomo en población general de Bogotá 2012/2013 / Mercury and lead prevalence in a sample of people living in Bogotá, 2012-2013

Objetivos Establecer la prevalencia de mercurio y plomo en población general de Bogotá, posibles efectos en salud y relación con zonas de exposición ambiental. Métodos Estudio transversal, muestra de 401 individuos de población general de Bogotá, distribuida aleatoria y proporcionalmente según localidad y zonas de exposición ambiental de alto, medio y bajo riesgo. Se realizó valoración médica y cuantificación de plomo (sangre) y mercurio (sangre, cabello, orina). Se realizó análisis descriptivo preliminar. Resultados Edad de los participantes: 3-91 años (media 46), ocupación más frecuente ama de casa (45,1 %, n=181); promedios de concentraciones: mercurio en cabello: 1,00 µg/g, sangre: 3,13 µg/L, y orina: 0,29 µg/L; plomo en sangre: 8,62 µg/dL. Individuos con concentraciones superiores a los valores de referencia internacionales: 54 (13,5 %) para mercurio (OMS); 10 (2,5 %) para plomo (CDC). Los hallazgos clínicos son inespecíficos, las zonas de exposición no parecen relacionarse con las concentraciones encontradas. Discusión Un porcentaje importante de individuos presentan concentraciones elevadas de los metales estudiados, lo que resalta la necesidad de identificar y controlar las fuentes ambientales de mercurio y plomo que están afectando a la población general de Bogotá, con posibles consecuencias en su salud.(AU)

Objectives Establishing mercury and lead prevalence in a sample of people living in Bogotá, potential effects on their health and the relationship with areas of environmental exposure. Methods This was a cross-sectional study involving a randomly and proportionally distributed sample of 401 people living in Bogotá, according to locality and their high, medium and low risk environmental exposure. A medical assessment was made and lead (in blood) and mercury levels (blood, hair, urine) quantified. A preliminary descriptive analysis was made. Results The participants were aged 3-91 years-old (mean 46), the most frequently occurring occupation was that of housewife (45.1%, n=181). Mean mercury concentration in hair was 1µg/g, 3.13 µg/L in blood and 0.29 µg/L in urine; lead in blood was found to be 8.62 µg/dL. Fifty-four people (13.5%) had higher concentrations than international reference values for mercury (WHO) and 10 (2.5%) for lead (CDC). Clinical findings were non-specific; exposure areas did not seem to relate to the concentrations found. Discussion A significant percentage of the study population had high mercury and/or lead levels and such high prevalence highlights the need for identifying and controlling sources of exposure to mercury and lead which could have adverse consequences regarding the health of Bogota’s general population.(AU)

[Mercury and lead prevalence in a sample of people living in Bogotá, 2012-2013]. / Prevalencia de mercurio y plomo en población general de Bogotá 2012/2013.

OBJECTIVES: Establishing mercury and lead prevalence in a sample of people living in Bogotá, potential effects on their health and the relationship with areas of environmental exposure. METHODS: This was a cross-sectional study involving a randomly and proportionally distributed sample of 401 people living in Bogotá, according to locality and their high, medium and low risk environmental exposure. A medical assessment was made and lead (in blood) and mercury levels (blood, hair, urine) quantified. A preliminary descriptive analysis was made. RESULTS: The participants were aged 3-91 years-old (mean 46), the most frequently occurring occupation was that of housewife (45.1%, n=181). Mean mercury concentration in hair was 1µg/g, 3.13 µg/L in blood and 0.29 µg/L in urine; lead in blood was found to be 8.62 µg/dL. Fifty-four people (13.5%) had higher concentrations than international reference values for mercury (WHO) and 10 (2.5%) for lead (CDC). Clinical findings were non-specific; exposure areas did not seem to relate to the concentrations found. DISCUSSION: A significant percentage of the study population had high mercury and/or lead levels and such high prevalence highlights the need for identifying and controlling sources of exposure to mercury and lead which could have adverse consequences regarding the health of Bogotá'’s general population.

