RESUMO

We evaluated the cross-context validity and equivalence of the US- and Canada-originated Retail Food Environment Index (RFEI) and modified RFEI (mRFEI) against a retail food environment dataset from the indigenous-majority city of Quetzaltenango (Xela), Guatemala. The RFEI/mRFEI failed to identify 77% of retailers and misclassified the healthiness of 42% of the remaining retailers in Xela, inaccurately labeling the city a food swamp. The RFEI/mRFEI are not currently suitable for mapping retail food environments in places like Quetzaltenango. Alternative functional and temporal classifications of retail food environments may provide measures with greater contextual fit, highlighting important cultural considerations for the study of place and dietary health.

RESUMO

BACKGROUND: Air pollution exposure may contribute to rhinoconjunctivitis morbidity in children with underlying airways disease. Prior studies have not assessed rhinoconjunctivitis-related quality of life (QOL) in children with asthma chronically exposed to air pollution. METHODS: Children ages 9-19 years with asthma from peri-urban Peru, self-reporting rhinoconjunctivitis symptoms (n = 484), were administered the Rhinoconjunctivitis QOL Questionnaire (RQLQ) at repeated intervals over one year, with scores dichotomized into bothered (>0) and not bothered (= 0). Individual weekly exposures to particulate matter<2.5µm (PM2.5) and its black carbon (BC) component were estimated by inverse distance weighted methods. Generalized estimating equations, adjusting for covariates, estimated associations of PM2.5 and BC with QOL. RESULTS: Participants were on average 13 years old, 55% female, and majority were atopic (77%). Mean (SD) PM2.5 and BC concentrations were 21(3.2) µg/m3 and 4.4(1.5) µg/m3, respectively. In adjusted multi-pollutant models, each 10µg/m3 increase in PM2.5 was associated with increased odds of worse rhinoconjunctivitis QOL (OR;[95% CI]: 1.83;[1.33,2.52]). A 10% increase in the BC proportion was associated with higher rhinitis burden (OR;[95% CI]: 1.80;[1.22,2.66]), while increases in the non-BC component of PM did not significantly impact rhinoconjunctivitis QOL. Associations were similar regardless of atopy. CONCLUSION: Higher PM2.5 and BC exposure is associated with worse rhinitis QOL among asthmatic children.

Assuntos

RESUMO

Exposure assessments are key tools to conduct epidemiological studies. Since 2010, 28 riveters from 18 brake repair shops with different characteristics and workloads were sampled for asbestos exposure in Bogotá, Colombia. Short-term personal samples collected during manipulation activities of brake products, and personal samples collected during non-manipulation activities were used to calculate 103 8-h TWA PCM-equivalent personal asbestos concentrations. The aims of this study are to identify exposure determinant variables associated with the 8-h TWA personal asbestos concentrations among brake mechanics, and propose different models to estimate potential asbestos exposure of brake mechanics in an 8-h work-shift. Longitudinal-based multivariate linear regression models were used to determine the association between personal asbestos concentrations in a work-shift with different variables related to work tasks and workload of the mechanics, and some characteristics of the shops. Monte Carlo simulations were used to estimate the 8-h TWA PCM-Eq personal asbestos concentration in work-shifts that had manipulations of brake products or cleaning activities of the manipulation area, using the results of the sampling campaigns. The simulations proposed could be applied for both current and retrospective studies to determine personal asbestos exposures of brake mechanics, without the need of sampling campaigns or historical data of air asbestos concentrations.

