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A Call for Biomonitoring Systems in Latin America and the Caribbean: Considerations for Potentially Toxic Metals/ Metalloids
(Ubiquity Press, 2022) Tamayo-Ortiz, Marcela; Riojas-Rodríguez, Horacio; Téllez-Rojo, Marta M.; Boischio, Ana; Mañay, Nelly; Menezes-Filho, José Antonio; Queirolo, Elena I.; Cortés Arancibia, Sandra Isabel; Kordas, Katarzyna; CEDEUS (Chile)
The Latin America and the Caribbean (LAC) region makes up 8.4% of the world’s population. Human biomonitoring (HBM) programs, which can shed light on populationlevel exposure to environmental contaminants such as toxic metals and thus, improve the health of the populations are inexistent in LAC countries. We call for the creation of HBM programs in the region and identify three viable design options for HBM at the individual level, through national surveys, newborn blood collection, and biobanks. We highlight some of challenges to the implementation of HBM programs, including financial and human resources, technical constrains (laboratory), sample, and data logistics. Finally, we provide the case studies of Brazil, Chile, Mexico, and Uruguay, to illustrate a range of responses to toxic metal exposure in non-occupational populations. Although different in many respects, the individual country responses share two commonalities: 1) academic centers drive the research to raise awareness of governmental entities; 2) reference levels are adapted from international norms rather than arising from the studied populations. Well-designed and sufficiently funded biomonitoring systems need to be established in each country of the LAC region. HBM programs are key to promoting human health by informing the public and contributing to policy processes that establish sustainable environmental controls and health prevention programs.
A new methodology for source apportionment of gaseous industrial emissions
(2023) Jorquera, Héctor; Villalobos, Ana María; CEDEUS (Chile)
Air quality modeling (AQM) is often used to investigate gaseous pollution around industrial zones. However, this methodology requires accurate emission inventories, unbiased AQM algorithms and realistic boundary conditions. We introduce a new methodology for source apportionment of industrial gaseous emissions, which is based on a fuzzy clustering of ambient concentrations, along with a standard AQM approach. First, by applying fuzzy clustering, ambient concentration is expressed as a sum of non-negative contributions — each corresponding to a specific spatiotemporal pattern (STP); we denote this method as FUSTA (FUzzy SpatioTemporal Apportionment). Second, AQM of the major industrial emissions in the study zone generates another set of STP. By comparing both STP sets, all major source contributions resolved by FUSTA are identified, so a source apportionment is achieved. The uncertainty in FUSTA results may be estimated by comparing results for different numbers of clusters. We have applied FUSTA in an industrial zone in central Chile, obtaining the contributions from major sources of ambient SO2: a thermal power plant complex and a copper smelter, and other contributions from local and regional sources (outside the AQM domain). The methodology also identifies SO2 episodes associated to emissions from the copper smelter.
Air Pollution and Cardiorespiratory Changes in Older Adults Living in a Polluted Area in Central Chile
(SAGE PUBLICATIONS LTD, 2022) Cortes Arancibia, Sandra Isabel; Leiva Cisternas, Cinthya Aracely; Ojeda Valenzuela, María José; Bustamante-Ara, Natalia; Wambaa, Wanjiku; Domínguez, Alan; Pasten Salvo, Carlos; Rodriguez Peralta, Camila; Rojas Arenas, Barbara; Vargas Mesa, Diego; Ahumada Padilla Ericka Del Pilar; CEDEUS (Chile)
One recognized cause of cardiorespiratory diseases is air pollution. Older adults (OA) are one of the most vulnerable groups that suffer from its adverse effects. The objective of the study was to analyze the association between exposure to air pollution and changes in cardiorespiratory variables in OA. Observational prospective cohort study. Health questionnaires. blood pressure (BP) measurements, lung functions, respiratory symptoms, physical activity levels, and physical fitness in high and low exposure to air pollution were all methods used in evaluating OAs in communes with high contamination rates. Linear and logistic models were created to adjust for variables of interest. A total of 92 OA participated in this study. 73.9% of the subjects were women with 72.3 +/- 5.6 years. 46.7% were obese, while 12.1% consumed tobacco. The most prevalent diseases found were hypertension, diabetes, and cardiovascular disease. Adjusted linear models maintained an increase for systolic BP of 6.77 mmHg (95% CI: 1.04-12.51), and diastolic of 3.51 mmHg (95% CI: 0.72-6.29), during the period of high exposure to air pollution. The adjusted logistic regression model indicated that, during the period of high exposure to air pollution increase the respiratory symptoms 4 times more (OR: 4.43, 95% CI: 2.07-10.04) in the OA. The results are consistent with an adverse effect on cardiorespiratory variables in periods of high exposure to air pollution in the OA population.
