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El daño por plomo a la salud poblacional no es el saturnismo, sino la intoxicación crónica a dosis bajas. Aunque la máxima en toxicología de "a mayor dosis, mayor el efecto" aplica al plomo, enfocarse en prevenir exposiciones bajas o moderadas es más relevante para la salud pública. Esta es la paradoja de la prevención de la intoxicación con plomo: la gran mayoría de las personas tiene concentraciones relativamente bajas de plomo en sangre, pero al no haberse identificado un umbral por debajo del cual el plomo en sangre no dañe la salud, es en estos casos en donde más se concentra la carga total de la enfermedad atribuible al plomo. En México, la intoxicación con plomo ha sido una epidemia silenciosa: en 2019 resultó en la pérdida de más de 245 000 años de vida saludable.

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Diesel vehicles are significant contributors to air pollution in Mexico City. We estimate the costs and mortality benefits of retrofitting heavy-duty vehicles with particulate filters and oxidation catalysts. The feasibility and cost-effectiveness of controls differ by vehicle model-year and type. We evaluate 1985 to 2014 model-year vehicles from 10 vehicle classes and five model-year groups. Our analysis shows that retrofitting all vehicles with the control that maximizes expected net benefits for that vehicle type and model-year group has the potential to reduce emissions of primary fine particles (PM2.5 ) by 950 metric tons/year; cut the population-weighted annual mean concentration of PM2.5 in Mexico City by 0.90 µg/m3 ; reduce the annual number of deaths attributable to air pollution by over 80; and generate expected annual health benefits of close to 250 million US$. These benefits outweigh expected costs of 92 million US$ per year. Diesel retrofits are but one step that should viewed in the context of other efforts--such as development of an integrated public transportation system, promotion of the rational use of cars, reduction of emissions from industrial sources and fires, and redesign of the Mexico City Metropolitan Area to reduce urban sprawl--that must be analyzed and implemented to substantially control air pollution and protect public health. Even if considering other potential public health interventions, which would offer greater benefits at the same or lower costs, only by conducting, promoting, and publishing this sort of analyses, we can make strides to improve public health cost-effectively.

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BACKGROUND AND PURPOSE: Acute exposure to particulate matter with aerodynamic diameter <2.5 µm (PM2.5) is associated with acute cardiovascular and cerebrovascular mortality. The aim of this study was to evaluate these associations with specific causes of cardiovascular and cerebrovascular mortality in Mexico City. METHODS: We obtained daily mortality records for Mexico City from 2004 to 2013 for cardiovascular and cerebrovascular causes in people ≥25 and ≥65 years old. Exposure to PM2.5 was assessed with daily estimates from a new hybrid spatiotemporal model using satellite measurements of aerosol optical depth PM2.5 and compared to ground level PM2.5 measurements with missing data estimated with generalized additive models PM2.5. We fitted Poisson regression models with distributed lags for all mortality outcomes. RESULTS: An increase of 10 µg/m3 in aerosol optical depth PM2.5 was associated with increased cardiovascular (1.22%; 95% confidence interval, 0.17-2.28) and cerebrovascular mortality (3.43%; 95% confidence interval, 0.10-6.28) for lag days 0 to 1 (lag 0-1). Stronger effects were identified for hemorrhagic stroke and people ≥65 years. Associations were slightly smaller using generalized additive models PM2.5. CONCLUSIONS: These results support the evidence that acute exposure to PM2.5 is associated with increased risk of specific cardiovascular and cerebrovascular mortality causes.

