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Bautista-Arredondo LF, Trejo-Valdivia B, Estrada-Sánchez D, Tamayo-Ortiz M, Cantoral A, Figueroa JL, Romero-Martínez M, Gómez-Acosta LM, Cuevas-Nasu L, Tellez-Rojo MM. Intoxicación infantil por plomo en México: otras fuentes de exposición más allá del barro vidriado (Ensanut 2022). Salud Publica Mex 2023; 65:s197-s203. [PMID: 38060959 DOI: 10.21149/14798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/28/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Describir y actualizar al año 2022 la prevalencia de intoxicación por plomo (Pb) en la población infantil de 1-4 años en México y describir fuentes de exposición ambiental, paraocupacional y uso de barro vidriado (BV). Material y métodos. Estudio en una muestra de menores que participaron en la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). Se midió la concentración de plomo en sangre (PbS) capilar. Se aplicó un cuestionario para indagar sobre fuentes de exposición a Pb. RESULTADOS Se midió PbS en 1 158 menores de 1-4 años. La prevalencia nacional de intoxicación por Pb (≥5.0 μg/dL) fue 16.8% (IC95%:13.6,20.5). La proporción de hogares que reportó exposición a una fuente exclusiva fue de 21.2, 17.7 y 7.4% para BV, exposición ambiental y paraocupacional, respectivamente. La prevalencia de intoxicación de los expuestos a una sola fuente fue 21.5%, y esta cifra aumenta a 24.2% entre quienes reportaron exposición combinada tres tipos de fuentes. Conclusión. La prevalencia nacional de intoxicación por plomo permaneció estable con respecto a lo reportado en la Ensanut 2018-19. El uso de BV es una fuente de exposición relevante, pero no es la única. Se identificó una contribución importante por exposición ambiental y, en menor medida, de exposición paraocupacional.
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Affiliation(s)
- Luis F Bautista-Arredondo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Belem Trejo-Valdivia
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | | | - Marcela Tamayo-Ortiz
- Unidad de Investigación de Salud en el Trabajo, Instituto Mexicano del Seguro Social. Ciudad de México, México..
| | | | - José Luis Figueroa
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Martín Romero-Martínez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Luz María Gómez-Acosta
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Lucía Cuevas-Nasu
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Martha María Tellez-Rojo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
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Téllez-Rojo MM, Bautista-Arredondo LF, Rosa-Parra A, Martínez-Silva G. Concentración de metales en sangre de cordón umbilical debido a exposición prenatal en una cohorte de la Ciudad de México. GAC MED MEX 2023. [DOI: 10.24875/gmm.22000329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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Córdoba-Gamboa L, Vázquez-Salas RA, Romero-Martínez M, Cantoral A, Riojas-Rodríguez H, Bautista-Arredondo S, Bautista-Arredondo LF, de Castro F, Tamayo-Ortiz M, Téllez-Rojo MM. Lead Exposure Can Affect Early Childhood Development and Could Be Aggravated by Stunted Growth: Perspectives from Mexico. Int J Environ Res Public Health 2023; 20:5174. [PMID: 36982080 PMCID: PMC10049063 DOI: 10.3390/ijerph20065174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Lead can affect early childhood development (ECD) differentially due to nutritional deficiencies that lead to stunted growth, defined as being at least two standard deviations below the average height-for-age. These deficiencies are more frequent among children living in rural locations or with lower socioeconomic status (SES); however, studies at a population level are scarce worldwide. Early childhood development plays a crucial role in influencing a child's health and wellbeing throughout life. Therefore, the aim of this study was to analyze how stunted growth can modify the association between lead exposure and ECD in children from disadvantaged communities. METHODS Data were analyzed from the 2018 National Health and Nutrition Survey in localities with fewer than 100,000 inhabitants in Mexico (ENSANUT-100K). Capillary blood lead (BPb) levels were measured using a LeadCare II device and dichotomized as detectable (cutoff point ≥ 3.3 µg/dL) and non-detectable. As a measure of ECD, language development was assessed in n = 1394 children, representing 2,415,000 children aged 12-59 months. To assess the association between lead exposure and language z-scores, a linear model was generated adjusted by age, sex, stunted growth, maternal education, socioeconomic status, area, region (north, center, south), and family care characteristics; afterwards, the model was stratified by stunted growth. RESULTS Fifty percent of children had detectable BPb and 15.3% had stunted growth. BPb showed a marginal inverse association with language z-scores (β: -0.08, 95% CI: -0.53, 0.36). Children with detectable BPb and stunted growth had significantly lower language z-scores (β: -0.40, 95% CI: -0.71, -0.10) than those without stunted growth (β: -0.15, 95% CI: -0.36, 0.06). CONCLUSIONS Children with stunted growth are more vulnerable to the adverse effects of lead exposure. These results add to previous research calling for action to reduce lead exposure, particularly in children with chronic undernutrition.
