1
|
Rudke AP, Martins JA, de Almeida DS, Martins LD, Beal A, Hallak R, Freitas ED, Andrade MF, Foroutan H, Baek BH, de A Albuquerque TT. How mobility restrictions policy and atmospheric conditions impacted air quality in the State of São Paulo during the COVID-19 outbreak. ENVIRONMENTAL RESEARCH 2021; 198:111255. [PMID: 33971134 PMCID: PMC8547779 DOI: 10.1016/j.envres.2021.111255] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/01/2021] [Accepted: 04/26/2021] [Indexed: 05/28/2023]
Abstract
Mobility restrictions are among actions to prevent the spread of the COVID-19 pandemic and have been pointed as reasons for improving air quality, especially in large cities. However, it is crucial to assess the impact of atmospheric conditions on air quality and air pollutant dispersion in the face of the potential variability of all sources. In this study, the impact of mobility restrictions on the air quality was analyzed for the most populous Brazilian State, São Paulo, severely impacted by COVID-19. Ground-based air quality data (PM10, PM2.5, CO, SO2, NOx, NO2, NO, and O3) were used from 50 automatic air quality monitoring stations to evaluate the changes in concentrations before (January 01 - March 25) and during the partial quarantine (March 16 - June 30). Rainfall, fires, and daily cell phone mobility data were also used as supplementary information to the analyses. The Mann-Whitney U test was used to assess the heterogeneity of the air quality data during and before mobility restrictions. In general, the results demonstrated no substantial improvements in air quality for most of the pollutants when comparing before and during restrictions periods. Besides, when the analyzed period of 2020 is compared with the year 2019, there is no significant air quality improvement in the São Paulo State. However, special attention should be given to the Metropolitan Area of São Paulo (MASP), due to the vast population residing in this area and exposed to air pollution. The region reached an average decrease of 29% in CO, 28% in NOx, 40% in NO, 19% in SO2, 15% in PM2.5, and 8% in PM10 concentrations during the mobility restrictions period compared to the same period in 2019. The only pollutant that showed an increase in concentration was ozone, with a 20% increase compared to 2019 during the mobility restrictions period. Before the mobility restrictions period, the region reached an average decrease of 30% in CO, 39% in NOx, 63% in NO, 12% in SO2, 23% in PM2.5, 18% in PM10, and 16% in O3 concentrations when compared to the same period in 2019. On the other hand, Cubatão, a highly industrialized area, showed statistically significant increases above 20% for most monitored pollutants in both periods of 2020 compared to 2019. This study reinforces that the main driving force of pollutant concentration variability is the dynamics of the atmosphere at its various time scales. An abnormal rainy season, with above average rainfall before the restrictions and below average after it, generated a scenario in which the probable significant reductions in emissions did not substantially affect the concentration of pollutants.
Collapse
Affiliation(s)
- A P Rudke
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627, 31270-901, Belo Horizonte, Brazil; Federal University of Technology - Paraná, Av. Dos Pioneiros, 3131, 86036-370, Londrina, Brazil
| | - J A Martins
- Federal University of Technology - Paraná, Av. Dos Pioneiros, 3131, 86036-370, Londrina, Brazil; Affiliated with the Division of Water Resources Engineering, Lund University, John Ericssons Väg 1, V-Hus, Lund, Sweden
| | - D S de Almeida
- Federal University of Technology - Paraná, Av. Dos Pioneiros, 3131, 86036-370, Londrina, Brazil; Federal University of São Carlos, Rod. Washington Luiz, Km 235, SP310, 13565-905, São Carlos, Brazil
| | - L D Martins
- Federal University of Technology - Paraná, Av. Dos Pioneiros, 3131, 86036-370, Londrina, Brazil
| | - A Beal
- Federal University of Technology - Paraná, Av. Dos Pioneiros, 3131, 86036-370, Londrina, Brazil
| | - R Hallak
- Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, Rua Do Matão, 1226, Cidade Universitária, 05508-090, São Paulo, Brazil
| | - E D Freitas
- Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, Rua Do Matão, 1226, Cidade Universitária, 05508-090, São Paulo, Brazil
| | - M F Andrade
- Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, Rua Do Matão, 1226, Cidade Universitária, 05508-090, São Paulo, Brazil
| | - H Foroutan
- Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, VA, 24061, Blacksburg, USA
| | - B H Baek
- George Mason University, College of Science, 4400 University Dr, VA, 22030, Fairfax, USA
| | - T T de A Albuquerque
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627, 31270-901, Belo Horizonte, Brazil; Post Graduation Program on Environmental Engineering - Federal University of Espírito Santo, Av. Fernando Ferrari, 514, 29075-910, Vitória, Brazil.