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BACKGROUND: Observed seasonal differences in particulate matter (PM) associations with human health may be due to their composition and to toxicity-related seasonal interactions. OBJECTIVES: We assessed seasonality in PM composition and in vitro PM pro-inflammatory potential using multiple PM samples. METHODS: We collected 90 weekly PM10 and PM2.5 samples during the rainy-warm and dry-cold seasons in five urban areas with different pollution sources. The elements, polycyclic aromatic hydrocarbons (PAHs), and endotoxins identified in the samples were subjected to principal component analysis (PCA). We tested the potential of the PM to induce tumor necrosis factor alpha (TNFα) and interleukin 6 (IL-6) secretion in cultured human monocytes (THP-1), and we modeled pro-inflammatory responses using the component scores. RESULTS: PM composition varied by size and by season. PCA identified two main components that varied by season. Combustion-related constituents (e.g., vanadium, benzo[a]pyrene, benzo[a]anthracene) mainly comprised component 1 (C1). Soil-related constituents (e.g., endotoxins, silicon, aluminum) mainly comprised component 2 (C2). PM from the rainy-warm season was high in C2. PM (particularly PM2.5) from the dry-cold season was rich in C1. Elevated levels of cytokine production were associated with PM10 and C2 (rainy-warm season), whereas reduced levels of cytokine production were associated with PM2.5 and C1 (dry-cold season). TNFα secretion was increased following exposure to PM with high (vs. low) C2 content, but TNFα secretion in response to PM was decreased following exposure to samples containing ≥ 0.1% of C1-related PAHs, regardless of C2 content. The results of the IL-6 assays suggested more complex interactions between PM components and particle size. CONCLUSIONS: Variations in PM soil and PAH content underlie seasonal and PM size-related patterns in TNFα secretion. These results suggest that the mixture of components in PM explains some seasonal differences in associations between health outcomes and PM in epidemiologic studies. CITATION: Manzano-León N, Serrano-Lomelin J, Sánchez BN, Quintana-Belmares R, Vega E, Vázquez-López I, Rojas-Bracho L, López-Villegas MT, Vadillo-Ortega F, De Vizcaya-Ruiz A, Rosas Perez I, O'Neill MS, Osornio-Vargas AR. 2016. TNFα and IL-6 responses to particulate matter in vitro: variation according to PM size, season, and polycyclic aromatic hydrocarbon and soil content. Environ Health Perspect 124:406-412; http://dx.doi.org/10.1289/ehp.1409287.

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UNLABELLED: Geostatistical interpolation methods to estimate individual exposure to outdoor air pollutants can be used in pregnancy cohorts where personal exposure data are not collected. Our objectives were to a) develop four assessment methods (citywide average (CWA); nearest monitor (NM); inverse distance weighting (IDW); and ordinary Kriging (OK)), and b) compare daily metrics and cross-validations of interpolation models. We obtained 2008 hourly data from Mexico City's outdoor air monitoring network for PM10, PM2.5, O3, CO, NO2, and SO2 and constructed daily exposure metrics for 1,000 simulated individual locations across five populated geographic zones. Descriptive statistics from all methods were calculated for dry and wet seasons, and by zone. We also evaluated IDW and OK methods' ability to predict measured concentrations at monitors using cross validation and a coefficient of variation (COV). All methods were performed using SAS 9.3, except ordinary Kriging which was modeled using R's gstat package. Overall, mean concentrations and standard deviations were similar among the different methods for each pollutant. Correlations between methods were generally high (r=0.77 to 0.99). However, ranges of estimated concentrations determined by NM, IDW, and OK were wider than the ranges for CWA. Root mean square errors for OK were consistently equal to or lower than for the IDW method. OK standard errors varied considerably between pollutants and the computed COVs ranged from 0.46 (least error) for SO2 and PM10 to 3.91 (most error) for PM2.5. OK predicted concentrations measured at the monitors better than IDW and NM. Given the similarity in results for the exposure methods, OK is preferred because this method alone provides predicted standard errors which can be incorporated in statistical models. The daily estimated exposures calculated using these different exposure methods provide flexibility to evaluate multiple windows of exposure during pregnancy, not just trimester or pregnancy-long exposures. IMPLICATIONS: Many studies evaluating associations between outdoor air pollution and adverse pregnancy outcomes rely on outdoor air pollution monitoring data linked to information gathered from large birth registries, and often lack residence location information needed to estimate individual exposure. This study simulated 1,000 residential locations to evaluate four air pollution exposure assessment methods, and describes possible exposure misclassification from using spatial averaging versus geostatistical interpolation models. An implication of this work is that policies to reduce air pollution and exposure among pregnant women based on epidemiologic literature should take into account possible error in estimates of effect when spatial averages alone are evaluated.

