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1.
BMC Med Educ ; 24(1): 1138, 2024 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-39402539

RESUMO

BACKGROUND: Identifying and recognizing environmental risk factors for childhood cancer is crucial to prevent it. Medical guild are the first contact to monitor children's health. Therefore, courses about the contribution of chemical toxins in the environment and health outcomes such as cancer should be included in their professional training. This study aimed to evaluate the perceptions and attitudes of a medical guild and undergraduate students in health sciences about the contribution of the environment to childhood cancer. METHODS: A pilot study was conducted, an online survey including thirteen questions was shared among medical guild members and undergraduate students in health sciences. Frequencies, percentages, and chi-square homogeneity tests were calculated to compare groups. RESULTS: Genetic factors ranked as the first possible cause of childhood cancer (88.2% medical guild and 97.7% undergraduate students). However, 70.6% of medical guild and 64.6% of undergraduate students reported that they have ever suspected that childhood cancer could be related to the environmental conditions in which children live. More than 95% of the participants reported that they would find it useful to have more knowledge about environmental risks and cancer. When data were analyzed by profession (medical guild) and academic year (undergraduate students), no significant differences were observed. Nonetheless, comparisons by academic discipline between undergraduate students, showed that a higher percentage of medicine and environmental sciences and health (over 98%) reported environmental exposure as risk factors associated with childhood cancer compared to 75% from physiotherapy, (p = 0.001). CONCLUSIONS: In this study, the environmental contribution to childhood cancer is not clear among the medical guild and undergraduate students. They should be trained on the topic of cancer and the environment.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias , Estudantes de Medicina , Humanos , Projetos Piloto , Masculino , Feminino , Estudantes de Medicina/psicologia , Criança , Adulto , Atitude do Pessoal de Saúde , Inquéritos e Questionários , Exposição Ambiental/efeitos adversos , Adulto Jovem , Fatores de Risco , Pessoa de Meia-Idade , Educação de Graduação em Medicina
2.
Environ Res ; 252(Pt 1): 118790, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38555983

RESUMO

BACKGROUND: Acute Lymphoblastic Leukemia (ALL) is the most prevalent neoplasia in children and teenagers in Mexico. Although epidemiological data supports that children's residence close to emissions from vehicular traffic or industrial processes increases the risk of ALL; and the IARC states that benzene, PAHs, and PM 2.5 are well-known environmental carcinogens, there is a gap in linking these carcinogenic hazards with the sources and their distribution from scenario perspective. AIM: To identify ALL clusters in the population under 19 years of age and characterize the environment at the neighborhood level by integrating information on sources of carcinogenic exposure using spatial analysis techniques in the Metropolitan Area of San Luis Potosi, Mexico. METHODS: Using the Kernel Density test, we designed an ecological study to identify ALL clusters from incident cases in the population under 19 years of age. A multicriteria analysis was conducted to characterize the risk at the community level from carcinogenic sources. A hierarchical cluster analysis was performed to characterize risk at the individual level based on carcinogenic source count within 1 km for each ALL case. RESULTS: Eight clusters of carcinogenic sources were located within the five identified ALL clusters. The multicriteria analysis showed high-risk areas (by density of carcinogenic source) within ALL clusters. CONCLUSIONS: This study has a limited source and amount of available data on ALL cases, so selection bias is present as well as the inability to rule out residual confounding factors, since covariates were not included. However, in this study, children living in environments with high vehicular density, gas stations, brick kilns, incinerators, commercial establishments burning biomass, or near industrial zones may be at higher risk for ALL.


Assuntos
Carcinógenos Ambientais , Leucemia-Linfoma Linfoblástico de Células Precursoras , México/epidemiologia , Humanos , Criança , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/induzido quimicamente , Pré-Escolar , Adolescente , Lactente , Carcinógenos Ambientais/toxicidade , Feminino , Masculino , Análise por Conglomerados , Exposição Ambiental/efeitos adversos , Recém-Nascido , Hidrocarbonetos Policíclicos Aromáticos/toxicidade , Hidrocarbonetos Policíclicos Aromáticos/análise , Características de Residência
3.
Front Oncol ; 13: 1236942, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37901312

