From Samarco in Mariana to Vale in Brumadinho: mining dam disasters and Public Health

Use of psychotropic drugs by population in an area affected by the tailings dam rupture: Brumadinho Health Project

OBJECTIVE

To describe the consumption of psychotropic drugs in the adult population residing in Brumadinho, Minas Gerais, after the Vale dam collapse, which occurred in 2019.

METHODS

This is a cross-sectional study, part of the Brumadinho Health Project, developed in 2021, with a representative population-based sample of adults (18 years and over) residing in Brumadinho. A total of 2,805 adults with information on self-reported use of psychotropic drugs (antidepressants and anxiolytics-hypnotics/sedatives) in the last 15 days were included in the analysis. The prevalence of psychotropic drug use was estimated, and the most used psychotropic drugs were identified. Pearson's chi-square test (with Rao-Scott correction) was used to test associations between exposures and use of psychotropic drugs, considering a significance level of p<0.05.

RESULTS

The use of antidepressants (14.2%) was more common than the use of anxiolytics or hypnotics/sedatives (5.2%), with sertraline and fluoxetine being the most used antidepressants. The use of anxiolytics and hypnotics/sedatives was higher among residents who lived in the area directly affected by the dam's mud, and the use of any psychotropic drug was higher among those who lost a relative/friend in the disaster and assessed that their health worsened after the disaster, and among women.

CONCLUSION

The results of the study corroborate what was observed in other populations exposed to similar tragedies, regarding the pattern of associations and the of use of psychotropic drugs.

Cultural adaptation of the guidelines for offering mental health first aid to a person after a potentially traumatic event: a delphi expert consensus study in Brazil

BACKGROUND

Traumatic events increase the risk of mental disorders. In a country with relatively under-developed mental health support systems, services to assist people who have experienced potentially traumatic events may be unavailable. In such situations, people in the community become key sources of support. However, they do not always have the knowledge and skills to offer effective help. This study reports on the cultural adaptation for Brazil of the English-language mental health first aid guidelines for helping someone who has experienced a potentially traumatic event.

METHODS

A Delphi expert consensus study with two expert panels, one comprising health professionals with experience in the treatment of trauma (n = 33) and the other comprising people with lived experience, (n = 29) was conducted. A questionnaire containing 131 statements from the English language guidelines was translated into Brazilian Portuguese. Participants were asked to rate the importance of actions to be taken to help a person who has experienced a potentially traumatic event and to suggest new items where appropriate.

RESULTS

Data were collected over two survey rounds. A total of 149 items were included in the final guidelines (110 items from the English-language guidelines and 39 new items created from expert panel comments, in the second round). Immediate action items were endorsed by both panels, while items related to encouraging victims were rejected by the professional panel. The suggested statements mostly related to providing psychological support and attending to the person's subjective experience rather than providing material or structural support.

CONCLUSION

While there were many similarities with the English-language guidelines for high-income countries, the guidelines also incorporate actions of importance for Brazil, including the emphasis on the first aider's management of the person's subjective experiences. These guidelines may inform Mental Health First Aid training for Brazil and may also be used as standalone resources.

Trends and Climate Elasticity of Streamflow in South-Eastern Brazil Basins

Trends in streamflow, rainfall and potential evapotranspiration (PET) time series, from 1970 to 2017, were assessed for five important hydrological basins in Southeastern Brazil. The concept of elasticity was also used to assess the streamflow sensitivity to changes in climate variables, for annual data and 5-, 10- and 20-year moving averages. Significant negative trends in streamflow and rainfall and significant increasing trend in PET were detected. For annual analysis, elasticity revealed that 1% decrease in rainfall resulted in 1.21–2.19% decrease in streamflow, while 1% increase in PET induced different reductions percentages in streamflow, ranging from 2.45% to 9.67%. When both PET and rainfall were computed to calculate the elasticity, results were positive for some basins. Elasticity analysis considering 20-year moving averages revealed that impacts on the streamflow were cumulative: 1% decrease in rainfall resulted in 1.83–4.75% decrease in streamflow, while 1% increase in PET induced 3.47–28.3% decrease in streamflow. This different temporal response may be associated with the hydrological memory of the basins. Streamflow appears to be more sensitive in less rainy basins. This study provides useful information to support strategic government decisions, especially when the security of water resources and drought mitigation are considered in face of climate change.

