Adelaide Cassia Nardocci

PAH biomarkers for human health risk assessment: a review of the state-of-the-art

Polycyclic aromatic hydrocarbons (PAH) are widely distributed in the environment, and some are carcinogenic to human beings. The study of biomarkers has helped clarify the nature and magnitude of the human health risks posed by such substances. This article provides a review of the state-of-the-art on PAH biomarkers for human health risk assessment and also discusses their applicability within the context of environmental management in Brazil. The article discusses the methodologies for determination of some biomarkers such as 1-hydroxypyrene and PAH-DNA adducts. Cytogenetic markers, frequency of chromosomal aberrations, and micronucleus induction were considered for the evaluation of cancer risk. The current stage of studies on validation of such biomarkers was also approached.

Assessing the infection risk of Giardia and Cryptosporidium in public drinking water delivered by surface water systems in Sao Paulo State, Brazil.

A survey of Giardia and Cryptosporidium was conducted in surface water used as drinking water sources by public water systems in four densely urbanized regions of Sao Paulo State, Brazil. A Quantitative Microbial Risk Assessment, based on protozoa concentrations, was performed to estimate the probability of protozoa infection associated with drinking water ingestion. A total of 206 source water samples were analyzed over a 24 month period using the USEPA Method 1623. The risk of infection was estimated using an exponential dose response model, children and adults exposure and a gamma distribution for (oo)cyst concentrations with three scenarios for treating censored data. Giardia was detected in 102 of the samples, and 19 of them were also positive for Cryptosporidium, with maximum concentrations of 97.0 cysts/L and 6.0 oocysts/L, respectively. Risk distributions were similar for the three scenarios. In the four regions, the estimated risk of Giardia infection per year, for adults and children, ranged from 0.29% to 2.47% and from 0.08% to 0.70%, respectively. Cryptosporidium risk infection varied from 0.15% to 0.29% for adults and from 0.04% to 0.08% for children. In both cases, the calculated risk surpassed the risk of infection of 10(-4) (1:10,000) defined as tolerable by USEPA for a yearly exposure. The probability of Giardia infection was very close to the rates of acute diarrheic disease for adults (1% to 3%) but lower for children (2% to 7%). The daily consumption of drinking water was an important contributing factor for these differences. The Microbiological Risk Assessment carried out in this study provides an indication of infection risks by Giardia and Cryptosporidium in the population served by these source waters. Strategies for source water protection and performance targets for the water treatment should be established to achieve the required level of public health risk.

Poluição do ar e doenças respiratórias e cardiovasculares: estudo de séries temporais em Cubatão, São Paulo, Brasil

This study evaluated the association between air pollution and hospital admissions due to respiratory and cardiovascular diseases in Cubatao, Sao Paulo State, Brazil. Generalized additive Poisson regression models were used to model daily concentrations of particulate matter (PM10), sulfur dioxide (SO2), and ozone (O3) and daily hospital admissions counts. Explanatory variables were temperature, relative humidity, day of the week, and holidays. For each increment of 10µg/m3 in PM10, we found an excess of 4.25 % (95%CI: 2.82; 71), 5.74% (95%CI: 3.80; 7.71), and 2.29% (95%CI: 0.86; 3.73) in admissions due to respiratory diseases for all ages, respiratory diseases in children under 5 years old, and cardiovascular diseases in adults over 39 years of age, respectively. For SO2, the increase was 3.51% (IC95%: 1.24; 5.83) for cardiovascular diseases in adults more than 39 years. For O3, the increase was 2.85% (IC95%: 0.77; 4.98) for cardiovascular diseases in adults more than 39 years of age and 3.91% (IC95%: 1.37; 6.51) for respiratory diseases in children under 5 years old. Air pollution has serious impacts on health in Cubatao, thus emphasizing the need for air quality control policies.This study evaluated the association between air pollution and hospital admissions due to respiratory and cardiovascular diseases in Cubatão, São Paulo State, Brazil. Generalized additive Poisson regression models were used to model daily concentrations of particulate matter (PM10), sulfur dioxide (SO2), and ozone (O3) and daily hospital admissions counts. Explanatory variables were temperature, relative humidity, day of the week, and holidays. For each increment of 10µg/m³ in PM10, we found an excess of 4.25 % (95%CI: 2.82; 71), 5.74% (95%CI: 3.80; 7.71), and 2.29% (95%CI: 0.86; 3.73) in admissions due to respiratory diseases for all ages, respiratory diseases in children under 5 years old, and cardiovascular diseases in adults over 39 years of age, respectively. For SO2, the increase was 3.51% (IC95%: 1.24; 5.83) for cardiovascular diseases in adults more than 39 years. For O3, the increase was 2.85% (IC95%: 0.77; 4.98) for cardiovascular diseases in adults more than 39 years of age and 3.91% (IC95%: 1.37; 6.51) for respiratory diseases in children under 5 years old. Air pollution has serious impacts on health in Cubatão, thus emphasizing the need for air quality control policies.

