RESUMO
BACKGROUND: Cases for chronic kidney disease of unknown etiology (CKDu) are increasing in specific disease hotspots located in rural agricultural communities over Central America. The goal of the study was to estimate the prevalence and geographic distribution of self-reported work-related CKD and associated risk factors for CKDu by industry sector in Central America. METHODS: We calculated the prevalence and distribution of self-reported CKD, work-related CKD, and suspected CKDu risk factors among the 9032 workers in the Second Central American Survey of Working Conditions and Health (II ECCTS, 2018). We mapped the distribution of suspected CKDu risk factors to work-related CKDu and weather conditions using average annual temperatures. RESULTS: The primary and secondary industry sectors showed the highest proportion of males, suspected CKDu risk factors, and work-related CKD. Age (30-49 years: OR = 2.38, 95% CI 1.03-5.51), ethnicity (mestizo: OR, 7.44, 95% CI: 2.14-25.82), and exposure to high physical work demands (OR = 2.45, 95% CI: 1.18-5.09) were associated with work-related CKD. The majority of work-related CKD were reported in the western parts of Honduras and Nicaragua, in hot temperature regions, and overlapped with those areas with a high density of CKDu risk factors. Finally, some areas clustered CKDu risk factors without any work-related CKD points, mainly in the western part of Guatemala. CONCLUSION: Our findings supplement prior CKDu findings regarding a high prevalence of work-related CKD among 30- to 49-year-old mestizo males in the primary and secondary sectors, in hot temperature areas, in the central and western region, and overlapping with persons reporting two or more CKDu risk factors. Moreover, several geographic areas with CKDu risk factor clusters had no reported work-related CKD. These areas represent new industries and sectors to be monitored for possible future increases of CKDu cases.
Assuntos
Insuficiência Renal Crônica , Masculino , Humanos , Adulto , Pessoa de Meia-Idade , Prevalência , Autorrelato , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/etiologia , Fatores de Risco , América Central/epidemiologia , Doenças Renais Crônicas Idiopáticas , Sri Lanka/epidemiologiaRESUMO
The objective of this work is to present the key elements in the design of emergency management and response plans in scenarios where there has been loss of containment of chemical agents of acute effect focused in the protection of not routinely exposed in a determined occupational environment. To this purpose, a validation of the current criteria for the management of accidental releases is carried out, taking into account hypothetical risk scenarios. The essential elements of the emergency management system are stated, from a systemic perspective and the corresponding risk control actions; recommendations for their implementation are showed, taking as prototype hydrogen sulfide, a highly toxic gas. Non controlled emissions of toxic gases of acute effect from an occupational standpoint represents a priority because of their human and financial high toll. Design and implementation of an appropriate emergency plan for uncontrollable emissions of toxics chemical agents must be addressed.
Assuntos
Gases/toxicidade , Exposição Ocupacional/prevenção & controle , Indústria de Petróleo e Gás , Gestão de Riscos/normas , Planejamento em Desastres/normas , Humanos , Sulfeto de Hidrogênio/toxicidade , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/normas , Fatores de TempoRESUMO
Given disproportionate burden of physical inactivity among US Hispanics and emerging interests in the potential role of the built environment on physical activity, we tested the hypothesis that residing in a more walkable block group is associated with increased physical activity in a cohort of Mexican-American adults. 10,183 Mexican-American adults from Houston, TX, USA were studied. Physical activity was assessed through self-report. Geographical information systems were used to create a "walkability index" (WI). We examined the relationship between WI and physical activity using regression models. Findings for the entire study population suggested a direct association between neighborhood walkability and physical activity that approached statistical significance (High WI vs. Low WI: OR = 1.16; 95% CI 0.95-1.40). Furthermore, participants who lived in a higher WI neighborhood were more likely to meet physical activity guidelines in 2 groups: (1) men whose recreational physical activity included walking (High WI vs. Low WI: OR = 5.43; 95% CI 1.30-22.73) and (2) men whose only recreational physical activity was (High WI vs. Low WI: OR = 9.54; 95% CI 1.84-49.60). Our findings suggest gender differences in the association between the built environment and physical activity in Mexican-American adults. Attempts to encourage walking among Mexican-American adults may be easier in high-walkability neighborhoods than in low-walkability neighborhoods.
Assuntos
Planejamento Ambiental , Americanos Mexicanos , Atividade Motora , Características de Residência , Adolescente , Adulto , Idoso , Feminino , Sistemas de Informação Geográfica , Humanos , Masculino , Pessoa de Meia-Idade , TexasRESUMO
There are limited data on exposures to ambient air toxics experienced by inhabitants of urban areas in developing countries that have high levels of outdoor air pollution. In particular, little is known about exposures experienced by individuals working outdoors - typically as part of the informal sector of the economy - as compared to workers in office-type environments that approach the indoor air quality conditions of the more developed countries. The objective of this study is to explore these differences in personal exposures using a convenience sample of 68 outdoor and indoor workers living in Mexico City (higher outdoor air pollution) and Puebla (lower outdoor air pollution), Mexico. Occupational and non-occupational exposures to airborne volatile organic compounds (VOCs) were monitored during a 2 day period, monitoring 2 consecutives occupational and non-occupational periods, using organic vapor monitors (OVMs). Socio-demographic and personal time-location-activity information were collected by means of questionnaires and activity logs. Outdoor workers experienced significantly higher exposures to most VOCs compared to indoor workers in each of these cities. The outdoor workers in Mexico City had the highest exposures both during- and off-work, with maximum occupational exposures for toluene, MTBE, n-pentane, and d-limonene exceeding 1 mg/m(3). The inter-city pattern of exposures between the outdoor workers is consistent with the higher outdoor air pollution levels in Mexico City, and is above exposures reported for urban areas of the more developed countries. Results from this study suggest that elevated outdoor air pollution concentrations have a larger impact on outdoor workers' personal exposures compared to the contribution from indoor pollution sources. This contrasts with the more dominant role of indoor air VOC contributions to personal exposures typically reported for urban populations of the more developed countries.