| |
Collapse
|
2
|
Banci KRDS, Mori GM, Oliveira MAD, Paganelli FL, Pereira MR, Pinheiro MAA. Can environmental pollution by metals change genetic diversity? Ucides cordatus (Linnaeus, 1763) as a study case in Southeastern Brazilian mangroves. MARINE POLLUTION BULLETIN 2017; 116:440-447. [PMID: 28129923 DOI: 10.1016/j.marpolbul.2017.01.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 06/06/2023]
Abstract
Industrial areas on estuarine systems are commonly affected by heavy metals, affecting all local biota. Random Amplified Polymorphic DNA (RAPD) was used to evaluate genetic diversity of Ucides cordatus at mangroves in southeastern Brazil (Juréia, J; São Vicente, SV; and Cubatão, C), with distinct pollution levels by metals. The genetic diversity of this species was compared with concentrations of metals (Cd, Pb, Cu, Cr and Hg) in the environment. A pollution gradient was confirmed (SV>C>J), with low levels detected in water, except for mercury in SV. All metals in the sediment samples were below Threshold Effect Level (TEL), without an apparent biological risk to the biota. Genetic distance was very similar between J and C, with SV occurring as an out-group. RAPD was a powerful tool to investigate the effect of metal pollution on genetic diversity of this mangrove crab, and to evaluate the conservation status of the mangrove ecosystem.
Collapse
Affiliation(s)
| | - Gustavo Maruyama Mori
- UNESP - Univ Estadual Paulista, Instituto de Biociências (IB), Campus do Litoral Paulista (CLP) - Pç. Infante Dom Henrique, s/n° - Parque Bitaru, 11330-900 São Vicente (SP), Brazil
| | - Marcos Antonio de Oliveira
- UNESP - Univ Estadual Paulista, Instituto de Biociências (IB), Campus do Litoral Paulista (CLP) - Pç. Infante Dom Henrique, s/n° - Parque Bitaru, 11330-900 São Vicente (SP), Brazil
| | | | | | - Marcelo Antonio Amaro Pinheiro
- UNESP - Univ Estadual Paulista, Instituto de Biociências (IB), Campus do Litoral Paulista (CLP) - Pç. Infante Dom Henrique, s/n° - Parque Bitaru, 11330-900 São Vicente (SP), Brazil; Grupo de Pesquisa em Biologia de Crustáceos (CRUSTA), Brazil.
| |
Collapse
|
3
|
Smythe T, Kuper H, Macleod D, Foster A, Lavy C. Birth prevalence of congenital talipes equinovarus in low- and middle-income countries: a systematic review and meta-analysis. Trop Med Int Health 2017; 22:269-285. [PMID: 28000394 DOI: 10.1111/tmi.12833] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Congenital talipes equinovarus (CTEV), or clubfoot, is a structural malformation that develops early in gestation. Birth prevalence of clubfoot is reported to vary both between and within low- and middle-income countries (LMICs), and this information is needed to plan treatment services. This systematic review aimed to understand the birth prevalence of clubfoot in LMIC settings. METHODS Six databases were searched for studies that reported birth prevalence of clubfoot in LMICs. Results were screened and assessed for eligibility using pre-defined criteria. Data on birth prevalence were extracted and weighted pooled estimates were calculated for different regions. Wilcoxon rank-sum test was used to examine changes in birth prevalence over time. Included studies were appraised for their methodological quality, and a narrative synthesis of findings was conducted. RESULTS Forty-eight studies provided data from 13 962 989 children in 20 countries over 55 years (1960-2015). The pooled estimate for clubfoot birth prevalence in LMICs within the Africa region is 1.11 (0.96, 1.26); in the Americas 1.74 (1.69, 1.80); in South-East Asia (excluding India) 1.21 (0.73, 1.68); in India 1.19 (0.96, 1.42); in Turkey (Europe region) 2.03 (1.54, 2.53); in Eastern Mediterranean region 1.19 (0.98, 1.40); in West Pacific (excluding China) 0.94 (0.64, 1.24); and in China 0.51 (0.50, 0.53). CONCLUSION Birth prevalence of clubfoot varies between 0.51 and 2.03/1000 live births in LMICs. A standardised approach to the study of the epidemiology of clubfoot is required to better understand the variations of clubfoot birth prevalence and identify possible risk factors.
