RESUMEN
INTRODUCCIÓN: La Fibrosis Pulmonar Idiopática (FPI) es una de las enfermedades respiratorias crónicas del adulto de mayor impacto y letalidad, diversos estudios epidemiológicos muestran tendencias progresivas al aumento de las tasas de mortalidad por FPI. En Chile no existen reportes sobre las tendencias de las tasas de mortalidad por FPI. El objetivo del presente estudio es determinar las tendencias de la mortalidad por FPI en Chile entre los años 2002 y 2015. MÉTODO: Estudio descriptivo de diseño ecológico, a partir de la información de bases de datos secundarias de libre disposición de las estadísticas vitales del Departamento de Estadísticas e Información de Salud (DEIS) y del Instituto Nacional de Estadísticas (INE) de Ministerio de Salud de Chile entre los años 2002 y 2015 se obtuvieron las tasas crudas de mortalidad por fibrosis pulmonar idiopática en población de 45 años y más en ambos sexos y las tasas ajustadas por sexo y edad por regiones, se calculó también la frecuencia mensual de las muertes por FPI y se compararon las tasas medias de mortalidad por regiones. RESULTADOS: Se observó un incremento progresivo de la tasa nacional cruda de mortalidad por FPI entre los años 2002 a 2015, la que fue de 18,5 fallecidos por 100.000 habitantes en el año 2002 hasta 24,6 fallecidos por 100.000 habitantes en el año 2015 con una pendiente de ascenso por año de +0,27 por 100.000 habitantes (p = 0,013). En las mujeres las tasas fueron más altas que en los hombres, pero las pendientes de ascenso no presentaron diferencias entre sexos. En la gran mayoría de las regiones las tasas ajustadas presentaron tendencias significativas al ascenso y las tasas medias más altas se presentaron en las regiones del norte de Chile. Se observó un comportamiento estacional de las muertes siendo las frecuencias más altas en los meses de invierno. CONCLUSIONES: Las tasas de mortalidad por FPI en Chile presentan una tendencia progresiva al aumento, con marcadas diferencias regionales lo que lleva a considerar, entre otros factores, influencia ambiental y contaminación del aire y de suelos que se debieran investigar para poder realizar intervenciones de salud pública que permitan reducir la mortalidad de esta enfermedad en nuestro país.
BACKGROUND: Idiopathic Pulmonary Fibrosis (IPF) is one of the chronic respiratory diseases in adults with the greatest impact and high case fatality rate. Various epidemiological studies show progressive trends towards increasing IPF mortality rates. In Chile there are no national reports on country and regional trends in IPF mortality rates. The objective of this study is to determine trends in mortality due to IPF in Chile from year 2002 to 2015. METHOD: Epidemiological study of ecological design based on information from public databases of vital statistics of the Department of Health Statistics and Information (DEIS) and the National Institute of Statistics (INE) of the Ministry of Health of Chile. Crude mortality rates due to IPF in the population aged 45 years and over in both sexes were obtained from years 2002 to 2015. Besides the adjusted mortality rates for sex and age by region, the monthly frequency of IPF deaths during the same period and the average mortality rates by Chilean regions were calculated. RESULTS: A progressive increasing trend in the crude national IPF mortality rate was observed between years 2002 to 2015, which went from 18.5 deaths per 100,000 inhabitants in 2002 to 24.6 deaths per 100,000 inhabitants in 2015 with a slope of ascent per year of +0.27 per 100,000 inhabitants (p = 0.013); female rates were higher than men rates, but without differences in the slopes between sexes; in the vast majority of the regions the rates showed significant upward trends with the higher ones in the northern regions of Chile. A seasonal behavior of the death's frequency was observed being the highest in the winter term. CONCLUSIONS: Mortality rates due to IPF in Chile show a progressive upward trend, with marked regional differences which leads to consider, among other factors, environmental influence and air and soil contamination that should be investigated to carry out public health interventions that allow reducing the mortality of this disease in our country.