An integrated study of health, environmental and socioeconomic indicators in a mining-impacted community exposed to metal enrichment
(2019) Moya, Pablo M.; Arce, Guillermo J.; Leiva Cisternas, Cinthya Aracely; Vega, Alejandro S.; Gutierrez Muñoz, Santiago Yvan; Adaros, Héctor; Muñoz, Luis; Pastén González, Pablo Arturo; Cortés Arancibia, Sandra; CEDEUS (Chile)
The occurrence of toxic metals and metalloids associated with mine tailings is a serious public health concern for communities living in mining areas. This work explores the relationship between metal occurrence (e.g., spatial distribution in street dusts), human health indicators (e.g., metals in urine samples, lifestyle and self-reported diseases) and socioeconomic status (SES) using Chanaral city (in northern Chile) as study site, where a copper mine tailing was disposed in the periurban area. This study model may shed light on the development of environmental and health surveillance plans on arid cities where legacy mining is a sustainability challenge. High concentrations of metals were found in street dust, with arsenic and copper concentrations of 24 +/- 13 and 607 +/- 911 mg/kg, respectively. The arsenic concentration in street dust correlated with distance to the mine tailing (r = - 0.32, p-value = 0.009), suggesting that arsenic is dispersed from this source toward the city. Despite these high environmental concentrations, urinary levels of metals were low, while 90% of the population had concentrations of inorganic arsenic and its metabolites in urine below 33.2 mu g/L, copper was detected in few urine samples (< 6%). Our results detected statistically significant differences in environmental exposures across SES, but, surprisingly, there was no significant correlation between urinary levels of metals and SES. Despite this, future assessment and control strategies in follow-up research or surveillance programs should consider environmental and urinary concentrations and SES as indicators of environmental exposure to metals in mining communities.
Assessing cohesion and diversity in the collaboration network of the SALURBAL project
(2023) Baquero, Sofia; Montes, Felipe; Stankov, Ivana; Sarmiento, Olga L.; Medina, Pablo; Slesinski, S. Claire; Diez-Canseco, Francisco; Kroker-Lobos, Maria F.; Teixeira, Waleska; Vives Vergara, Alejandra; Alazraqui, Marcio; Barrientos-Gutierrez, Tonatiuh; Diez Roux, Ana V.; CEDEUS (Chile)
The SALURBAL (Urban Health in Latin America) Project is an interdisciplinary multinational network aimed at generating and disseminating actionable evidence on the drivers of health in cities of Latin America. We conducted a temporal multilayer network analysis where we measured cohesion over time using network structural properties and assessed diversity within and between different project activities according to participant attributes. Between 2017 and 2020 the SALURBAL network comprised 395 participants across 26 countries, 23 disciplines, and 181 institutions. While the cohesion of the SALURBAL network fluctuated over time, overall, an increase was observed from the first to the last time point of our analysis (clustering coefficient increased [0.83-0.91] and shortest path decreased [1.70-1.68]). SALURBAL also exhibited balanced overall diversity within project activities (0.5-0.6) by designing activities for different purposes such as capacity building, team-building, research, and dissemination. The network's growth was facilitated by the creation of new diverse collaborations across a range of activities over time, while maintaining the diversity of existing collaborations (0.69-0.75 between activity diversity depending on the attribute). The SALURBAL experience can serve as an example for multinational research projects aiming to build cohesive networks while leveraging heterogeneity in countries, disciplines, career stage, and across sectors.