RESUMO

Background: Acute lymphoblastic leukemia (ALL) etiology remains largely unknown; incidence patterns by age, sex, and geographical distribution suggest a potential environmental role. Aim: To identify ALL clusters from four contrasting urban areas of Mexico and to characterize the sources of environmental carcinogens. Methods: Hospital-based ALL cases (n = 443) diagnosed in children <19 years old from the Metropolitan Zones of Merida and San Luis Potosi, the State of Mexico, and Tijuana were analyzed (2015-2020). ALL cases were coded according to the International Classification of Diseases for Oncology. ALL clusters were identified by Kernel Density, and excess risk was estimated. Data of particulate matter ≤2.5 µm (PM2.5) concentrations measured by community-monitoring stations were analyzed. Geocoded datasets of benzene, polycyclic aromatic hydrocarbons, and PM2.5 sources were analyzed to characterize patterns of exposure in ALL clusters. Results: The survival rate for ALL ranged from 61.5% to 78.6%. Seven ALL clusters with excess risk (RR 1.4-2.3, p < 0.05) were identified. The carcinogen sources included artisanal brick kilns, gas stations, cement works, carpentry, paint, and chemical manufacturing establishments. PM2.5 levels ranged from 15 µg/m3 to 37 µg/m3 among study areas. Conclusion: ALL clusters were identified at the community level; the excess risk could be explained by small-scale carcinogen sources. The levels of PM2.5 in outdoor air ranged from 3 to 6 times above the World Health Organization (WHO) air quality guidelines. Healthcare providers must raise awareness of the increased risk of ALL in children living near sources of environmental carcinogens; cancer control and prevention strategies must be steered from a multi-sectoral and multi-action perspective to protect children's health.

4.
Int J Environ Health Res ; 32(6): 1304-1312, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33499674

RESUMO

To assess the relationship between urinary fluoride and micronutrients intake we recruited 121 schoolchildren from San Luis Potosí. We evaluated fluoride concentrations in drinking water and urine with the ion-selective electrode method and estimated calcium, magnesium, and phosphorus intakes with a validated consumption frequency questionnaire. About 72% of the population used tap water for drinking and cooking. Fluoride concentrations were 2.36 ± 0.02 mg/L in tap water, 0.14 ± 0.04 mg/L in bottled water and 2.05 ± 0.62 mg/L in urine. Urinary fluoride was higher in children with a consumption <50% of the Recommended Daily Intake (RDI) of calcium (2.20 v/s 1.96 mg/L; p < 0.05), <50% RDI of magnesium (2.58 v/s 1.96 and 1.90 mg/L; p < 0.05) and >150% RDI of phosphorus (2.43 v/s 1.82 mg/L; p < 0.05). These data indicated that fluoride concentration in tap water is higher than bottled water and estimated micronutrients intake is related to urinary fluoride.


Assuntos
Água Potável , Fluoretos , Cálcio , Criança , Água Potável/análise , Fluoretos/análise , Humanos , Magnésio , México/epidemiologia , Micronutrientes , Fósforo , Abastecimento de Água
5.
An Pediatr (Engl Ed) ; 90(6): 342-348, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-30660388

RESUMO

INTRODUCTION: Several studies have shown the presence of fluorosis (DF) in primary dentition, suggesting an exposure to fluorides (F-) in early childhood. Breast milk is recommended as an exclusive food until 6 months of age. Although it is mentioned that only a small amount of F- can be eliminated by breast milk, studies have shown the presence of this element in milk of women living in contaminated areas, as well as in infant formulas. The objective of this project was to evaluate the exposure level to F- through milk in children living in an area with endemic hydrofluorosis. METHODOLOGY: The study included 110 children between 6 and 36 months of age from the municipality of Lagos de Moreno, Jalisco. Water samples were collected from the homes, as well as samples of milk (maternal, formula, whole or raw), and urine. Measurments were made with a selective ion electrode. The exposure level of F- for milk intake was calculated using the Oracle Crystal Ball package. RESULTS: Levels greater than the reference level for DF were observed in infant formula reconstituted with public supply water, pasteurised cow's milk (whole) and untreated cow's milk treatment (raw) in the 90th, 70th, and 50th percentile, respectively, with a correlation being found between the levels of F- in milk and F- in urine (r=0.41, P<.001). CONCLUSIONS: The identification of sources of F- in the early stages of child development could reduce the risk of developing DF.


Assuntos
Exposição Ambiental/análise , Fluoretos/análise , Fórmulas Infantis/química , Leite Humano/química , Leite/química , Poluentes Químicos da Água/análise , Animais , Pré-Escolar , Humanos , Lactente , México
6.
Artigo em Espanhol | PAHO-IRIS | ID: phr-33831