Asunto(s)
Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Fibrosis Pulmonar Idiopática/mortalidad , Estaciones del Año , Chile/epidemiología , Epidemiología Descriptiva , Estadísticas Vitales , Mortalidad/tendencias , Distribución por Sexo , Estudios EcológicosRESUMEN
INTRODUCTION: With seven million inhabitants, Santiago de Chile reaches high levels of air pollution in winter, the particulate matter usually exceeds WHO standards. OBJECTIVE: To assess the influence of air pollution caused by particulate matter on children's hospitalizations due to respiratory diseases between 2001 and 2005 in the Metropolitan Region of Chile, independently from the environmental presence of respiratory syncytial virus (RSV). MATERIAL AND METHOD: 72,479 public and private hospitalizations due to respiratory diseases of children under 15 years of age residing in the study region were analyzed using a time-stratified alternating case-control design. The main evaluations were: hospitalizations due to respiratory diseases (J00-J99), pneumonia (J12-J18); asthma (J21.0 - J21.9), and bronchiolitis (J45 - J46). Daily compilation of temperature data, PM10, PM2.5, ozone, respiratory virus (RSV), and environmental humidity. RESULTS: Mean values of PM10 and PM2,5 were 81.5 and 41.2 pg/m3 respec tively. The average temperature was 12.8 °C and air humidity 72.6%. An increase of 10 pg/m3 of PM25 with one and two days of lag was associated with an hospitalizations increase due to respiratory diseases close to 2%, this percentage increased to 5% when the exposure was with eight days of lag, reflecting synergism between particulate matter and respiratory viruses (RSV). CONCLUSION: Short air pollution exposure can lead to children's hospitalizations due to respiratory diseases.
Asunto(s)
Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Hospitalización/estadística & datos numéricos , Material Particulado/toxicidad , Enfermedades Respiratorias/etiología , Adolescente , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Contaminación del Aire/estadística & datos numéricos , Niño , Preescolar , Chile/epidemiología , Estudios Cruzados , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Material Particulado/análisis , Enfermedades Respiratorias/diagnóstico , Enfermedades Respiratorias/epidemiología , Factores de RiesgoRESUMEN
INTRODUCCIÓN: Santiago de Chile con 7 millones de habitantes alcanza elevados niveles de contaminación atmosférica en invierno, el material particulado habitualmente excede los estándares de la OMS. OBJETIVO: Evaluar la influencia de la contaminación atmosférica por material particulado en las hospitalizaciones por enfermedades respiratorias en niños, entre 2001 y 2005 en la Región Metropolitana de Chile, independientemente de la presencia ambiental de virus sincicial respiratorio (VRS). MATERIAL Y MÉTODO: 72.479 hospitalizaciones públicas y privadas por enfermedades respiratorias de niños menores de 15 años residentes en la región del estudio se analizaron con un diseño de caso control alternante, con estratificación temporal. Se evaluó principalmente: hospitalizaciones por enfermedades respiratorias (J00-J99), neumonía (J12-J18); asma (J21.0 - J21.9) y bronquiolitis (J45 - J46). Recopilándose diariamente temperatura, MP10, MP2,5, ozono, virus respiratorios (VRS) y humedad ambientales. RESULTADOS: Los promedios de MP10 y MP2,5 fueron 81,5 y 41,2 pg/m3 respectivamente. El promedio de temperatura fue 12,8 °C y de la humedad del aire 72,6 %. Un aumento de 10 pg/m3 de MP25 con 1 y 2 días de rezago se asoció con un incremento de las hospitalizaciones por enfermedades respiratorias cercano a 2%, este porcentaje aumentó a 5% cuando la exposición fue con 8 días de rezago, reflejando sinergismo entre material particulado y virus respiratorio (VRS). CONCLUSIÓN: La exposición breve a contaminación atmosférica puede provocar hospitalizaciones por enfermedades respiratorias en niños.