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Affiliation(s)
- Leonel Córdoba-Gamboa
- Dirección de Salud Ambiental, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico; (L.C.-G.)
| | - Ruth Argelia Vázquez-Salas
- Dirección de Salud Reproductiva, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Ciudad de México 14080, Morelos, Mexico
| | - Martin Romero-Martínez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico
| | - Alejandra Cantoral
- Departamento de Salud, Universidad Iberoamericana, Ciudad de Mexico 01219, Morelos, Mexico
| | - Horacio Riojas-Rodríguez
- Dirección de Salud Ambiental, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico; (L.C.-G.)
| | - Sergio Bautista-Arredondo
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico
| | - Luis F. Bautista-Arredondo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico
| | - Filipa de Castro
- Research, Evidence, and Learning, Department of Education and Child Population, Save the Children, 501 Kings Highway East, Suite 400, Fairfield, CT 06825, USA
| | - Marcela Tamayo-Ortiz
- Unidad de Investigación de Salud en el Trabajo, Instituto Mexicano del Seguro Social, Ciudad de México 6720, Morelos, Mexico
| | - Martha María Téllez-Rojo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico
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Téllez-Rojo MM, Ríos-Blancas MJ, Lerma-Treviño C, Bautista-Arredondo LF, Spearman S, Marsh L, Burkart K, Stanaway J, Ashbaugh C, Brauer M, Hurtado-Díaz M. Analysis of the burden of disease attributable to environmental risk factors in Mexico in the 1990-2021 period. Identification of advances, lags and emergencies. GAC MED MEX 2023; 159:532-542. [PMID: 38386867 DOI: 10.24875/gmm.m24000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/01/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND It is estimated that environmental risk factors (ERF) were responsible for nine million deaths worldwide in 2019. OBJECTIVE Using data from the Global Burden of Disease study, indicators of health loss associated with exposure to ERF in Mexico were analyzed. MATERIAL AND METHODS Absolute numbers and population percentages of deaths and disability-adjusted life years (DALY) lost attributed to selected ERFs were analyzed at the national and state level and by sex, as well as age-standardized trends from 1990 to 2021. RESULTS In 2021, ambient particulate matter pollution showed the highest mortality and DALYs lost attributed to selected ERFs (42.2 and 38.1% respectively), followed by lead exposure (20.6 and 13.4%) and low temperature (19.8 and 12.3%). Both indicators have decreased for all selected ERAs by different magnitudes between 1991 and 2021, except for high temperature. CONCLUSIONS Despite decreases in the last 32 years, outdoor environment particulate matter showed the highest mortality and DALYs lost, followed by lead exposure. It is essential to strengthen air quality and lead exposure policies in Mexico.