Impacto en la salud por el cambio y la variabilidad del clima en Bogotá, D. C / Health Impact Associated with Climate Change and Variability in Bogotá, D. C / Impacto na saúde pela variabilidade climática e mudança de Bogotá, D. C

Colombia fue uno de países más afectados por los eventos climáticos asociados al cambio y la variabilidad climáticos durante 2010; Bogotá fue una de las regiones más golpeadas por las inundaciones ocurridas durante dicho periodo. Por otro lado, se sabe poco sobre el efecto del cambio y la variabilidad climáticos sobre el Distrito, por lo cual es necesario determinar las enfermedades sensibles al clima para Bogotá, D. C., así como identificar a la población vulnerable ante dichas enfermedades. Resultados preliminares de la relación entre cambio climático y salud en Bogotá muestran un aumento en la carga y en la severidad de ciertas enfermedades asociadas a la variabilidad climática, como un pico epidémico de hospitalizaciones por dengue durante 2011 en relación con el aumento regional de las precipitaciones, y una correlación positiva entre la infección respiratoria aguda grave (irag) y la precipitación promedio por semanas epidemiológicas durante 2011. Tales hallazgos requieren un análisis más profundo; por lo tanto, se propone diseñar un sistema de monitoreo con una perspectiva holística, para mejorar la capacidad de adaptación del Distrito Capital ante los eventos climáticos extremos y la variabilidad climática.

Colombia was one of the most affected countries by events associated to climate change during 2010. Bogota was one of the most affected cities by floods during this period. On the other hand, little is known about the effect that climate change had over this city. Thus, it is important to determine which diseases are related to climate change in Bogota, and identify the vulnerable population to these affections. Preliminary results showing the relationship between climate change and healthcare in Bogota explain an increase in burden and severity of certain diseases associated to climate change. For instance, an epidemic peak of hospitalizations due to dengue during 2011 was highly related to a regional increase of rainfall. A positive correlation between Severe Acute Respiratory Syndrome (sars) and average precipitation for epidemiological weeks during 2011 was calculated. Said results require an in-depth analysis, obtained by the use of a monitoring system with holistic perspective, to help improve the capacity of Bogota to adapt to extreme climate events and their variability.

Colômbia foi um dos países mais afetados por eventos climáticos associados às mudanças climáticas ao longo de 2010; Bogotá foi uma das regiões mais atingidas pelas enchentes durante este periodo. Entretanto, pouco se sabe sobre os efeitos da mudança climática e a variação climática no Distrito, por isso, é necessário determinar as doenças sensíveis ao clima de Bogotá, DC, bem como identificar o público mais vulnerável a essas doenças. Os resultados preliminares da relação entre as mudanças climáticas e saúde em Bogotá mostram um aumento da carga e agravamento de certas doenças que estão associadas com a variação climática, com um pico epidêmico em internações por dengue ocorrido em 2011 em relação ao aumento de chuvas regionais, e uma correlação positiva entre infecção respiratória aguda grave (sari) e a precipitação média de semanas epidemiológicas ao longo de 2011. Estes resultados exigem uma análise mais aprofundada; Portanto, propõe-se criar um sistema de monitoramento com uma abordagem holística para melhorar a adaptabilidade do Distrito Capital frente aos eventos climáticos extremos e sua variação climática.