RESUMO

Objetivos. Estimar la prevalencia de síntomas depresivos y de ansiedad (SDyA) en madres de tres zonas poblacionales (ZP) del estado de San Luis Potosí, México, y analizar la asociación entre los SDyA y sus efectos en la salud emocional de sus hijos. Métodos. Se evaluaron 173 parejas (madre-hijo) de tres ZP: Zona urbana (ZU), rural (ZR) y rural indígena (ZRI). Se estudiaron los SDyA de las mujeres, y las dificultades conductuales (DC) de los niños. Resultados. Se encontró una alta prevalencia de SDyA en las tres ZP. La mayor proporción de síntomas depresivos la presentaron la ZU y la ZR (38,7 y 38,6%). La prevalencia más alta de síntomas de ansiedad se observó en la ZR (31,8%). La asociación entre los SDyA y la depresión materna más fuerte se estimó en la ZR (razón de momios o RM = 11,0; IC95%: 1,3-95,5). En la ZRI se estimó la mayor prevalencia de DC en los niños (61%). Se encontró una asociación entre las DC y la ansiedad materna (RM = 2,2; IC95%: 1,1-4,3) y la depresión materna (RM = 2,5; IC95%: 1,3-4,6). Conclusiones. La salud mental de las madres puede poner en riesgo el bienestar socioemocional de sus hijos, lo que viene respaldado por la alta prevalencia y la asociación entre SDyA y DC encontrada. En México se necesita disponer de información fiable sobre el estado de salud mental de las mujeres y los niños de las tres ZP, para implantar medidas que amplíen su cobertura evaluativa y preventiva.


Objectives. To estimate the prevalence of symptoms of depression and anxiety in mothers from three population areas in the state of San Luis Potosí, Mexico, and to analyze the association between these symptoms and the emotional health of their children. Methods. Assessment was conducted on 173 mother–child pairs from three different population areas: urban, rural, and indigenous rural. Women's symptoms of depression and anxiety were evaluated, together with their children's behavioral problems. Results. A high prevalence of symptoms of depression and anxiety was found in the three areas included. The proportion of depressive symptoms was highest in the urban and rural areas (38.7% and 38.6%, respectively). The highest prevalence of anxiety symptoms was observed in the rural area (31.8%). The strongest association between maternal anxiety and maternal depression was found in the rural area (odds ratio [OR] = 11.0; 95% CI: 1.3-95.5). The indigenous rural area showed the highest prevalence of behavioral problems among children (61%). An association between such problems and maternal anxiety (OR = 2.2; 95% CI: 1.1-4.3) and maternal depression (OR = 2.5; 95% CI: 1.3-4.6) was noted. Conclusions. The mental health of mothers can put the social and emotional wellbeing of their children at risk. This conclusion is supported by the findings, namely high prevalences and an association between symptoms of anxiety and depression and behavioral problems. In Mexico, reliable information on the mental health status of women and children in the three population areas studied is needed in order to implement measures towards expanding coverage for evaluation and prevention.


Assuntos
Saúde Mental , Mulheres , Depressão , Ansiedade , Desenvolvimento Infantil , México , Saúde Mental , Mulheres , Depressão , Ansiedade , Desenvolvimento Infantil
7.
Int J Equity Health ; 15(1): 161, 2016 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-27681081

RESUMO

BACKGROUND: Worldwide, Cervical Cancer (CC) is the fourth most common type of cancer and cause of death in women. It is a significant public health problem, especially in low and middle-income/Gross Domestic Product (GDP) countries. In the past decade, several studies of CC have been published, that identify the main modifiable and non-modifiable CC risk factors for Mexican women. However, there are no studies that attempt to explain the residual spatial variation in CC incidence In Mexico, i.e. spatial variation that cannot be ascribed to known, spatially varying risk factors. METHODS: This paper uses a spatial statistical methodology that takes into account spatial variation in socio-economic factors and accessibility to health services, whilst allowing for residual, unexplained spatial variation in risk. To describe residual spatial variations in CC risk, we used generalised linear mixed models (GLMM) with both spatially structured and unstructured random effects, using a Bayesian approach to inference. RESULTS: The highest risk is concentrated in the southeast, where the Matlapa and Aquismón municipalities register excessive risk, with posterior probabilities greater than 0.8. The lack of coverage of Cervical Cancer-Screening Programme (CCSP) (RR 1.17, 95 % CI 1.12-1.22), Marginalisation Index (RR 1.05, 95 % CI 1.03-1.08), and lack of accessibility to health services (RR 1.01, 95 % CI 1.00-1.03) were significant covariates. CONCLUSIONS: There are substantial differences between municipalities, with high-risk areas mainly in low-resource areas lacking accessibility to health services for CC. Our results clearly indicate the presence of spatial patterns, and the relevance of the spatial analysis for public health intervention. Ignoring the spatial variability means to continue a public policy that does not tackle deficiencies in its national CCSP and to keep disadvantaging and disempowering Mexican women in regard to their health care.

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