Environmental nickel exposure from oil refinery emissions: a case study in Ecuador.

INTRODUCTION: Nickel is a strong skin and respiratory sensitizer and a recognized carcinogen. Oil refineries are important sources of atmospheric emissions of toxic pollutants, including nickel. Populations residing close to oil refineries are at potential risk. The aim of this study was to evaluate the exposure to nickel in a population living close to the largest oil refinery in Ecuador, located in the city of Esmeraldas. METHODOLOGY: We recruited 47 workers from the oil refinery as well as 195 students from 4 different schools close to the plant and 94 students from another school 25 km far from the industry. Urinary nickel concentrations were used to assess the exposure to nickel. RESULTS: Students from the school next to the oil refinery showed the highest urinary nickel concentrations while workers from the refinery showed the lowest concentrations. Median nickel concentrations were > 2µg/L in all study groups. CONCLUSIONS: The populations living close to the oil refineries are potentially exposed to nickel from atmospheric emissions. Further studies investigating nickel-related health effects in the population residing close to the refinery of Esmeralda are needed.

Descriptive Epidemiology of Somatising Tendency: Findings from the CUPID Study.

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.

Children's health in Latin America: the influence of environmental exposures.

BACKGROUND: Chronic diseases are increasing among children in Latin America. OBJECTIVE AND METHODS: To examine environmental risk factors for chronic disease in Latin American children and to develop a strategic initiative for control of these exposures, the World Health Organization (WHO) including the Pan American Health Organization (PAHO), the Collegium Ramazzini, and Latin American scientists reviewed regional and relevant global data. RESULTS: Industrial development and urbanization are proceeding rapidly in Latin America, and environmental pollution has become widespread. Environmental threats to children's health include traditional hazards such as indoor air pollution and drinking-water contamination; the newer hazards of urban air pollution; toxic chemicals such as lead, asbestos, mercury, arsenic, and pesticides; hazardous and electronic waste; and climate change. The mix of traditional and modern hazards varies greatly across and within countries reflecting industrialization, urbanization, and socioeconomic forces. CONCLUSIONS: To control environmental threats to children's health in Latin America, WHO, including PAHO, will focus on the most highly prevalent and serious hazards-indoor and outdoor air pollution, water pollution, and toxic chemicals. Strategies for controlling these hazards include developing tracking data on regional trends in children's environmental health (CEH), building a network of Collaborating Centres, promoting biomedical research in CEH, building regional capacity, supporting development of evidence-based prevention policies, studying the economic costs of chronic diseases in children, and developing platforms for dialogue with relevant stakeholders.

Cadmium, mercury and lead in the blood of urban women in Croatia, the Czech Republic, Poland, Slovakia, Slovenia, Sweden, China, Ecuador and Morocco.

OBJECTIVES: The aim of the study was to make an international comparison of blood levels of cadmium (B-Cd), lead (B-Pb) and mercury (B-Hg) of women in seven European, and three non-European cities, and to identify determinants. MATERIALS AND METHODS: About 50 women (age: 46-62) from each city were recruited (totally 480) in 2006-2009. Interview and questionnaire data were obtained. Blood samples were analysed in one laboratory to avoid interlaboratory variation. RESULTS: Between the European cities, the B-Pb and B-Cd results vary little (range of geometric means: 13.5-27.0 µg/l and 0.25-0.65 µg/l, respectively); the variation of B-Hg was larger (0.40-1.38 µg/l). Between the non-European cities the results for B-Pb, B-Cd and B-Hg were 19.2-68.0, 0.39-0.99 and 1.01-2.73 µg/l, respectively. Smoking was a statistically significant determinant for B-Cd, while fish and shellfish intakes contributed to B-Hg and B-Pb, amalgam fillings also contributed to B-Hg. CONCLUSIONS: The present results confirm the previous results from children; the exposure to lead and cadmium varies only little between different European cities suggesting that other factors than the living area are more important. The study also confirms the previous findings of higher cadmium and lead levels in some non-European cities. The geographical variation for mercury is significant.

Blood cadmium, mercury, and lead in children: an international comparison of cities in six European countries, and China, Ecuador, and Morocco.