Rupture of Brumadinho dam (Minas Gerais, Brazil): embryotoxicity in zebrafish induced by metal mixture-contaminated water

Rupture of dam B-1 at the Córrego do Feijão mine in Brumadinho, state of Minas Gerais, Brazil (25/Jan/2019) contaminated the Paraopeba River with mine waste. To identify the adverse effects of this event on public and environmental health, we conducted the Fish Embryo Acute Toxicity (FET) test (OECD No. 236). During the tests, zebrafish embryos were exposed for 144 hours to solutions containing realistic concentrations of dissolved iron and aluminum and total manganese at the following analysis points upstream or downstream of the dam: 10 km, upstream; 19.7 km, downstream, at the point where water for consumption is collected; 24.5 km, downstream, in the city of Mário Franco; and 59 km, downstream, on the border between the towns of Juatuba and Betim. Metal concentrations were taken from September 2019 report No. 53 released by IGAM. Mortality was high at all exposure points and reached 93% at the Juatuba/Betim point. We also detected lethal, sublethal and teratogenic effects, such as non-hatching, non-inflation of the swim bladder, pericardial edema and scoliosis, affecting up to 25% of embryos at the other analysis points. The results highlight the need for continuous monitoring of the water quality of the Paraopeba River.

Brumadinho Health Project: methodological aspects and epidemiological profile of participants in the cohort baseline

ABSTRACT: Objective: To present the methodological aspects of the Brumadinho Health Project and to describe the epidemiological profile of participants in the baseline cohort. Methods: Prospective, population-based cohort study in a representative sample of residents (aged 12 and over) of Brumadinho, Minas Gerais, after a mining tailings dam failure. Information for the baseline was collected in 2021, two years after the mining tailings dam collapsed, including sociodemographic, health and service use aspects, among others. Prevalence estimates of health outcomes were described in Brumadinho, as well as in the Metropolitan Region of Belo Horizonte and Minas Gerais, using data from the 2019 National Health Survey. All analyses were performed in the software Stata 17.0, considering the sampling weights and design effect. Results: 3,080 (86.4%) residents participated in the study, most of them being females (56.7%) and with a mean age of 46.1 years. The diseases more frequently reported were arterial hypertension (30.1%), high cholesterol (23.1%) and depression (22.5%), similarly to what was observed in the Metropolitan Region of Belo Horizonte and Minas Gerais, although the prevalence in Brumadinho was higher. At least one medical appointment and one hospitalization occurred in 75.2% and 9.4% of residents in the past year, respectively. Conclusion: It is important to monitor health, physical and mental conditions of residents after the occurrence of a disaster of this magnitude. This information can contribute with risk management of these processes, not only in the affected municipality, but also in other areas where populations are at risk of major disasters.

Desastres em barragens de mineração como riscos sistêmicos

RESUMO: Entre 2015 e 2019, o Brasil registrou os dois mais graves desastres envolvendo barragens de mineração do século XXI. O objetivo deste artigo é oferecer a compreensão desses desastres como riscos sistêmicos, que envolvem desde processos globais e nacionais relacionados aos determinantes sociais que se concretizam em um complexo sistema de barragens distribuídas pelo País com seus riscos intrínsecos. Quando ocorrem, resultam em um conjunto de impactos com potencial de danos e efeitos imediatos combinados com impactos secundários e terciários que podem desencadear reações em cadeia, promovendo fatores de riscos de ocorrência heterogênea e complexa. Abordar esses eventos com base no conceito de risco sistêmico permite uma compreensão mais ampla tanto da singularidade de cada um desses desastres e seus múltiplos processos de exposição, riscos e doenças, como também das características estruturais com que os processos e dinâmicas sociais, políticas e econômicas reproduzem, em múltiplos territórios, um padrão comum de desastres e seus efeitos. Concluímos que a promoção da saúde da população e de territórios sustentáveis deve orientar a organização dos processos produtivos e não o contrário, com a externalização dos custos humanos, ambientais e sociais da mineração e seus desastres.

Mining dams disasters as systemic risks

ABSTRACT: Between 2015 and 2019, Brazil recorded the two most serious disasters involving mining dams of the 21st century. The purpose of this article is to offer an understanding of these disasters as systemic risks. They involve from global and national processes related to social determinants that materialize in a complex system of dams distributed throughout the country with their intrinsic risks. When they occur, result in a set of impacts with potential damage and immediate effects combined with secondary and tertiary impacts that can trigger chain reactions, which promote risk factors of heterogeneous and complex occurrence. Approaching these events from the point of view of systemic risk allows for a broader understanding of both the singularity of each of these disasters and their multiple exposure, risk and disease processes, as well as the structural characteristics in which social, political processes and dynamics and economic factors reproduce in multiple territories a common pattern of disasters and their effects. We conclude that the promotion of population health and sustainable territories should guide the organization of production processes and not the opposite, with the externalization of human, environmental and social costs of mining and its disasters.