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Affiliation(s)
- Martha M Téllez-Rojo
- Center of Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - María J Ríos-Blancas
- Center of Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
- Fundación "Carlos Slim", Mexico City, Mexico
| | - Carolina Lerma-Treviño
- Center of Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Luis F Bautista-Arredondo
- Center of Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Sandra Spearman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Liz Marsh
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Katrin Burkart
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Jeff Stanaway
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Charlie Ashbaugh
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Michael Brauer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Magali Hurtado-Díaz
- Population Health Research Center, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
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Téllez-Rojo MM, Bautista-Arredondo LF, Rosa-Parra A, Silva GM. Prenatal exposure to metals and concentration thereof in umbilical cord blood in a Mexico City cohort. GAC MED MEX 2023; 159:129-134. [PMID: 37094245 DOI: 10.24875/gmm.m23000759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND In Mexico, there is a paucity of evidence on the magnitude of prenatal exposure to metals. OBJECTIVE To estimate the concentration of arsenic, cadmium, manganese and lead in umbilical cord blood (UCB) and its association with maternal blood concentrations during pregnancy and delivery. MATERIAL AND METHODS Metal concentration in maternal blood was analyzed during pregnancy (n = 901), delivery (n = 732) and in UCB (n = 512) from participants of the PROGRESS cohort residing in Mexico City. The association between concentrations in UCB and maternal biomarkers was analyzed using generalized linear models, adjusted for relevant covariates. RESULTS Mean concentrations (μg/L) of lead, arsenic and manganese in UCB were 27.14 (25.28-29.14), 0.77 (0.71-0.84) and 42.60 (40.45-44.83), respectively. Cadmium concentration could not be estimated because 86.2% of measurements were below the detection limit. Lead and manganese concentrations in UCB were significantly associated with maternal biomarkers during pregnancy and delivery; at delivery, association was only observed with arsenic. CONCLUSIONS Prenatal exposure to toxic metals in sensitive periods of organogenesis shows a neglected public health problem. Biomonitoring of the population and establishment of regulations aimed at providing care to vulnerable populations is required.
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Affiliation(s)
- Martha M Téllez-Rojo
- Center of Nutrition and Health Research, Instituto Nacional de Salud Pública, Secretaría de Salud, Morelos, Mexico
| | - Luis F Bautista-Arredondo
- Center of Nutrition and Health Research, Instituto Nacional de Salud Pública, Secretaría de Salud, Morelos, Mexico
| | - Antonio Rosa-Parra
- Center of Nutrition and Health Research, Instituto Nacional de Salud Pública, Secretaría de Salud, Morelos, Mexico
| | - Gisela Martínez Silva
- Center of Nutrition and Health Research, Instituto Nacional de Salud Pública, Secretaría de Salud, Morelos, Mexico
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Chilian-Herrera OL, Tamayo-Ortiz M, Texcalac-Sangrador JL, Rothenberg SJ, López-Ridaura R, Romero-Martínez M, Wright RO, Just AC, Kloog I, Bautista-Arredondo LF, Téllez-Rojo MM. PM 2.5 exposure as a risk factor for type 2 diabetes mellitus in the Mexico City metropolitan area. BMC Public Health 2021; 21:2087. [PMID: 34774026 PMCID: PMC8590776 DOI: 10.1186/s12889-021-12112-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 10/15/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Exposure to air pollution is the main risk factor for morbidity and mortality in the world. Exposure to particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) is associated with cardiovascular and respiratory conditions, as well as with lung cancer, and there is evidence to suggest that it is also associated with type II diabetes (DM). The Mexico City Metropolitan Area (MCMA) is home to more than 20 million people, where PM2.5 levels exceed national and international standards every day. Likewise, DM represents a growing public health problem with prevalence around 12%. In this study, the objective was to evaluate the association between exposure to PM2.5 and DM in adults living in the MCMA. METHODS Data from the 2006 or 2012 National Health and Nutrition Surveys (ENSANUT) were used to identify subjects with DM and year of diagnosis. We estimated PM2.5 exposure at a residence level, based on information from the air quality monitoring system (monitors), as well as satellite measurements (satellite). We analyzed the relationship through a cross-sectional approach and as a case - control study. RESULTS For every 10 μg/m3 increase of PM2.5 we found an OR = 3.09 (95% CI 1.17-8.15) in the 2012 sample. These results were not conclusive for the 2006 data or for the case - control approach. CONCLUSIONS Our results add to the evidence linking PM2.5 exposure to DM in Mexican adults. Studies in low- and middle-income countries, where PM2.5 atmospheric concentrations exceed WHO standards, are required to strengthen the evidence.