Collapse
Affiliation(s)
- Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - David Macleod
- London School of Hygiene & Tropical Medicine, London, UK
| | - Allen Foster
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Christopher Lavy
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK
| |
Collapse
|
4
|
Gili JA, Poletta FA, Giménez LG, Pawluk MS, Campaña H, Castilla EE, López-Camelo JS. Descriptive analysis of high birth prevalence rate geographical clusters of congenital anomalies in South America. ACTA ACUST UNITED AC 2016; 106:257-66. [PMID: 26887535 DOI: 10.1002/bdra.23481] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 12/07/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND The birth prevalence rate (BPR) of congenital anomalies (CAs) is heterogeneous and exhibits geographical and sociocultural variations throughout the world. In South America (SA), high birth prevalence regions of congenital anomalies have been observed. The aim of this study was to identify, describe, and characterize geographical clusters of congenital anomalies in SA. METHODS This observational descriptive study is based on clinical epidemiological data registered by the Latin-American Collaborative Study of Congenital Malformations network. Between 1995 and 2012, a total of 25,082 malformed newborns were ascertained from 2,557,424 births at 129 hospitals in SA. The spatial scan statistic was used to determine geographical regions with high BPR of CAs. The BPR was obtained with a Poisson regression model. Odds ratios were estimated for several risk factors inside the geographical clusters. RESULTS We confirmed the existence of high BPR regions of CAs in SA. Indicators of low socioeconomic conditions, such as a low maternal education, extreme age childbearing, infectious diseases, and medicine use during pregnancy were detected as risk factors inside these regions. Native and African ancestries with high frequency of consanguineous marriages could explain partially these high BPR clusters. CONCLUSION The recognition of clusters could be a starting point in the identification of susceptibility genes associated with the occurrence of CA in high BPR regions.
Collapse
Affiliation(s)
- Juan Antonio Gili
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina
| | - Fernando Adrián Poletta
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.,Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Instituto Nacional de Genética Médica Populacional, Rio de Janeiro, Brazil
| | - Lucas Gabriel Giménez
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina
| | - Mariela Soledad Pawluk
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina
| | - Hebe Campaña
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina
| | - Eduardo Enrique Castilla
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.,Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Instituto Nacional de Genética Médica Populacional, Rio de Janeiro, Brazil
| | - Jorge Santiago López-Camelo
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.,Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Instituto Nacional de Genética Médica Populacional, Rio de Janeiro, Brazil
| |
Collapse
|
5
|
Rosenthal J, Casas J, Taren D, Alverson CJ, Flores A, Frias J. Neural tube defects in Latin America and the impact of fortification: a literature review. Public Health Nutr 2014; 17:537-50. [PMID: 23464652 PMCID: PMC4479156 DOI: 10.1017/s1368980013000256] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 12/14/2012] [Accepted: 01/04/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Data on the prevalence of birth defects and neural tube defects (NTD) in Latin America are limited. The present review summarizes NTD prevalence and time trends in Latin American countries and compares pre- and post-fortification periods to assess the impact of folic acid fortification in these countries. DESIGN We carried out a literature review of studies and institutional reports published between 1990 and 2010 that contained information on NTD prevalence in Latin America. RESULTS NTD prevalence in Latin American countries varied from 0·2 to 9·6 per 1000 live births and was influenced by methods of ascertainment. Time trends from Bogota, Costa Rica, Dominican Republic, Guatemala City, Mexico and Puerto Rico showed average annual declines of 2·5 % to 21·8 %. Pre- and post-fortification comparisons were available for Argentina, Brazil, Chile, Costa Rica, Puerto Rico and Mexico. The aggregate percentage decline in NTD prevalence ranged from 33 % to 59 %. CONCLUSIONS The present publication is the first to review data on time trends and the impact of folic acid fortification on NTD prevalence in Latin America. Reported NTD prevalence varied markedly by geographic region and in some areas of Latin America was among the lowest in the world, while in other areas it was among the highest. For countries with available information, time trends showed significant declines in NTD prevalence and these declines were greater in countries where folic acid fortification of staples reached the majority of the population at risk, such as Chile and Costa Rica.
