"Characterization of residential proximity to sources of environmental carcinogens in clusters of Acute Lymphoblastic Leukemia in San Luis Potosi, Mexico".

BACKGROUND: Acute Lymphoblastic Leukemia (ALL) is the most prevalent neoplasia in children and teenagers in Mexico. Although epidemiological data supports that children's residence close to emissions from vehicular traffic or industrial processes increases the risk of ALL; and the IARC states that benzene, PAHs, and PM 2.5 are well-known environmental carcinogens, there is a gap in linking these carcinogenic hazards with the sources and their distribution from scenario perspective. AIM: To identify ALL clusters in the population under 19 years of age and characterize the environment at the neighborhood level by integrating information on sources of carcinogenic exposure using spatial analysis techniques in the Metropolitan Area of San Luis Potosi, Mexico. METHODS: Using the Kernel Density test, we designed an ecological study to identify ALL clusters from incident cases in the population under 19 years of age. A multicriteria analysis was conducted to characterize the risk at the community level from carcinogenic sources. A hierarchical cluster analysis was performed to characterize risk at the individual level based on carcinogenic source count within 1 km for each ALL case. RESULTS: Eight clusters of carcinogenic sources were located within the five identified ALL clusters. The multicriteria analysis showed high-risk areas (by density of carcinogenic source) within ALL clusters. CONCLUSIONS: This study has a limited source and amount of available data on ALL cases, so selection bias is present as well as the inability to rule out residual confounding factors, since covariates were not included. However, in this study, children living in environments with high vehicular density, gas stations, brick kilns, incinerators, commercial establishments burning biomass, or near industrial zones may be at higher risk for ALL.

Childhood acute lymphoblastic leukemia survival and spatial analysis of socio-environmental risks in Mexico.

Background: Acute lymphoblastic leukemia (ALL) etiology remains largely unknown; incidence patterns by age, sex, and geographical distribution suggest a potential environmental role. Aim: To identify ALL clusters from four contrasting urban areas of Mexico and to characterize the sources of environmental carcinogens. Methods: Hospital-based ALL cases (n = 443) diagnosed in children <19 years old from the Metropolitan Zones of Merida and San Luis Potosi, the State of Mexico, and Tijuana were analyzed (2015-2020). ALL cases were coded according to the International Classification of Diseases for Oncology. ALL clusters were identified by Kernel Density, and excess risk was estimated. Data of particulate matter ≤2.5 µm (PM2.5) concentrations measured by community-monitoring stations were analyzed. Geocoded datasets of benzene, polycyclic aromatic hydrocarbons, and PM2.5 sources were analyzed to characterize patterns of exposure in ALL clusters. Results: The survival rate for ALL ranged from 61.5% to 78.6%. Seven ALL clusters with excess risk (RR 1.4-2.3, p < 0.05) were identified. The carcinogen sources included artisanal brick kilns, gas stations, cement works, carpentry, paint, and chemical manufacturing establishments. PM2.5 levels ranged from 15 µg/m3 to 37 µg/m3 among study areas. Conclusion: ALL clusters were identified at the community level; the excess risk could be explained by small-scale carcinogen sources. The levels of PM2.5 in outdoor air ranged from 3 to 6 times above the World Health Organization (WHO) air quality guidelines. Healthcare providers must raise awareness of the increased risk of ALL in children living near sources of environmental carcinogens; cancer control and prevention strategies must be steered from a multi-sectoral and multi-action perspective to protect children's health.

Urinary fluoride and micronutrients intake in children from San Luis Potosi, Mexico.

To assess the relationship between urinary fluoride and micronutrients intake we recruited 121 schoolchildren from San Luis Potosí. We evaluated fluoride concentrations in drinking water and urine with the ion-selective electrode method and estimated calcium, magnesium, and phosphorus intakes with a validated consumption frequency questionnaire. About 72% of the population used tap water for drinking and cooking. Fluoride concentrations were 2.36 ± 0.02 mg/L in tap water, 0.14 ± 0.04 mg/L in bottled water and 2.05 ± 0.62 mg/L in urine. Urinary fluoride was higher in children with a consumption <50% of the Recommended Daily Intake (RDI) of calcium (2.20 v/s 1.96 mg/L; p < 0.05), <50% RDI of magnesium (2.58 v/s 1.96 and 1.90 mg/L; p < 0.05) and >150% RDI of phosphorus (2.43 v/s 1.82 mg/L; p < 0.05). These data indicated that fluoride concentration in tap water is higher than bottled water and estimated micronutrients intake is related to urinary fluoride.

