RESUMEN

Arsenic, cadmium, lead, and mercury present potential health risks to children who are exposed through inhalation or ingestion. Emerging Market countries experience rapid industrial development that may coincide with the increased release of these metals into the environment. A literature review was conducted for English language articles from the 21st century on pediatric exposures to arsenic, cadmium, lead, and mercury in the International Monetary Fund's (IMF) top 10 Emerging Market countries: Brazil, China, India, Indonesia, Mexico, Poland, Russia, South Korea, Taiwan, and Turkey. Seventy-six peer-reviewed, published studies on pediatric exposure to metals met the inclusion criteria. The reported concentrations of metals in blood and urine from these studies were generally higher than US reference values, and many studies identified adverse health effects associated with metals exposure. Evidence of exposure to metals in the pediatric population of these Emerging Market countries demonstrates a need for interventions to reduce exposure and efforts to establish country-specific reference values through surveillance or biomonitoring. The findings from review of these 10 countries also suggest the need for country-specific public health policies and clinician education in Emerging Markets.

RESUMEN

OBJECTIVE: To describe the investigation of a 2007 occupational coccidioidomycosis outbreak in California, recommend prevention measures, and assess statewide disease burden. METHODS: We evaluated the worksite, observed work practices, interviewed the workers and employer, reviewed medical records, provided prevention recommendations including risk-based respirator selection, and analyzed statewide workers' compensation claims. RESULTS: Ten of 12 workers developed acute pulmonary coccidioidomycosis; none used respiratory protection. We recommended engineering, work practice, and administrative controls, powered air-purifying respirator use, and medical care. Occupational coccidioidomycosis incidence nearly quadrupled in California from 2000 to 2006, with the highest rates in construction and agricultural workers. CONCLUSIONS: Construction workers are at risk for occupational coccidioidomycosis. The high attack rate in this outbreak was due to lack of awareness, rainfall patterns, soil disruption, and failure to use appropriate controls. Multiple risk-based measures are needed to control occupational coccidioidomycosis in endemic areas.

Asunto(s)

Coccidioides , Coccidioidomicosis/epidemiología , Brotes de Enfermedades , Exposición por Inhalación/prevención & control , Enfermedades Profesionales/epidemiología , Vigilancia de la Población , Microbiología del Suelo , California/epidemiología , Coccidioidomicosis/prevención & control , Industria de la Construcción/organización & administración , Conocimientos, Actitudes y Práctica en Salud , Humanos , Enfermedades Profesionales/prevención & control , Política Organizacional , Dispositivos de Protección Respiratoria , Indemnización para Trabajadores/estadística & datos numéricos

RESUMEN

BACKGROUND: Damp buildings are commonly remediated without removing employees or ongoing medical surveillance. METHODS: We examined paired pulmonary function and questionnaire data from 2002 and 2005 for 97 employees in a water-damaged building during ongoing but incomplete remediation. RESULTS: We observed no overall improvement in respiratory health, as reflected in symptom scores, overall medication use, spirometry abnormalities, or sick leave. Four employees went from borderline bronchial hyperresponsiveness to bronchial hyperresponsiveness; six developed abnormal spirometry; three more reported post-occupancy current asthma, and four hypersensitivity pneumonitis. The number of participants without lower respiratory symptoms decreased from 27 in 2002 to 20 in 2005. Respiratory cases relocated in the building had a decrease in medication use and sick leave in 2005. CONCLUSIONS: During dampness remediation, relocation may be health protective and prevent incident building-related respiratory cases. Without relocation of entire workforces, medical surveillance is advisable for secondary prevention of existing building-related disease.

Asunto(s)

Contaminación del Aire Interior/efectos adversos , Arquitectura y Construcción de Instituciones de Salud/métodos , Salud Laboral , Enfermedades Respiratorias/etiología , Agua/efectos adversos , Adulto , Factores de Edad , Asma/diagnóstico , Asma/epidemiología , Asma/etiología , Estudios Transversales , Monitoreo del Ambiente/métodos , Monitoreo Epidemiológico , Femenino , Humanos , Humedad/efectos adversos , Incidencia , Masculino , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Pruebas de Función Respiratoria , Enfermedades Respiratorias/diagnóstico , Enfermedades Respiratorias/epidemiología , Medición de Riesgo , Factores Sexuales , Síndrome del Edificio Enfermo/etiología , Síndrome del Edificio Enfermo/fisiopatología , Encuestas y Cuestionarios

RESUMEN

An examination of ambient air lead monitoring data was used to demonstrate success of banning the import and use of leaded gasoline in Bulgaria. From 1996-2007 air lead levels in Varna, the third largest city, decreased up to 63-fold.