Assessment of Mycotoxin Exposure in a Rural County of Chile by Urinary Biomarker Determination
(2021) Foerster, Claudia; Ríos-Gajardo, Gisela; Gómez, Patricia; Muñoz, Katherine; Cortés Arancibia, Sandra Isabel; Maldonado, Carlos; Ferreccio Readi, Fresia Catterina; CEDEUS (Chile)
Aflatoxin B1 (AFB1), ochratoxin A (OTA), zearalenone (ZEN), and deoxynivalenol (DON) are frequent mycotoxins that may cause carcinogenic, mutagenic, estrogenic, or gastrointestinal effects. The aim of this study was to assess the exposure to and risk from AFB1, OTA, ZEN, and DON in 172 participants of the Maule Cohort (MAUCO) by a biomarker analysis in urine and to associate their exposure with food consumption and occupation. Mycotoxins in the first morning urine were analyzed by solid-phase extraction and quantified by Ultra-High-Performance Liquid Chromatography with a mass–mass detector. Participants’ information regarding food consumption, occupation, and other characteristics was obtained from a baseline and 2-year follow-up survey of the cohort. The prevalence and mean levels of mycotoxins in the urine were as follows: DON 63%, 60.7 (±78.7) ng/mL; AFB1 8%, 0.3 (±0.3) ng/mL; α-zearalenol (α-ZEL) 4.1%, 41.8 (±115) ng/mL; β ZEL 3.5%, 17.4 (±16.1) ng/mL; AFM1 2%, 1.8 (±1.0) ng/mL; OTA 0.6% (1/172), 1.3 ng/mL; and ZEN 0.6%, 1.1 ng/mL. These results were translated into exposures of DON, ZEN, and aflatoxins of public health concern. Participants who consumed coffee and pepper the day before had a significantly greater presence of DON (OR: 2.3, CI95 1.17–4.96) and total ZEL (OR: 14.7, CI95 3.1–81.0), respectively, in their urine. Additionally, we observed associations between the habitual consumption of beer and DON (OR: 2.89, CI95 1.39– .42). Regarding the levels of mycotoxins and the amount of food consumed, we found correlations between DON and nuts (p = 0.003), total ZEL and cereals (p = 0.01), and aflatoxins with capsicum powder (p = 0.03) and walnuts (p = 0.03). Occupation did not show an association with the presence of mycotoxins in urine.
Association between maternity leave policies and postpartum depression: a systematic review
(Springer, 2023) Hidalgo-Padilla, Liliana; Toyama, Mauricio; Hanae, Jessica; Tanaka, Zafra; Vives Vergara, Alejandra; Diez-Canseco, Francisco; CEDEUS (Chile)
Purpose: Working mothers are at greater risk for postpartum depression. Maternity leave characteristics, including length, wage replacement and employment protection, could have relevant implications for mothers’ mental health. We propose to explore whether there is an association between maternity leave characteristics and postpartum depression. Methods: We conducted a systematic review searching for randomized controlled trials, quasi-experimental, cohort or cross-sectional studies on five databases using search terms including maternity and parental leave and depression, as well as references in relevant articles. We identified 500 articles and included 23 of those. We used the EPHPP Quality Assessment Tool for Quantitative Studies to assess the quality of the studies. Results: Paid and longer maternity leaves tend to be associated with a reduction of postpartum depression symptoms in high-income countries. No studies explored the association between employment protection and postpartum depression. The quality of studies ranged from strong to weak, mostly influenced by study design. Conclusion: More restrictive maternity leave policies tend to be associated with higher rates of postpartum depression, although more research needs to be conducted in the Global South.
Association of Kawasaki disease with tropospheric winds in Central Chile : Is wind-borne desert dust a risk factor?