Contaminación del aire y enfermedad respiratoria en menores de cinco años de Bogotá, 2007 / Air pollution and respiratory illness in children aged less than 5 years-old in Bogotá, 2007

Objetivos Determinar la relación entre contaminación del aire extra e intramuros por material particulado MP10 con síntomas respiratorios en niños menores de 5 años en tres localidades del Distrito Capital. Métodos Estudio de cohortes. 315 niños y niñas de jardines ubicados en zona de mayor exposición a material particulado MP10, y 304 de jardines en zona de menor exposición. Se siguieron las cohortes por 19 semanas, teniendo en cuenta síntomas respiratorios. Se midió material particulado intramuros y extramuros en los jardines. Se determinaron prevalencias y asociación entre variables. Resultados Hubo una diferencia de promedios de MP intramuros entre mayor y menor exposición de 85.6 μg/m³vs. 61.8 μg/m³ (p<0,05). 74.3 % de los niños presentaron sibilancias en el último año, con diferencia entre mayor y menor exposición de 79,6 % vs 69,0 % (p<0,05). Sibilancias y expectoración estuvieron asociados a mayor exposición a MP10 (RR 1,39 y 1,30). Factores asociados a síntomas respiratorios: tabaquismo pasivo, el antecedente de bajo peso al nacer, el antecedente de sibilancias, la cercanía del jardín o vivienda a menos de 100 metros de chimeneas, vías de alto flujo vehicular, vías en mal estado y colecho. Discusión Un niño menor de 5 años expuesto a MP10 tiene 1,70 veces más riesgo de presentar ausentismo escolar por enfermedad respiratoria aguda, una disminución del MP10 reduciría en un 41,1 % este ausentismo escolar.

Objectives Determining the relationship between indoor and outdoor air pollution caused by particulate matter PM10 and respiratory symptoms in children aged younger than 5 years-old in three locations in Bogota. Methods This was a cohort study, involving 315 children in kindergartens located in the area of greatest exposure to PM10, and 304 in kindergartens located in an area of less exposure. The cohort was followed-up for 19 weeks considering respiratory symptoms. Particulate matter was intramurally and extramurally measured in the kindergartens. Prevalence and association between variables were determined. Results There was a difference regarding average intramural PM between higher and lower exposure (85.6 ug/m³cf 61.8 g/m³; p<0.05); 74.3 % of the children had suffered wheezing during the last year, difference between greater and lesser exposure being 79.6 % cf 69.0 % (p<0.05). Wheezing and coughing were associated with greater exposure to PM10 (RR 1.39 and 1.30). Factors associated with respiratory symptoms concerned passive smoking, having a history of low birth weight, a history of wheezing, a child's kindergarten or home being within 100 meters of (industrial) chimneys, high traffic flow routes, roads in disrepair and bed-sharing. Discussion A child aged less than 5 years-old exposed to PM10 had a 1.7 times higher risk of truancy due to acute respiratory illness; a decrease in PM10 reduced such truancy by 41.1 %.

[Air pollution and respiratory illness in children aged less than 5 years-old in Bogotá, 2007]. / Contaminación del aire y enfermedad respiratoria en menores de cinco años de Bogotá, 2007.

OBJECTIVES: Determining the relationship between indoor and outdoor air pollution caused by particulate matter PM10 and respiratory symptoms in children aged younger than 5 years-old in three locations in Bogota. METHODS: This was a cohort study, involving 315 children in kindergartens located in the area of greatest exposure to PM10, and 304 in kindergartens located in an area of less exposure. The cohort was followed-up for 19 weeks considering respiratory symptoms. Particulate matter was intramurally and extramurally measured in the kindergartens. Prevalence and association between variables were determined. RESULTS: There was a difference regarding average intramural PM between higher and lower exposure (85.6 ug/m³cf 61.8 g/m³; p<0.05); 74.3 % of the children had suffered wheezing during the last year, difference between greater and lesser exposure being 79.6 % cf 69.0 % (p<0.05). Wheezing and coughing were associated with greater exposure to PM10 (RR 1.39 and 1.30). Factors associated with respiratory symptoms concerned passive smoking, having a history of low birth weight, a history of wheezing, a child's kindergarten or home being within 100 meters of (industrial) chimneys, high traffic flow routes, roads in disrepair and bed-sharing. DISCUSSION: A child aged less than 5 years-old exposed to PM10 had a 1.7 times higher risk of truancy due to acute respiratory illness; a decrease in PM10 reduced such truancy by 41.1 %.