Asunto(s)

Contaminantes Atmosféricos/análisis , Gasolina/análisis , Plomo/análisis , Emisiones de Vehículos/análisis , Bulgaria , Ciudades

RESUMEN

This study examined: (i) biocontaminant levels in flooded homes of New Orleans two years after the flooding; (ii) seasonal changes in biocontaminant levels, and (iii) correlations between biocontaminant levels obtained by different environmental monitoring methods. Endotoxin, (1→3)-ß-d-glucan, fungal spores, and dust mite allergens were measured in 35 homes during summer and winter. A combination of dust sampling, aerosolization-based microbial source assessment, and long-term inhalable bioaerosol sampling aided in understanding exposure matrices. On average, endotoxin found in the aerosolized fraction accounted for <2% of that measured in the floor dust, suggesting that vacuuming could overestimate inhalation exposures. In contrast, the (1→3)-ß-d-glucan levels in the floor dust and aerosolized fractions were mostly comparable, and 25% of the homes showed aerosolizable levels even higher than the dust-borne levels. The seasonal patterns for endotoxin in dust and the aerosolizable fraction were different from those found for (1→3)-ß-d-glucan, reflecting the temperature and humidity effects on bacterial and fungal contamination. While the concentration of airborne endotoxin followed the same seasonal trend as endotoxin aerosolized from surfaces, no significant seasonal difference was identified for the concentrations of airborne (1→3)-ß-d-glucan and fungal spores. This was attributed to the difference in the particle size; smaller endotoxin-containing particles can remain airborne for longer time than larger fungal spores or (1→3)-ß-d-glucan-containing particles. It is also possible that fungal aerosolization in home environments did not reach its full potential. Detectable dust mite allergens were found only in dust samples, and more commonly in occupied homes. Levels of endotoxin, (1→3)-ß-d-glucan, and fungi in air had decreased during the two-year period following the flooding as compared to immediate measurements; however, the dust-borne endotoxin and (1→3)-ß-d-glucan levels remained elevated. No conclusive correlations were found between the three environmental monitoring methods. The findings support the use of multiple methods when assessing exposure to microbial contaminants.

Asunto(s)

Contaminación del Aire Interior/análisis , Antígenos Dermatofagoides/análisis , Endotoxinas/análisis , Exposición por Inhalación/análisis , Esporas Fúngicas/aislamiento & purificación , beta-Glucanos/análisis , Contaminación del Aire Interior/estadística & datos numéricos , Polvo/análisis , Monitoreo del Ambiente , Inundaciones , Vivienda/estadística & datos numéricos , Humedad , Exposición por Inhalación/estadística & datos numéricos , Nueva Orleans , Proteoglicanos , Medición de Riesgo , Estaciones del Año , Temperatura

RESUMEN

To examine risk for mycosis among persons with silicosis, we examined US mortality data for 1979-2004. Persons with silicosis were more likely to die with pulmonary mycosis than were those without pneumoconiosis or those with more common pneumoconioses. Health professionals should consider enhanced risk for mycosis for silica-exposed patients.

Asunto(s)

Enfermedades Pulmonares Fúngicas/mortalidad , Silicosis/mortalidad , Asbestosis/complicaciones , Asbestosis/mortalidad , Humanos , Enfermedades Pulmonares Fúngicas/complicaciones , Neumoconiosis/complicaciones , Neumoconiosis/mortalidad , Silicosis/complicaciones , Estados Unidos/epidemiología