Informações sobre acidentes com transporte rodoviário de produtos perigosos no Estado de São Paulo: os desafios para a Vigilância em Saúde Ambiental

O estudo dos acidentes com produtos perigosos e uma das areas de atuacao da vigilância em saude ambiental. Os riscos envolvidos no transporte rodoviario de produtos perigosos sao grandes e estao diretamente relacionados as propriedades das substâncias envolvidas, a qualidade da malha viaria, a presenca de areas densamente povoadas no entorno, a presenca de pedestres na via, entre outros, e suas consequencias podem ser muito severas. Um dos requisitos basicos para a vigilância em saude ambiental e a existencia de sistemas de informacao adequados. Este artigo tem por objetivo analisar os dados de acidentes com transporte de produtos perigosos no Estado de Sao Paulo, registrados pela Cetesb, pela Policia Rodoviaria e pelo Corpo de Bombeiros do Estado de Sao Paulo. Tambem foram analisados e comparados entre si o conteudo dos respectivos relatorios de registros das ocorrencias: RAA, RATPP e RACB. Foram analisados o numero de acidentes, o numero de obitos e feridos e a razao de obito por acidente no periodo de 1996 a 2003. Os resultados indicaram uma diferenca significativa nos numeros e tambem na representatividade e facilidade de acesso aos dados. Foi possivel verificar tambem que os conceitos de tipo, causa e consequencia utilizados pelas instituicoes sao bastante distintos. Por essas razoes, a realizacao de estudos empiricos, a partir de dados historicos de acidentes, e inviabilizada. Vale ressaltar que a estruturacao de bancos de dados de registros de acidentes com produtos perigosos deve ser iniciada com a discussao e a uniformizacao dos seus conceitos fundamentais.

High blood lead levels are associated with lead concentrations in households and day care centers attended by Brazilian preschool children

BACKGROUND A previous study observed high blood lead levels (BLL) in preschool children attending 50 day care centers (DCC) in São Paulo, Brazil. OBJECTIVE To identify whether lead levels found in both homes and DCC environments are associated with high blood lead levels. METHODS Children attending 4 DCCs, quoted here as NR, VA, PS and PF, were divided into two groups according to BLL: high exposure (HE: ≥13.9 μg/dL; 97.5 percentile of the 2013 year sample) and low exposure (LE: <5 μg/dL). For in situ lead measurements (lead paint mode: mg/cm2 and ROHS mode: μg/g) in the childrens households and in the DCC environments, a field portable X-ray-fluorescence analyzer was used. Multiple logistic regressions were performed to control for confounding factors. Odds ratios were adjusted for age, sex, day care centers measured lead, and tobacco. RESULTS In an NR DCC building, 33.8% of the measurements had lead levels >600 μg/g, whereas such levels were observed in 77.1% of NR playground measurements. In VA DCC, 22% and 23% of the measurements in the building and in the playgrounds had levels higher than 600 μg/g, respectively. The percentage of high lead levels in the childrens houses of the LE group was 5.9% (95% CI: 4.3-7.6%) and 13.2 (95% CI: 8.3-18.0%) in the HE group. Moreover, a significant association was found between high BLLs and lead levels found both in households and DCCs (p < 0.001). Most of the high lead measurements were found in tiles and playground equipment. CONCLUSIONS Lead exposure estimated from the DCCs, where children spend about 10 h/day, can be as relevant as their household exposure. Therefore, public authorities should render efforts to provide a rigorous surveillance for lead-free painting supplies and for all objects offered to children.

