RESUMEN
Diesel exhaust presents a community exposure hazard, but methods to measure internal exposure are lacking. We report results from a community-based study using 1-nitropyrene (1-NP) and its urinary metabolites as markers of exposure to traffic-related diesel particulate matter (DPM). The study participants were Tijuana, Mexico residents who commuted on foot into San Diego, California for work or school using the International San Ysidro Port of Entry, placing them within feet of idling traffic (referred to as border commuters). The comparison group (non-border commuters) was comprised of residents of south San Diego who did not commute into Mexico. Air concentration of 1-NP in fine particulate matter (PM2.5) was measured in personal samples from participants. Spot urine samples were analyzed for 1-NP urinary metabolites 8-hydroxy-1-nitropyrene (8-OHNP) and 8-hydroxy-N-acetyl-1-aminopyrene (8-OHNAAP). Compared with non-border commuters, border commuters had two- to threefold higher mean urinary concentrations for unadjusted and creatinine-adjusted 8-OHNP and 8-OHNAAP. Urinary 8-OHNAAP and the sum of 8-OHNP and 8-OHNAAP were both associated with personal exposure to 1-NP in the prior 24 h. These results suggest that 1-NP urinary metabolites reflect recent exposure to DPM-derived 1-NP in community settings and can be useful for exposure analysis.
Asunto(s)
Contaminantes Atmosféricos/orina , Biomarcadores/orina , Pirenos/orina , Emisiones de Vehículos/análisis , Contaminación del Aire/análisis , California , Cromatografía Líquida de Alta Presión , Creatinina/orina , Humanos , Modelos Lineales , México , Material ParticuladoRESUMEN
Health policymakers in many countries are looking at ways of increasing health care coverage by scaling up the deployment of community health workers. In this commentary, we describe the rationale for the UK to learn from Brazil's scaled-up Community Health Worker primary care strategy, starting with a pilot project in North Wales.