Identifying local barriers to access to healthcare services in Chile using a communitarian approach.

INTRODUCTION: Previous research has used proxy variables or a unique construct to quantify healthcare access. However, there is a need for a different model that can handle this multivariable problem. This study seeks to develop a way to measure access to the local healthcare system with higher local resolution. METHODS: A new survey was developed based on communitarian claims, following a behavioural model and an ontological framework. The survey was used to identify local barriers to healthcare services and the local preferences for priority settings. The results were analysed using multiattribute utility functions and individual weights were assigned by a panel of experts. National and regional indexes of access to healthcare were developed. RESULTS: The survey contained seven modules and 104 questions. It was conducted on 1885 participants at 42 rural and 231 urban locations in three regions of Chile. The total disutility of the identified barriers to healthcare access at the national level was low (0.1448; values ranged between 0 and 1, with 1 representing a higher barrier) and was higher in the northern region (0.1467). The barriers associated with the health-policy component showed the highest disutility value, and specific barriers for each community were identified. CONCLUSIONS: These results have the potential to improve health decision-making in Chile and can be used to assess the impacts of new health policy reforms. Although this model was tested in Chile, it can be adapted for use in any other country. PATIENT OR PUBLIC CONTRIBUTION: Participants contributed to this study by completing a survey, participating in general talks and receiving brochures with the results obtained from this study.

Nontargeted Analysis Study Reporting Tool: A Framework to Improve Research Transparency and Reproducibility.

Non-targeted analysis (NTA) workflows using mass spectrometry are gaining popularity in many disciplines, but universally accepted reporting standards are nonexistent. Current guidance addresses limited elements of NTA reporting-most notably, identification confidence-and is insufficient to ensure scientific transparency and reproducibility given the complexity of these methods. This lack of reporting standards hinders researchers' development of thorough study protocols and reviewers' ability to efficiently assess grant and manuscript submissions. To overcome these challenges, we developed the NTA Study Reporting Tool (SRT), an easy-to-use, interdisciplinary framework for comprehensive NTA methods and results reporting. Eleven NTA practitioners reviewed eight published articles covering environmental, food, and health-based exposomic applications with the SRT. Overall, our analysis demonstrated that the SRT provides a valid structure to guide study design and manuscript writing, as well as to evaluate NTA reporting quality. Scores self-assigned by authors fell within the range of peer-reviewer scores, indicating that SRT use for self-evaluation will strengthen reporting practices. The results also highlighted NTA reporting areas that need immediate improvement, such as analytical sequence and quality assurance/quality control information. Although scores intentionally do not correspond to data/results quality, widespread implementation of the SRT could improve study design and standardize reporting practices, ultimately leading to broader use and acceptance of NTA data.

Patterns of Personal Exposure to Urban Pollutants Using Personal Passive Samplers and GC × GC/ToF-MS.

The performance of silicon wristband passive samplers (WB), combined with comprehensive two-dimensional gas-chromatography/time-of-flight mass-spectrometry (GC × GC/ToF-MS), for the analysis of urban derived pollutants in the personal environment was evaluated. Cumulative 5-day exposure samples from 27 individuals in areas with different geographical/socioeconomic characteristics within the Santiago Metropolitan Region (Chile) were collected during winter and summer (2016-2017). Samples were extracted without cleanup/fractionation and analyzed using targeted and nontargeted methods. The quantified semivolatile organic compounds (SVOCs, n = 33) (targeted analysis), and tentatively identified features ( n = 595-1011) (nontargeted analysis) were classified according to their use/source. Seasonal differences were observed in the targeted analysis, while seasonal and spatial differences were observed in the nontargeted analysis. Higher concentrations of combustion products were observed in winter, while higher concentrations of consumer products were found in summer. Spatial differences were observed in hierarchical clustering analysis of the nontargeted data, with distinct clusters corresponding to specific subregions of the urban area. Results from this study provide spatial and seasonal distributions of urban pollutants within an urban area and establish the utility of linking WB with nontargeted analysis as a tool to identify and prioritize new exposures to urban contaminants at the local/community level.