RESUMEN

BACKGROUND: Exposure to mold has been associated with exacerbation of asthma symptoms in children. OBJECTIVE: To report how the presence of visible mold and exposure to (1-3)-beta-D-glucan in infancy affects the risk of asthma at the age of 3 years as defined by an Asthma Predictive Index (API). METHODS: Visible mold was evaluated by means of home inspection. (1-3)-beta-D-glucan levels were measured in settled dust. Children were considered to be at high risk for asthma at later ages if they reported recurrent wheezing at the age of 3 years and met at least 1 of 3 major or 2 of 3 minor API criteria. RESULTS: Children aged 3 years with high visible mold in the home during infancy were 7 times more likely to have a positive API than were those with no visible mold (adjusted odds ratio [aOR], 7.1; 95% confidence interval [CI], 2.2-12.6). In contrast, at low (1-3)-beta-D-glucan levels (< 22 microg/g), children were at increased risk of a positive API (aOR, 3.4; 95% CI, 0.5-23.5), whereas those with high (1-3)-beta-D-glucan levels (> 133 microg/g) were at decreased risk (aOR, 0.6; 95% CI, 0.2-1.6). Of the other covariates, mother's smoking was the strongest significant risk factor for the future development of asthma based on a positive API (aOR, 4.4; 95% CI, 1.7-11.6). CONCLUSIONS: The presence of high visible mold and mother's smoking during infancy were the strongest risk factors for a positive API at the age of 3 years, suggesting an increased risk of asthma. High (1-3)-beta-D-glucan exposure seems to have an opposite effect on API than does visible mold.

Asunto(s)

Alérgenos/inmunología , Asma/inmunología , Hongos/inmunología , Ruidos Respiratorios/inmunología , Asma/etiología , Preescolar , Femenino , Humanos , Lactante , Masculino , Ruidos Respiratorios/etiología , Factores de Riesgo

RESUMEN

Traditional and modern techniques for bioaerosol enumeration were used to evaluate the relative efficiency of gaseous chlorine dioxide (ClO2) in reducing the indoor microbial contamination under field and laboratory conditions. The field study was performed in a highly microbially contaminated house, which had had an undetected roof leak for an extended period of time and exhibited large areas of visible microbial growth. Air concentrations of culturable fungi and bacteria, total fungi determined by microscopic count and polymerase chain reaction (PCR) assays, endotoxin, and (1 --> 3)-beta-D-glucan were determined before and after the house was tented and treated with ClO2. The laboratory study was designed to evaluate the efficiency of ClO2 treatment against known concentrations of spores of Aspergillus versicolor and Stachybotrys chartarum on filter paper (surrogate for surface treatment). These species are commonly found in damp indoor environments and were detected in the field study. Upon analysis of the environmental data from the treated house, it was found that the culturable bacteria and fungi as well as total count of fungi (as determined by microscopic count and PCR) were decreased at least 85% after the ClO2 application. However, microscopic analyses of tape samples collected from surfaces after treatment showed that the fungal structures were still present on surfaces. There was no statistically significant change in airborne endotoxin and (1 --> 3)-beta-D-glucan concentration in the field study. The laboratory study supported these results and showed a nonsignificant increase in the concentration of (1 --> 3)-beta-D-glucan after ClO2 treatment.

Asunto(s)

Microbiología del Aire , Compuestos de Cloro/farmacología , Desinfectantes/farmacología , Óxidos/farmacología , Aerosoles , Recuento de Colonia Microbiana , Gases , Esporas Fúngicas/efectos de los fármacos

RESUMEN

The results of a traditional visual mold inspection were compared to a mold evaluation based on the Relative Moldiness Index (RMI). The RMI is calculated from mold-specific quantitative PCR (MSQPCR) measurements of the concentration of 36 species of molds in floor dust samples. These two prospective mold evaluations were used to classify the mold condition in 271 homes of infants. Later, the development of respiratory illness was measured in the infants living in these homes and the predictive value of each classification system was evaluated. The binary classification of homes as either moldy or non-moldy by on-site visual home inspection was not predictive of the development of respiratory illness (wheeze and/or rhinitis) (P=0.27). Conversely, a method developed and validated in this paper, using the RMI index fit to a logistic function, can be used to predict the occurrence of illness in homes and allows stake-holders the choice among various levels of risk.

Asunto(s)

Hongos , Enfermedades Respiratorias/microbiología , Hongos/clasificación , Hongos/patogenicidad , Humanos , Lactante , Reacción en Cadena de la Polimerasa