Prevalence of hypertension and its associated factors in contaminated areas of the Santos-São Vicente Estuarine region and Bertioga, Brazil: 2006-2009

Seasonal monitoring, ecological risk assessment, and prioritization of pharmaceuticals in a tropical semi-enclosed bay (Santos, São Paulo coast, Brazil)

Research on the occurrence and seasonal monitoring of pharmaceutically active compounds (PhACs) in estuarine and coastal waters has intensified recently. However, few studies have been conducted with PhACs flowing into the marine waters of South America (such as Brazil). Against this backdrop, the aims of this study were: (i) evaluate, for the first time, the seasonal occurrence throughout a year and the potential ecological risks of ten selected PhACs in marine bathing waters from Santos Bay, São Paulo, Brazil (a tropical low-wave energy semi-closed bay); and (ii) develop a list of high-priority PhACs for the monitoring based on "occurrence, persistence, bioaccumulation, and toxicity" criteria (OPBT). Four water sampling campaigns were carried out throughout the four seasons of the year. The results showed that: (i) ten PhACs (namely, caffeine/CAF (87.20-567.23 ng/L); carbamazepine/CAR [below the limit of quantification ( ACE > DIC and CAR to algae, crustaceans, and fishes; (iv) Finally, regarding the OPBT ranking, the DIC was the highest-priority PhAC in Santos Bay, followed by: ORP > LOS > CIT > CAR > FUR > ATE > CAF > ACE > ENA.

Temporal variability and ecological risks of pharmaceuticals and cocaine during the Christmas and New Year holidays in a beach area of North Coast of São Paulo, Brazil

This study assessed the occurrence and ecological potential risk of nine selected pharmaceuticals in water samples from the Juquehy River. The river flows continuously to Juquehy Beach, known as "the jewel of the north coast" of São Paulo, Brazil. Samples were collected during Christmas and the New Year (period of December 2023-January 2024), in addition to a previous baseline weekend, to compare the loads during "celebratory parties" versus "normal operational conditions." The findings indicated that the "mass gathering" during Christmas and New Year holidays contributed significantly to an increase of the mass load of the nine pharmaceuticals flowing along to the Juquehy River, i.e., caffeine (14.40-633.00 ng/L) > losartan ( furosemide (< LOQ to 9.16 ng/L) > diclofenac (0.61-4.55 ng/L) > carbamazepine (< LOQ to 0.73 ng/L) > orphenadrine (< LOQ to 0.11 ng/L) showed higher concentrations during the New Year holiday. Conversely, atenolol (< LOQ to 13.10 ng/L) > benzoylecgonine (0.33-7.23 ng/L) > cocaine (0.12-6.59 ng/L) showed higher concentrations during the Christmas day. The individual ecological risk assessment in the Juquehy River revealed a clear environmental concern for the aquatic ecosystem. The threat to the aquatic biota is significant, with caffeine and losartan presenting a moderate level of risk. Moreover, the mixture ecological risk assessment of nine compounds indicates acute moderate risks to algae, crustaceans, and fishes, as well as chronic low risks to fishes.

Occurrence, ecological risk assessment and prioritization of pharmaceuticals and abuse drugs in estuarine waters along the São Paulo coast, Brazil

The pollution of the surface waters by pharmaceuticals and personal care products (PPCPs) has attracted worldwide attention, but data regarding their occurrence and potential risks for the aquatic biota on tropical coastal rivers of South America are still scarce. In this context, the occurrence and the preliminary ecological risk assessment of eleven pharmaceuticals of various therapeutic classes (including cocaine and its primary metabolite, benzoylecgonine) were investigated, for the first time, in five rivers of São Paulo, southeast Brazil, covering a coastline of about 140 km, namely Perequê River, Itinga River, Mongaguá River, Itanhaém River and Guaraú River. Although these five rivers are born in well-preserved areas of the Atlantic rainforest biome, on its way to sea and when they cross the urban perimeter, they receive untreated sewage discharges containing a complex mixture of contaminants. In addition, a "persistence, bioaccumulation and toxicity" (PBT) approach allowed to pre-select the priority PPCPs to be monitored in this coastline. Identification of several PPCPs in the samples was done using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Ten PPCPs were successfully quantified in all five rivers, namely caffeine (9.00-560.00 ng/L), acetaminophen ( Collapse