Collapse
Affiliation(s)
- Jorge Rosenthal
- National Center of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS-86, Atlanta, GA 30333, USA
| | - Jessica Casas
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Douglas Taren
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Clinton J Alverson
- National Center of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS-86, Atlanta, GA 30333, USA
| | - Alina Flores
- National Center of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS-86, Atlanta, GA 30333, USA
| | | |
Collapse
|
6
|
Nicola PDRD, Cernach MCSP, Perez ABA, Brunoni D. A utilização da Internet na notificação dos defeitos congênitos na Declaração de Nascido Vivo em quatro maternidades públicas do Município de São Paulo, Brasil. CAD SAUDE PUBLICA 2010; 26:1383-90. [DOI: 10.1590/s0102-311x2010000700017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 04/05/2010] [Indexed: 11/21/2022] Open
Abstract
O objetivo foi aumentar a freqüência da notificação de anomalias congênitas no campo 34 da Declaração de Nascido Vivo em quatro maternidades do Município de São Paulo, Brasil, ao longo do ano de 2008. Utilizamos o banco de dados do Sistema de Informações sobre Nascidos Vivos da Secretária Municipal de Saúde de São Paulo para acompanhar a evolução dos registros dos defeitos congênitos. Mediante prontuário eletrônico, via Internet, os casos suspeitos eram enviados para um centro de referência em genética médica. O prontuário eletrônico contém anamnese, exame físico e fotos do recém-nascido. O estudo ocorreu em quatro maternidades com uma amostra total de 10 mil nascimentos no ano e que não apresentam médico geneticista. Houve aumento da notificação dos defeitos congênitos nas quatro maternidades onde o estudo foi realizado quando comparado com os anos anteriores e com o registro do Município de São Paulo. O método de referência e contra-referência utilizando a Internet mostrou-se eficaz.
Collapse
|
7
|
Castilla EE, Orioli IM. ECLAMC: the Latin-American collaborative study of congenital malformations. Public Health Genomics 2005; 7:76-94. [PMID: 15539822 DOI: 10.1159/000080776] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
DEFINITION ECLAMC ('Estudio Colaborativo Latino Americano de Malformaciones Congenitas') is a program for the clinical and epidemiological investigation of risk factors in the etiology of congenital anomalies in Latin-American hospitals, using a case-control methodological approach. It is a voluntary agreement among professionals lacking institutional base as well as designated budgets. ECLAMC has been usually funded by research-funding agencies rather than public health ministries. The National Research Councils of Argentina and Brazil have been the main sources of support during its 36 years of existence. Since vital and health statistics are unreliable in South America, ECLAMC collects all the information required for the denominators in a hospital-based sample of births. ECLAMC can be defined as a continental network of persons interested in research and prevention of birth defects. HISTORY AND EVOLUTION From the institutional point of view, ECLAMC has had headquarters in diverse centers of Argentina and Brazil, but always as an independent research project, without a defined administrative link. ECLAMC began operating in 1967, as an investigation limited to the city of Buenos Aires, Argentina, and it gradually expanded until covering all the 10 countries of South America as well as Costa Rica and the Dominican Republic. Even though ECLAMC has maintained essentially the same original experimental design since 1967, due to the data accumulated by the program, the increasing experience as well as the development in science, technical modifications occurred including a DNA bank and a fully informatized data handling system. Since 1974 ECLAMC has been a founder member of the International Clearinghouse for Birth Defects Monitoring Systems; since 1994 a WHO Collaborating Center for the Prevention of Congenital Malformations, and since 2000 a collaborating member of the NIH Global Netwok for Women's and Children's Health Research. METHODOLOGY The maternity hospital network of ECLAMC examines around 200,000 births per year. All major and minor anomalies diagnosed at birth in infants weighing 500 g or more are registered according to a manual of procedures. The next non-malformed baby of the same sex born in the same hospital is selected as a control subject for each case. Thus, a one-to-one healthy control group matched by sex, time and place of birth is obtained. As a system of epidemic surveillance, ECLAMC systematically observes the fluctuations in the frequencies of different malformations and, in the case of an alarm for a probable epidemic of a given malformation, at a given moment, and given area, it acts to identify its cause. As termination of pregnancy has severe legal restrictions in South America, prevention of birth defects should concentrate on primary, preconceptional and tertiary measures. Tertiary measures aim to avoid complications of the affected patients from the medical, psychological, and social standpoints.