Deposition and Source Identification of Nitrogen Heterocyclic Polycyclic Aromatic Compounds in Snow, Sediment, and Air Samples from the Athabasca Oil Sands Region.

Polycyclic aromatic compounds (PACs) can have multiple sources in the Athabasca Oil Sands Region (AOSR). The current study was designed to identify and explore the potential of nitrogen heterocyclic PACs (NPACs) as source indicators in snowpack, lake sediment and passive air samples from the AOSR during 2014-2015. Source samples including petroleum coke (petcoke), haul road dust, and unprocessed oil sands were also analyzed. Samples were analyzed using comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry, and liquid chromatography-high resolution Orbitrap mass spectrometry. Over 200 NPACs were identified and classified into at least 24 isomer groups, including alkylated carbazoles, benzocarbazoles, and indenoquinolines. Levels of NPACs in environmental samples decreased with distance from the main developments and with increasing depth in lake sediments but were detected within 50 km from the major developments. The composition profiles of several NPAC isomer classes, such as dimethylcarbazoles, showed that petcoke had a distinct distribution of NPACs compared to the haul road dust and unprocessed oil sands ores and was the most similar source material to near-field environmental samples. These results suggest that petcoke is a major contributing source for the identified NPACs and that these compounds have the potential to be used as source indicators for future research in the AOSR.

Heterocyclic Aromatics in Petroleum Coke, Snow, Lake Sediments, and Air Samples from the Athabasca Oil Sands Region.

The aromatic fractions of snow, lake sediment, and air samples collected during 2011-2014 in the Athabasca oil sands region were analyzed using two-dimensional gas chromatography following a nontargeted approach. Commonly monitored aromatics (parent and alkylated-polycyclic aromatic hydrocarbons and dibenzothiophenes) were excluded from the analysis, focusing mainly on other heterocyclic aromatics. The unknowns detected were classified into isomeric groups and tentatively identified using mass spectral libraries. Relative concentrations of heterocyclic aromatics were estimated and were found to decrease with distance from a reference site near the center of the developments and with increasing depth of sediments. The same heterocyclic aromatics identified in snow, lake sediments, and air were observed in extracts of delayed petroleum coke, with similar distributions. This suggests that petroleum coke particles are a potential source of heterocyclic aromatics to the local environment, but other oil sands sources must also be considered. Although the signals of these heterocyclic aromatics diminished with distance, some were detected at large distances (>100 km) in snow and surface lake sediments, suggesting that the impact of industry can extend >50 km. The list of heterocyclic aromatics and the mass spectral library generated in this study can be used for future source apportionment studies.

Temporal variation in the deposition of polycyclic aromatic compounds in snow in the Athabasca Oil Sands area of Alberta.

Atmospheric deposition of polycyclic aromatic compounds (PACs) via and onto snow, and their releasing during spring snowmelt has been a concern in the Athabasca Oil Sands Region of Alberta. This study was designed to evaluate the concentrations, loadings, and distribution of PACs in springtime snowpack and how they have changed since the first study in 2008. Snowpack samples were collected in late winters 2011-2014 at varying distances from the main developments. PAC concentration and deposition declined exponentially with distance, with pyrenes, chrysenes, and dibenzothiophenes dominating the distribution within the first 50 km. The distribution of PACs was different between sites located close to upgraders and others located close to mining facilities. Overall, PAC loadings were correlated with priority pollutant elements and water chemistry parameters, while wind direction and speed were not strong contributors to the variability observed. Total PAC mass deposition during winter months and within the first 50 km was initially estimated by integrating the exponential decay function fitted through the data using a limited number of sites from 2011 to 2014: 1236 kg (2011), 1800 kg (2012), 814 kg (2013), and 1367 (2014). Total loadings were estimated to have a twofold increase between 2008 and 2014, although the increase observed was not constant. Finally, kriging interpolation is presented as an alternative and more robust approach to estimate PAC mass deposition in the area. After a more intensive sampling campaign in 2014, the PAC mass deposition was estimated to be 1968 kg.