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Preterm birth is a public health issue of global significance, which may result in mortality during the perinatal period or may lead to major health and financial consequences due to lifelong impacts. Even though several risk factors for preterm birth have been identified, prevention efforts have failed to halt the increasing rates of preterm birth. Epidemiological studies have identified air pollution as an emerging potential risk factor for preterm birth. However, many studies were limited by study design and inadequate exposure assessment. Due to the ubiquitous nature of ambient air pollution and the potential public health significance of any role in causing preterm birth, a novel focus investigating possible causal mechanisms influenced by air pollution is therefore a global health priority. We hypothesize that air pollution may act together with other biological factors to induce systemic inflammation and influence the duration of pregnancy. Evaluation and testing of this hypothesis is currently being conducted in a prospective cohort study in Mexico City and will provide an understanding of the pathways that mediate the effects of air pollution on preterm birth. The important public health implication is that crucial steps in this mechanistic pathway can potentially be acted on early in pregnancy to reduce the risk of preterm birth.

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Spatial variation in particulate matter-related health and toxicological outcomes is partly due to its composition. We studied spatial variability in particle composition and induced cellular responses in Mexico City to complement an ongoing epidemiologic study. We measured elements, endotoxins, and polycyclic aromatic hydrocarbons in two particle size fractions collected in five sites. We compared the in vitro proinflammatory response of J774A.1 and THP-1 cells after exposure to particles, measuring subsequent TNFα and IL-6 secretion. Particle composition varied by site and size. Particle constituents were subjected to principal component analysis, identifying three components: C(1) (Si, Sr, Mg, Ca, Al, Fe, Mn, endotoxin), C(2) (polycyclic aromatic hydrocarbons), and C(3) (Zn, S, Sb, Ni, Cu, Pb). Induced TNFα levels were higher and more heterogeneous than IL-6 levels. Cytokines produced by both cell lines only correlated with C(1) , suggesting that constituents associated with soil induced the inflammatory response and explain observed spatial differences.

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Preterm birth is one of the leading causes of perinatal mortality and is associated with long-term adverse health consequences for surviving infants. Preterm birth rates are rising worldwide, and no effective means for prevention currently exists. Air pollution exposure may be a significant cause of prematurity, but many published studies lack the individual, clinical data needed to elucidate possible biological mechanisms mediating these epidemiological associations. This paper presents the design of a prospective study now underway to evaluate those mechanisms in a cohort of pregnant women residing in Mexico City. We address how air quality may act together with other factors to induce systemic inflammation and influence the duration of pregnancy. Data collection includes: biomarkers relevant to inflammation in cervico-vaginal exudate and peripheral blood, along with full clinical information, pro-inflammatory cytokine gene polymorphisms and air pollution data to evaluate spatial and temporal variability in air pollution exposure. Samples are collected on a monthly basis and participants are followed for the duration of pregnancy. The data will be used to evaluate whether ambient air pollution is associated with preterm birth, controlling for other risk factors. We will evaluate which time windows during pregnancy are most influential in the air pollution and preterm birth association. In addition, the epidemiological study will be complemented with a parallel toxicology invitro study, in which monocytic cells will be exposed to air particle samples to evaluate the expression of biomarkers of inflammation.

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BACKGROUND: Cooking with biomass fuels on open fires results in exposure to health-damaging pollutants such as carbon monoxide (CO), polycyclic aromatic hydrocarbons (PAHs), and particulate matter. OBJECTIVE: We compared CO exposures and urinary PAH biomarkers pre- and postintervention with an improved biomass stove, the Patsari stove. METHODS: In a subsample of 63 women participating in a randomized controlled trial in central Mexico, we measured personal CO exposure for 8 hr during the day using continuous monitors and passive samplers. In addition, first-morning urine samples obtained the next day were analyzed for monohydroxylated PAH metabolites by gas chromatography/isotope dilution/high-resolution mass spectrometry. Exposure data were collected during the use of an open fire (preintervention) and after installation of the improved stove (postintervention) for 47 women, enabling paired comparisons. RESULTS: Median pre- and postintervention values were 4 and 1 ppm for continuous personal CO and 3 and 1 ppm for passive sampler CO, respectively. Postintervention measurements indicated an average reduction of 42% for hydroxylated metabolites of naphthalene, fluorene, phenanthrene, and pyrene on a whole-weight concentration basis (micrograms per liter of urine), and a 34% reduction on a creatinine-adjusted basis (micrograms per gram of creatinine). Pre- and postintervention geometric mean values for 1-hydroxypyrene were 3.2 and 2.0 µg/g creatinine, respectively. CONCLUSION: Use of the Patsari stove significantly reduced CO and PAH exposures in women. However, levels of many PAH biomarkers remained higher than those reported among smokers.