Manganese-Induced Neurotoxicity through Impairment of Cross-Talk Pathways in Human Neuroblastoma Cell Line SH-SY5Y Differentiated with Retinoic Acid

Manganese (Mn) is an important element; yet acute and/or chronic exposure to this metal has been linked to neurotoxicity and neurodegenerative illnesses such as Parkinson’s disease and others via an unknown mechanism. To better understand it, we exposed a human neuroblastoma cell model (SH-SY5Y) to two Mn chemical species, MnCl₂ and Citrate of Mn(II) (0–2000 µM), followed by a cell viability assay, transcriptomics, and bioinformatics. Even though these cells have been chemically and genetically modified, which may limit the significance of our findings, we discovered that by using RA-differentiated cells instead of undifferentiated SH-SY5Y cell line, both chemical species induce a similar toxicity, potentially governed by disruption of protein metabolism, with some differences. The MnCl₂ altered amino acid metabolism, which affects RNA metabolism and protein synthesis. Citrate of Mn(II), however, inhibited the E3 ubiquitin ligases–target protein degradation pathway, which can lead to the buildup of damaged/unfolded proteins, consistent with histone modification. Finally, we discovered that Mn(II)-induced cytotoxicity in RA-SH-SY5Y cells shared 84 percent of the pathways involved in neurodegenerative diseases.

Mining Dam Failures in Brazil: Comparing Legal Post-Disaster Decisions

Mining dam failures have increased worldwide since the 1980s. Two large mining dam failures occurred recently in Mariana and Brumadinho, both in the state of Minas Gerais, Brazil. We hypothesize that there were significant differences in legal post-disaster decisions. The aim of this article is to understand the similarities and differences of post-disaster actions and controversies in Mariana and Brumadinho. We reviewed 686 news reports about court decisions and settlement agreements from the websites of state and federal courts and judicial institutions. After classifying the reports using an adapted protocol from a media health observatory, we conducted a thematic analysis. Our analysis suggests that there were significant differences in legal post-disaster decisions in the cases of Mariana and Brumadinho. In Mariana, there was privatization of post-disaster management, with the creation of the Renova Foundation, a mediated indemnity program, lack of access to information for those affected, and uncertainties in health and resettlement issues. In Brumadinho, there was faster implementation of the recovery and compensation measures, faster recognition of affected parties, and stronger participation of the population since the first hearings. Even though there were particularities in post-disaster management, the ultimate goal of the corporations responsible for the disasters was to protect their profits.

Methylmercury Impact on Adult Neurogenesis: Is the Worst Yet to Come From Recent Brazilian Environmental Disasters?

Worldwide environmental tragedies of anthropogenic origin causing massive release of metals and other pollutants have been increasing considerably. These pollution outbreaks affect the ecosystems and impact human health. Among those tragedies, recent large-scale environmental disasters in Brazil strongly affected riverside populations, leading to high-risk exposure to methylmercury (MeHg). MeHg is highly neurotoxic to the developing brain. This toxicant causes neural stem cell dysfunction and neurodevelopmental abnormalities. However, less is known about the effects of MeHg in the postnatal neurogenic niche, which harbors neural stem cells and their progeny, in the adult brain. Therefore, taking in consideration the impact of MeHg in human health it is urgent to clarify possible associations between exposure to mercury, accelerated cognitive decline, and neurodegenerative diseases. In this perspectives paper, we discuss the neurotoxic mechanisms of MeHg on postnatal neurogenesis and the putative implications associated with accelerated brain aging and early-onset cognitive decline in populations highly exposed to this environmental neurotoxicant.