Assuntos

RESUMO

Asbestos and non-asbestos containing brake products are currently used in low- and middle-income countries like Colombia. Because brake products are distributed detached from their supports, they require manipulation before installation, which release fibers and expose workers. Previous studies of our research group have documented exposures in excess of the widely accepted 0.1 f/cm(3) exposure guideline. The aim of this study is to identify factors associated with non-compliance of the 8-h time weighted average (TWA) 0.1 f/cm(3) asbestos occupational limit among brake mechanics (i.e. riveters). Eighteen brake repair shops (BRS) located in Bogotá (Colombia) were sampled during 3 to 6 consecutive days for the entire work-shift. Personal and short-term personal samples were collected following NIOSH methods 7400 and 7402. Longitudinal based logistic regression models were used to determine the association between the odds of exceeding the 8-h TWA 0.1 f/cm(3) asbestos occupational limit and variables such as type of tasks performed by workers, workload (number of products manipulated daily), years of experience as riveters, and shop characteristics. These models can be used to estimate the odds of being currently or historically overexposed when sampling data do not exist. Since the information required to run the models can vary for both retrospective and current asbestos occupational exposure studies, three models were constructed with different information requirements. The first model evaluated the association between the odds of non-compliance with variables related to the workload, the second model evaluated the association between the odds of non-compliance with variables related to the manipulation tasks, and the third model evaluated the association between the odds of non-compliance with variables related with both the type of tasks performed by workers and the workload. Variables associated with the odds of non-compliance included conducting at least one manipulation activity with beveling and grinding of asbestos and non-asbestos containing brake products during the work shift, the location of the worker in the shop during non-manipulation activities, cleaning activities of the manipulation area, the years of experience working as riveters, and the number of asbestos and non-asbestos containing brake products manipulated daily. These models could be useful for current and retrospective occupational studies, in determining the odds of non-compliance of the asbestos occupational limit among brake mechanics.

Assuntos

RESUMO

The influence of traffic-related air pollution on indoor residential exposure is not well characterized in homes with high natural ventilation in low-income countries. Additionally, domestic allergen exposure is unknown in such populations. We conducted a pilot study of 25 homes in peri-urban Lima, Peru to estimate the effects of roadway proximity and season on residential concentrations. Indoor and outdoor concentrations of particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) were measured during two seasons, and allergens were measured in bedroom dust. Allergen levels were highest for dust mite and mouse allergens, with concentrations above clinically relevant thresholds in over a quarter and half of all homes, respectively. Mean indoor and outdoor pollutant concentrations were similar (PM2.5: 20.0 vs. 16.9 µg/m³, BC: 7.6 vs. 8.1 µg/m³, NO2: 7.3 vs. 7.5 ppb), and tended to be higher in the summer compared to the winter. Road proximity was significantly correlated with overall concentrations of outdoor PM2.5 (rs = -0.42, p = 0.01) and NO2 (rs = -0.36, p = 0.03), and outdoor BC concentrations in the winter (rs = -0.51, p = 0.03). Our results suggest that outdoor-sourced pollutants significantly influence indoor air quality in peri-urban Peruvian communities, and homes closer to roadways are particularly vulnerable.

Assuntos

RESUMO

PURPOSE: Adherence to a Mediterranean diet pattern may be associated with lower asthma prevalence in children. We sought to corroborate these findings in Peruvian children. METHODS: This case-control study included children of ages 9-19 years living in Lima, Peru. A food frequency questionnaire (FFQ) was completed and diet pattern was analyzed using a modified Mediterranean diet score (MDS). Primary analysis investigated the relationship between MDS and asthma status. Maternal education, age, sex, and body mass index category were included in multivariate model. Secondary outcomes included asthma control, forced expiratory volume in 1 s (FEV1), allergic rhinitis, and atopic status. RESULTS: 287 participants with asthma and 96 controls without asthma completed a FFQ. Mean age was 13.5 years. According to the asthma control test (ACT), 86 % of those with asthma were controlled (score >19). MDS scores ranged 6-18 (median 15). In adjusted analysis, being above the median MDS scores was associated with decreased odds of asthma [OR = 0.55, 95 % CI (0.33, 0.92), p = 0.02]. Among children whose mothers completed secondary education, being above the median MDS significantly decreased the odds of asthma [OR = 0.31, 95 % CI (0.14, 0.71), p < 0.01], whereas among those whose mothers did not complete secondary education there was no protective effect [OR = 0.86, 95 % CI (0.43, 1.7), p = 0.66]. There was no association between MDS scores and asthma control, FEV1, allergic rhinitis, or atopic status. CONCLUSION: Adherence to the Mediterranean diet was inversely associated with having asthma among children in Lima, Peru. This effect was strongest among children with better educated mothers.