Dosis de exposición a fluoruros por el consumo de diferentes tipos de leche en residentes de una zona con hidrofluorosis endémica en México / Level of exposure to fluorides by the consumption of different types of milk in residents from an area of Mexico with endemic hydrofluorosis

Introducción: Diversos estudios han demostrado la presencia de fluorosis (FD) en la dentición primaria, lo que puede indicar una exposición a los fluoruros (F-) en la primera infancia. La leche materna se recomienda como alimento exclusivo hasta los 6 meses de edad. Aunque se menciona que solo una pequeña cantidad de F- puede eliminarse por leche materna, estudios han demostrado la presencia de este elemento en leche de mujeres residentes de zonas contaminadas, así como en leche de fórmulas comerciales. El objetivo del proyecto fue evaluar la dosis de exposición a F- a través de leche en niños residentes de una zona con hidrofluorosis endémica. Metodología: Un total de 110 niños de entre 6 y 36 meses de edad del municipio de Lagos de Moreno, Jalisco, México, participaron en el estudio. Se colectaron muestras de agua de los hogares, leche y orina. Las muestras se cuantificaron con el electrodo de ion selectivo. Se calculó la dosis de exposición a F- a través del programa Oracle Crystal Ball. Resultados: Se observaron dosis superiores a la dosis de referencia para FD en la leche de fórmula reconstituida con agua de abastecimiento público, de vaca pasteurizada (entera) y de vaca sin tratamiento sanitario (cruda) en el percentil 90, 70 y 50, respectivamente, así como una correlación entre los niveles de F- en leche y F- en orina (r = 0,41; p < 0,001). Conclusiones: La identificación de fuentes de F- en etapas tempranas del desarrollo infantil podría reducir el riesgo de presentar FD

Introduction: Several studies have shown the presence of fluorosis (DF) in primary dentition, suggesting an exposure to fluorides (F-) in early childhood. Breast milk is recommended as an exclusive food until 6 months of age. Although it is mentioned that only a small amount of F- can be eliminated by breast milk, studies have shown the presence of this element in milk of women living in contaminated areas, as well as in infant formulas. The objective of this project was to evaluate the exposure level to F- through milk in children living in an area with endemic hydrofluorosis. Methodology: The study included 110 children between 6 and 36 months of age from the municipality of Lagos de Moreno, Jalisco. Water samples were collected from the homes, as well as samples of milk (maternal, formula, whole or raw), and urine. Measurments were made with a selective ion electrode. The exposure level of F- for milk intake was calculated using the Oracle Crystal Ball package. Results: Levels greater than the reference level for DF were observed in infant formula reconstituted with public supply water, pasteurised cow's milk (whole) and untreated cow's milk treatment (raw) in the 90th, 70th, and 50th percentile, respectively, with a correlation being found between the levels of F- in milk and F- in urine (r = 0.41, P < .001)

[Level of exposure to fluorides by the consumption of different types of milk in residents from an area of Mexico with endemic hydrofluorosis]. / Dosis de exposición a fluoruros por el consumo de diferentes tipos de leche en residentes de una zona con hidrofluorosis endémica en México.

INTRODUCTION: Several studies have shown the presence of fluorosis (DF) in primary dentition, suggesting an exposure to fluorides (F-) in early childhood. Breast milk is recommended as an exclusive food until 6 months of age. Although it is mentioned that only a small amount of F- can be eliminated by breast milk, studies have shown the presence of this element in milk of women living in contaminated areas, as well as in infant formulas. The objective of this project was to evaluate the exposure level to F- through milk in children living in an area with endemic hydrofluorosis. METHODOLOGY: The study included 110 children between 6 and 36 months of age from the municipality of Lagos de Moreno, Jalisco. Water samples were collected from the homes, as well as samples of milk (maternal, formula, whole or raw), and urine. Measurments were made with a selective ion electrode. The exposure level of F- for milk intake was calculated using the Oracle Crystal Ball package. RESULTS: Levels greater than the reference level for DF were observed in infant formula reconstituted with public supply water, pasteurised cow's milk (whole) and untreated cow's milk treatment (raw) in the 90th, 70th, and 50th percentile, respectively, with a correlation being found between the levels of F- in milk and F- in urine (r=0.41, P<.001). CONCLUSIONS: The identification of sources of F- in the early stages of child development could reduce the risk of developing DF.

