Economic activity and congenital anomalies: an ecologic study in Argentina. ECLAMC ECOTERAT Group

Assessment of Environmental Hazards to Public Health in Temperate Urban Argentina

Human health risk in urban areas depends on multiple environmental features. We performed a year-round survey in a highly urbanized district located in temperate Argentina (General San Martín, Buenos Aires) to establish baseline information about environmental hazards associated with health risks. Sampling was stratified into low and high hazardous zones according to estimated indexes previously developed for the area for four hazards: drinking water and air pollution, and mosquito and rodent infestation. Water from wells showed lower concentrations of aluminum, manganese and iron, and higher values of arsenic than tap samples, with the latter showing records above the maximum permitted for arsenic, aluminum and chromium. Benzene concentration in air was higher in summer than in winter, and in areas close to dumps and landfills, gas stations, high traffic pathways and industries with respect to low hazard areas. Adult mosquito collections were more abundant in high hazardous areas, three species from the genus Culex dominated the captures and the proportion of individuals from each species was variable seasonally and spatially. Rodent activity was recorded inside and outside dwellings, and its observed values did not differ between low and high hazardous areas. In the comparison between field data and estimated hazard maps, high accuracy was obtained for air pollution maps, intermediate accuracy for water pollution and mosquito infestation, and poor accuracy for rodent infestation. How to improve field surveys and estimated maps are both discussed, highlighting the need for dynamic feedback between GIS-based models and environmental monitoring.

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

In Brazil, cardiovascular diseases account for 33% of deaths and the prevalence of hypertension is of approximately 22%. The Santos and São Vicente Estuarine System is the most important example of environmental degradation by chemicals from industrial sources. The aim of the present study was to evaluate the prevalence of hypertension and its associated factors in the population of this estuary in the period 2006-2009. A cross-sectional study was conducted to assess the aforementioned prevalence of hypertension in the evaluated areas, as well as risk factors for this disease in four contaminated areas located in the Estuary, and one area outside Estuary, the city of Bertioga. Associations between categorical variables were tested using Pearson's chi-square test incorporating Yates' correction, or Fisher's exact test. Single and multiple logistic regression models were applied to evaluate the risk factors for hypertension. The highest prevalence of hypertension was found in Continental São Vicente (28.4%). The risk factors for hypertension were the following: living in Center of Cubatão (OR: 1.3; IC95%: 1.0 - 1.6) and Continental São Vicente (OR: 1.4; IC95%: 1.1 - 1.8); illiterate (OR: 1.9; IC95%: 1.1 - 3.2); living in the area for more than 20 years (OR: 1.2; IC95%: 1.0 - 1.5); group of people aged 36-60 years (OR: 3.9; IC95%: 3.3 - 4.6) and who have had past occupational exposure (OR: 1.3; IC95%: 1.1 - 1.6). Results indicate that living in contaminated areas, especially for a longer time, is a risk factor for hypertension.

Environmental and socio-economic determinants of infant mortality in Poland: an ecological study

BACKGROUND

Health status of infants is related to the general state of health of women of child-bearing age; however, women's occupational environment and socio-economic conditions also seem to play an important role. The aim of the present ecological study was to assess the relationship between occupational environment, industrial pollution, socio-economic status and infant mortality in Poland.

METHODS

Data on infant mortality and environmental and socio-economic characteristics for the 66 sub-regions of Poland for the years 2005-2011 were used in the analysis. Factor analysis was used to extract the most important factors explaining total variance among the 23 studied exposures. Generalized Estimating Equations model was used to evaluate the link between infant mortality and the studied extracted factors.

RESULTS

Marked variation for infant mortality and the characteristics of industrialization was observed among the 66 sub-regions of Poland. Four extracted factors: "poor working environment", "urbanization and employment in the service sector", "industrial pollution", "economic wealth" accounted for 77.3% of cumulative variance between the studied exposures. In the multivariate regression analysis, an increase in factor "poor working environment" of 1 SD was related to an increase in infant mortality of 40 (95% CI: 28-53) per 100,000 live births. Additionally, an increase in factor "industrial pollution" of 1 SD was associated with an increase in infant mortality of 16 (95% CI: 2-30) per 100,000 live births. The factors "urbanization and employment in the service sector" and "economic wealth" were not significantly related to infant mortality.

CONCLUSION

The study findings suggested that, at the population level, infant mortality was associated with an industrial environment. Strategies to improve working conditions and reduce industrial pollution might contribute to a reduction in infant mortality in Poland.