Conservation paradox: Large-scale mining waste in protected areas in two global hotspots, southeastern Brazil

Irreversible losses of natural areas and damage to ecosystem services are caused by large-scale mining. These effects are prominent in Minas Gerais, which is home to a mining industry with hundreds of tailings dams concentrated in global hotspots: the Cerrado and the Atlantic Forest. We present an overview of the spatial overlap between protected areas (PAs), priority conservation areas (PCAs), tailings dams, and their influence areas. A total of 218 dams accumulated environmental costs and liability that are represented by 2.24 thousand million m³ of tailings and industrial waste. Most dams (≈ 70%) are located in PCAs, 45 dams in conservation units, 58 in their respective buffer zones, and 51 in special protection areas. We have identified an urgent need to implement adequate public policies to establish management and monitoring mechanisms in PAs and PCAs and to address a scenario of high potential for socioenvironmental damage associated with tailings dams.

Segurança de barragens e os riscos potenciais à saúde pública

RESUMO Este artigo visou refletir sobre a implementação e a efetividade da Política Nacional de Segurança de Barragens (PNSB) e sobre as ações de redução do risco de desastres no contexto da saúde pública. As barragens podem ter diversos usos, e seu rompimento causa danos sociais, ambientais e sanitários de grande dimensão que perduram ao longo do tempo. O estudo foi realizado a partir de revisão da literatura e análise de dados do cadastro de barragens no Brasil de 2017. Hoje, não se sabe o quantitativo de barragens existentes nem as reais estatísticas das ocorrências de incidentes/acidentes por danos ou colapso das estruturas. São vários os atores envolvidos no processo de segurança de barragens, e 43 órgãos têm a atribuição de fiscalizar mais de 24 mil barragens cadastradas no Sistema Nacional de Informações sobre Segurança de Barragens, em que 76% dos registros não possuem informações suficientes para definir sua submissão à PNSB. Os impactos sobre a saúde, pessoas e serviços são diversos, diretos e indiretos. Assim, o trabalho procura demostrar que a PNSB é um dispositivo com potencialidade mudar o cenário de gestão de risco de desastre, e sua efetiva implementação promoverá a redução das incertezas quanto ao risco à população.

Do global ao local: desafios para redução de riscos à saúde relacionados com mudanças climáticas, desastre e Emergências em Saúde Pública

RESUMO Pela primeira vez na história, presenciam-se transformações no padrão esperado do clima com consequências ainda desconhecidas para sociedade industrial moderna. Esses riscos globais ocorrem em um mundo cada vez mais conectado, com população crescente e ambientalmente degradado, tendo como pano de fundo um cenário em que há uma relação proporcionalmente inversa entre os países, populações e grupos sociais que sofrem, de modo mais amplo e intenso, os riscos e danos provocados pelas mudanças climáticas. Um dos impactos imediatos já observados é o aumento na frequência e na magnitude de eventos extremos, gerando cenários propícios ao surgimento de emergências em saúde. Este artigo teve como objetivo apresentar os principais desafios para redução de riscos à saúde relacionados com mudanças no clima, desastre e Emergências em Saúde Pública; os principais avanços nas políticas sobre o tema; e ações de saúde dentro desse complexo cenário social, ambiental e sanitário iminente. Como resultado, apresentam-se os principais acordos globais relacionados e as necessidades de ampliação do Sistema Nacional de Redução de Riscos à Saúde visando fortalecer as ações necessárias, a fim de obter resposta adequada aos fatores de risco apresentados. Para tanto, apresentam-se seis recomendações necessária à elaboração desse sistema.

Território e desterritorialização: o sofrimento social por desastre ambiental decorrente do rompimento de barragens de mineração

RESUMO Em Mariana, estado de Minas Gerais, após o Rompimento da Barragem de Fundão, famílias passaram por processo de desterritorialização, em que foram deslocadas da área rural para a área urbana. Assim, o objetivo do estudo foi compreender o processo de desterritorialização nesse contexto, as implicações da perda desse locus social para a vida dos atingidos e para a construção de respostas e políticas públicas de saúde. Foi realizada pesquisa qualitativa no período de 2016 a 2018 no município de Mariana, utilizando as técnicas de observação participante e entrevistas com pessoas atingidas. As entrevistas foram analisadas a partir da Análise de Conteúdo, e a discussão foi orientada pelo referencial teórico dos conceitos de território, desterritorialização e sofrimento social. Na observação e nos relatos dos participantes, é marcante a relação simbólica com seu lugar de origem, traduzidos na forma de vínculos e pertencimento. As perdas, em suas diferentes dimensões, impactam a vida desde o luto até o sofrimento social. Até o reassentamento, é necessário que as interpretações desse novo viver não sejam patologizadas para que as pessoas consigam estar conscientes desse processo e serem protagonistas das escolhas.

