RESUMO
INTRODUCTION: Several publications have highlighted the adverse effects of chlordecone on human and animal species. The possible long-term consequences continue to be explored as chlordecone still contaminates Caribbean soils. The objective of this literature review is to determine the long-term effects of chlordecone on human health. MATERIAL AND METHOD: We searched for the keyword "chlordecone" on different scientific databases: Medline®, ISI Web of Knowledge, Google Scholar, EM Premium. We have enriched our research with first degree references, related articles on PubMed and grey literature. RESULTS: Of the 192 articles analyzed, 12 responded to the impact of chlordecone on human health in the French West Indies. In obstetrics, exposure to chlordecone was associated with a lower incidence of gestational hypertension. In pediatrics, these studies have shown an association between prenatal exposure to chlordecone and increased risk of prematurity, decreased birth weight (especially when the mother gained excessive weight during pregnancy), decreased fine cognitive and motor acquisition, and changes in circulating concentrations of certain thyroid hormones. In oncology, exposure was associated with an increased risk of prostate cancer, particularly if there was a family history of prostate cancer. CONCLUSION: While the effects of acute exposure to chlordecone at high doses are well described (Kepone Shake syndrome at the time of the Hopewell accident), the effects at environmental doses are becoming clearer even if they remain complex to identify.
Assuntos
Clordecona/efeitos adversos , Exposição Ambiental/estatística & dados numéricos , Saúde Ambiental/estatística & dados numéricos , Inseticidas/efeitos adversos , Exposição Ambiental/análise , Doença Ambiental/epidemiologia , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Transtornos Mentais/epidemiologia , Exposição Ocupacional/análise , Exposição Ocupacional/estatística & dados numéricos , Saúde Ocupacional/estatística & dados numéricos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Neoplasias da Próstata/epidemiologia , Índias Ocidentais/epidemiologiaRESUMO
BACKGROUND: COPD is the third most frequent cause of death globally, with much of this burden attributable to household biomass smoke exposure in developing countries. As biomass smoke exposure is also associated with cardiovascular disease, lower respiratory infection, lung cancer, and cataracts, it presents an important target for public health intervention. METHODS: Lung function in Guatemalan women exposed to wood smoke from open fires was measured throughout the Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) stove intervention trial and continued during the Chronic Respiratory Effects of Early Childhood Exposure to Respirable Particulate Matter (CRECER) cohort study. In RESPIRE, early stove households received a chimney woodstove at the beginning of the 18-month trial, and delayed stove households received a stove at trial completion. Personal exposure to wood smoke was assessed with exhaled breath carbon monoxide (CO) and personal CO tubes. Change in lung function between intervention groups and as a function of wood smoke exposure was assessed using random effects models. RESULTS: Of 306 women participating in both studies, acceptable spirometry was collected in 129 early stove and 136 delayed stove households (n = 265), with a mean follow-up of 5.6 years. Despite reduced wood smoke exposures in early stove households, there were no significant differences in any of the measured spirometric variables during the study period (FEV1, FVC, FEV1/FVC ratio, and annual change) after adjustment for confounding. CONCLUSIONS: In these young Guatemalan women, there was no association between lung function and early randomization to a chimney stove or personal wood smoke exposure. Future stove intervention trials should incorporate cleaner stoves, longer follow-up, or potentially susceptible groups to identify meaningful differences in lung function.
Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Monóxido de Carbono/análise , Doença Ambiental/epidemiologia , Material Particulado/efeitos adversos , Respiração/efeitos dos fármacos , População Rural , Madeira , Adulto , Criança , Culinária , Doença Ambiental/fisiopatologia , Feminino , Guatemala/epidemiologia , Humanos , Incidência , Fumaça , EspirometriaRESUMO
The aim of this study was to investigate the frequency of hematological and hepatic alterations and possible association with serum levels of beta-hexachlorocyclohexane (beta-HCH), p,p'-DDE, and hexachlorobenzene (HCB) among residents in an area heavily contaminated with organochlorine (OC) pesticides. A cross-sectional study was conducted in 415 male and 432 female residents aged >14 years. Serum samples were collected and analyzed for OC pesticides concentrations and biochemical parameters. Frequencies of hematological and hepatic alterations were calculated for each gender. Association between beta-HCH, p,p'-DDE (1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene), and HCB levels and presence of alterations was determined by logistic regression stratified by gender and controlling for confounders. Highest frequencies were observed for eosinophilia (23% men and 18% women), low hemoglobin (12% men and 15% women), and low erythrocyte count (12% men). High levels of bilirubin, glutamic-oxaloacetic transaminase (GOT), and glutamic-pyruvic transaminase (GPT) were observed, respectively, in 10, 11, and 12% of men and <10% of women. Gamma-glutamyl transferase (GGT) was elevated in 26 and 25% of males and females, respectively. Multivariate analysis revealed associations between eosinophilia and beta-HCH in men (OR = 1.06, 95%CI = 1.01-1.12) and women (OR = 1.05, 96%CI = 0.99-1.11), p,p'-DDE in men (OR = 1.03, 95%CI = 0.99-1.06) and women (OR = 1.02, 95%CI = 0.99-1.06), and HCB in women (OR = 1.54, 95%IC = 0.85-4.45). Beta-HCH was found to be associated with increased risk of elevated bilirubin in females (OR = 1.18, 95%CI = 1.07-1.29) and males (OR = 4.21, 95%CI = 1.87-9.47 for fourth vs. first quintile). Thus, OC pesticides may exert adverse effects on hematopoietic tissue and liver in populations chronically exposed to high levels of these compounds.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Exposição Ambiental/efeitos adversos , Doença Ambiental/induzido quimicamente , Poluentes Ambientais/toxicidade , Doenças Hematológicas/induzido quimicamente , Hidrocarbonetos Clorados/toxicidade , Resíduos de Praguicidas/toxicidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Brasil/epidemiologia , Doença Hepática Induzida por Substâncias e Drogas/sangue , Estudos Transversais , Diclorodifenil Dicloroetileno/sangue , Diclorodifenil Dicloroetileno/toxicidade , Doença Ambiental/sangue , Doença Ambiental/epidemiologia , Poluentes Ambientais/sangue , Feminino , Doenças Hematológicas/sangue , Doenças Hematológicas/epidemiologia , Hexaclorobenzeno/sangue , Hexaclorobenzeno/toxicidade , Hexaclorocicloexano/sangue , Hexaclorocicloexano/toxicidade , Humanos , Hidrocarbonetos Clorados/sangue , Indústrias , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Resíduos de Praguicidas/sangue , Risco , Caracteres Sexuais , Adulto JovemRESUMO
Household air pollution from biomass fuel use affects 3 billion people worldwide; however, few studies have examined the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with elevated blood pressure in high altitude Peru and if this relationship was affected by lung function. We analyzed baseline information from a population-based cohort study of adults aged ≥ 35 years in Puno, Peru. Daily biomass fuel use was self-reported. We used multivariable regression models to examine the relationship between daily exposure to biomass fuel smoke and blood pressure outcomes. Interactions with sex and quartiles of forced vital capacity were conducted to evaluate for effect modification. Data from 1004 individuals (mean age, 55.3 years; 51.7% women) were included. We found an association between biomass fuel use with both prehypertension (adjusted relative risk ratio, 5.0; 95% confidence interval, 2.6-9.9) and hypertension (adjusted relative risk ratio, 3.5; 95% confidence interval, 1.7-7.0). Biomass fuel users had a higher systolic blood pressure (7.0 mm Hg; 95% confidence interval, 4.4-9.6) and a higher diastolic blood pressure (5.9 mm Hg; 95% confidence interval, 4.2-7.6) when compared with nonusers. We did not find interaction effects between daily biomass fuel use and sex or percent predicted forced vital capacity for either systolic blood pressure or diastolic blood pressure. Biomass fuel use was associated with a higher likelihood of having hypertension and higher blood pressure in Peru. Reducing exposure to household air pollution from biomass fuel use represents an opportunity for cardiovascular prevention.
Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Altitude , Biomassa , Doença Ambiental/complicações , Hipertensão/epidemiologia , População Rural , Fumaça/efeitos adversos , Adulto , Idoso , Pressão Sanguínea , Doença Ambiental/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/etiologia , Incidência , Masculino , Pessoa de Meia-Idade , Peru/epidemiologiaRESUMO
The lung is a target organ for adverse health outcomes following exposure to As. Several studies have reported a high prevalence of respiratory symptoms and diseases in subjects highly exposed to As through drinking water; however, most studies to date has been performed in exposed adults, with little information on respiratory effects in children. The objective of the study was to evaluate the association between urinary levels of As and its metabolites with lung function in children exposed in utero and in early childhood to high As levels through drinking water. A total of 358 healthy children were included in our study. Individual exposure was assessed based on urinary concentration of inorganic As. Lung function was assessed by spirometry. Participants were exposed since pregnancy until early childhood to an average water As concentration of 152.13 µg l⻹. The mean urinary As level registered in the studied subjects was 141.2 µg l⻹ and only 16.7% had a urinary concentration below the national concern level. Forced vital capacity was significantly decreased in the studied population and it was negatively associated with the percentage of inorganic As. More than 57% of the subjects had a restrictive spirometric pattern. The urinary As level was higher in those children with restrictive lung patterns when compared with the levels registered in subjects with normal spirometric patterns. Exposure to As through drinking water during in utero and early life was associated with a decrease in forced vital capacity and with a restrictive spirometric pattern in the children evaluated.
Assuntos
Arsênio/toxicidade , Exposição Ambiental/efeitos adversos , Doença Ambiental/induzido quimicamente , Pneumopatias/induzido quimicamente , Pulmão/efeitos dos fármacos , Efeitos Tardios da Exposição Pré-Natal , Poluentes Químicos da Água/toxicidade , Arsênio/análise , Arsênio/urina , Criança , Água Potável/química , Doença Ambiental/epidemiologia , Doença Ambiental/fisiopatologia , Doença Ambiental/urina , Monitoramento Ambiental , Feminino , Humanos , Pulmão/embriologia , Pulmão/fisiopatologia , Pneumopatias/epidemiologia , Pneumopatias/fisiopatologia , Pneumopatias/urina , Masculino , México/epidemiologia , Gravidez , Prevalência , Fatores de Risco , Saúde da População Rural , Índice de Gravidade de Doença , Capacidade Vital/efeitos dos fármacos , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/urina , Poluição Química da Água/efeitos adversosRESUMO
OBJECTIVES: The aim of the study was to make an international comparison of blood levels of cadmium (B-Cd), lead (B-Pb) and mercury (B-Hg) of women in seven European, and three non-European cities, and to identify determinants. MATERIALS AND METHODS: About 50 women (age: 46-62) from each city were recruited (totally 480) in 2006-2009. Interview and questionnaire data were obtained. Blood samples were analysed in one laboratory to avoid interlaboratory variation. RESULTS: Between the European cities, the B-Pb and B-Cd results vary little (range of geometric means: 13.5-27.0 µg/l and 0.25-0.65 µg/l, respectively); the variation of B-Hg was larger (0.40-1.38 µg/l). Between the non-European cities the results for B-Pb, B-Cd and B-Hg were 19.2-68.0, 0.39-0.99 and 1.01-2.73 µg/l, respectively. Smoking was a statistically significant determinant for B-Cd, while fish and shellfish intakes contributed to B-Hg and B-Pb, amalgam fillings also contributed to B-Hg. CONCLUSIONS: The present results confirm the previous results from children; the exposure to lead and cadmium varies only little between different European cities suggesting that other factors than the living area are more important. The study also confirms the previous findings of higher cadmium and lead levels in some non-European cities. The geographical variation for mercury is significant.
Assuntos
Cádmio/sangue , Doença Ambiental/sangue , Chumbo/sangue , Mercúrio/sangue , População Urbana , Saúde da Mulher , Croácia/epidemiologia , República Tcheca/epidemiologia , Equador/epidemiologia , Exposição Ambiental/análise , Doença Ambiental/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Marrocos/epidemiologia , Polônia/epidemiologia , Eslováquia/epidemiologia , Eslovênia/epidemiologia , Suécia/epidemiologiaRESUMO
OBJECTIVE: To examine longitudinal associations of prenatal, infancy, and early childhood lead exposure during sensitive periods with height and body mass index (BMI). STUDY DESIGN: A total of 773 participants were recruited between 1994 and 2005 in Mexico City. Lead exposure history categories were constructed for the prenatal period (maternal patellar lead concentration) and for infancy and childhood (mean child blood lead concentration at birth to 24 months and 30-48 months, respectively). Linear regression models were used to study lead exposure history with height and BMI at 48 months. RESULTS: Mean height at age 48 months was significantly lower in children with a blood lead level exceeding the median during infancy (-0.84 cm; 95% CI, -1.42 to -0.25) than in children with a level below the median. Prenatal lead exposure was not associated with height at 48 months. Results for attained BMI generally trended in the same direction as for height. CONCLUSION: Our findings suggest an effect of lead exposure early in life on height attainment at 48 months, with the exposure window of greatest sensitivity in infancy.
