RESUMO
The 2022 wildfires in New Mexico, United States, were unparalleled compared to past wildfires in the state in both their scale and intensity, resulting in poor air quality and a catastrophic loss of habitat and livelihood. Among all wildfires in New Mexico in 2022, six wildfires were selected for our study based on the size of the burn area and their proximity to populated areas. These fires accounted for approximately 90 % of the total burn area in New Mexico in 2022. We used a regional chemical transport model and data-fusion technique to quantify the contribution of these six wildfires (April 6 to August 22) on particulate matter (PM2.5: diameter ≤ 2.5 µm) and ozone (O3) concentrations, as well as the associated health impacts from short-term exposure. We estimated that these six wildfires emitted 152 thousand tons of PM2.5 and 287 thousand tons of volatile organic compounds to the atmosphere. We estimated that the average daily wildfire smoke PM2.5 across New Mexico was 0.3 µg/m3, though 1 h maximum exceeded 120 µg/m3 near Santa Fe. Average wildfire smoke maximum daily average 8-h O3 (MDA8-O3) contribution was 0.2 ppb during the study period over New Mexico. However, over the state 1 h maximum smoke O3 exceeded 60 ppb in some locations near Santa Fe. Estimated all-cause excess mortality attributable to short term exposure to wildfire PM2.5 and MDA8-O3 from these six wildfires were 18 (95 % Confidence Interval (CI), 15-21) and 4 (95 % CI: 3-6) deaths. Additionally, we estimate that wildfire PM2.5 was responsible for 171 (95 %: 124-217) excess cases of asthma emergency department visits. Our findings underscore the impact of wildfires on air quality and human health risks, which are anticipated to intensify with global warming, even as local anthropogenic emissions decline.
Assuntos
Poluição do Ar , Incêndios Florestais , Poluição do Ar/estatística & dados numéricos , New Mexico , Nível de Saúde , Incêndios Florestais/estatística & dados numéricos , Material Particulado/análise , Monitoramento Ambiental , Exposição por Inalação/estatística & dados numéricos , Modelos Estatísticos , Humanos , Mortalidade PrematuraRESUMO
OBJECTIVES: The aim of this study was to analyse the trends of avoidable mortality in Brazil from 1990 to 2019 and its correlation with sociodemographic indexes (SDIs). STUDY DESIGN: Epidemiological mortality trends. METHODS: This study analysed data from the Global Burden of Disease database. The list of causes of avoidable death, as proposed by Nolte and McKee, was applied and included 32 causes. The current study used age-standardised mortality rates and the rates of change, in addition to a correlation analysis between avoidable death and the SDI. RESULTS: Mortality rates decreased from 343.90/100,000 inhabitants in 1990 to 155.80/100,000 inhabitants in 2019. Infectious diseases showed the largest decline in mortality rates, but notable decreases were also found for diarrhoeal diseases (-94.9%), maternal conditions (-66.5%) and neonatal conditions (-60.5%). Mortality rates for non-communicable diseases (NCDs) also decreased (-48%) but maintained a similar absolute number of deaths in 2019 compared with 1990. Decreased mortality rates were also found for ischaemic heart disease (-49.1%), stroke (-61.4%) and deaths due to adverse effects caused by medical treatments (-26.2%). Avoidable mortality rates declined in all of the 27 Brazilian states, and a high correlation was found between deaths and SDI (R = -0.74; P < 0.000001). CONCLUSIONS: A reduction in avoidable deaths was found throughout Brazil over the study period, although major regional inequalities were revealed. Richer states presented the best overall reduction in mortality rates. The biggest decreases in mortality were seen in maternal and paediatric infectious diseases in the poorest states due to the expansion of the Primary Health System and improvements in sanitation. Today, NCDs predominate and efforts should be made to formulate public policies for the prevention and control of NCDs.