Children's blood-lead concentration (B-Pb) is well studied, but little is known about cadmium (B-Cd) and mercury (B-Hg), in particular for central Europe. Such information is necessary for risk assessment and management. Therefore, we here describe and compare B-Pb, B-Cd and B-Hg in children in six European, and three non-European cities, and identify determinants of these exposures. About 50 school children (7-14 years) from each city were recruited (totally 433) in 2007-2008. Interview and questionnaire data were obtained. A blood sample was analyzed: only two laboratories with strict quality control were used. The European cities showed only minor differences for B-Cd (geometric means 0.11-0.17 µg/L) and B-Pb (14-20 µg/L), but larger for B-Hg (0.12-0.94 µg/L). Corresponding means for the non-European countries were 0.21-0.26, 32-71, and 0.3-3.2 µg/L, respectively. For B-Cd in European samples, traffic intensity close to home was a statistically significant determinant, for B-Hg fish consumption and amalgam fillings, and for B-Pb sex (boys higher). This study shows that European city children's B-Cd and B-Pb vary only little between countries; B-Hg differs considerably, due to varying tooth restoration practices and fish intake. Traffic intensity seemed to be a determinant for B-Cd. The metal concentrations were low from a risk perspective but the chosen non-European cities showed higher concentrations than the cities in Europe.

Exposure and toxic effects of elemental mercury in gold-mining activities in Ecuador.

Traditional gold mining, using metallic mercury (Hg(0)) to form gold amalgam, followed by burning to remove the Hg(0), is widely used in South America, Africa and Asia. The gold is sold to merchants who burn it again to eliminate remaining Hg(0). In Ecuador, 200 gold miners, 37 gold merchants and 72 referents were studied. The median Hg concentrations in urine (U-Hg) were 3.3 (range 0.23-170), 37 (3.2-420), and 1.6 (0.2-13)µg/g creatinine, respectively, and in whole blood (B-Hg) were 5.2, 30, and 5.0 µg/L, respectively. Biomarker concentrations among merchants were statistically significantly higher than among miners and referents; also the miners differed from the referents. Burning of gold amalgam among miners was intermittent; U-Hg decreased in the burning-free period. In computerized neuromotor examinations, B-Hg and U-Hg concentrations were associated with increases in the centre frequency of the tremor, as well as in reaction time and postural stability.Retention of Hg (B-Hg), and the elimination rate (U-Hg) appears to be modified by polymorphism in a gene of an enzyme in the glutathione synthesis (GCLM), but there were no significant genetic modifications for the associations between exposure and neurotoxicity.Thus, the gold merchants have a much higher exposure and risk than the miners, in whom the exposure varies over time. The metabolism of Hg is modified by genetic traits. The present exposure to Hg had limited neurotoxic effects.

La prevención de las patologías del asbesto: perspectivas operativas de la cooperación italiana con los países de América Latina / Preventing asbestos-related diseases: operative action for Italian cooperation with Latin-American countries

El propósito del presente estudio es el de valorar la tesis de que el impacto a la salud de la exposición a fibras de asbesto presentes en los lugares de trabajo y en el ambiente requiere contramedidas basadas en la evidencia científica y la cooperación internacional. La evidencia científica adquirida a nivel internacional sobre el asbesto, la experiencia pluridecenal madurada en Italia sobre este tema, así como la conciencia de que la adaptación de medidas para combatir los efectos en la salud causados por la exposición a asbesto debe ser verificada considerando la especificidad de los diversos contextos nacionales y locales en América Latina, constituyen la base para la identificación de las cuatro principales directrices de intervención (Promoción del acceso a la documentación sobre el asbesto - Realización de intervenciones para reducir la exposición al asbesto - Vigilancia sanitaria de los sujetos expuestos - Detección del mesotelioma) - que pueden ser desarrolladas en el ámbito de la cooperación técnico-científica entre Italia y los países de América Latina. La integración de las capacidades de los investigadores colombianos e italianos podrá permitir conseguir estos resultados, contribuyendo al proceso de eliminación del asbesto ya en curso en América Latina.

The present paper was aimed at promoting countermeasures based on scientific evidence and international cooperation for evaluating the impact on health caused by exposure to asbestos fibres in the workplace and the environment. Scientific evidence regarding asbestos made available by the international scientific community, decades of experience gained in Italy on this issue and being aware that adopting measures to combat the health effects caused by asbestos exposure should be verified considering the specificity of various national and local contexts in Latin-America form the basis for identifying four main areas for intervention which may be developed in the field of technical and scientific cooperation between Italy and Latin-America countries: promoting access to information about asbestos, interventions for reducing exposure to asbestos, health surveillance of exposed subjects and mesothelioma detection. Integrating Colombian and Italian researchers' abilities may lead to such results being achieved, thereby contributing to banning asbestos, which is already underway in Latin-America.

Neurobehavioral deficits and increased blood pressure in school-age children prenatally exposed to pesticides.