When another one bites the dust: Environmental impact of global copper demand on local communities in the Atacama mining hotspot as registered by tree rings.

Assessing the impact of mining activity on the availability of environmental pollutants is crucial for informing health policies in anticipation of future production scenarios of critical minerals essential for the transition to a net-zero carbon society. However, temporal and spatial monitoring is often sparse, and measurements may not extend far enough back in time. In this study, we utilize variations of chemical elements contained in tree-rings collected in local villages from an area heavily affected by copper mining in the Atacama Desert since the early 20th century to evaluate the temporal distribution of pollutants and their relationship with local drivers. By combining time-varying data on local drivers, such as copper production and the dry tailings deposit area, we show how the surge in copper production during the 1990s, fueled by trade liberalization and increased international demand, led to a significant increment in the availability of metal(loid)s related to mining activities on indigenous lands. Our findings suggest that the environmental legislation in Chile may be underestimating the environmental impact of tailing dams in neighboring populations, affecting the well-being of Indigenous Peoples from the Atacama mining hotspot region. We argue that future changes in production rates driven by international demand could have negative repercussions on the environment and local communities. Therefore, mining emissions and the management of tailing dams should be carefully considered to anticipate their potential negative effects on human and ecosystem health.

Priority pesticides in Chile: Predicting their environmental distribution, bioaccumulation, and transport potential.

Agriculture is one of the main economic activities in Chile and is associated with extensive use of pesticides, which can represent a risk to the environment and to human health. Currently, there are over 400 pesticides approved for commerce in Chile, including chemicals banned in other countries (e.g., flocoumafen and chlorfenapyr). An empirical analysis of their potential environmental effects is difficult due to this large number, thus opening the doors for the use of computational tools for prioritization efforts based on their persistence, bioaccumulation, and transport potential in the environment. The main objectives of this study were to estimate the properties and environmental distribution of pesticides approved for commerce in Chile and to generate a priority list for further evaluation in local environments. We used the Estimation Program Interface Suite interface to estimate the distribution coefficients, half-lives, and bioaccumulation potential of all pesticides registered in the Chilean Agriculture and Livestock Services. Additionally, the Pov & LRTP Screening Tool was used to estimate their overall persistence and long-range transport potential in the environment. The results were used to develop a P-B-lon range transport (LRT) score, which considered persistence, bioaccumulation, and long-range transport potential. All pesticides were compared to a group of polychlorinated biphenyls (PCBs), used as reference compounds, to generate a list of priority pesticides with persistent organic pollutants characteristics. The results showed that most pesticides were distributed between the organic phase and water, where they also showed the longest half-lives and bioaccumulation potential. A group of 21 pesticides showed relatively high P-B-LRT scores, compared to PCBs, and were classified as priority compounds. The list was further refined based on the volume of sales for each pesticide.  Integr Environ Assess Manag 2023;19:676-683. © 2022 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Early screening of suspected microplastics in bottled water in the Santiago Metropolitan Region of Chile.

Bottled water has emerged as a possible healthier alternative due to concerns about the quality of drinking water sources. However, recent studies have detected worrying concentrations of environmental contaminants in bottled water, including microplastics. Therefore, it is an emerging need to quantify their concentrations in local suppliers which could differ among countries and regions. In this work, we used fluorescence microscopy with Nile Red for the identification and quantification of potential microplastics in twelve brands of bottled water distributed in the Santiago Metropolitan Region of Chile. The average concentration of microplastics was 391 ± 125 p L-1, while the highest concentration observed was 633 ± 33 p L-1. Microplastics between 5 and 20 µm were the major contributors, a size fraction that has been reported to be susceptible to accumulate in the digestive tract or generate potential alterations in the lymphatic and circulatory systems. The estimated daily intake value for per capita was estimated to be 229 p kg-1 year-1 for people weighing 65 kg and 198 p kg-1 year-1 for those weighing 75 kg.

The oxidative potential of airborne particulate matter in two urban areas of Chile: More than meets the eye.