(2015) Jorquera, Héctor; Borzutzky Schachter, Arturo; Hoyos Bachiloglu, Rodrigo Andrés; García A.; CEDEUS (Chile)
Chilean institutional policies and multi-level agents: Challenges from the COVID-19 pandemic and carbon footprint
(2023) Bergamini Ladrón de Guevara, Kay Joaquín; Ojeda Leal, Carolina Grace; Gutiérrez, Patricia; Salazar Preece, Gonzalo; Curillán, Christian; CEDEUS (Chile)
As a result of the increasing number of multilateral agreements that Chile has signed, different sectors of consumption have become sources of emissions. In this context attempts to implement guidelines to address this issue have been made. Nevertheless, international policies such as sustainable development goals (SDG) 11–12 often generate dissonance in national and local administrations and have been approached by different instruments to reduce the effects of emissions, mostly focused on the private industrial sector. Methods: This article focuses on four of the most polluted cities in south-central Chile (Coronel, Temuco, Valdivia, and Osorno). Key agents (ministries, regional government, municipalities, and civil society) from three levels of policy development were selected at three scales (national, regional, and local) and interviewed considering three thematic axes: knowledge of carbon footprint areas (housing, heating, food, mobility, and energy), institutional governance, and adaptive changes due to COVID-19. Results: The results show that in Chile, there is a multiscale climate governance led by the Ministry of the Environment (national level), followed by the regional and local levels. Citizens are then left with few capacities, which is negatively viewed. In relation to the carbon footprint and COVID-19, it can be observed that the topic of energy was more addressed at the national and regional levels. Food and energy, followed by heating and then mobility were addressed at the communal level and in civil society. Discussion: Decision-making strategies and policies were discussed in this paper.
COVID-19 and Precarious Employment: Consequences of the Evolving Crisis
(SAGE Publications Inc., 2021) Matilla-Santander, Nuria; Ahonen, Emily; Albin, María; Baron, Sherry; Bolíbar, Mireia; Bosmans, Kim; Burström, Bo; Cuervo, Isabel; Davis, Letitia; Gunn, Virginia; Håkansta, Carin; Hemmingsson, Tomas; Hogstedt, Christer; Jonsson, Johanna; Julià, Mirei; Kjellberg, Katarina; Kreshpaj, Bertina; Lewchuk, Wayne; Muntaner, Carles; O’Campo, Patricia; Orellana, Cecilia; Östergren, Per-Olof; Padrosa, Eva; Ruiz, Marisol E.; Vanroelen, Christophe; Vignola, Emilia; Vives Vergara, Alejandra; Wegman, David H.; CEDEUS (Chile); Department de Salud Pública.Pontificia Universidad Católica de Chile
The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be felt globally: (a) PE will increase, (b) workers in PE will become more precarious, (c) workers in PE will face unemployment without being officially laid off, (d) workers in PE will be exposed to serious stressors and dramatic life changes that may lead to a rise in diseases of despair, and (e) PE might be a factor in deterring the control of or in generating new COVID-19 outbreaks. We conclude that what we really need is a new social contract, where the work of all workers is recognized and protected with adequate job contracts, employment security, and social protection in a new economy, both during and after the COVID-19 crisis.
Dynamics of metals in street dust after a mudslide: Case of mining city in Chile
(2019) Vega Contreras, Alejandra Soledad; Arce, Guillermo; Carkovic Aguilera, Athena B.; Moya, Pablo; Coquery, Marina; Pastén González, Pablo Arturo; CEDEUS (Chile)
Effects of an urban regeneration program on related social determinants of health in Chile: A pre-post intervention study
(Elsevier Ltd, 2021) López-Contreras, Natalia; Puig-Barrachina, Vanessa; Vives Vergara, Alejandra; Olave-Müller, Paola; Gotsens, Mercè; CEDEUS (Chile); Pontificia Universidad Católica de Chile. Escuela de Medicina
Urban regeneration programs, such as “Programa Quiero mi Barrio” (PQMB) that is carried out in neighborhoods with greater deprivation across Chile, can improve health and quality of life in socio-economically deprived neighborhoods. The aim of this study was to analyze the effects of this program on the physical, social, and safety environments of neighborhoods intervened between 2011 and 2018, according to gender and socioeconomic position. Four indices and six sub-indices were constructed to measure physical, social, and safety environments of the neighborhoods. We conducted a pre- and post-intervention analysis with 2095 people using linear models adjusted for repeated measurements. After the intervention, participants had an improved perception of physical, social, and safety environments, as well as the use of spaces, particularly among women and people with higher levels of education. Therefore, the PQMB program is a form of public policy that can improve the quality of life and health of people living in underprivileged areas.