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Affiliation(s)
- Olivia L Chilian-Herrera
- Homologous Normative Coordination, General Directorate, Mexican Social Security Institute, Mexico City, Mexico
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Social Security Institute, Av. Cuauhtémoc 330, Doctores, Cuauhtémoc, 06720, Mexico City, Mexico.
| | - Jose L Texcalac-Sangrador
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Stephen J Rothenberg
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ruy López-Ridaura
- National Center for Disease Prevention and Control Programs, Mexico City, Mexico
| | - Martín Romero-Martínez
- Center for Research in Surveys and Evaluation, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Luis F Bautista-Arredondo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Martha María Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Tellez-Rojo MM, Bautista-Arredondo LF, Trejo-Valdivia B, Tamayo-Ortiz M, Estrada-Sánchez D, Kraiem R, Pantic I, Mercado-García A, Romero-Martínez M, Shamah-Levy T, Fuller R, Cantoral A. [Analysis of the national distributionof lead poisoning in 1-4 year-old children.Implications for Mexican public policy]. Salud Publica Mex 2021; 62:627-636. [PMID: 33620961 DOI: 10.21149/11155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/29/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To estimate de magnitude of Pb poisoning (≥5μg/dL blood) in 1-4 year old children and to identify the contribution of lead-glazed ceramics use (LGC) as a source of exposure in the 32 Mexican states. MATERIALS AND METHODS Using the results from a sample of capillary blood lead (BPb) we estimated the prevalence of Pb poisoning, it's association with LGC and national distribution. RESULTS The national prevalence of Pb poisoning was 17.4% representing 1.4 million children. The prevalence was 30.7% among LGC users and 11.8% in non-users. In 17 states the prevalence of Pb poisoning was ≥10%, in 11 states between 5-10%, and in 4 states <5%. CONCLUSIONS There is a geographic differential distribution of the problem; confirming the association with LGC and estimating the contribution of other Pb exposure sources. This information offers a guide to implement preven-tion and control actions in Mexico.
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Affiliation(s)
- Martha María Tellez-Rojo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Luis F Bautista-Arredondo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Belem Trejo-Valdivia
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Marcela Tamayo-Ortiz
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.,Cátedras Conacyt. Ciudad de México, México
| | | | | | - Ivan Pantic
- Departamento de Neurobiología del Desarrollo, Instituto Nacional de Perinatología. Ciudad de México, México
| | - Adriana Mercado-García
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Martín Romero-Martínez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | | | - Alejandra Cantoral
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.,Cátedras Conacyt. Ciudad de México, México
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Tellez-Rojo MM, Bautista-Arredondo LF, Trejo-Valdivia B, Tamayo-Ortiz M, Estrad- Sánchez D, Kraiem R, Pantic I, Mercado-García A, Romero-Martínez M, Shamah-Levy T, Fuller R, Cantoral A. Análisis de la distribución nacional de intoxicación por plomo en niños de 1 a 4 años. Implicaciones para la política pública en México. Salud Publica Mex 2020. [DOI: 10.21149/11550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Estimar la magnitud de intoxicación por plomo(Pb) (≥5μg/dL en sangre) en niños de 1 a 4 años e identificarla contribución del uso de loza de barro vidriado con Pb(LBVPb) como fuente de exposición en los 32 estados deMéxico. Material y métodos. Muestra de Pb en sangre(PbS) capilar de niños participantes en la Encuesta Nacionalde Salud y Nutrición 2018-2019. Se estimó la prevalencia deintoxicación, su asociación con LBVPb y distribución nacional.Resultados. La prevalencia nacional de intoxicación fue17.4%, lo cual representa 1.4 millones de niños. Esta prevalenciafue 30.7% entre usuarios de LBVPb y 11.8% entre nousuarios. En 17 estados la prevalencia de intoxicación es ≥10%;en 11 es ≥5-10% y en 4 es <5%. Conclusiones. Existe una distribución diferencial geográfica del problema; se confirma la asociación con LBVPb y se estima la contribución de otrasfuentes de exposición. Esta información ofrece una guía paraimplementar acciones de prevención y control en México.