Oxidative potential (OP) has gained attention as a parameter that can reveal the ability of different properties of particulate matter (PM) to generate reactive oxygen species (ROS) as one single value. Moreover, OP is also believed to be a predictor of toxicity and hence the health effects of PM. This study evaluated the OP of PM10, PM2.5,and PM1.0samples using dithiothreitol assays in two cities of Chile (Santiago and Chillán). The results showed that the OP was different between cities, PM size fractions, and seasons. Additionally, OP was strongly correlated with certain metals and meteorological variables. Higher mass-normalized OP was observed during cold periods in Chillán and warm periods in Santiago and was associated with PM2.5 and PM1. On the other hand, volume-normalized OP was higher during winter in both cities and for PM10. Additionally, we compared the OP values to the Air Quality Index (AQI) scale and found cases of days that were classified as having "good" air quality (supposed to be less harmful to health) showing extremely high OP values that were similar to those on days that were classified as "unhealthy". Based on these results,we suggest using the OP as a complementary measure to the PM mass concentration because it includes important new information related to PM properties and compositions that could help improvecurrent air quality management tools.

Impact of mining on the metal content of dust in indigenous villages of northern Chile.

Indigenous communities from northern Chile have historically been exposed to the impacts of massive copper industrial activities conducted in the region. Some of the communities belonging to the Alto El Loa Indigenous Development Area are located less than 10 km from the "Talabre'' tailings dam, which contains residues from copper production and other metals that can be toxic to human health (e.g., As, Sb, Cd, Mo, Pb). Given the increasing demand of copper production to achieve net-zero emission scenarios and concomitant expansions of the tailings, the exposure to toxic metals is a latent risk to local communities. Despite the impact that copper production could generate on ancestral communities from northern Chile, studies and monitoring are limited and the results are often not made accessible for local communities. Here, we evaluate such risks by characterizing metal concentrations in dust collected from roofs and windows of houses from the Alto El Loa area. Our results showed that As, Sb, Cd, Cu, Mo, Ag, S, and Pb concentrations in these matrices can be connected to local copper mining activities. Additionally, air transport models indicate that high concentrations of toxic elements (As, Sb, and Cd) can be explained by the atmospheric transport of particles from the tailings in a NE direction up to 50 km away. Pollution indices and Health Risk Assessment suggested a highly contaminated region with a health risk for its inhabitants. Our analysis on a local scale seeks to make visible the case of northern Chile as a critical territory where actions should be taken to mitigate the effects of mining in the face of this new scenario of international demand for the raw materials necessary for the transition to a net-zero carbon global society.

Local Air Quality Issues and Research Priorities Through the Lenses of Chilean Experts: An Ontological Analysis.

Air pollution problems can be large, complex, and ill-structured. They can vary from location to location and combine many complex components: urban expansion, increasing vehicles and industrial emissions, biomass burning, geographic and meteorological conditions, cultural aspects, and economic effects. However, the existing research, accumulated knowledge, and local research priorities are spread over many disciplines and lack a systematic mapping to help manage and develop new strategies for researchers and policy makers. Ontological analysis can be used as a tool to capture this complexity through simple natural-language descriptions and a structured terminology. We describe the development of an ontological framework for "Air Quality Management in Chile" and its application to evaluate the current state of the research. The process was based on focus groups and validated by a panel of multidisciplinary experts. We used the developed framework to highlight the topics that have been heavily emphasized, lightly emphasized, or overlooked in the Chilean research. The framework developed can help researchers, practitioners, and policy makers systematically navigate the domain and provide the opportunity to correct blind spots by enabling more informed hypotheses that deal with air quality issues at a national level. We believe that applying this same process to different countries will yield different results (due to differences in local knowledge and experience). The framework presented could be used to evaluate other important stakeholders (government, media, NGOs, etc.), which will provide a complete picture of how local societies deal with air quality issues at different levels. Additionally, local government institutions will benefit from this analysis by improving funding allocation and opening new research opportunities to improve the distribution of the local body of knowledge. Integr Environ Assess Manag 2021;17:273-281. © 2020 SETAC.