Environmental signature and health risk assessment of polybrominated diphenyl ethers (PBDEs) emitted from a landfill fire in Santiago de Chile
(2023) Pozo, Karla; Oyola, Germán; Jorquera, Hector; Gomez, Victoria; Galbán-Malagón, Cristobal; Mena-Carrasco, Marcelo; Audy, Ondřej; Příbylová, Petra; Guida, Yago; Estellano, Victor Hugo; Lammel, Gerhard; Klánová, Jana; CEDEUS (Chile)
Polybrominated diphenyl ethers (PBDEs) have been used as flame retardants in building materials, electronics, furnishings, vehicles, airplanes, plastics, polyurethane foams, and textiles for many years. Currently, the primary commercial mixtures, penta-, octa-, and deca-BDE, are globally restricted. Still, products containing PBDEs are expected to impact waste management and the environment for many years. In January 2016, an open fire in the Santa Marta landfill close to Santiago de Chile affected the city and surroundings. The fire caused several acute health effects and an increase in emergency hospitalizations. We measured PBDE levels in the areas affected by the fire in the air (gaseous and particulate) and soil, and PBDE emissions were estimated using a dispersion model. The results showed an increase in PBDE concentrations by a factor of 2–4 one day after the start of the fire. However, PBDE concentrations measured after the fire in PM10 and the gas phase were considered low compared to other regions. Interestingly, PBDEs’ patterns differed across the sites; however, BDE209 was the dominant congener for all environmental matrices. A preliminary risk assessment was conducted using the daily exposure dose (DED) by air inhalation estimation. The results showed low DED values for adults and children and suggested no direct health risk due to PBDE exposure. This study brings new data useful for future solid waste management initiatives in the country
Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019
(2023) Ríos-Blancas, María Jesus; Pando-Robles, Victoria; Razo, Christian; Carcamo, César P.; Mendoza, Walter; Pacheco-Barríos, Kevin; Miranda, J. Jaime; Lansingh, Van Charles; Demie, Takele Gezahegn; Saha, Manika; Okonji, Osaretin Christabel; Yigit, Arzu; Cahuana-Hurtado, Lucero; Chacón-Uscamaita, Pamela R.; Bernabe, Eduardo; Culquichicon, Carlos; Chirinos-Caceres, Jesus Lorenzo; Cárdenas, Rosario; Alcalde-Rabanal, Jacqueline Elizabeth; Barrera, Francisco J.; Ayala Quintanilla, Beatriz Paulina; Shorofi, Seyed Afshin; Nuwan, Darshana Wickramasinghe; Nuno, Ferreira; Louay, Almidani; Vivek, Kumar Gupta; Hanie, Karimi; Alayu, Daniel Shewaye; Benziger, Catherine P.; Takeshi, Fukumoto; Ebrahim, Mostafavi; Elrashdy, Moustafa Mohamed Redwan; Mesfin, Gebrehiwot; Khaled, Khatab; Ai, Koyanagi; Krapp, Fiorella; Lee, Seung; Noori, Maryam; Qattea. Ibrahim; Rosenthal, Victor Daniel; Sakshaug, Joseph W.; Wagaye, Birhanu; Iman, Zare; Ortega-Altamirano, Doris V.; Murillo-Zamora, Efrén; Vervoort, Dominique; Santos Silva, Diego Augusto; Abderrahim, Oulhaj; Herrera-Serna, Brenda Yuliana; Mehra, Rahul; Mehrdad, Amir-Behghadami; Nasrin, Adib; Cortés Arancibia, Sandra; Anh, Kim Dang; Binh, Thanh Nguyen; Ali, H. Mokdad; Hay, Simon I.; Murray, Christopher J. L.; Lozano, Rafael; García, Patricia J.; CEDEUS (Chile)
Background Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru’s healthcare system performance.MethodsUsing estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region.ResultsThe Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8–70.3) to 80.3 (77.2–83.2) years. This increase was driven by the decline in under-5 mortality (−80.7%) and mortality from infectious diseases in older age groups (+60 years old). The number of DALYs in 1990 was 9.2 million (8.5–10.1) and reached 7.5 million (6.1–9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region.ConclusionIn the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.
Exposición a contaminantes provenientes de termoeléctricas a carbón y salud infantil: ¿cuál es la evidencia internacional y nacional?