Assuntos
Doenças Transmissíveis , Doenças não Transmissíveis , Criança , Recém-Nascido , Humanos , Causas de Morte , Brasil/epidemiologia , Carga Global da Doença , Saúde Global , MortalidadeRESUMO
Hairdresser is an occupation classified by the International Agency for Research on Cancer as probably carcinogenic (Group 2A) for lung and bladder cancer, but evidence is accumulating on its association with other cancer types. To our knowledge, this is the first study aimed to compare the cancer mortality and premature mortality between hairdressers and other workers in Brazil. METHODS: In this exploratory study, information on deaths by selected cancers that occurred in Brazil, from 1996 to 2020, among workers aged 20-70y, with identified occupation was gathered from the Brazilian Mortality Information System. Sociodemographic characteristics, sex-specific mortality ratio, and Years of Potential Life Lost (YPLL) were compared between hairdressers, service workers, and general workers. We used logistic regression models to estimate crude (ORC) and adjusted (ORADJ) odds ratios. Models were adjusted by age, educational level, and ethnicity. We also used Poisson regression models to compare the YPLL rates across the occupational groups. RESULTS: From 1996 to 2020, 23 557 deaths occurred among hairdressers, 576 428 among service workers, and 13 332 996 among general workers in Brazil. Higher mortality ORs and YPLL were observed for several types of cancer among hairdressers, compared to service and general workers, especially for women. Hairdressers' mortality was significantly higher among whites, women, younger workers, and those who completed high school. Female hairdressers had significantly higher odds of dying from cancer of the digestive, respiratory, reproductive, urinary, and hematological systems, both in crude and adjusted models. For male hairdressers, higher odds were found only for urinary tract and bladder cancer, while other significant associations indicated lower mortality than the comparison groups. YPLL analyses revealed significant premature deaths among Brazilian hairdressers. In women, this was more evident among those who died of neoplasms of salivary glands, bones and articular cartilages, and acute lymphoid leukemia; in men, tongue, pharynx, and thyroid. CONCLUSIONS: Our results suggest that Brazilian female hairdressers are more likely to die from several cancers, with potential consequences on premature deaths. Causal associations to occupational risks, such as exposure to chemicals, should be investigated by observational epidemiologic studies. Meanwhile, it is important to promote public policies, regulations, and Occupational Safety and Health (OSH) strategies to protect hairdressers' health, mitigate occupational risks, and ensure safe workplaces.
Assuntos
Exposição Ocupacional , Neoplasias da Bexiga Urinária , Humanos , Masculino , Feminino , Mortalidade Prematura , Brasil/epidemiologia , Carcinógenos , Modelos Logísticos , Exposição Ocupacional/efeitos adversosRESUMO
We discuss premature deaths due to coronary heart disease (CHD) in developing countries and the importance of a comprehensive approach, involving clinical judgement, prevention, appropriate use of technology to diagnose and guide CHD treatment. Healthcare policies and levels of knowledge vary tremendously resulting heterogeneous utilization of diagnostic strategies and treatments worldwide. Many countries with high mortality have low utilization of non-invasive cardiac imaging. Appropriate use coupled with guideline-based management could help to improve care in the developing world and potentially result in better life expectancy already experienced by most high-income countries. In a scenario of increasing costs, a rational utilization of resources is imperative for all nations. A stepwise approach to suspected CHD is necessary, starting from good judgement, adding tests only as needed, preferably filtering patients who might benefit from advanced imaging. In stable patients, non-invasive tests should be used as filters to invasive procedure, preventing stable patients from undergoing revascularizations of questionable benefit. In this article, we review the relative role of exercise testing, myocardial perfusion imaging, and coronary computed tomography angiography to evaluate CHD and how these can be utilized as ways to help guide management that could impact premature mortality in developing nations.
Assuntos
Técnicas de Imagem Cardíaca , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Países em Desenvolvimento , Doenças Cardiovasculares/diagnóstico por imagem , Teste de Esforço , Humanos , Mortalidade PrematuraRESUMO
The document details the strategic objectives of the Ministry and includes financial statements, estimates of expenditure for the period under review. It features a special report on the National Health Information System.
Assuntos
Saúde Pública , Atenção à Saúde , Políticas, Planejamento e Administração em Saúde , Administração em SaúdeRESUMO
The document details the strategic objectives of the Ministry and includes financial statements , estimates of expenditure for the period 2012 - 2013. It features a special report on the National HIV Programme (NHP) Integrated into National Family Planning Board (NFPB) - Sexual Reproductive Health Authority. It also includes achievements of selected programme areas of the Ministry for the period.
Assuntos
Saúde Pública , Atenção à Saúde , Políticas, Planejamento e Administração em Saúde , Administração em SaúdeRESUMO
The document details the strategic objectives of the Ministry and includes financial statements , estimates of expenditure for the period 2013 - 2014. It features a special report on the Public Health (Tobacco Control) Regulations. It also includes achievements in various programme areas for the period.
Assuntos
Políticas, Planejamento e Administração em Saúde , Saúde Pública , Administração de Serviços de Saúde , Atenção à SaúdeRESUMO
This document details the strategic objectives of the ministry. It also looks at the organizational structure and highlights the performance of the ministry.