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Quinteros ME, Blazquez C, Ayala S, Kilby D, Cárdenas-R JP, Ossa X, Rosas-Diaz F, Stone EA, Blanco E, Delgado-Saborit JM, Harrison RM, Ruiz-Rudolph P. Development of Spatio-Temporal Land Use Regression Models for Fine Particulate Matter and Wood-Burning Tracers in Temuco, Chile. Environ Sci Technol 2023; 57:19473-19486. [PMID: 37976408 DOI: 10.1021/acs.est.3c00720] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Biomass burning is common in much of the world, and in some areas, residential wood-burning has increased. However, air pollution resulting from biomass burning is an important public health problem. A sampling campaign was carried out between May 2017 and July 2018 in over 64 sites in four sessions, to develop a spatio-temporal land use regression (LUR) model for fine particulate matter (PM) and wood-burning tracers levoglucosan and soluble potassium (Ksol) in a city heavily impacted by wood-burning. The mean (sd) was 46.5 (37.4) μg m-3 for PM2.5, 0.607 (0.538) μg m-3 for levoglucosan, and 0.635 (0.489) μg m-3 for Ksol. LUR models for PM2.5, levoglucosan, and Ksol had a satisfactory performance (LOSOCV R2), explaining 88.8%, 87.4%, and 87.3% of the total variance, respectively. All models included sociodemographic predictors consistent with the pattern of use of wood-burning in homes. The models were applied to predict concentrations surfaces and to estimate exposures for an epidemiological study.
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Affiliation(s)
- María Elisa Quinteros
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Avenida Lircay s/n, Talca, 3460000, Chile
- Programa Doctorado en Salud Pública, Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago, 1025000, Chile
| | - Carola Blazquez
- Department of Engineering Sciences, Universidad Andres Bello, Quillota 980, Viña del Mar, 2531015, Chile
| | - Salvador Ayala
- Programa Doctorado en Salud Pública, Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago, 1025000, Chile
- Departamento Agencia Nacional de Dispositivos Médicos, Innovación y Desarrollo, Instituto de Salud Pública de Chile, Marathon 1000, Ñuñoa, Santiago 0000000000, Chile
| | - Dylan Kilby
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, Michigan 48109, United States
| | - Juan Pablo Cárdenas-R
- Departamento de Ingeniería en Obras Civiles, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco, Chile
- Facultad de Arquitectura, Construcción y Medio Ambiente, Universidad Autónoma de Chile, Temuco 4810101, Chile
| | - Ximena Ossa
- Departamento de Salud Pública y Centro de Excelencia CIGES, Universidad de la Frontera, Caro Solar 115, Temuco, 4780000, Chile
| | - Felipe Rosas-Diaz
- Facultad de Ingeniería Civil, Universidad Autónoma de Nuevo León, San Nicolás de Los Garza 66451, Nuevo León, México
| | - Elizabeth A Stone
- Department of Chemistry and Department of Chemical and Biochemical Engineering, University of Iowa, Iowa City, Iowa 52242, United States
| | - Estela Blanco
- Programa Doctorado en Salud Pública, Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago, 1025000, Chile
- Centro de Investigación en Sociedad y Salud and Núcleo Milenio de Sociomedicina, Universidad Mayor, Santiago, 7510041, Chile
| | - Juana-María Delgado-Saborit
- Perinatal Epidemiology, Environmental Health and Clinical Research, School of Medicine, Universitat Jaume I, Avinguda de Vicent Sos Baynat, s/n, 12071 Castelló de la Plana, Castellon Spain
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, SW7 2BX, United Kingdom
- Division of Environmental Health & Risk Management, School of Geography, Earth & Environmental Sciences, University of Birmingham, Edgbaston Birmingham B152TT, U.K
| | - Roy M Harrison
- Division of Environmental Health & Risk Management, School of Geography, Earth & Environmental Sciences, University of Birmingham, Edgbaston Birmingham B152TT, U.K
- Department of Environmental Sciences/Center of Excellence in Environmental Studies, King Abdulaziz University, PO Box 80203, Jeddah, 21589, Saudi Arabia
| | - Pablo Ruiz-Rudolph
- * Programa de Epidemiología, Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago 1025000, Chile
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Blanco E, Ruiz-Rudolph P, Yohannessen K, Ayala S, Quinteros ME, Delgado-Saborit JM, Blazquez CA, Iglesias V, Zapata DA, Bartington SE, Harrison RM, Ossa X. Temporal and Spatial Trends of Adverse Pregnancy and Birth Outcomes in a Sample of Births from a Public Hospital in Chile. J Urban Health 2023; 100:513-524. [PMID: 37213068 PMCID: PMC10322795 DOI: 10.1007/s11524-023-00733-y] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 05/23/2023]
Abstract
Understanding temporal and spatial trends in pregnancy and birth outcomes within an urban area is important for the monitoring of health indicators of a population. We conducted a retrospective cohort study of all births in the public hospital of Temuco, a medium-sized city in Southern Chile between 2009 and 2016 (n = 17,237). Information on adverse pregnancy and birth outcomes, as well as spatial and maternal characteristics (insurance type, employment, smoking, age, and overweight/obesity), was collected from medical charts. Home addresses were geocoded and assigned to neighborhood. We tested whether births and prevalence of adverse pregnancy outcomes changed over time, whether birth events were spatially clustered (Moran's I statistic), and whether neighborhood deprivation was correlated to outcomes (Spearman's rho). We observed decreases in eclampsia, hypertensive disorders of pregnancy, and small for gestational age, while gestational diabetes, preterm birth, and low birth weight increased over the study period (all p < 0.01 for trend), with little changes after adjusting for maternal characteristics. We observed neighborhood clusters for birth rate, preterm birth, and low birth weight. Neighborhood deprivation was negatively correlated with low birth weight and preterm birth, but not correlated with eclampsia, preeclampsia, hypertensive disorders of pregnancy, small for gestational age, gestational diabetes, nor stillbirth. Several encouraging downward trends and some increases in adverse pregnancy and birth outcomes, which, overall, were not explained by changes in maternal characteristics were observed. Identified clusters of higher adverse birth outcomes may be used to evaluate preventive health coverage in this setting.