(Sociedad Chilena de Pediatría, 2019) Cortés Arancibia, Sandra; Yohannessen, Karla V.; Tellerias C., Lidya; Ahumada P., Ericka; CEDEUS (Chile)
Las centrales termoeléctricas (CTE) a carbón representan un riesgo para la salud de las comunidades expuestas. Se realizó una revisión de la literatura científica nacional e internacional enfocada en los efectos en salud de niños y la exposición a emisiones al aire provenientes de CTE a carbón. Se incluyeron 21 artículos para su revisión en texto completo, donde se midieron efectos en salud infantil relacionados a presencia de biomarcadores de exposición y efecto, daños perinatales, neuroconductuales y respiratorios principalmente. La exposición a emisiones de CTE a carbón en el embarazo se asoció a niños con bajo peso y muy bajo peso al nacer, menor talla, menor diámetro de Circunferencia del Cráneo (CC) y prematuridad; el diámetro de CC aumentó en recién nacidos después del cierre de CTE. Se encontraron menor coeficiente de desarrollo (CD) y coeficiente intelectual (CI) en niños expuestos a emisiones de CTE a carbón comparados con no expuestos; CD aumentó cuando la central fue cerrada. Por otro lado, vivir en zonas con fuentes de emisión de mercurio (asociadas a CTE y plantas de cemento que funcionan con carbón) se asoció con mayor riesgo de autismo. En salud respiratoria, los artículos fueron consistentes en reportar menor función pulmonar en niños residentes en zonas expuestas a fuentes de combustión de carbón comparados con grupos de niños no expuestos. Es muy necesario abrir el debate en Chile sobre los riesgos controlables a los que se enfrenta la población infantil a consecuencia de plantas generadoras de energía instaladas en Chile.
Gender inequality, women's empowerment, and adolescent birth rates in 363 Latin American cities
(2023) Braverman-Bronstein, Ariela; Ortigoza, Ana F.; Vidaña-Pérez, Dèsirée; Barrientos-Gutiérrez, Tonatiuh; Baldovino-Chiquillo, Laura; Bilal, Usama; Friche, Amélia Augusta de Lima; Diez-Canseco, Francisco; Maslowsky, Julie; Vives Vergara, Alejandra; Diez Roux, Ana V.; CEDEUS (Chile)
Background: Gender inequality is high in Latin America (LA). Empowering girls and young women and reducing gender gaps has been proposed as a pathway to reduce adolescent pregnancy. We investigated the associations of urban measures of women's empowerment and gender inequality with adolescent birth rates (ABR) in 366 Latin American cities in nine countries. Methods: We created a gender inequality index (GII) and three Women Achievement scores reflecting domains of women's empowerment (employment, education, and health care access) using censuses, surveys, and political participation data at city and sub-city levels. We used 3-level negative binomial models (sub-city-city-countries) to assess the association between the GII and scores, with ABR while accounting for other city and sub-city characteristics. Results: We found within country heterogeneity in gender inequality and women's empowerment measures. The ABR was 4% higher for each 1 standard deviation (1-SD) higher GII (RR 1.04; 95%CI 1.01,1.06), 8% lower for each SD higher autonomy score (RR 0.92; 95%CI 0.86, 0.99), and 12% lower for each SD health care access score (RR 0.88; 95%CI 0.82,0.95) after adjustment for city level population size, population growth, homicide rates, and sub-city population educational attainment and living conditions scores. Conclusion: Our findings show the key role cities have in reducing ABR through the implementation of strategies that foster women's socioeconomic progress such as education, employment, and health care access.