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Téllez-Rojo MM, Rothenberg SJ, Texcalac-Sangrador JL, Just AC, Kloog I, Rojas-Saunero LP, Gutiérrez-Avila I, Bautista-Arredondo LF, Tamayo-Ortiz M, Romero M, Hurtado-Díaz M, Schwartz JD, Wright R, Riojas-Rodríguez H. Children's acute respiratory symptoms associated with PM 2.5 estimates in two sequential representative surveys from the Mexico City Metropolitan Area. Environ Res 2020; 180:108868. [PMID: 31711659 DOI: 10.1016/j.envres.2019.108868] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/26/2019] [Accepted: 10/27/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Respiratory diseases are a major component of morbidity in children and their symptoms may be spatially and temporally exacerbated by exposure gradients of fine particulate matter (PM2.5) in large polluted urban areas, like the Mexico City Metropolitan Area (MCMA). OBJECTIVES To analyze the association between satellite-derived and interpolated PM2.5 estimates with children's (≤9 years old) acute respiratory symptoms (ARS) in two probabilistic samples representing the MCMA. METHODS We obtained ARS data from the 2006 and 2012 National Surveys for Health and Nutrition (ENSaNut). Two week average exposure to PM2.5 was assessed for each household with spatial estimates from a hybrid model with satellite measurements of aerosol optical depth (AOD-PM2.5) and also with interpolated PM2.5 measurements from ground stations, from the Mexico City monitoring network (MNW-PM2.5). We used survey-adjusted logistic regressions to analyze the association between PM2.5 estimates and ARS reported on children. RESULTS A total of 1,005 and 1,233 children were surveyed in 2006 and 2012 representing 3.1 and 3.5 million children, respectively. For the same years and over the periods of study, the estimated prevalence of ARS decreased from 49.4% (95% CI: 44.9,53.9%) to 37.8% (95% CI: 34,41.7%). AOD-PM2.5 and MNW-PM2.5 estimates were associated with significantly higher reports of ARS in children 0-4 years old [OR2006 = 1.29 (95% (CI): 0.99,1.68) and OR2006 = 1.24 (95% CI: 1.08,1.42), respectively]. We observed positive non-significant associations in 2012 in both age groups and in 2006 for children 5-9 years old. No statistically significant differences in health effect estimates of PM2.5 were found comparing AOD-PM2.5 or MNW-PM2.5 for exposure assessment. CONCLUSIONS Our findings suggest that PM2.5 is a risk factor for the prevalence of ARS in children and expand the growing evidence of the utility of new satellite AOD-based methods for estimating health effects from acute exposure to PM2.5.