Territory and deterritorialization: the social suffering by environmental disaster resulting from the breaking of mining dams

RESUMO Em Mariana, estado de Minas Gerais, após o Rompimento da Barragem de Fundão, famílias passaram por processo de desterritorialização, em que foram deslocadas da área rural para a área urbana. Assim, o objetivo do estudo foi compreender o processo de desterritorialização nesse contexto, as implicações da perda desse locus social para a vida dos atingidos e para a construção de respostas e políticas públicas de saúde. Foi realizada pesquisa qualitativa no período de 2016 a 2018 no município de Mariana, utilizando as técnicas de observação participante e entrevistas com pessoas atingidas. As entrevistas foram analisadas a partir da Análise de Conteúdo, e a discussão foi orientada pelo referencial teórico dos conceitos de território, desterritorialização e sofrimento social. Na observação e nos relatos dos participantes, é marcante a relação simbólica com seu lugar de origem, traduzidos na forma de vínculos e pertencimento. As perdas, em suas diferentes dimensões, impactam a vida desde o luto até o sofrimento social. Até o reassentamento, é necessário que as interpretações desse novo viver não sejam patologizadas para que as pessoas consigam estar conscientes desse processo e serem protagonistas das escolhas.

O rejeito e suas diversas marcas: saúde dos trabalhadores da Defesa Civil no rompimento da barragem de Fundão

RESUMO A partir do desastre socioambiental ocorrido em Mariana (MG), em 5 de novembro de 2015, o estudo buscou compreender a atividade dos técnicos da Defesa Civil que atuaram no desastre. A reflexão que aqui se desenvolve parte do esforço de dar visibilidade à atividade desses profissionais que atuam em condições permeadas de imprevisibilidades e pressões. O estudo tem como referenciais os aportes do campo da Saúde do Trabalhador e da ergologia. Trata-se de uma pesquisa empírica, de abordagem qualitativa, realizada por meio de observação direta e entrevistas individuais semiestruturadas com trabalhadores da Defesa Civil. A análise dos resultados foi organizada em duas grandes seções com os seus respectivos desdobramentos: a primeira traz uma contextualização do desastre narrada pelos diversificados profissionais que atuaram; a segunda evidencia desafios e perspectivas que os agentes de defesa civil puderam tirar da catástrofe. Diante da complexidade das situações e da dimensão imprevisível do risco, os agentes de defesa civil são constantemente convocados a ‘renormatizar’ e a operar escolhas a partir de sua história e de seus valores para lidar com as infidelidades do meio.

Environmental disasters and birth outcomes: Impact of a tailings dam breakage in Brazil

There is evidence of a relationship between in utero exposure to catastrophic events and adverse birth outcomes, usually attributed to heightened maternal stress. The objective of our work was to evaluate if the breakage of a dam containing wastefrom a mining cite in Brazil, in 2015, an environmental disaster popularly known as the Mariana Tragedy, affected the health of newborns exposed in utero. We used administrative data on birth records and reports on the Mariana Tragedy to identify all births from newborns exposed in utero and the intensity of that exposure, according to the mother's municipality of residence. Using a difference-in-differences framework, we estimated the impact of different intensities of exposure on birth outcomes. We found that being directly exposed in utero to the Tragedy resulted in 1.86 days shorter gestational age and 2.6 percentage points higher incidence of preterm birth (<37 weeks). We found no impact on birthweight related outcomes. The effect is larger than previously identified for other catastrophic events. We hypothesize that this is probably due to the Tragedy impacting birth outcomes not exclusively through heightened maternal stress, but also through depressed economic activity in directly affected municipalities.

Fuzzy Rules to Help Predict Rains and Temperatures in a Brazilian Capital State Based on Data Collected from Satellites

The forecast for rainfall and temperatures in underdevelope countries can help in the definition of public and private investment strategies in preventive and corrective nature. Water is an essential element for the economy and living things. This study had a main objective to use an intelligent hybrid model capable of extracting fuzzy rules from a historical series of temperatures and rainfall indices of the state of Minas Gerais in Brazil, more specifically in the capital. Because this is state has several rivers fundamental to the Brazilian economy, this study intended to find knowledge in the data of the problem to help public managers and private investors to act dynamically in the prediction of future temperatures and how they can interfere in the decisions related to the population of the state. The results confirm that the intelligent hybrid model can act with efficiency in the generation of predictions about the temperatures and average rainfall indices, being an efficient tool to predict the water situation in the future of this critical state for Brazil.