Salud mental materna: factor de riesgo del bienestar socioemocional en niños mexicanos / Maternal mental health: a risk factor affecting the social and emotional well-being of Mexican children

Objetivos. Estimar la prevalencia de síntomas depresivos y de ansiedad (SDyA) en madres de tres zonas poblacionales (ZP) del estado de San Luis Potosí, México, y analizar la asociación entre los SDyA y sus efectos en la salud emocional de sus hijos. Métodos. Se evaluaron 173 parejas (madre-hijo) de tres ZP: Zona urbana (ZU), rural (ZR) y rural indígena (ZRI). Se estudiaron los SDyA de las mujeres, y las dificultades conductuales (DC) de los niños. Resultados. Se encontró una alta prevalencia de SDyA en las tres ZP. La mayor proporción de síntomas depresivos la presentaron la ZU y la ZR (38,7 y 38,6%). La prevalencia más alta de síntomas de ansiedad se observó en la ZR (31,8%). La asociación entre los SDyA y la depresión materna más fuerte se estimó en la ZR (razón de momios o RM = 11,0; IC95%: 1,3-95,5). En la ZRI se estimó la mayor prevalencia de DC en los niños (61%). Se encontró una asociación entre las DC y la ansiedad materna (RM = 2,2; IC95%: 1,1-4,3) y la depresión materna (RM = 2,5; IC95%: 1,3-4,6). Conclusiones. La salud mental de las madres puede poner en riesgo el bienestar socioemocional de sus hijos, lo que viene respaldado por la alta prevalencia y la asociación entre SDyA y DC encontrada. En México se necesita disponer de información fiable sobre el estado de salud mental de las mujeres y los niños de las tres ZP, para implantar medidas que amplíen su cobertura evaluativa y preventiva.

Objectives. To estimate the prevalence of symptoms of depression and anxiety in mothers from three population areas in the state of San Luis Potosí, Mexico, and to analyze the association between these symptoms and the emotional health of their children. Methods. Assessment was conducted on 173 mother–child pairs from three different population areas: urban, rural, and indigenous rural. Women's symptoms of depression and anxiety were evaluated, together with their children's behavioral problems. Results. A high prevalence of symptoms of depression and anxiety was found in the three areas included. The proportion of depressive symptoms was highest in the urban and rural areas (38.7% and 38.6%, respectively). The highest prevalence of anxiety symptoms was observed in the rural area (31.8%). The strongest association between maternal anxiety and maternal depression was found in the rural area (odds ratio [OR] = 11.0; 95% CI: 1.3-95.5). The indigenous rural area showed the highest prevalence of behavioral problems among children (61%). An association between such problems and maternal anxiety (OR = 2.2; 95% CI: 1.1-4.3) and maternal depression (OR = 2.5; 95% CI: 1.3-4.6) was noted. Conclusions. The mental health of mothers can put the social and emotional wellbeing of their children at risk. This conclusion is supported by the findings, namely high prevalences and an association between symptoms of anxiety and depression and behavioral problems. In Mexico, reliable information on the mental health status of women and children in the three population areas studied is needed in order to implement measures towards expanding coverage for evaluation and prevention.

Geographic variations in cervical cancer risk in San Luis Potosí state, Mexico: A spatial statistical approach.

BACKGROUND: Worldwide, Cervical Cancer (CC) is the fourth most common type of cancer and cause of death in women. It is a significant public health problem, especially in low and middle-income/Gross Domestic Product (GDP) countries. In the past decade, several studies of CC have been published, that identify the main modifiable and non-modifiable CC risk factors for Mexican women. However, there are no studies that attempt to explain the residual spatial variation in CC incidence In Mexico, i.e. spatial variation that cannot be ascribed to known, spatially varying risk factors. METHODS: This paper uses a spatial statistical methodology that takes into account spatial variation in socio-economic factors and accessibility to health services, whilst allowing for residual, unexplained spatial variation in risk. To describe residual spatial variations in CC risk, we used generalised linear mixed models (GLMM) with both spatially structured and unstructured random effects, using a Bayesian approach to inference. RESULTS: The highest risk is concentrated in the southeast, where the Matlapa and Aquismón municipalities register excessive risk, with posterior probabilities greater than 0.8. The lack of coverage of Cervical Cancer-Screening Programme (CCSP) (RR 1.17, 95 % CI 1.12-1.22), Marginalisation Index (RR 1.05, 95 % CI 1.03-1.08), and lack of accessibility to health services (RR 1.01, 95 % CI 1.00-1.03) were significant covariates. CONCLUSIONS: There are substantial differences between municipalities, with high-risk areas mainly in low-resource areas lacking accessibility to health services for CC. Our results clearly indicate the presence of spatial patterns, and the relevance of the spatial analysis for public health intervention. Ignoring the spatial variability means to continue a public policy that does not tackle deficiencies in its national CCSP and to keep disadvantaging and disempowering Mexican women in regard to their health care.