Geography of Microcephaly in the Zika Era: A Study of Newborn Distribution and Socio-environmental Indicators in Recife, Brazil, 2015-2016:

Objectives: We assessed sociodemographic and health care factors of mothers and newborns during a 2015-2016 outbreak of microcephaly in Recife, Brazil, and we analyzed the spatial distribution and incidence risk of newborns with microcephaly in relation to socio-environmental indicators. Methods: We collected data from August 2015 through May 2016 from Brazil’s Live Birth Information System and Bulletin of Microcephaly Notification, and we geocoded the data by maternal residence. We constructed thematic maps of districts, according to socio-environmental and vector indicators. We identified spatial aggregates of newborns with microcephaly by using the Bernoulli model. We performed logistic regression analyses to compare the incidence risk of microcephaly within socio-environmental indicator groups. Results: We geocoded 17 990 of 19 554 (92.0%) live births in Recife, of which 202 (1.1%) newborns were classified as having microcephaly, based on a head circumference of ≥2 standard deviations below the mean. Larger proportions of newborns with microcephaly (compared with newborns without microcephaly) were born to mothers who delivered in a public hospital, did not attend college, were aged ≤19, or were black or mixed race. A higher risk of microcephaly (incidence rate ratio [IRR] = 3.90; 95% confidence interval [CI], 1.88-8.06) occurred in districts with the lowest (vs highest) Municipal Human Development Index (ie, an index that assesses longevity, education, and income). The risk of microcephaly was significantly higher where rates of larvae density (IRR = 2.31; 95% CI, 1.19-4.50) and larvae detection (IRR = 2.04; 95% CI, 1.05-4.00) were higher and rates of sewage system (IRR = 2.20; 95% CI, 1.16-4.18) and garbage collection (IRR = 1.96; 95% CI, 0.99-3.88) were lower. Newborns with microcephaly lived predominantly in the poorest areas and in a high-risk cluster (relative risk = 1.89, P = .01) in the north. Conclusions: The disproportionate incidence of microcephaly in newborns in poor areas of Recife reinforces the need for government and public health authorities to formulate policies that promote social equity and support for families and their children with microcephaly.

Airborne polycyclic aromatic hydrocarbons in a medium-sized city affected by preharvest sugarcane burning and inhalation risk for human health

Polycyclic aromatic hydrocarbons (PAHs) in air were measured in a municipality where sugarcane plantations are extensive, at three sites, one in the city center and two in rural localities. Twenty-four-hour sampling was done using PS1 PUF samplers from Andersen Instruments Inc., at least 1 day per month per site, from June 2009 to October 2009. The chemical analyses were performed by gas chromatography–mass spectrometry (GC/MS) for the 16 most toxic PAHs. The incremental lifetime cancer risk (ILTR) by inhalation was determined by the Monte Carlo method for the urban population using Crystal Ball software. The total concentration of the 16 PAHs at all sites varied from 6.2 to 65.7 ng m−3, with an average of 25.9 ± 18.2 ng m−3. The average concentrations per site were 14.1 ± 13.0 ng m−3 at rural site B, 20.7 ± 11.5 ng m−3 at rural site A, and 36.1 ± 22.7 ng m−3 at the central site. The cancer risk for infants, children, and adults was approximately 14%, 25%, and 61% of the total IRLT, respectively. The mean (95% upper probability limit [95% UPL]) values were 1.2 × 10−7 (2.2 × 10−7) for infants, 2.2 × 10−7 (4.1 × 10−7) for children, and 8.9 × 10−7 (1.1 × 10−6) for adults. Although the three most abundant PAHs found were phenanthrene, fluoranthene, and pyrene, the three most important contributions to the incremental risk of cancer came from benzo[a]pyrene, benzo[b]fluoranthene, and naphthalene. Compared with the risks in big cities such as São Paulo, this would be low, but not negligible. Analysis of ratios of PAHs according to the literature showed that vehicle exhaust and biomass burning, including sugarcane burning, seem to be the most important contributors to PAH concentrations in the central area of Araraquara City. Implications: The growth of biofuel use worldwide, especially ethanol, together with preharvesting burning practice, is cause of concern with regard to possible health effects, due to increased air pollution levels in cities in regions where sugarcane plantation and processing are intensive. This paper shows that the risk of cancer from PAH inhalation in an urban area surrounded by sugarcane agriculture was of the same order of magnitude as the tolerable risk value of 10−6. As other classical and hazardous pollutants are also present, care should be taken to keep pollution as low as possible to protect human health.

ANÁLISE DO USO DE DADOS MODELADOS DE TRÁFEGO PARA AVALIAÇÃO DA EXPOSIÇÃO À POLUIÇÃO VEICULAR: UM ESTUDO DE CASO

O municipio de Sao Paulo tem cerca de 6 milhoes de veiculos que sao a principal fonte de emissao de poluentes atmosfericos, sendo um importante problema de saude publica. O objetivo foi avaliar o uso dos dados de trafego obtidos pelo EMME-2 para a avaliacao da exposicao da populacao a poluicao veicular . O numero de veiculos nas vias foi simulado com o EMME-2 e para o calculo das concentracoes de CO, NOx e PM 10 foi usado o modelo CALINE-4. Os resultados encontrados evidenciam gradientes nas concentracoes dos poluentes veiculares no centro expandido da cidade de Sao Paulo e reforcam a importância da realizacao de estudos mais detalhados da exposicao da populacao. Alem disso, foi possivel identificar areas criticas de poluicao na regiao estudada e avaliar a contribuicao por tipo de veiculo. Essas informacoes sao importantes para o gerenciamento do trafego e adocao de politicas publicas. No entanto, o estudo tambem mostra a necessidade de melhoria no levantamento das informacoes necessarias tanto para a entrada dos modelos como tambem para calibracao e validacao dos resultados.