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Affiliation(s)
- Estela Blanco
- Centro de Investigación en Sociedad y Salud y Núcleo Milenio de Sociomedicina, Universidad Mayor, Santiago, Chile
- Center for Climate and Resilience Research, (CR)2, Santiago, Chile
| | - Pablo Ruiz-Rudolph
- Programa de Epidemiología, Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile
| | - Karla Yohannessen
- Programa de Epidemiología, Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile
| | - Salvador Ayala
- PhD Program in Public Health, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile
| | - María Elisa Quinteros
- Departamento de Salud Pública, Facultad de Ciencias de La Salud, Universidad de Talca, Avenida Lircay S/N, Talca, Chile
- PhD Program in Public Health, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile
| | - Juana Maria Delgado-Saborit
- Perinatal Epidemiology, Environmental Health and Clinical Research, School of Medicine, Universitat Jaume I, Avinguda de Vicent Sos Baynat, S/N, 12071, Castellón de La Plana, Castellón, Spain
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, Michael Uren Biomedical Engineering Hub, White City Campus, Wood Lane, London, W12 0BZ, UK
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Carola A Blazquez
- Department of Engineering Sciences, Universidad Andres Bello, Quillota 980, Viña del Mar, Chile
| | - Verónica Iglesias
- Programa de Epidemiología, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile
| | - Diana Alcántara Zapata
- PhD Program in Public Health, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile
| | - Suzanne E Bartington
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Roy M Harrison
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Department of Environment, Faculty of Environmental Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Ximena Ossa
- Departamento de Salud Pública y Centro de Excelencia CIGES, Universidad de La Frontera, Claro Solar 115, Temuco, Chile.
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Ossa X, Quinteros ME, Baeza B, Saavedra A, Robinovich J. [Secular trend for overweight and excessive weight gain during pregnancy in a Southern Chilean region]. Rev Med Chil 2022; 150:868-878. [PMID: 37906820 DOI: 10.4067/s0034-98872022000700868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/01/2022] [Indexed: 02/17/2023]
Abstract
BACKGROUND Overweight during pregnancy has increased in Chile. In the region of La Araucanía it occurs in 67% of pregnancies, which exceeds the national indicators. AIM To analyze the secular trend during eight years of the nutritional status at the beginning of gestation, the excessive weight gain during pregnancy, and its association with individual factors in pregnant women cared the public health system of two Southern Chilean neighboring cities. MATERIAL AND METHODS This is an analytical observational study with a cross-sectional and longitudinal trend design. We used an anonymized database with 17,270 reproductive data of urban pregnant women who were cared between 2009 and 2016. Trend analysis was performed to evaluate secular changes (nptrend < 0.05) in nutritional indicators and logistic regression to determine the association with individual characteristics. RESULTS In the study period, overweight at the beginning of pregnancy increased by 13.1 percentage points. Forty percent of pregnant women with normal initial body mass index, were overweight or obese at the end of pregnancy. The excessive weight gain decreased slightly (z=-3.33, p = 0.001), but unevenly in both cities. Adolescent pregnancy, a low education and low socio-economic level of household together with previous overweight and a family or personal history of chronic diseases are associated with excessive gestational weight gain. CONCLUSIONS The results show social inequality. Female malnutrition by excess is a problem that must be addressed through a robust public policy, centered on primary health care level and with a focus on social determinants. Prenatal care provides a window of opportunity to intervene.
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Affiliation(s)
- Ximena Ossa
- Departamento de Salud Pública, Universidad de La Frontera, Temuco, Chile
| | - María Elisa Quinteros
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Bernardita Baeza
- Centro de Excelencia Gestión e Investigación en Salud (CIGES), Universidad de La Frontera, Temuco, Chile
| | - Araceli Saavedra
- Departamento de Salud Pública, Universidad de La Frontera, Temuco, Chile
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Blanco E, Marcela M, Nuñez L, Retamal E, Ossa X, Woolley KE, Oludotun T, Bartington SE, Delgado-Saborit JM, Harrison RM, Ruiz-Rudolph P, Quinteros ME. Adverse pregnancy and perinatal outcomes in Latin America and the Caribbean: systematic review and meta-analysis. Rev Panam Salud Publica 2022; 46:e21. [PMID: 35509645 PMCID: PMC9060182 DOI: 10.26633/rpsp.2022.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/15/2022] [Indexed: 12/04/2022] Open
Abstract
Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabetes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.
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Affiliation(s)
- Estela Blanco
- Facultad de Medicina, Pontifica Universidad Católica, Santiago, Chile
| | - Marin Marcela
- Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Loreto Nuñez
- Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Erika Retamal
- Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Ximena Ossa
- Departamento de Salud Pública y Centro de Excelencia CIGES, Universidad de la Frontera, Temuco, Chile
| | - Katherine E. Woolley
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Tosin Oludotun
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Suzanne E. Bartington
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | | | - Roy M. Harrison
- School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Pablo Ruiz-Rudolph
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Quinteros ME. Bioethical considerations about water fluoridation: a critical review. J Oral Res 2016. [DOI: 10.17126/joralres.2016.044] [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: 11/17/2022] Open
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