Assuntos

RESUMO

Household air pollution from the burning of biomass fuels is recognized as the third greatest contributor to the global burden of disease. Incomplete combustion of biomass fuels releases a complex mixture of carbon monoxide (CO), particulate matter (PM) and other toxins into the household environment. Some investigators have used indoor CO concentrations as a reliable surrogate of indoor PM concentrations; however, the assumption that indoor CO concentration is a reasonable proxy of indoor PM concentration has been a subject of controversy. We sought to describe the relationship between indoor PM2.5 and CO concentrations in 128 households across three resource-poor settings in Peru, Nepal, and Kenya. We simultaneously collected minute-to-minute PM2.5 and CO concentrations within a meter of the open-fire stove for approximately 24h using the EasyLog-USB-CO data logger (Lascar Electronics, Erie, PA) and the personal DataRAM-1000AN (Thermo Fisher Scientific Inc., Waltham, MA), respectively. We also collected information regarding household construction characteristics, and cooking practices of the primary cook. Average 24h indoor PM2.5 and CO concentrations ranged between 615 and 1440 µg/m(3), and between 9.1 and 35.1 ppm, respectively. Minute-to-minute indoor PM2.5 concentrations were in a safe range (<25 µg/m(3)) between 17% and 65% of the time, and exceeded 1000 µg/m(3) between 8% and 21% of the time, whereas indoor CO concentrations were in a safe range (<7 ppm) between 46% and 79% of the time and exceeded 50 ppm between 4%, and 20% of the time. Overall correlations between indoor PM2.5 and CO concentrations were low to moderate (Spearman ρ between 0.59 and 0.83). There was also poor agreement and evidence of proportional bias between observed indoor PM2.5 concentrations vs. those estimated based on indoor CO concentrations, with greater discordance at lower concentrations. Our analysis does not support the notion that indoor CO concentration is a surrogate marker for indoor PM2.5 concentration across all settings. Both are important markers of household air pollution with different health and environmental implications and should therefore be independently measured.

Assuntos

RESUMO

OBJECTIVES: Asbestos has been used in a broad variety of industrial products, including clutch discs of the transmission system of vehicles. Studies conducted in high-income countries that have analyzed personal asbestos exposures of transmission mechanics have concluded that these workers are exposed to asbestos concentrations in compliance with the US Occupational Safety and Health Administration (US OSHA) occupational standards. Clutch facings are the friction component of clutch discs. If clutch facings are sold separated from the support, they require manipulation before installation in the vehicle. The manipulation of asbestos containing clutch facings is performed by a group of mechanics known as riveters, and includes drilling, countersinking, riveting, sanding, and occasionally grinding, tasks that can potentially release asbestos fibers, exposing the mechanics. These manipulation activities are not reported in studies conducted in high-income countries. This study analyzes personal asbestos exposures of transmission mechanics that manipulate clutch facings. METHODS: Air sampling campaigns in two transmission repair shops (TRS) were conducted in November 2012 and July 2013 in Bogotá, Colombia. Four workers employed in these TRS were sampled (i.e. three riveters and one supervisor). Personal samples (n = 39), short-term personal samples (n = 49), area samples (n = 52), blank samples (n = 8), and background samples (n = 2) were collected in both TRS during 3-5 consecutive days, following US National Institute for Occupational Safety and Health (US NIOSH) methods 7400 and 7402. Asbestos samples were analyzed by an American Industrial Hygiene Association accredited laboratory. RESULTS: On at least one of the days sampled, all riveters were exposed to asbestos concentrations that exceeded the US OSHA permissible exposure limit or the Colombian permissible limit value. Additionally, from the forty-seven 30-min short-term personal samples collected, two (4.3%) exceeded the US OSHA excursion limit of 1 f cm(-3). CONCLUSIONS: In this study, we identified that the working conditions and use of asbestos containing transmission products expose transmission mechanics to asbestos concentrations that exceed both the Colombian and OSHA standards. The potential consequences for the health of these workers are of great concern.