Assuntos
Estatura/efeitos dos fármacos , Índice de Massa Corporal , Desenvolvimento Infantil/efeitos dos fármacos , Exposição Ambiental/efeitos adversos , Doença Ambiental/epidemiologia , Intoxicação por Chumbo/epidemiologia , Chumbo/efeitos adversos , Pré-Escolar , Doença Ambiental/fisiopatologia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Intoxicação por Chumbo/fisiopatologia , Masculino , México/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
CONCLUSION: The results suggested mercury (Hg)-induced anomalies in the brainstem-mediated acoustic stapedius muscle reflex in children. OBJECTIVES: Hg exposure has been associated with hearing impairment and brainstem anomalies. Acoustic stapedius reflex (ASR) thresholds, growth functions, decay/adaptation times, and behavioral auditory thresholds were used to screen Andean children and adults for Hg-induced auditory brainstem and facial nerve impairment. METHODS: Fifty-one participants, which included 22 children (aged 6-17 years) and 29 adults (aged 19-83 years) living in gold mining areas of Ecuador where Hg is widely used in amalgamation, were screened using ASR immittance procedures. RESULTS: Mean blood mercury (HgB) level in the children was 15.6 µg/L (SD, 21.3; median, 7 µg/L; range, 2.0-89 µg/L), and in the adults 8.5 µg/L (SD, 7.1; median, 6 µg/L; range, 2.0-32 µg/L). Mean contralateral ASR thresholds (ASRT) for the screening frequency of 2000 Hz in the children (39 ears) was 92.9 dB HL (SD, 6.1; range, 80-105 dB HL), and in the adults (53 ears) 90.0 dB HL (SD, 6.4; range, 65-105 dB HL). The ASRT in the children increased significantly with HgB level (rho = 0.433; p = 0.008).
Assuntos
Limiar Auditivo/fisiologia , Exposição Ambiental/efeitos adversos , Doença Ambiental/fisiopatologia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Mercúrio/efeitos adversos , Mineração , Reflexo Acústico/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Limiar Auditivo/efeitos dos fármacos , Criança , Equador/epidemiologia , Doença Ambiental/induzido quimicamente , Doença Ambiental/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Reflexo Acústico/efeitos dos fármacos , Adulto JovemRESUMO
INTRODUCTION: Pneumonia and diarrhoea are leading causes of death in children. There is a need to develop effective interventions. OBJECTIVE: We present the design and baseline findings of a community-randomised controlled trial in rural Peru to evaluate the health impact of an Integrated Home-based Intervention Package in children aged 6 to 35 months. METHODS: We randomised 51 communities. The intervention was developed through a community-participatory approach prior to the trial. They comprised the construction of improved stoves and kitchen sinks, the promotion of hand washing, and solar drinking water disinfection (SODIS). To reduce the potential impact of non-blinding bias, a psychomotor stimulation intervention was implemented in the control arm. The baseline survey included anthropometric and socio-economic characteristics. In a sub-sample we determined the level of faecal contamination of drinking water, hands and kitchen utensils and the prevalence of diarrhoegenic Escherichia coli in stool specimen. RESULTS: We enrolled 534 children. At baseline all households used open fires and 77% had access to piped water supplies. E. coli was found in drinking water in 68% and 64% of the intervention and control households. Diarrhoegenic E. coli strains were isolated from 45/139 stool samples. The proportion of stunted children was 54%. CONCLUSIONS: Randomization resulted in comparable study arms. Recently, several critical reviews raised major concerns on the reliability of open health intervention trials, because of uncertain sustainability and non-blinding bias. In this regard, the presented trial featuring objective outcome measures, a simultaneous intervention in the control communities and a 12-month follow up period will provide valuable evidence.