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Compelling evidence indicates that exposure to urban airborne particulate matter (PM) affects health. However, how PM components interact with PM-size to cause adverse health effects needs elucidation, especially when considering soil and anthropogenic sources. We studied PM from Mexicali, Mexico, where soil particles contribute importantly to air pollution, expecting to differentiate in vitro effects related to PM-size and composition. PM samples with mean aerodynamic diameters ≤2.5µm (PM(2.5)) and ≤10µm (PM(10)) were collected in Mexicali (October 2005-March 2006) from a semi-urban (expected larger participation of soil sources) and an urban (predominately combustion sources) site. Samples were pooled by site and size, analyzed for elemental composition (particle-induced X-ray emission) and tested in vitro for: induction of human erythrocytes membrane disruption (hemolysis) (colorimetrically); inhibition of cell proliferation (ICP) (crystal violet) and TNFα/IL-6 secretion (ELISA) using J774.A1 murine monocytic cells; and DNA degradation using Balb/c3T3 cell naked DNA (electrophoretically). Results of PM elemental composition principal component analysis were used in associating cellular effects. Sixteen elements identified in PM grouped in two principal components: Component(1) (C(1)): Mg, Al, Si, P, Cl, K, Ca, Ti, V, Cr, Fe, and Component(2) (C(2)): Cu, Zn. Hemolysis was predominately induced by semi-urban-PM(10) (p<0.05) and was associated with urban-PM(10)C(1) (r=0.62, p=0.003). Major ICP resulted with semi-urban PM(2.5) (p<0.05). TNFα was mainly induced by urban samples regardless of size (p<0.05) and associated with urban-PM(2.5)C(2) (r=0.48, p=0.02). Both PM(10) samples induced highest DNA degradation (p<0.05), regardless of location. We conclude that PM-size and PM-related soil or anthropogenic elements trigger specific biological-response patterns.

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Cardiovascular diseases are the main cause of death in Mexico City and have shown a rising trend over the past 20 years. Various epidemiological studies have reported an association between respirable particles and carbon monoxide (CO), with cardiorespiratory outcomes. The purpose of this study was to assess the effect of particulate matter with aerodynamic diameters of less than 2.5 microm (PM(2.5)), also known as respirable or fine particles and CO on heart rate variability (HRV) in 5-min periods in patients with known ischemic heart disease. 30 patients were selected from the outpatient clinic of the National Institute of Cardiology of Mexico and followed during 11 h, using electrocardiography (ECG) ambulatory electrocardiograms and personal monitors for CO and PM(2.5). We calculated frequency-domain measurements using power spectral analysis and assessed the association with pollutants using mixed models analysis in 5-min periods. We found a decrease in HRV measured as high frequency (Ln) (coefficient=-0.008, 95% confidence interval (CI), -0.015, 0.0004) for each 10 microg/m(3) (micrograms per cubic meter) increase of personal PM(2.5) exposure. We also found a decrease of low (ln) (coefficient=-0.024, 95% CI, -0.041, -0.007) and very low frequencies (ln) (coefficient=-0.034, 95% CI, -0.061, -0.007) for 1 parts per million (p.p.m.) increase in CO personal exposure after adjustment for potential confounding factors. These results show that for this high-risk population, the alteration of the cardiac autonomic regulation was significantly associated with both PM(2.5) and CO personal exposures.