Health protection among own account and platform workers during COVID19 in Chile. The PWR project
(2022) Ruiz, M. ; Vives Vergara, Alejandra; Alvarez, V.; Diaz, I.; Zaupa, A.; CEDEUS (Chile)
Background: In the last decades, non-standard employment has grown globally. Especially for own account workers (OAW), this implies the self-management of economic, health and other work-related risks. In the context of COVID19, this management was stressed by lockdowns and the novel health risks imposed by an unknown and highly contagious virus, demanding the incorporation of new knowledge and preventive actions. As part of a six-country multiple case qualitative study on non-standard workers (NSW), we explore their experiences and strategies deployed to protect their health while continuing to work. Methods: We performed 40 in-depth interviews to NSWs between October 2020 and February 2021, identified through the PWR online-survey and selected through an intentional sampling strategy according to levels of precarity (high-low), gender (male/female) and age (18-39/40-55). Interviews were analysed through abductive thematic analysis. Results: We observed a significant transfer to platform, Uber-like jobs in the delivery of goods during lockdown (n = 7). In the absence of institutional prevention programs and provision of protective equipment, OAWs (n = 13) refer the self-provision of COVID19 prevention to protect themselves and their families while continuing to work, deploying a series of strategies amidst limited understanding of both mode of transmission of the virus and actual effective preventive measures. This had serious consequences for them and their families, expressed in anguish, sense of lack of control, fear, and fragility in the face of a major health risk given their constant potential exposure to the virus, leading to both physical and mental health problems, as well as COVID19 infection. Conclusions: The substantial growth worldwide of gig delivery work during lockdowns magnified a pressing public health problem, critically requiring social security for gig and OAWs and the development of more equitable and accessible occupational health for all. Key messages: • Substantial growth worldwide of gig delivery work during lockdowns magnified a pressing public health problem.• Social security for gig and OAWs are critically required as well as the development of more equitable and accessible occupational health for all.
Human exposure to polycyclic aromatic hydrocarbons in the atmosphere of an agricultural area of central Chile and inhalation cancer risk assessments
(2023) Pozo, Karla; Cortés Arancibia, Sandra; Gómez, Victoria; Guida, Yago; Torres, Mariett; Carvalho, Gabriel Oliveira de; P?ibylová, Petra; Klánová, Jana; Jorquera, Héctor; CEDEUS (Chile)
Polycyclic aromatic hydrocarbons (PAHs) are persistent toxic substances prone to long-range atmospheric transport. Even in low concentrations, environmental exposure to PAHs can impact human health. In this study we aimed to i) investigate the occurrence of 15 polycyclic aromatic hydrocarbons (?15PAHs), from August 2016 to January 2018, in the atmosphere of Molina, using polyurethane foam disks (PAS-PUF) in central Chile; and ii) perform deterministic and probabilistic (using Monte Carlo simulations) inhalation cancer risk assessments. Gas chromatography and tandem quadrupole mass spectrometry (GC- MS/MS) measured target PAHs. Results showed ?15PAHs ranging from 2 ng m-3 to 108 ng m-3, with four-ring PAHs as the prevalent compounds, including phenanthrene (44%) and fluoranthene (24%). Winter season showed the highest PAH levels (increasing factor up to ?8 times). PAHs diagnostic ratios showed the prevalence of pyrogenic combustion (winter) and petrogenic combustion (summer). Lifetime cancer risk assessments, using BaP-eq values, indicated an increased cancer risk for the exposed population considering different risk assessment approaches. Younger individuals were the most affected by an increased cancer risk at all sampling sites. The Monte Carlo probabilistic assessment indicated that infants and toddlers could be exposed to PAH air concentrations exceeding the cancer risk threshold in over 94% of the simulations. The coldest months in the studied region are critical for human exposure and health risk due to intense wood combustion. Indoor air can be even more relevant due to the chronic inhalation of the smoke and associated chemicals.
Informal employment, precariousness, and decent work: from research to preventive action
(2022) Benavides, Fernando G.; Silva-Peñaherrera, Michael; Vives Vergara Alejandra; CEDEUS (Chile)
La amenaza del cambio climático a la salud de la población y la necesidad urgente de actuar
(2020) Palmeiro Silva, Yasna Karina; Cifuentes, Luis A.; Cortés, Sandra; Olivares, Macarena; Silva, Ignacio; CEDEUS (Chile)
Climate change is associated with negative health outcomes, such as cardiovascular and respiratory diseases. This article analyses the threat of climate change on population health and the urgent need to implement measures to avoid this damage. Heat vulnerability, heatwave exposures, and wildfire exposure to forest fires have increased in Chile. In 2018, the annual mean concentration of fine particulate matter (PM2.5) exceeded the safe level proposed by the World Health Organization, increasing the risk of negative health outcomes. Thus, multidisciplinary and inter-sectoral mitigation and adaptation policies are needed. Among other elements, mental health impacts of climate change, health education provided by health workers to reduce negative health impacts of climate change, greater engagement of academia to generate evidence useful for policy-making processes and a better articulation between central and local governments should be considered. Finally, achieving a healthy population should be the aim of all these policies and efforts.

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