Key Words

• Coastal rivers
• Domestic sewage
• Illicit drugs
• Pharmaceuticals
• Prioritization
• Risk assessment
• Subtropical ecosystem

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MESH Headings

• Environmental Monitoring/methods
• Water Pollutants, Chemical/analysis
• Chromatography, Liquid
• Caffeine/analysis
• Brazil
• Diclofenac
• Ecosystem
• Atenolol
• Orphenadrine/analysis
• Acetaminophen
• Losartan
• Furosemide
• Tandem Mass Spectrometry
• Rivers/chemistry
• Illicit Drugs/analysis
• Cocaine/analysis
• Risk Assessment
• Carbamazepine/analysis
• Pharmaceutical Preparations

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Affiliation(s)

Vinicius Roveri Universidade Metropolitana de Santos (UNIMES), Avenida Conselheiro Nébias, 536 - Encruzilhada, 11045-002, Santos, São Paulo, Brazil Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Avenida General Norton de Matos S/N, 4450-208, Matosinhos, Portugal
Luciana Lopes Guimarães Laboratório de Pesquisa em Produtos Naturais, Universidade Santa Cecília, Rua Cesário Mota 8, F83A, 11045-040 Santos, São Paulo, Brazil
Walber Toma Laboratório de Pesquisa em Produtos Naturais, Universidade Santa Cecília, Rua Cesário Mota 8, F83A, 11045-040 Santos, São Paulo, Brazil
Alberto Teodorico Correia Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Avenida General Norton de Matos S/N, 4450-208, Matosinhos, Portugal. Faculdade de Ciências da Saúde da Universidade Fernando Pessoa (FCS-UFP), Rua Carlos da Maia 296, 4200-150, Porto, Portugal. Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto (ICBAS-UP), Rua de Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal.

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Occurrence of pharmaceuticals and cocaine in the urban drainage channels located on the outskirts of the São Vicente Island (São Paulo, Brazil) and related ecological risk assessment

"Wealth by the sea and poverty away from the sea breeze" is a metaphor that mirrors what happens along the Brazilian coastal zone, namely in São Vicente Island, São Paulo, Brazil. Due to the high cost of the properties on this shore, the impoverished population started to migrate to the northern outskirts of the island (away from the tourist beaches), potentiating the emergence of poor housing conditions, namely stilt-house slums. Consequently, the urban drainage channels across these outskirts neighbourhoods are potentially contaminated by human wastes. In this context, the occurrence and preliminary ecological risk assessment of eleven pharmaceuticals of various therapeutic classes (including cocaine and its primary metabolite, benzoylecgonine) were investigated, for the first time, in five urban drainage channels whose diffuse loads flow continuously to the estuarine waters of São Vicente Island. The results showed the widespread presence of these environmental stressors in all urban channels analysed, namely losartan (7.3-2680.0 ng/L), caffeine (314.0-726.0 ng/L), acetaminophen (7.0-78.2 ng/L), atenolol (6.2-23.6 ng/L), benzoylecgonine (10.2-17.2 ng/L), furosemide (1.0-7.2 ng/L), cocaine (2.3-6.7 ng/L), carbamazepine (0.2-2.6 ng/L), diclofenac (1.1-2.5 ng/L), orphenadrine (0.2-1.1 ng/L) and chlortalidone (0.5-1.0 ng/L). The overall total estimated load of pharmaceuticals and personal care products flowing to the estuarine waters of São Vicente Island is on the order of 41.1 g/day. The ecological risk assessment revealed a great environmental concern for São Vicente Island, ranging between low (e.g. carbamazepine and cocaine) and moderate to high (e.g. caffeine, acetaminophen and losartan) threats for the aquatic biota. Therefore, initiatives promoting basic sanitation, land-use regularisation and population awareness are highly recommended.