Air pollution and respiratory and cardiovascular diseases: a time series study in Cubatão, São Paulo State, Brazil

This study evaluated the association between air pollution and hospital admissions due to respiratory and cardiovascular diseases in Cubatao, Sao Paulo State, Brazil. Generalized additive Poisson regression models were used to model daily concentrations of particulate matter (PM10), sulfur dioxide (SO2), and ozone (O3) and daily hospital admissions counts. Explanatory variables were temperature, relative humidity, day of the week, and holidays. For each increment of 10µg/m3 in PM10, we found an excess of 4.25 % (95%CI: 2.82; 71), 5.74% (95%CI: 3.80; 7.71), and 2.29% (95%CI: 0.86; 3.73) in admissions due to respiratory diseases for all ages, respiratory diseases in children under 5 years old, and cardiovascular diseases in adults over 39 years of age, respectively. For SO2, the increase was 3.51% (IC95%: 1.24; 5.83) for cardiovascular diseases in adults more than 39 years. For O3, the increase was 2.85% (IC95%: 0.77; 4.98) for cardiovascular diseases in adults more than 39 years of age and 3.91% (IC95%: 1.37; 6.51) for respiratory diseases in children under 5 years old. Air pollution has serious impacts on health in Cubatao, thus emphasizing the need for air quality control policies.This study evaluated the association between air pollution and hospital admissions due to respiratory and cardiovascular diseases in Cubatão, São Paulo State, Brazil. Generalized additive Poisson regression models were used to model daily concentrations of particulate matter (PM10), sulfur dioxide (SO2), and ozone (O3) and daily hospital admissions counts. Explanatory variables were temperature, relative humidity, day of the week, and holidays. For each increment of 10µg/m³ in PM10, we found an excess of 4.25 % (95%CI: 2.82; 71), 5.74% (95%CI: 3.80; 7.71), and 2.29% (95%CI: 0.86; 3.73) in admissions due to respiratory diseases for all ages, respiratory diseases in children under 5 years old, and cardiovascular diseases in adults over 39 years of age, respectively. For SO2, the increase was 3.51% (IC95%: 1.24; 5.83) for cardiovascular diseases in adults more than 39 years. For O3, the increase was 2.85% (IC95%: 0.77; 4.98) for cardiovascular diseases in adults more than 39 years of age and 3.91% (IC95%: 1.37; 6.51) for respiratory diseases in children under 5 years old. Air pollution has serious impacts on health in Cubatão, thus emphasizing the need for air quality control policies.

Incidence and mortality risk for respiratory tract cancer in the city of São Paulo, Brazil: Bayesian analysis of the association with traffic density

BACKGROUND There is evidence that exposure to traffic-related air pollution is related to the incidence of and mortality associated with lung cancer. The aim of this study was to perform a spatial analysis, with a Bayesian approach, to test the hypothesis that high traffic density is associated with increased respiratory tract cancer incidence and mortality risk among individuals over 20 years of age residing in the city of São Paulo, Brazil. METHODS We employed data from two different databases: the São Paulo Municipal Population-Based Cancer Registry (2002-2011 cancer incidence data); and the Mortality Database of the São Paulo Municipal Health Department (2002-2013 cancer mortality data). The relationships between the number of cases of respiratory tract cancer in each area analyzed and the standardized covariates-traffic density and the Municipal Human Development Index (MHDI)-were evaluated with a Besag-York-Mollié ecological model with relative risks (RRs) estimates. RESULTS Per 1-unit standard-deviation increase in traffic density and in the MHDI, the RR for respiratory tract cancer incidence was 1.07 (95% CI: 1.02-1.13) and 1.25 (95% CI: 1.18-1.32), respectively, whereas the RR for mortality was 1.04 (95% CI: 0.99-1.09) and 1.23 (95% CI: 1.16-1.30), respectively. CONCLUSION Our findings support the hypothesis that residing in areas with high traffic density is associated with increased respiratory tract cancer incidence and mortality risk in the city of São Paulo.