Collapse
Affiliation(s)
- Eduardo E Castilla
- ECLAMC, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, Argentina.
| | | |
Collapse
|
8
|
Castilla EE, Orioli IM, Lopez-Camelo JS, Dutra MDG, Nazer-Herrera J. Preliminary data on changes in neural tube defect prevalence rates after folic acid fortification in South America. ACTA ACUST UNITED AC 2003; 123A:123-8. [PMID: 14598335 DOI: 10.1002/ajmg.a.20230] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Several South American countries are fortifying wheat flour with folic acid. However, only Chile started in 2000 to add 2.2 mg/kg, providing 360 microg daily per capita, an acceptable dosage for preventing the occurrence of some neural tube defect (NTD) cases. ECLAMC (Spanish acronym for the Latin American Collaborative Study of Congenital Malformations) routinely monitoring birth defects in South America since 1976, surveyed the impact of this fortification. Data from 361,374 births occurred in 43 South American hospitals, distributed in five different countries, active throughout the 1999-2001 triennium, were selected from the ECLAMC network. Birth prevalence rates for three different congenital anomalies with similar expected prevalence rates, were surveyed by the Cumulative Sum Method (CUSUM) method. They were NTD, oral clefts (OC), and Down syndrome (DS). Expected values were derived from observations made in 1999, and CUSUM was applied to the consecutive series of 24 months covering years 2000 and 2001. Only one of three congenital anomaly types, NTDs, in only one of five sampled out countries, Chile, showed a significant decrease, of 31%, during the 2000-2001 biennium, corresponding to the birth of the periconceptionally fortified infants. The level of significance (P < 0.001) was reached in the 20th month after fortification started, corresponding to August 2001. This is the first observation of a significant decrease in the occurrence of NTD after folic acid food fortification in a population little influenced by confounders common in the developed world as pre-existing secular decreasing trends, and partially unregistered induced abortions.
Collapse
Affiliation(s)
- Eduardo E Castilla
- ECLAMC at Instituto Oswaldo Cruz, Fiocruz, CP 926, Rio de Janeiro, RJ 20001-970 Brazil.
| | | | | | | | | |
Collapse
|
9
|
Abstract
Major congenital anomalies are diagnosed in 2-4% of births. In this paper we review epidemiological studies that have specifically looked at congenital anomalies as a possible outcome of community exposure to chemical exposures associated with environmental pollution. These include studies of drinking water contaminants (heavy metals and nitrates, chlorinated and aromatic solvents, and chlorination by-products), residence near waste disposal sites and contaminated land, pesticide exposure in agricultural areas, air pollution and industrial pollution sources, food contamination, and disasters involving accidental, negligent or deliberate chemical releases of great magnitude. We conclude that there are relatively few environmental pollution exposures for which we can draw strong conclusions about the potential to cause congenital anomalies and, if so, the chemical constituents implicated, to provide an evidence base for public health and clinical practice. A precautionary approach should be adopted at both community and individual level. In order to prevent congenital anomalies, one must reduce exposure to potential teratogens before pregnancy is recognized (i.e. preconceptionally and in the first few weeks of pregnancy). It is a challenge to develop effective strategies for preconceptional care within the primary care framework. Prenatal service providers and counsellors need to be aware of the uncertainties regarding environmental pollution when addressing parental concerns.
Collapse
|
10
|
Oliveira LM, Stein N, Sanseverino MTV, Vargas VMF, Fachel JMG, Schuler L. Reproductive outcomes in an area adjacent to a petrochemical plant in southern Brazil. Rev Saude Publica 2002; 36:81-7. [PMID: 11887234 DOI: 10.1590/s0034-89102002000100013] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate possible adverse reproductive outcomes in an area adjacent to a petrochemical plant in southern Brazil. METHODS A review of 17,113 birth records of the main hospital of the municipality of Montenegro, southern Brazil, from 1983 to 1998 was carried out. Three groups of cases were selected: (1) newborns with major congenital malformations; (2) newborns with low birth weight (<2,500 g); and (3) stillborns (>500 g). A control was assigned to each case. Controls were the first newborns weighing </= 12,500 g without malformations and of case-matching sex. Mother's residence during pregnancy was used as an exposure parameter. Statistical analyses were performed using Chi-square test or Fisher test, odds ratio, 0.05 significance level, and 95% confidence interval. RESULTS For unadjusted analysis, it was found a correlation between low birth weight and geographical proximity of mother's residence to the petrochemical plant (OR = 1.66; 95% CI = 1.01 - 2.72) or residence on the way of preferential wind direction (OR = 1.62; 95% CI = 1.03 - 2.56). When other covariates were added in the conditional logistic regression (maternal smoking habits, chronic disease and age), there was no association. CONCLUSIONS Despite final results were negative, low birth weight could be a good parameter of environmental contamination and should be closely monitored in the studied area.