Air Pollution and Chronic Kidney Disease Risk in Oil and Gas- Situated Communities: A Systematic Review and Meta-Analysis

Objective: This systematic review and meta-analysis aimed at synthesising epidemiological data on the association between long-term air pollution and kidney-related outcomes in oil and natural gas (ONG) situated communities.

Methods: We synthesised studies using the PRISMA 2020 guideline. We searched databases including Medline, Cochrane Library, CIHANL, CAB Abstracts, Greenlife, African Journal Online, Google Scholar and Web of Science, from inception to April 2021. Heterogeneity across studies and publication bias were assessed.

Results: Twenty-five studies were systematically reviewed but only 14 were included in the meta-analysis and categorised based on the outcome studied. Residents of exposed communities have increased risk for Chronic Kidney Disease (CKD) (OR = 1.70, 95% CI 1.44–2.01), lower eGFR (OR = 0.55, 95% CI 0.48–0.67) and higher serum creatinine (OR = 1.39, 95% CI 1.06–1.82) compared to less exposed or unexposed populations. The risks for hypertension and kidney cancer between the two populations were not significantly different.

Conclusion: We report an increased risk for CKD and kidney dysfunction in populations residing near petrochemical plants, although from a limited number of studies. The scientific community needs to explore this environment and non-communicable disease relationship, particularly in vulnerable populations.

Association between high-risk pregnancy and environmental contaminants in the Metropolitan Region of Baixada Santista, Brazil

The Metropolitan Region of Baixada Santista (MRBS) is a highly contaminated area. High-risk pregnancy is one factor that leads to a higher chance of both morbidity and mortality of the mother-fetus binomial. The purpose of this study is to analyze the association between exposure to environmental contaminants and high-risk pregnancy. Case-control study, using a probabilistic and random sample composed of 201 high-risk pregnant women (cases) and 201 no high-risk pregnant women (control) followed up during prenatal care at a Public Hospital. The instrument used was a self-administered questionnaire. Contaminated areas data were obtained from the Environmental Company of the São Paulo State. The participants were georeferenced by their place of residence. Descriptive analysis, Chi-square test, and univariate and multiple logistic regression analysis were performed. The multiple logistic regression model demonstrated that living in a contaminated area (OR = 1.565; 95%CI: 1.033; 2.370), preterm delivery in the current pregnancy (OR = 1.989; 95%CI: 1.239; 3.194), and more than 35 years old (OR = 2.822; 95%CI: 1.692; 4.706) are factors jointly related to high-risk pregnancy. Environmental contaminants play an important role in high-risk pregnancy, and mitigating measures are needed to improve the environment and reduce high-risk pregnancy.

In vivo experimental study to investigate cytogenotoxicity of a contaminated estuary from Southeastern Brazilian Coast

The aim of this study was to evaluate cytogenotoxicity in mammalian cells induced by ingestion of superficial water from SESS. For this purpose, surface water was collected from two points of SESS: São Vicente Channel (SVC) and Piaçaguera Channel (PIC). Four groups (n = 5) of adult male Wistar (8 weeks old) received for 5 days: (a) filtered tap water (water control), (b) tap water with 2.4% of NaCl (saline control), (c) estuarine water from PIC and (d) estuarine water from SVC. Results demonstrated that Ki67 immunoexpression was higher in hepatocytes exposed to both sampling site, while caspase-3 demonstrated downregulation in rat liver exposed to estuarine water. There was also significant increase in micronuclei frequency in bone marrow cells and hepatocytes, and DNA damage in blood and liver of rats exposed to estuarine water from SVC and PIC. In summary, studies with complex mixtures, such as contaminated estuarine water are important since this work confirmed by experiments using in vivo mammalian cells of rats that SESS water are genotoxic, mutagenic and cytotoxic, denoting concern for environmental health.

