Prevalence of liver diseases as referred by people living in the Santos and São Vicente Estuary

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.

Use of health services by the population living in contaminated areas in the region of the Santos and São Vicente estuarine system, Brazil

Objective: To relate the socio-demographic profile with access to health services of the population living in environmentally degraded areas in an estuary region.Study design: A sectional field study of 8819 people, evaluating three contaminated areas of São Vicente.Methods: Households were divided by studied area. A structured and pre-tested questionnaire was applied to obtain the data. A probabilistic sample was used. The prevalence of each of the outcomes of interest by area was calculated. To verify the existence of an association between the outcomes of interest and other variables (qualitative), by area, a descriptive analysis and to compare percentages and a comparison test was used between two proportions, a Chi-square test and/or a Fisher's exact test and a Kruska-wallis and Dunn multiple comparison were used as well. The significance level was 5%.Results: Most residents (94%) reported the use of public health services at least once a year (p < 0.001), mainly through the Basic Health Units (BHU) (p < 0.001). Most of the studied population (65%) did not have private health insurance and their schooling was basically restricted to primary education (p < 0.001). The predominant family income (70%) in the three areas was between one and five minimum wages (p < 0.001), with a higher incidence of people receiving one to three minimum wages at the time. The demand for health services was not associated with education or income.Conclusion: The population of the regions analysed heavily rely on the Unified Health System - SUS, but there was no association between income and frequency of health services and there was also no association between education and use of health services.

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.

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.