Collapse
Affiliation(s)
- Lenice Minussi Oliveira
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | | | | | | | | |
Collapse
|
11
|
Abstract
OBJETIVO: Avaliar a relação entre o impacto ambiental decorrente da extração de carvão e sua repercussão na saúde reprodutiva de uma população, residente em pequenas cidades do Sul do Brasil, pela observação da freqüência de defeitos congênitos nos recém-nascidos. MÉTODOS: Foram monitoradas as freqüências de oito defeitos congênitos em 10.391 nascidos vivos, ocorridos no período de janeiro de 1985 a dezembro de 1995 em um hospital localizado no município de São Jerônimo, RS. Destes, foram selecionados oito maiores defeitos congênitos, e a análise de suas prevalências ao nascimento visou reduzir os possíveis erros-diagnósticos. As taxas de defeitos congênitos foram comparadas às de outros hospitais geograficamente próximos e às fornecidas pelo Estudo Colaborativo Latino-Americano de Malformações Congênitas (ECLAMC) para a América Latina. RESULTADOS/CONCLUSÕES: As freqüências observadas não diferiram das encontradas em hospitais regionais e no ECLAMC. O pequeno número de crianças avaliadas mostra apenas algumas tendências, concluindo serem necessários outros estudos mais profundos.
Collapse
Affiliation(s)
- J C Leite
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
| | | |
Collapse
|
12
|
Feuchtbaum LB, Currier RJ, Riggle S, Roberson M, Lorey FW, Cunningham GC. Neural tube defect prevalence in California (1990-1994): eliciting patterns by type of defect and maternal race/ethnicity. GENETIC TESTING 1999; 3:265-72. [PMID: 10495925 DOI: 10.1089/109065799316572] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study presents race/ethnicity-specific prevalence estimates of neural tube defects (NTDs) in California using 5 years of population-based data. NTD prevalence estimates include prenatally diagnosed cases, as well as cases diagnosed at birth. The California NTD Registry contains NTD case reports identified through the California Maternal Serum Alpha-Feto Protein (AFP) Screening Program, the California Birth Defects Monitoring Program, and additional reports from clinicians and clinics throughout the state. These data were used to estimate NTD prevalence in a large population-based study (n = 1,618,279). The overall NTD prevalence among White, Black, Hispanic, and Asian women are reported, as well as race/ethnic prevalence, for anencephaly, spina bifida, and encephalocele. Rates are expressed as the number of cases per 1,000 women screened between 1990 and 1994. Among 1,457 women with an NTD-affected pregnancy, the overall rate for anencephaly, spina bifida, and encephalocele was 0.49 (95% CI 0.46-0.53), 0.42 (95% CI 0.38-0.45), and 0.08 (95% CI 0.07-0.09), respectively. When these types of NTDs are combined, Hispanic women had the highest overall rate (1.12, 95% CI 1.04-1.21), followed by Whites (0.96, 95% CI 0.89-1.04), Blacks (0.75, 95% CI 0.59-0.91), and Asians (0.75, 95% CI 0.60-0.90). Hispanic women were 45% more likely than White women to have a pregnancy affected with anencephaly (odds ratio = 1.45, 95% CI 1.24-1.70), while Asian women were over two times less likely to have a pregnancy affected with spina bifida (odds ratio = 0.44, 95% CI 0.29-0.65). Considerable variation exists in the prevalence of NTDs by race/ethnicity and by type of NTD, with Hispanic women exhibiting the highest overall NTD rate.
Collapse
Affiliation(s)
- L B Feuchtbaum
- Genetic Disease Branch, California Department of Health Services, Berkeley 94704, USA.
| | | | | | | | | | | |
Collapse
|