BACKGROUND: The long-term neurotoxicity risks caused by prenatal exposures to pesticides are unclear, but a previous pilot study of Ecuadorian school children suggested that blood pressure and visuospatial processing may be vulnerable. OBJECTIVES: In northern Ecuador, where floriculture is intensive and relies on female employment, we carried out an intensive cross-sectional study to assess children's neurobehavioral functions at 6-8 years of age. METHODS: We examined all 87 children attending two grades in the local public school with an expanded battery of neurobehavioral tests. Information on pesticide exposure during the index pregnancy was obtained from maternal interview. The children's current pesticide exposure was assessed from the urinary excretion of organophosphate metabolites and erythrocyte acetylcholine esterase activity. RESULTS: Of 84 eligible participants, 35 were exposed to pesticides during pregnancy via maternal occupational exposure, and 23 had indirect exposure from paternal work. Twenty-two children had detectable current exposure irrespective of their prenatal exposure status. Only children with pre-natal exposure from maternal greenhouse work showed consistent deficits after covariate adjustment, which included stunting and socioeconomic variables. Exposure-related deficits were the strongest for motor speed (Finger Tapping Task), motor coordination (Santa Ana Form Board), visuospatial performance (Stanford-Binet Copying Test), and visual memory (Stanford-Binet Copying Recall Test). These associations corresponded to a developmental delay of 1.5-2 years. Prenatal pesticide exposure was also significantly associated with an average increase of 3.6 mmHg in systolic blood pressure and a slight decrease in body mass index of 1.1 kg/m2. Inclusion of the pilot data strengthened these results. CONCLUSIONS: These findings support the notion that prenatal exposure to pesticides-at levels not producing adverse health outcomes in the mother-can cause lasting adverse effects on brain development in children. Pesticide exposure therefore may contribute to a "silent pandemic" of developmental neurotoxicity.

[Preventing asbestos-related diseases: operative action for Italian cooperation with Latin-American countries]. / La prevención de las patologías del asbesto: perspectivas operativas de la cooperación italiana con los países de América Latina.

The present paper was aimed at promoting countermeasures based on scientific evidence and international cooperation for evaluating the impact on health caused by exposure to asbestos fibres in the workplace and the environment. Scientific evidence regarding asbestos made available by the international scientific community, decades of experience gained in Italy on this issue and being aware that adopting measures to combat the health effects caused by asbestos exposure should be verified considering the specificity of various national and local contexts in Latin-America form the basis for identifying four main areas for intervention which may be developed in the field of technical and scientific cooperation between Italy and Latin-America countries: promoting access to information about asbestos, interventions for reducing exposure to asbestos, health surveillance of exposed subjects and mesothelioma detection. Integrating Colombian and Italian researchers' abilities may lead to such results being achieved, thereby contributing to banning asbestos, which is already underway in Latin-America.

El asbesto en Ecuador: el día después / Asbestos in Ecuador: the day after

Alrededor de 1960, cuando se inician acciones dirigidas al desarrollo de la estrategia de sustitución de importaciones en la industria ecuatoriana, ingresan al Ecuador varias empresas que utilizan sustancias conocidas como nocivas, entre ellas, aquellas que producen materiales de construcción con asbesto. El interés de crear una industria nacional, de generar puestos de trabajo, de elaborar productos semimanufacturados o manufacturados se hizo sin prever las mejores condiciones de seguridad. Por lo tanto ni legalmente, ni productivamente, ni desde el punto de vista de la ubicación, condiciones de seguridad y salud existían salvaguardas, mas que las que las empresas decidieran adoptar. En síntesis, ni la estrategia de industrialización ni el marco legal que la acompañó incluyeron medidas de prevención sobre el asbesto y cuando los organismos de control comenzaron a actuar lo hicieron con retardo y poca capacidad de control. Las normativas surgidas a partir de 2000 demuestran claramente el retraso en abordar el tema y la propuestas de esfuerzos dirigidos a lograr un uso seguro del asbesto, algo ya cuestionado en esos años. De tal manera que se hace necesario desarrollar una Propuesta Nacional acerca de cómo enfrentar el tema del asbesto en Ecuador, que debe incluir desde su prohibición, control de producción, capacitación de personal en evaluaciones ambientales hasta la realización de un censo nacional.

Around 1960, when actions aimed at the development of a strategy for the substitution of imports in Ecuadorian industry began, several companies using known harmful substances were established in Ecuador, among them those that produce construction materials containing asbestos. The interest in creating a national industry, generating jobs, making semi-manufactured or manufactured products was implemented without anticipating the best conditions of safety. Therefore, there were no safeguards neither from a legal point of view, nor from productivity, location, safety conditions and health, except those that companies decided to adopt. In synthesis, neither the industrialization strategies nor the accompanying legal framework included prevention measures with regard to asbestos and when regulating agencies began to act they did it with delay and little capacity of control. Regulations arising since 2000 show clearly the delay in addressing the subject and the proposals of efforts aimed at achieving a safe use of asbestos, something already questioned in those years. So it is necessary to develop a National Proposal on how to meet the subject of asbestos in Ecuador, which should include from banning, roduction control, training of personnel in environmentalevaluations to the conduct of a national census.

