Mining leachate contamination and subfecundity among women living near the USA-Mexico border.

The contamination of the Sonora River with 40,000 m3 of toxic leachate released from a copper mine on August 6, 2014, was considered the worst environmental disaster of the mining industry in Mexico, exceeding safety levels in the concentrations of heavy metals and arsenic. To explore the potential association of the toxic release with subfecundity, by comparing time to pregnancy (TTP) of women with different levels of exposure at municipalities located along the Sonora River watershed, just 35 km south of the Arizona-Mexico border. Data from 235 pregnancies were included in a retrospective cohort study. Exposure was measured whether pregnancy occurred before or after the disaster and included a non-exposed community outside the watershed. Pregnancies were also compared between communities according to the concentration-level gradient of water pollutants found in the river. Fecundability odds ratios (fORs) were calculated using discrete time analogue of Cox's proportional hazard models. Multiple analysis included all pregnancies with TTP of no more than 12 months, only first-time pregnancy, or excluding women with TTP = 1. The probability for pregnancy decreased after the disaster (fOR 0.55, 95% CI 0.31, 0.97), when the residency was located mid-or-downstream the watershed (fOR 0.37, 95% CI 0.15, 0.91), when reported chicken consumption, when mining was the father's occupation, and when surface water was reported to be used for crop irrigation and for animal consumption. There was a decrease in fecundity on women exposed to the contaminated river. There is a need for more studies to prove these findings and to broaden the knowledge of other possible adverse health effects associated with this environmental disaster.

Amenazas para la salud en el Río Sonora: análisis exploratorio de la calidad del agua reportada en la base de datos oficial de México / Health threats in the Sonora River: exploratory analysis of water quality reported in the official database of Mexico

El 6 de agosto de 2014 ocurrió en el Río Sonora, México, lo que fue llamado "el peor desastre ambiental de la industria minera del país" cuando la mina Buenavista del Cobre derramó alrededor de 40,000 metros cúbicos de lixiviado ácido. Con el fin de avanzar en el conocimiento de las consecuencias de este evento, se analizó la base de datos del monitoreo de la calidad del agua subterránea que aparece en el portal electrónico del Fideicomiso Río Sonora. Por las implicaciones que este evento tiene para la salud, los valores reportados se confrontaron con los límites máximos permisibles establecidos en la Norma Oficial Mexicana vigente. Asímismo, para enriquecer la discusión, se analizó el caso del arsénico, comparando los valores reportados en relación con la Norma Mexicana y con la Guía de calidad para el agua de la Organización Mundial de la Salud.

On August 6th, 2014, the event labelled as the "worst environmental disaster of the mining industry in Mexico" ocurred in the Sonora River, when Buenavista del Cobre mine spilled around 40,000 cubic meters of an acidic leachate. In order to expand our knowledge of the consequences of this event, the water quality monitoring data base was analyzed for groundwater from the Río Sonora trust fund webpage. Due to the health relevance of the spill, the reported data was compared to the established maximum allowance values of Mexican regulations. Furthermore, for an enhanced discussion, the case of arsenic was also analyzed, comparing the data with Mexican regulations as well as with the WHO guidelines for drinking water.

[Biodiversity and depressive symptoms in Mexican adults: Exploration of beneficial environmental effects]. / Biodiversidad y síntomas depresivos en adultos mexicanos: exploración de los efectos benéficos del ambiente.

INTRODUCTION: Depression is a highly prevalent illness among adults, and it is the second most frequently reported mental disorder in urban settings in México. Exposure to natural environments and its components may improve the mental health of the population. OBJECTIVE: To evaluate the association between biodiversity indicators and the prevalence of depressive symptoms among the adult population (20 to 65 years of age) in México. MATERIALS AND METHODS: Information from the Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006) and the Compendio de Estadísticas Ambientales 2008 was analyzed. A biodiversity index was constructed based on the species richness and ecoregions in each state. A multilevel logistic regression model was built with random intercepts and a multiple logistic regression was generated with clustering by state. RESULTS: The factors associated with depressive symptoms were being female, self-perceived as indigenous, lower education level, not living with a partner, lack of steady paid work, having a chronic illness and drinking alcohol. The biodiversity index was found to be inversely associated with the prevalence of depressive symptoms when defined as a continuous variable, and the results from the regression were grouped by state (OR=0.71; 95% CI = 0.59-0.87). CONCLUSIONS: Although the design was cross-sectional, this study adds to the evidence of the potential benefits to mental health from contact with nature and its components.