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An exposure study of children (aged 10-12 years) living in Santiago, Chile, was conducted. Personal, indoor and outdoor fine and inhalable particulate matter (< 2.5 .m in diameter, PM2.5 and < 10 microm in diameter, PM10, respectively), and nitrogen dioxide (NO2) were measured during pilot (N = 8) and main (N = 20) studies, which were conducted during the winters of 1998 and 1999, respectively. For the main study, personal, indoor and outdoor 24-h samples were collected for five consecutive days. Similar mean personal, indoor and outdoor PM2.5 concentrations (69.5, 68.5 and 68.1 microg/m3, respectively) were found. However, for coarse particles (calculated as the difference between measured PM10 and PM2.5, PM2.5-10), indoor and outdoor levels (35.4 and 47.4 microg/m3) were lower than their corresponding personal exposures (76.3 microg/m3). Indoor and outdoor NO2 concentrations were comparable (35.8 and 36.9 ppb) and higher than personal exposures (25.9 ppb). Very low ambient indoor and personal O3 levels were found, which were mostly below the method's limit of detection (LOD). Outdoor particles contributed significantly to indoor concentrations, with effective penetration efficiencies of 0.61 and 0.30 for PM2.5 and PM2.5-10, respectively. Personal exposures were strongly associated with indoor and outdoor concentrations for PM2.5, but weakly associated for PM2.5-10. For NO2, weak associations were obtained for indoor-outdoor and personal-outdoor relationships. This is probably a result of the presence of gas cooking stoves in all the homes. Median I/O, P/I and P/O ratios for PM2.5 were close to unity, and for NO2 they ranged between 0.64 and 0.95. These ratios were probably due to high ambient PM2.5 and NO2 levels in Santiago, which diminished the relative contribution of indoor sources and subjects' activities to indoor and personal PM2.5 and NO2 levels.

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La evaluación de exposición total permite conocer las distintas fuentes de exposición de cada individuo y es útil para el manejo clínico y ambiental. Con el propósito de elaborar un modelo de exposición integral a partículas inhalables, se efectuó un estudio transversal, en una muestra de 544 individuos, en la zona incluida en un diámetro de 3 Km de la estación Merced de la red de monitoreo ambiental de la ciudad de México. Se elaboró una encuesta de vivienda, un cuestionario de síntomas respiratorios y un diario de tiempo-actividad. Se estableció una estancia de monitoreo atmosférico extramuros y, para el monitoreo personal e intramuros, se adecuó nueva tecnología. Se identificó hasta un .38 de correlación entre las concentraciones de exposición. Las exposiciones en casa y de otras actividades extramuros son las más predictivas de exposición personal. De los inividuos, 8.8 por ciento tiene bronquitis crónica y esta cifra se incrementa con la mayor exposición y con deporte extramuros. Se concluye que estos modelos son pertinentes para la evaluación y el manejo de riesgos de enfermedades respiratorias en México

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En el presente trabajo se analizan las complejas relaciones que existen, en el caso concreto de México, entre población y medio ambiente. Para ello se echa mano de datos cuantitativos que provienen de instituciones gubernamentales y no gubernamentales y de las apreciaciones de un grupo de individuos con experiencia en el análisis de problemas ambientales. El estudio está organizado en capítulos que tratan diversos aspectos del tema. El primer capítulo delínea la problemática planteada por las relaciones entre población, medio ambiente y desarrollo, para lo cual se toma como marco de referencia al mundo en su totalidad. El segundo capítulo ofrece un perfil de la realidad demográfica de México, impresindible para poder establecer más adelante las interrelaciones con el medio ambiente y el desarrollo. En el capítulo tres se abordan, de manera regionalizada, las interrelaciones entre dos recursos naturales de gran importancia, el suelo y el agua, y la población. Los capítulos cuatro y cinco se refieren a las interrelaciones entre los procesos de industrialización y urbanización con el medio ambiente y los recursos naturales. Se hace especial referencia al desarrollo de la industria petrolera, por su importancia en la historia contemporánea de México. El capítulo seis es un análisis breve de las repercusiones que los cambios en el medio ambiente han tenido en la salud de la población. El siete es una síntesis de lo que se ha señalado a lo largo del libro. Finalmente, el capítulo ocho presenta algunas reflexiones que señalan las opciones para el futuro y las dificultades que se encuentran si se pretenden realizar acciones que modifiquen la realidad actual, mejoren la situación y eviten la aparición de nuevos problemas ambientales y poblacionales

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