Children's environment and health in Latin America: the Ecuadorian case.

Environmental health problems of children in Latin America and Ecuador are complex due to the close relationship that exists between social and environmental factors. Extended poverty and basic problems, such as the lack of drinking water and sanitation, are common. Infectious diseases are the greatest cause of morbidity and mortality among children. Development in industry and the introduction of chemical substances in agriculture add new risks including pesticide use, heavy metal exposure, and air pollution. Major problems can be divided into (a) lack of basic infrastructure, (b) poor living conditions, (c) specific environmental problems, and (d) child labor. Reproductive health disorders are frequent in developing countries like Ecuador. Issues related to children's health should consider new approaches, creative methodologies, and the search for independent predictors to separate environmental from social problems. Only with knowledge of the specific contribution of each factor, can it be possible to develop a strategy for prevention.

Pesticide exposure and stunting as independent predictors of neurobehavioral deficits in Ecuadorian school children.

OBJECTIVES: To examine possible effects on blood pressure, neurological function, and neurobehavioral tests in school-aged children with and without prenatal pesticide exposure in an area where stunting is common. METHODS: In a community of Northern Ecuador with intensive floriculture and a high female employment rate, we invited 79 children attending the 2 lowest grades of a public school for clinical examinations. In addition to a thorough physical examination, we administered simple reaction time, Santa Ana dexterity test, Stanford-Binet copying, and Wechsler Intelligence Scale for Children-Revised Digit Spans forward. Maternal interview included detailed assessment of occupational history to determine pesticide exposure during pregnancy. Recent and current pesticide exposure was assessed by erythrocyte acetylcholine esterase activity and urinary excretion of organophosphate metabolites. RESULTS: All eligible children participated in the study, but 7 children were excluded from data analysis due to other disease or age >9 years. A total of 31 of the remaining 72 children were classified as stunted based on their height for age. Maternal occupational history revealed that 37 children had been exposed to pesticides during development. After confounder adjustment, prenatal pesticide exposure was associated with a higher systolic blood pressure than in the controls. On neurological examination, 14 exposed children and 9 controls showed > or =1 abnormalities. Of 5 neurobehavioral tests, the Stanford-Binet copying test showed a lower drawing score for copying designs in exposed children than in controls. Stunting was associated with a lower score on this test only, and both risk factors remained statistically significant in a multiple regression analysis with adjustment for demographic and social confounders. Increased excretion of dimethyl and diethyl metabolites of organophosphates was associated with increased reaction time and no other outcomes. CONCLUSION: Prenatal pesticide exposure may cause lasting neurotoxic damage and add to the adverse effects of malnutrition in developing countries. The effects differ from those due to acute pesticide exposure.

Genetic influences on the retention of inorganic mercury.

Mercury is eliminated as glutathione (GSH) conjugates. GSH production is mediated by glutamyl-cysteine ligase (GCL), and conjugation by glutathione S-transferases (GST). This study tested if polymorphisms in GCL and GST genes modify mercury retention in humans exposed to elemental mercury vapor. Total mercury concentrations in whole blood, plasma and urine, and genotypes for GCLC, GCLM, GSTA1, GSTM1, GSTP1, and GSTT1 were determined in 309 gold miners, gold buyers and controls. The presence of the GCLM-588T allele was associated with increased blood, plasma and urine mercury levels. These results indicate that genotypes with decreased GSH availability for mercury conjugation affect the metabolism of inorganic mercury.

Major concerns in developing countries: applications of the Precautionary Principle in Ecuador.

Ecuador is a Latin American country with one of the biggest biodiversities. At the same time, social and environmental problems are also big. Poverty, political and social problems as well as questions like old transport systems, imported hazards from industrialized countries and lack of information and weak health care systems are the framework of this situation. The most common problems are the use of heavy metals in many activities without safety and health protection, a low technological oil production during two decades, intensive use of pesticides in agriculture, and some other chemical risks. A limited capacity to develop prevention strategies, reduced technical and scientific skills, and the absence of a reliable information and control system, lead to a weak response mechanism. The Precautionary Principle could help to stimulate prevention, protection and to have a new tool to improve the interest in environment and health problems. Reinforcing the presence of international organizations like the World Health Organization or the International Labour Organization, establishing bridges among scientific organizations from developed and developing countries and introducing the Precautionary Principle in the legislation and daily practices of industry and agriculture could lead to an improvement in our environment and health.

Estrategia industrial y medio ambiente laboral en Ecuador 1975-2000 / Labor industrial and medio ambiente strategy in Ecuador 1975-2000

Plantea políticas para una mayor eficacia en los servicios de salud laboral. Analiza la historia de las estadísticas de mortalidad por accidentes laborales e inseguridad industrial...