Biodiversidad y síntomas depresivos en adultos mexicanos: exploración de los efectos benéficos del ambiente / Biodiversity and depressive symptoms in Mexican adults: Exploration of beneficial environmental effects

Introducción. La depresión es una enfermedad muy prevalente entre adultos, y es el segundo trastorno mental más frecuente en los centros urbanos de México. Es posible que la exposición a los ambientes naturales y a sus componentes mejore la salud mental de la población. Objetivo. Evaluar la asociación entre indicadores de biodiversidad y la prevalencia de síntomas depresivos en la población adulta (20 a 65 años de edad) de México. Materiales y métodos. Se analizó la información de la Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006), así como el Compendio de Estadísticas Ambientales del 2008. Además, se elaboró un índice de biodiversidad, teniendo en cuenta la abundancia de especies y las ecorregiones en cada entidad federativa, y un modelo de regresión logística multinivel con interceptos aleatorios, y otro de regresión logística múltiple con agrupación por estados. Resultados. Los factores asociados con los síntomas depresivos fueron: ser mujer, considerarse indígena, tener menor escolaridad, vivir sin pareja, carecer de trabajo remunerado de forma regular, padecer una enfermedad crónica y beber alcohol. Se encontró una asociación inversa entre el índice de biodiversidad y la prevalencia de los síntomas depresivos cuando se definió de manera continua y los resultados de la regresión se agruparon por estados (OR=0,71; IC 95% 0,59-0,87). Conclusión. A pesar de su diseño transversal, el estudio contribuye a aumentar la ´evidencia´ científica en torno a los beneficios potenciales que el contacto con la naturaleza y sus componentes tiene para la salud mental.

Introduction: Depression is a highly prevalent illness among adults, and it is the second most frequently reported mental disorder in urban settings in México. Exposure to natural environments and its components may improve the mental health of the population. Objective: To evaluate the association between biodiversity indicators and the prevalence of depressive symptoms among the adult population (20 to 65 years of age) in México. Materials and methods: Information from the Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006) and the Compendio de Estadísticas Ambientales 2008 was analyzed. A biodiversity index was constructed based on the species richness and ecoregions in each state. A multilevel logistic regression model was built with random intercepts and a multiple logistic regression was generated with clustering by state. Results: The factors associated with depressive symptoms were being female, self-perceived as indigenous, lower education level, not living with a partner, lack of steady paid work, having a chronic illness and drinking alcohol. The biodiversity index was found to be inversely associated with the prevalence of depressive symptoms when defined as a continuous variable, and the results from the regression were grouped by state (OR=0.71; 95% CI = 0.59-0.87). Conclusions: Although the design was cross-sectional, this study adds to the evidence of the potential benefits to mental health from contact with nature and its components.

Presencia de sintomatología ansiosa y depresiva en pacientes ambulatorios con patología neurológica / Presence of anxiety and depression symptoms in outpatients with neurological disease