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Affiliation(s)
- Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Stephen J Rothenberg
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - José Luis Texcalac-Sangrador
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Iván Gutiérrez-Avila
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Luis F Bautista-Arredondo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Marcela Tamayo-Ortiz
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; National Council of Science and Technology Fellowship, Mexico City, Mexico
| | - Martín Romero
- Center for Research in Surveys and Evaluation, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Magali Hurtado-Díaz
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Joel D Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Horacio Riojas-Rodríguez
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Téllez-Rojo MM, Bautista-Arredondo LF, Trejo-Valdivia B, Cantoral A, Estrada-Sánchez D, Kraiem R, Pantic I, Rosa-Parra A, Gómez-Acosta LM, Romero-Martínez M, Cuevas-Nasu L, Shamah-Levy T, Fuller R, Tamayo-Ortiz M. Reporte nacional de niveles de plomo en sangre y uso de barro vidriado en población infantil vulnerable. ACTA ACUST UNITED AC 2019; 61:787-797. [DOI: 10.21149/10555] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/03/2019] [Indexed: 11/06/2022]
Abstract
Objetivo. Estimar la prevalencia de niveles elevados (≥5.0μg/ dL) de plomo en sangre (PbS) y su asociación con el uso de loza de barro vidriado con plomo (LBVPb). Material y métodos. En 2018 se midió PbS capilar en una muestra representativa de niños de 1 a 4 años de edad residentes en localidades de México menores de 100 000 habitantes (Ensanut 100k). Se indagó sobre uso de LBVPb para consumo de alimentos. Para estimar su asociación con PbS, se generaron modelos logit multinomial estratificados por región. Resultados. La prevalencia de niveles elevados de PbS fue de 21.8%. En las regiones Norte, Centro y Sur las prevalencias fueron 9.8, 20.7 y 25.8%, respectivamente. La asociación con uso y frecuencia de LBVPb fue altamente significativa y diferencial por región. Conclusiones. La exposición a plomo permanece como un problema de salud pública en México, particularmente en el Centro y Sur, y está fuertemente asociada con el uso de LBVPb.
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Perng W, Tamayo-Ortiz M, Tang L, Sánchez BN, Cantoral A, Meeker JD, Dolinoy DC, Roberts EF, Martinez-Mier EA, Lamadrid-Figueroa H, Song PXK, Ettinger AS, Wright R, Arora M, Schnaas L, Watkins DJ, Goodrich JM, Garcia RC, Solano-Gonzalez M, Bautista-Arredondo LF, Mercado-Garcia A, Hu H, Hernandez-Avila M, Tellez-Rojo MM, Peterson KE. Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) Project. BMJ Open 2019; 9:e030427. [PMID: 31455712 PMCID: PMC6720157 DOI: 10.1136/bmjopen-2019-030427] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) Project is a mother-child pregnancy and birth cohort originally initiated in the mid-1990s to explore: (1) whether enhanced mobilisation of lead from maternal bone stores during pregnancy poses a risk to fetal and subsequent offspring neurodevelopment; and (2) whether maternal calcium supplementation during pregnancy and lactation can suppress bone lead mobilisation and mitigate the adverse effects of lead exposure on offspring health and development. Through utilisation of carefully archived biospecimens to measure other prenatal exposures, banking of DNA and rigorous measurement of a diverse array of outcomes, ELEMENT has since evolved into a major resource for research on early life exposures and developmental outcomes. PARTICIPANTS n=1643 mother-child pairs sequentially recruited (between 1994 and 2003) during pregnancy or at delivery from maternity hospitals in Mexico City, Mexico. FINDINGS TO DATE Maternal bone (eg, patella, tibia) is an endogenous source for fetal lead exposure due to mobilisation of stored lead into circulation during pregnancy and lactation, leading to increased risk of miscarriage, low birth weight and smaller head circumference, and transfer of lead into breastmilk. Daily supplementation with 1200 mg of elemental calcium during pregnancy and lactation reduces lead resorption from maternal bone and thereby, levels of circulating lead. Beyond perinatal outcomes, early life exposure to lead is associated with neurocognitive deficits, behavioural disorders, higher blood pressure and lower weight in offspring during childhood. Some of these relationships were modified by dietary factors; genetic polymorphisms specific for iron, folate and lipid metabolism; and timing of exposure. Research has also expanded to include findings published on other toxicants such as those associated with personal care products and plastics (eg, phthalates, bisphenol A), other metals (eg, mercury, manganese, cadmium), pesticides (organophosphates) and fluoride; other biomarkers (eg, toxicant levels in plasma, hair and teeth); other outcomes (eg, sexual maturation, metabolic syndrome, dental caries); and identification of novel mechanisms via epigenetic and metabolomics profiling. FUTURE PLANS As the ELEMENT mothers and children age, we plan to (1) continue studying the long-term consequences of toxicant exposure during the perinatal period on adolescent and young adult outcomes as well as outcomes related to the original ELEMENT mothers, such as their metabolic and bone health during perimenopause; and (2) follow the third generation of participants (children of the children) to study intergenerational effects of in utero exposures. TRIAL REGISTRATION NUMBER NCT00558623.