Long-term spatial and temporal trends, and source apportionment of polycyclic aromatic compounds in the Athabasca Oil Sands Region.

We investigated the spatio-temporal trends of polycyclic aromatic compounds (PACs) deposition in the Athabasca Oil Sands Region (AOSR) between 2008 and 2017, and applied source apportionment tools to assess sources using snowpacks. Estimated PAC mass deposition was significantly correlated with crude oil production (R2 = 0.48, p = 0.03), and increased between 2008 and 2017. Loadings of alkylated PACs c1-, c2-fluorenes/pyrenes and c1-, c3-benzo[a]anthracenes/chrysenes/triphenylenes significantly increased at mid-field sites (25-50 km from central industrial reference site, AR6) (Mann-Kendall, p < 0.05) reflecting physical expansion of the AOSR. The distance from emission sources was important in the deposition of PACs, including the distance from AR6 (R2 = 0.69-0.91), nearest petcoke storage (R2 = 0.77-0.88), 0.89) and upgrader stack (R2 = 0.56-0.61). Source apportionment PAC distribution profiles of the source materials (petcokes, oil sand ores, road dust) did not show unique matching profiles with the snowpacks. However, the minimal presence of retene in petcokes and an abundance of benzo[ghi]fluoranthene in road dust was observed, and suggests potential for these compounds as chemical markers in distinguishing sources. Furthermore, correlations between PACs and selected metal(loid)s in the AOSR snowpacks were assessed to infer potential common sources. Significant positive (p < 0.05) correlations between metal(loid)s enriched in bitumen (vanadium, molybdenum, nickel) and PACs, at near to mid-field (0-50 km from AR6) sites suggests common sources or similar transfer and fate processes. The results of our study convey data necessary for monitoring studies in the constantly developing AOSR, advance our knowledge of PACs profiles in source materials (including the much less studied alkylated PACs and dibenzothiophenes), which will be valuable for other studies related to oil pollution, urban run-off and forest fires. PACs mass deposition increasing between 2008 and 2017 coincident with crude oil production, and retene and benzo[ghi]fluoranthene show potential in distinguishing AOSR sources.

Air pollution and COVID-19 lockdown in a large South American city: Santiago Metropolitan Area, Chile.

The implementation of confinement and physical distancing measures to restrict people's activities and transit in the midst of the COVID-19 pandemic allowed us to study how these measures affect the air quality in urban areas with high pollution rates, such as Santiago, Chile. A comparative study between the concentrations of PM10, PM2.5, NOx, CO, and O3 during the months of March to May 2020 and the corresponding concentrations during the same period in 2017-2019 is presented. A combination of surface measurements from the air quality monitoring network of the city, remote satellite measurements, and simulations of traffic activity and road transport emissions allowed us to quantify the change in the average concentrations of each pollutant. Average relative changes of traffic emissions (between 61% and 68%) implied statistically significant concentrations reductions of 54%, 13%, and 11% for NOx, CO, and PM2.5, respectively, during the pandemic period compared to historical period. In contrast, the average concentration of O3 increased by 63% during 2020 compared to 2017-2019. The nonlinear response observed in the pollution levels can be attributed to the changes in the vehicular emission patterns during the pandemic and to the role of other sources such as residential emissions or secondary PM.

Dithiothreitol-based oxidative potential for airborne particulate matter: an estimation of the associated uncertainty.

Oxidative stress is considered as one of the main mechanisms by which airborne particles produce adverse health effects. Several methods to estimate the oxidative potential (OP) of particulate matter (PM) have been proposed. Among them, the dithiothreitol (DTT) assay has gained popularity due to its simplicity and overall low implementation cost. Usually, the estimations of OPDTT are based on n-replicates of a set of samples and their associated standard deviation. However, interlaboratory comparisons of OPDTT can be difficult and lead to misinterpretations. This work presents an estimation of the total uncertainty for the OPDTT measurement of PM10 and PM2.5 samples collected in Santiago (Chile), based on recommendations by the Joint Committee for Guides in Metrology and Eurachem. The expanded uncertainty expressed as a percentage of the mass-normalized OPDTT measurements was 18.0% and 16.3% for PM10 and PM2.5 samples respectively. The dominating contributor to the total uncertainty was identified (i.e., DTT consumption rate, related to the regression and repeatability of experimental data), while the volumetric operations (i.e., pipettes) were also important. The results showed that, although the OP measured following the DTT assay has been successfully used to estimate the potential health impacts of airborne PM, uncertainty estimations must be considered before interpreting the results.