La información referente a la presencia de síntomas psiquiátricos en la práctica no psiquiátrica es escasa, cerca del 25% de los pacientes son reportados con esta sintomatología. Esto se observa más comúnmente en trastornos neurológicos dada la severidad de los síntomas y el grado de discapacidad que ocasionan. El objetivo de la presente investigación es identificar factores asociados a la presencia de síntomas de ansiedad y/o depresión en pacientes con patología neurológica. Se realizó un estudio transversal, descriptivo, tomando 209 pacientes de la consulta externa del servicio de neurología del Hospital General del Estado de Sonora a fin de obtener una prevalencia de periodo de la presencia de síntomas de ansiedad y depresión mediante la Escala de Malestar Psicológico de Kessler en su versión extendida (K10), así como una encuesta sociodemográfica para determinar su asociación con factores que pudieran influir en la presencia y severidad de dicha sintomatología. Todos los participantes otorgaron su consentimiento informado. Se encontraron puntuaciones superiores a 21 puntos en la escala K10 (altamente sugestiva de la presencia de un trastorno de ansiedad y/o depresión) en 63.2% de los pacientes. Estas puntuaciones fueron más frecuentes en los pacientes con enfermedades cerebrovasculares (85.7%), manteniéndose por arriba del 60% para el resto de los trastornos, con una mayor frecuencia en el sexo femenino (85%). Los resultados sugieren una mayor asociación, para más de la mitad de los pacientes que acuden a la consulta de neurología, de padecer sintomatología ansiosa y/o depresiva con una severidad suficiente para verse beneficiados por un tratamiento integral. Existe una mayor asociación en relación con padecimientos más severos o discapacitantes, así como con el sexo femenino, por lo que se proponen investigaciones subsecuentes a fin de determinar los componentes de esta asociación e identificar intervenciones eficaces a fin de mejorar no solamente el estado de salud de estos pacientes sino su propia calidad de vida.

There is little information available describing psychiatric symptoms in non-psychiatric patients, with 25% of the patients being reported with such symptoms. These are most commonly observed with neurological disorders given the severity and degree of disability that they cause. The objective of this research was to identify the factors associated with the presence of anxiety and/or depression symptoms in patients with a neurological disorder. A transversal, descriptive study was carried out, taking 209 outpatients from the neurology service, with the aim of obtaining a period prevalence of the presence of anxiety and depression symptoms using the extended version of the Kessler Psychological Distress Scale (K10), and a sociodemographic interview to determine the association with factors that might influence on the presence and severity of such symptoms. All the participants signed an informed consent. We found scores superior to 21 points on the K10 scale (highly suggestive of the presence of an anxiety and/or depressive disorder) on 63.2% of the patients. These scores were more frequently found on patients with cerebrovascular diseases (85.7%), maintaining themselves above the 60% of the rest of the disorders. These results suggest a bigger association for more than half of the neurology outpatients to suffer from an anxiety and/or depressive symptoms severe enough to have benefits from an integral approach, with a bigger association in relation with more severe or incapacitating disorders, also the association was bigger on women. Thus, we need further research to determine the components of this association and identify effective interventions aiming to improve not just the patients' health, but also their quality of life.

Recruiting strategy and 24-hour biomonitoring of paraquat in agricultural workers.

The objectives of this study were to recruit agricultural workers in Costa Rica to participate in a 24-hour urine collection for paraquat exposure assessment and to compare the 24-hour sampling to end-of-shift sampling. The authors recruited 187 handlers and 54 nonhandlers from coffee, banana, and palm oil plantations. The completeness of 24-hour urine samples collected (a total of 393 samples) was confirmed by questionnaire and urinary creatinine level. For a subset of 12 samples, the absorbed paraquat level was determined in 24-hours and end-of-shift spot urine samples. The participation rate for handlers was approximately 90%. The completeness of 24-hour urine collections was verified as the overall average of creatinine levels from 393 urines (1.11+/-0.50 g/L). A total of 92.4% to 96.7% of urine samples were considered within the acceptable range of urinary creatinine, whereas 94.7% of the samples were described as "complete" from the questionnaire. Measured creatinine correlated well to predicted values (r=.327, p=.0024, 95% CI .12-.51). Detected paraquat levels in spot urine samples had a sensitivity of 96.9% at the high specificity of 100% compared to 24-hour urine samples as the gold standard. There was a significant (p<.0001) correlation between spot and 24-hour urine paraquat levels (r=.7825, 95% CI .61-.88). The recruiting strategy was successful in getting 24-hour urine samples from a farm worker population. Comparison between the paraquat levels in spot and 24-hour urine samples demonstrated that for this compound, end-of-shift spot urine samples would be an appropriate substitute for 24-hour collections.