Desfechos relacionados à gravidez em áreas contaminadas, SP, Brasil

OBJETIVO: Estimar e comparar a prevalência dos eventos relacionados à gravidez (engravidar, baixo peso de nascimento, parto prematuro, aborto espontâneo, natimortalidade, malformações congênitas e gemelaridade) em populações exposta e não-exposta aos contaminantes ambientais na região do estuário de Santos e São Vicente. MÉTODOS: O estudo fez parte de um amplo projeto financiado pelo CNPq, que teve como objetivo estimar os efeitos à saúde associados à exposição aos contaminantes ambientais entre os moradores da Baixada Santista. O estudo transversal avaliou dois bairros do município de São Vicente, próximos a uma área contaminada, e um bairro no município de Bertioga, área controle. Para a obtenção dos dados foi aplicado um questionário estruturado e pré-testado em 236 domicílios em São Vicente e 251 domicílios em Bertioga. Para avaliar associações entre a área e as variáveis qualitativas utilizouse o teste qui-quadrado ou teste exato de Fisher; para avaliar as diferenças entre as variáveis, o teste t de Student ou o teste de comparação de duas proporções, e adotado nível de significância de 5%. RESULTADOS: Houve associação significativa entre morar em Bertioga (p = 0,01) e o número de gestações ocorridas nos últimos cinco anos. Em São Vicente, 64 (28,3%) mulheres em idade fértil engravidaram, enquanto em Bertioga foram 109 (38,8%). Não houve associações estatísticas significativas nas áreas com os demais desfechos da gravidez avaliados. CONCLUSÕES: As prevalências e as razões de chances prevalentes de baixo peso ao nascer, nascimentos prematuros e abortos espontâneos foram maiores nas áreas contaminadas, sem associações significativas. A evidência do estudo de diminuição do número de gestações na área contaminada reforça a necessidade de aprofundamento de estudos na região do estuário de Santos e São Vicente.

Tracing drinking water to its source: An ecological study of the relationship between textile mills and gastroschisis in North Carolina

Gastroschisis is a rare birth defect that has increased in prevalence over the past several decades but the etiology of the disease is largely unknown. Using data from the North Carolina Birth Defects Monitoring Program, we estimated multilevel logistic regression models to evaluate the association between drinking water source and upstream textile mills and the risk of a gastroschisis birth. Results indicate that while prenatal exposure to upstream textile mill effluent does not have an impact on the risk of a gastroschisis birth, women relying on public water systems that draw from a surface water source have an elevated risk. These findings suggest the possibility of a contaminant found in higher levels in surface water compared to groundwater.

Major congenital malformations and residential proximity to a regional industrial park including a national toxic waste site: an ecological study

BACKGROUND

Public concern about exposure to emissions from the regional industrial park (IP), including 17 chemical plants and the national industrial toxic waste site, initiated this study of the possible association between major congenital malformations (MCM) and residence near the IP in Israel's Southern District.

METHODS

The study was conducted during the period 1995-2000 and included 63,850 deliveries. Data on deliveries and MCM detected at births were obtained from the regional medical center, and stratified by ethnicity and type of locality. As exposure indicator we used distance categories (proximal and distant) and predominant wind direction from the IP. Distance stratification was based on the geographical distribution of the localities and complaints about the odor related to IP emissions. Based on these complaints, localities up to 20 km from the IP were considered proximal to the IP.

RESULTS

Average rates of MCM were 5.0% and 4.1% for Bedouin and Jewish newborns, respectively. The rate of MCM for Bedouin from proximal localities was significantly greater compared with distant localities (5.6% vs. 4.8%; RR = 1.17 with 95% CI: 1.04-1.29). In the proximal Bedouin permanent localities, the MCM rate reached 8.2 %, which was significantly higher than in distant areas (RR = 1.63, 95% CI: 1.39-1.80). Significant risk increase of central nervous system MCM was found in these localities, compared to distant ones (RR = 2.27, 95% CI: 1.44-3.60). Among newborns from the traditional tribal settlements, proximity to the IP was associated with increased rates of the following MCM: 1) all combined, 2) those associated with chromosomal abnormalities, and 3) those defined as "others unclassified MCM." Comparison of autosomal recessive disease rates by proximity to the IP in Bedouin newborns indicates that the observed increased risk of MCM is not explained by consanguineous marriages. The rates of MCM in the Jewish population were similar among "exposed" and "unexposed" inhabitants.

CONCLUSION

Residential proximity to the IP is associated with increased rates of MCM among Arab-Beduin but not in Jewish populations. These observations indicate the need for public health protection of a vulnerable society in transition, although the relative importance of chemical exposure and health care utilization requires further study.

Endocrine disruptors and congenital anomalies

The specialized literature was reviewed concerning the suspected increasing secular trends in the frequency of female births, male genital congenital anomalies, abnormal sperm counts, and testicular cancer. Although no risk factors could be identified yet, the observed sex ratio decline during the last decades has been considered to be an effect of certain pollutants on normal hormone activity, and human reproductive development. Reported increasing trends in the frequencies of hypospadias and cryptorchidism are very difficult to be interpreted due to the large variability in the registered frequency of these malformations due to operational as well as biological reasons.

Reproductive outcomes in an area adjacent to a petrochemical plant in southern Brazil

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.