Assuntos

RESUMO

Asbestos brake linings and blocks are currently used in heavy vehicle brake repair shops (BRSs) in Bogotá, Colombia. Some brake products are sold detached from their supports and without holes, requiring manipulation before installation. The aim of this study was to assess asbestos exposures and conduct a preliminary evaluation of respiratory health in workers of heavy vehicles in BRSs. To estimate asbestos exposures, personal and area samples were collected in two heavy vehicle BRSs. Each shop was sampled during six consecutive days for the entire work shift. Personal samples were collected on 10 workers including riveters, brake mechanics, and administrative staff. Among workers sampled, riveters had the highest phase contrast microscopy equivalent (PCME) asbestos concentrations, with 8-h time-weighted average (TWA) personal exposures ranging between 0.003 and 0.157 f/cm(3). Respiratory health evaluations were performed on the 10 workers sampled. Three workers (30%) had circumscribed pleural thickening (pleural plaques), with calcifications in two of them. This finding is strongly suggestive of asbestos exposure. The results of this study provide preliminary evidence that workers in heavy vehicle BRSs could be at excessive risk of developing asbestos-related diseases.

Assuntos

RESUMO

BACKGROUND: Burning biomass fuels indoors for cooking is associated with high concentrations of particulate matter (PM) and carbon monoxide (CO). More efficient biomass-burning stoves and chimneys for ventilation have been proposed as solutions to reduce indoor pollution. We sought to quantify indoor PM and CO exposures in urban and rural households and determine factors associated with higher exposures. A secondary objective was to identify chronic vs. acute changes in cardiopulmonary biomarkers associated with exposure to biomass smoke. METHODS: We conducted a census survey followed by a cross-sectional study of indoor environmental exposures and cardiopulmonary biomarkers in the main household cook in Puno, Peru. We measured 24-hour indoor PM and CO concentrations in 86 households. We also measured PM2.5 and PM10 concentrations gravimetrically for 24 hours in urban households and during cook times in rural households, and generated a calibration equation using PM2.5 measurements. RESULTS: In a census of 4903 households, 93% vs. 16% of rural vs. urban households used an open-fire stove; 22% of rural households had a homemade chimney; and <3% of rural households participated in a national program encouraging installation of a chimney. Median 24-hour indoor PM2.5 and CO concentrations were 130 vs. 22 µg/m3 and 5.8 vs. 0.4 ppm (all p<0.001) in rural vs. urban households. Having a chimney did not significantly reduce median concentrations in 24-hour indoor PM2.5 (119 vs. 137 µg/m3; p=0.40) or CO (4.6 vs. 7.2 ppm; p=0.23) among rural households with and without chimneys. Having a chimney did not significantly reduce median cook-time PM2.5 (360 vs. 298 µg/m3, p=0.45) or cook-time CO concentrations (15.2 vs. 9.4 ppm, p=0.23). Having a thatched roof (p=0.007) and hours spent cooking (p=0.02) were associated with higher 24-hour average PM concentrations. Rural participants had higher median exhaled CO (10 vs. 6 ppm; p=0.01) and exhaled carboxyhemoglobin (1.6% vs. 1.0%; p=0.04) than urban participants. CONCLUSIONS: Indoor air concentrations associated with biomass smoke were six-fold greater in rural vs. urban households. Having a homemade chimney did not reduce environmental exposures significantly. Measures of exhaled CO provide useful cardiopulmonary biomarkers for chronic exposure to biomass smoke.

Assuntos