Atmospheric Occurrence of Organochlorine Pesticides and Inhalation Cancer Risk in Urban Areas at Southeast Brazil

Organochlorine pesticides (OCPs) have been produced for almost a century and some of them are still used, even after they have been proved to be toxic, persistent, bioaccumulative and prone to long-range transport. Brazil has used and produced pesticides in industrial scales for both agricultural and public health purposes. Urban and industrial regions are of special concern due to their high population density and their increased exposure to chemical pollution, many times enhanced by chemical production, application or irregular dumping. Therefore, we aimed to investigate the occurrence of OCPs in outdoor air of urban sites from two major regions of southeast Brazil. Some of these sites have been affected by OCP production and their irregular dumping. Deterministic and probabilistic inhalation cancer risk (CR) assessments were conducted for the human populations exposed to OCPs in ambient air. Ambient air was mainly affected by Ʃ-HCH (median = 340 pg m^-3) and Ʃ-DDT (median = 233 pg m^-3), the only two OCPs registered for domissanitary purposes in Brazil. OCP concentrations tended to be higher in summer than in winter. Dumping sites resulted in the highest OCP atmospheric concentrations and, thus, in the highest CR estimations. Despite of all limitations, probabilistic simulations suggested that people living in the studied regions are exposed to an increased risk of hepatic cancer. Infants and toddlers (0 < 2 y) were exposed to the highest inhalation CRs compared to other age groups. Other exposure pathways (such as ingestion and dermic uptake) are needed for a more comprehensive risk assessment. Moreover, this study also highlights the need to review the human exposure to OCPs through inhalation and their respective CR in other impacted areas worldwide, especially where high levels of OCPs are still being measured.

Use of an Integrated Geochemical and Ecotoxicological Approach to Evaluate Sediment Metal Contamination in Three Protected Estuarine Areas Along the Coast of São Paulo State, Brazil

We compared sediment quality in estuaries at three locations along the coast of São Paulo State, Brazil, using geochemical analyses and whole sediment toxicity tests, during the southern summer and winter of 2013. Each locality is afforded a distinct degree of legal protection, and exhibits a different level of metal pollution: overall, Rio Diana (RD, the most polluted, a Permanent Protection Area) > Rio Itapanhaú (RI, intermediate contamination, an Environmental Protection Area) > Rio Picinguaba (RP, pristine, a State Park). Chronic sediment toxicity tests evaluated reproductive rates of the copepod Nitokra sp. RI sediments showed the highest metal concentrations and toxicity in both seasons. Metal concentrations at RD were low but toxic in summer. RP sediments were not contaminated, suggesting effective legal protection from pollution at this locality. RI and RD, although provided some legal protection, showed clear signs of environmental degradation, emphasizing the need for more effective pollution control.

Hypertension Prevalence, Treatment and Control in Older Adults in a Brazilian Capital City

BACKGROUND

The diagnosis, treatment and control of arterial hypertension are fundamental for a reduction in cardiovascular outcomes, especially in the elderly. In Brazil, there are few studies that specifically identified these rates in the elderly population.

OBJECTIVE

To verify rates of prevalence, treatment and control of hypertension in elderly people living in the urban area of a Brazilian capital city.

METHODS

A cross-sectional, population-based, randomized, cluster-based study with 912 non-institutionalized elderly individuals (≥ 60 years), living in urban areas in the city of Goiania, Midwest Brazil. Predictor variables were: age, gender, socioeconomic and lifestyle aspects. Blood pressure measurements were performed at home; patients were considered as having arterial hypertension when SBP and/or DBP ≥ 140/90 mmHg or when using antihypertensive drugs (dependent variable). Rates of hypertension treatment and control were evaluated. Variable association analyses were performed by multivariate logistic regression and level of significance was set at 5%.

RESULTS

The prevalence of arterial hypertension was 74.9%, being higher (78.6%) in men (OR 1.4, 95% CI: 1.04-1.92); the treatment rate was 72.6%, with higher rates being observed in smokers (OR 2.06, 95% CI: 1.28-3.33). The rate of hypertension control was 50.8%,being higher in women (OR 1.57, 95% CI: 1.19-2.08).

CONCLUSION

The prevalence rates were high. Treatment and control rates were low and associated with gender, age and lifestyle, indicating the need for early and individual interventions.

Hypertension prevalence and living conditions related to air pollution: results of a national epidemiological study in Lebanon

Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.