INTRODUCTION: With seven million inhabitants, Santiago de Chile reaches high levels of air pollution in winter, the particulate matter usually exceeds WHO standards. OBJECTIVE: To assess the influence of air pollution caused by particulate matter on children's hospitalizations due to respiratory diseases between 2001 and 2005 in the Metropolitan Region of Chile, independently from the environmental presence of respiratory syncytial virus (RSV). MATERIAL AND METHOD: 72,479 public and private hospitalizations due to respiratory diseases of children under 15 years of age residing in the study region were analyzed using a time-stratified alternating case-control design. The main evaluations were: hospitalizations due to respiratory diseases (J00-J99), pneumonia (J12-J18); asthma (J21.0 - J21.9), and bronchiolitis (J45 - J46). Daily compilation of temperature data, PM10, PM2,5, ozone, respiratory virus (RSV), and environmental humidity. RESULTS: Mean values of PM10 and PM2.5 were 81.5 and 41.2 pg/m3 respec tively. The average temperature was 12.8 °C and air humidity 72.6%. An increase of 10 pg/m3 of PM25 with one and two days of lag was associated with an hospitalizations increase due to respiratory diseases close to 2%, this percentage increased to 5% when the exposure was with eight days of lag, reflecting synergism between particulate matter and respiratory viruses (RSV). CONCLUSION: Short air pollution exposure can lead to children's hospitalizations due to respiratory diseases.
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Enfermedades Respiratorias/etiología , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Material Particulado/toxicidad , Hospitalización/estadística & datos numéricos , Enfermedades Respiratorias/diagnóstico , Enfermedades Respiratorias/epidemiología , Modelos Logísticos , Chile/epidemiología , Factores de Riesgo , Estudios Cruzados , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Contaminación del Aire/estadística & datos numéricos , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Material Particulado/análisisRESUMEN
Cerebrovascular accidents, or strokes, are the second leading cause of mortality and the leading cause of morbidity in both Chile and the rest of the world. However, the relationship between particulate matter pollution and strokes is not well characterized. The association between fine particle concentration and stroke admissions was studied. Data on hospital admissions due to cerebrovascular accidents were collected from the Ministry of Health. Air quality and meteorological data were taken from the Air Quality database of the Santiago Metropolitan Area. Santiago reported 33,624 stroke admissions between January 1, 2002 and December 30, 2006. PM2.5 concentration was markedly seasonal, increasing during the winter. This study found an association between PM2.5 exposure and hospital admissions for stroke; for every PM2.5 concentration increase of 10 µg m(-3), the risk of emergency hospital admissions for cerebrovascular causes increased by 1.29% (95% CI 0.552%-2.03%).
Asunto(s)
Contaminantes Atmosféricos/análisis , Enfermedades Cardiovasculares/epidemiología , Material Particulado/análisis , Contaminación del Aire/estadística & datos numéricos , Chile/epidemiología , Exposición a Riesgos Ambientales/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Estaciones del AñoRESUMEN
One of the main challenges in environmental management is to prevent the public health impact of projects that can cause pollution. To tackle this problem, the new Chilean bill on environmental management has defined the need to determine the potential health risks of a given Project. This paper gives a summary of the method used for risk evaluation and its evolution. Its incorporation in the Environmental Impact Evaluation System is proposed, to guarantee an effective prevention of the potential risks on health of new projects.
Asunto(s)
Humanos , Contaminantes Atmosféricos/toxicidad , Exposición a Riesgos Ambientales/prevención & control , Salud Ambiental/métodos , Chile , Salud Ambiental/legislación & jurisprudencia , Medición de Riesgo/métodosRESUMEN
One of the main challenges in environmental management is to prevent the public health impact of projects that can cause pollution. To tackle this problem, the new Chilean bill on environmental management has defined the need to determine the potential health risks of a given Project. This paper gives a summary of the method used for risk evaluation and its evolution. Its incorporation in the Environmental Impact Evaluation System is proposed, to guarantee an effective prevention of the potential risks on health of new projects.