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Affiliation(s)
- Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Center, Aurora, Colorado, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Center, Aurora, Colorado, USA
| | - Marcela Tamayo-Ortiz
- National Council of Science and Technology, National Institute of Public Health, Mexico City, Mexico
| | - Lu Tang
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Alejandra Cantoral
- National Council of Science and Technology, National Institute of Public Health, Mexico City, Mexico
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Dana C Dolinoy
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States
| | - Elizabeth F Roberts
- Department of Anthropology, University of Michigan, Ann Arbor, Michigan, USA
| | - Esperanza Angeles Martinez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | | | - Peter X K Song
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Adrienne S Ettinger
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Robert Wright
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Manish Arora
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Lourdes Schnaas
- Division of Research in Community Interventions, Instituto Nacional de Perinatologia, Mexico City, Mexico
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Robin C Garcia
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Maritsa Solano-Gonzalez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Adriana Mercado-Garcia
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Howard Hu
- Department of Environmental and Occupational Health, University of Washington School of Public Health, Seattle, Washington, USA
| | - Mauricio Hernandez-Avila
- Dirección de Prestaciones Económicas y Sociales, Mexican Institute of Social Security, Mexico City, Mexico
| | - Martha Maria Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Téllez-Rojo MM, Bautista-Arredondo LF, Richardson V, Estrada-Sánchez D, Ávila-Jiménez L, Ríos C, Cantoral-Preciado A, Romero-Martínez M, Flores-Pimentel D, Melo-Zurita MDC, Romero-Ramírez A, León-Mazón MA, Montes S, Fuller R, Hernández-Ávila M. [Lead poisoning and marginalization in newborns of Morelos, Mexico]. Salud Publica Mex 2017; 59:218-226. [PMID: 28902309 DOI: 10.21149/8045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 01/30/2017] [Indexed: 01/10/2023] Open
Abstract
Objective: To determine the prevalence of lead (Pb) poisoning at birth in Morelos, analyze its distribution by social marginalization level, and estimate the association with the use of lead glazed ceramics (LGC). Materials and methods: Blood lead level (BLL) in umbilical cord was measured in a representative sample of 300 randomly selected births at the Morelos Health Services and state IMSS. Results: The prevalence of Pb poisoning at birth (BLL> 5μg/dL) was 14.7% (95%CI: 11.1, 19.3) and 22.2% (95%CI: 14.4, 32.5) in the most socially marginalized municipalities. 57.1% (95%CI: 51.3, 62.7) of the mothers used LGC during pregnancy, and the frequency of use was significantly associated with BLL. Conclusion: This is the first study to document the proportion of newborns with Pb poisoning who are at risk of experiencing the related adverse effects. It is recommended to monitor BLL at birth and take action to reduce this exposure, especially in socially marginalized populations.
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Affiliation(s)
- Martha María Téllez-Rojo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México
| | - Luis F Bautista-Arredondo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México
| | | | | | - Laura Ávila-Jiménez
- Instituto Mexicano del Seguro Social. Delegación Estatal Morelos Cuernavaca, México
| | - Camilo Ríos
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía. Ciudad de México, México
| | | | - Martín Romero-Martínez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Ciudad de México, México
| | - Delia Flores-Pimentel
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, México
| | | | - Anita Romero-Ramírez
- Instituto Mexicano del Seguro Social. Delegación Estatal Morelos Cuernavaca, México
| | | | - Sergio Montes
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía. Ciudad de México, México
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