A one-century sedimentary record of N- and S-polycyclic aromatic compounds in the Athabasca oil sands region in Canada.

The atmospheric deposition of polycyclic aromatic compounds (PACs) is considered a major pathway to isolated lakes and bogs in the Athabasca oil sands region (AOSR), Canada. However, the suite of PACs measured has been limited. We report the detailed depositional history of nitrogen and sulphur heterocyclic PACs using a 210Pb dated sediment core (1914-2015) near major developments in the AOSR. We observed (1) an exponential growth in the deposition of heterocyclic PACs to recent times with an average doubling time of 12 years, (2) significant breakpoints in PAC fluxes in the mid to late 1980s, and (3) a synchronous increase of PACs with crude oil production (r2 = 0.82, p = 0.001). NPACs were not detected prior to the 1960s in the sediment core studied, suggesting they may hold promise in serving as indicators for atmospheric PAC deposition of industrial origin. Furthermore, a change in heterocyclic PAC distribution profiles beginning in the 1970-1980s, after the onset of mining, resembling a petcoke signature, was also observed. Significant positive correlations (p < 0.05) were observed between heterocyclic PACs, and several metal(loid)s, including priority pollutant elements, chromium and beryllium, and rare earth elements, cerium, lanthanum and yttrium (r2 > 0.75), suggesting the potential of a common source or similar transport and fate mechanisms. Significant negative or no correlations were observed between heterocyclic PACs and other metal(loid)s, including vanadium, total mercury and lead, possibly reflecting the impact of broader regulatory controls introduced in the mid-1970s on some metal(loids) but not on PACs, including the installation of electrostatic precipitators in major upgrader stacks.

GAPS-megacities: A new global platform for investigating persistent organic pollutants and chemicals of emerging concern in urban air.

A pilot study was initiated in 2018 under the Global Atmospheric Passive Sampling (GAPS) Network named GAPS-Megacities. This study included 20 megacities/major cities across the globe with the goal of better understanding and comparing ambient air levels of persistent organic pollutants and other chemicals of emerging concern, to which humans residing in large cities are exposed. The first results from the initial period of sampling are reported for 19 cities for several classes of flame retardants (FRs) including organophosphate esters (OPEs), polybrominated diphenyl ethers (PBDEs), and halogenated flame retardants (HFRs) including new flame retardants (NFRs), tetrabromobisphenol A (TBBPA) and hexabromocyclododecane (HBCDD). The two cities, New York (USA) and London (UK) stood out with ∼3.5 to 30 times higher total FR concentrations as compared to other major cities, with total concentrations of OPEs of 15,100 and 14,100 pg/m3, respectively. Atmospheric concentrations of OPEs significantly dominated the FR profile at all sites, with total concentrations in air that were 2-5 orders of magnitude higher compared to other targeted chemical classes. A moderately strong and significant correlation (r = 0.625, p < 0.001) was observed for Gross Domestic Product index of the cities with total OPEs levels. Although large differences in FR levels were observed between some cities, when averaged across the five United Nations regions, the FR classes were more evenly distributed and varied by less than a factor of five. Results for Toronto, which is a 'reference city' for this study, agreed well with a more in-depth investigation of the level of FRs over different seasons and across eight sites representing different urban source sectors (e.g. traffic, industrial, residential and background). Future sampling periods under this project will investigate trace metals and other contaminant classes, linkages to toxicology, non-targeted analysis, and eventually temporal trends. The study provides a unique urban platform for evaluating global exposome.