Asunto(s)
Contaminantes Atmosféricos/toxicidad , Exposición a Riesgos Ambientales/prevención & control , Salud Ambiental/métodos , Chile , Salud Ambiental/legislación & jurisprudencia , Humanos , Medición de Riesgo/métodosRESUMEN
BACKGROUND: An inadequate management of hospital waste, that have toxic, infectious and chemical wastes, is a risk factor for humans and environment. AIM: To identify, quantify and assess the risk associated to the management of hospital residues. MATERIAL AND METHODS: A cross sectional assessment of the generation of hazardous waste from a hospital, between June and August 2005, was performed. The environmental risk associated to the management of non-radioactive hospital waste was assessed and the main problems related to solid waste were identified. RESULTS: The rate of generation of hazardous non-radioactive waste was 1.35 tons per months or 0.7 kg/bed/day. Twenty five percent of hazardous liquid waste were drained directly to the sewage system. The drug preparation unit of the pharmacy had the higher environmental risk associated to the generation of hazardous waste. The internal transport of hazardous waste had a high risk due to the lack of trip planning. The lack of training of personnel dealing with these waste was another risk factor. CONCLUSIONS: Considering that an adequate management of hospital waste should minimize risks for patients, the hospital that was evaluated lacks an integral management system for its waste.
Asunto(s)
Contaminación Ambiental , Residuos Peligrosos , Eliminación de Residuos Sanitarios , Estudios Transversales , Residuos Peligrosos/clasificación , Humanos , Medición de Riesgo , Medidas de Seguridad , Transportes , Administración de ResiduosRESUMEN
Background: An inadequate management of hospital waste, that have toxic, infectious and chemical wastes, is a risk factor for humans and environment. Aim To identify, quantify and assess the risk associated to the management of hospital residues. Material and methods: A cross sectional assessment of the generation of hazardous waste from a hospital, between June and August 2005, was performed. The environmental risk associated to the management of non-radioactive hospital waste was assessed and the main problems related to solid waste were identified. Results: The rate of generation of hazardous non-radioactive waste was 1.35 tons per months or 0.7 kg/bed/day. Twenty five percent of hazardous liquid waste were drained directly to the sewage system. The drug preparation unit of the pharmacy had the higher environmental risk associated to the generation of hazardous waste. The internal transport of hazardous waste had a high risk due to the lack of trip planning. The lack of training of personnel dealing with these waste was another risk factor. Conclusions: Considering that an adequate management of hospital waste should minimize risks for patients, the hospital that was evaluated lacks an integral management system for its waste.
Asunto(s)
Humanos , Contaminación Ambiental , Residuos Peligrosos , Eliminación de Residuos Sanitarios , Estudios Transversales , Residuos Peligrosos/clasificación , Medición de Riesgo , Medidas de Seguridad , Transportes , Administración de ResiduosRESUMEN
Las normas primarias de calidad del aire tienen por finalidad proteger la salud de la población de la contaminación atmosférica. Ellas establecen un nivel de riesgo socialmente aceptado. Este artículo describe los antecedentes considerados durante el proceso de actualización de la regulación vigente en Chile. Detalla conceptos sobre la calidad del aire, describe los efectos en la salud de los contaminates, y el procedimiento seguido para fijar los nuevos estándares Finaliza enumerando la norma primaria de calidad de aire, sus valores y los límites definidos para ser considerados en el ámbito de la gestión de los episodios críticos o de alta contaminación
Asunto(s)
Humanos , Normas de Calidad del Aire , Contaminación del Aire/estadística & datos numéricos , Contaminantes Atmosféricos , Chile , Contaminación del Aire/prevención & control , Factores de RiesgoRESUMEN
The aim of this work was to study the prevalence, behavior and opinions towards smoking in a sample of 288 physicians from Santiago, stratified according to sex and specialty. The WHO Europe questionnaire was applied and smoker was defined as the person that consumed one or more cigarettes per day. Thirty six percent of the sample (40.2 percent of men and 23.8 percent of women) smoked an average of 9 cigarettes per day, compared to the figure of 28.3 percent obtained in a similar study in 1983. Fifty percent of smokers felt that they will not quit. No differences in knowledge about problems associated to smoking or forbidding smoking in hospitals, were observed between smokers and non-smokers. A majority of smokers did not smoke in front of their patients and did not allow smoking in their private clinics. It is concluded that, although a high proportion of physicians continue to smoke, their opinions and behavior will support smoking cessation efforts