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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 comparison of bus passengers' and car drivers' valuation of casualty risk reductions in their routes
(2019) Flugel, Stefan; Veisten, Knut; Rizzi Campanella, Luis Ignacio; Ortúzar Salas, Juan de Dios; Elvik, Rune; CEDEUS (Chile)
A greener urban environment: designing green infrastructure interventions to promote citizens’ subjective wellbeing
(Elsevier B.V., 2019) Navarrete-Hernández, Pablo; Laffan, Kate; CEDEUS (Chile); Pontificia Universidad Católica de Chile. Facultad de Arquitectura, Diseño y Estudios Urbanos
Research using subjective wellbeing (SWB) measures finds that the greener an individual's local environment is, the higher the levels of happiness and the lower levels of stress they tend to report experiencing. This literature presents positive associations between existing large-scale green spaces, such as urban parks or squares, and the wellbeing of residents living in close proximity to them. In contrast, in the current work, we present a novel approach which combines SWB measures with photo simulation in order to examine the impact of street-level green infrastructure interventions on the people's perceptions of the SWB associated with urban sites. We tested the approach with the attendees of the 20th Biennale on Architecture and Urbanism in Chile in 2017, exploring the impact of four different types of street-level green interventions. The results indicate that all types of green interventions considered significantly increase the perceived happiness and reduce the perceived stress associated with the sites during short exposures, with varying effect sizes across different types and scales of interventions. The proposed technique could be used in urban planning processes to examine the potential SWB benefits of green infrastructure investments prior to their being rolled out.
A preliminary study on aflatoxin exposure by urine biomonitoring in Chile
(2022) Foerster, Claudia; Monsalve, Liliam; Maldonado, Carlos; Cortés Arancibia, Sandra; Ferreccio, Catterina; CEDEUS (Chile)
We assessed the occurrence of aflatoxin M1 (AFM1) in urine in a sample of the MAUCO population-based cohort (n = 120) using an enzyme-linked immune sorbent assay (ELISA) kit specially designed for the analysis of AFM1 in urine. We found AFM1 in the urine of 59% of the participants (> limit of detection), with 12% of the samples being over the limit of quantification. The mean of the quantifiable samples was 0.66 (± 0.35) ng/mg adjusted creatinine, ranging from 0.31 to 1.39 ng/mg creatinine. The mean probable daily intake (PDI) of AFB1 was 0.23 (± 0.37) ng/kg bw according to the upper bound (UB), being significantly higher in women and 0.14 (± 0.23) ng/kg bw in the modified lower bound (mLB) approach, ranging from 0.01 to 1.98 ng/kg bw. The risk of AFB1 was assessed with the margin of exposure (MOE) approach estimated at 2800 in the mean mLB and 1733 in the mean UB. According to the MOE values obtained in this study, aflatoxin B1 exposure must be considered a public health concern and must be taken as a priority for food risk management.
Air quality management in Chile : effectiveness of PM2.5 regulations
(2021) Jorquera, Héctor; CEDEUS (Chile)
Ambient PM10 impacts brought by the extreme flooding event of March 24-26, 2015, in Copiapo, Chile
(2018) Jorquera, Héctor; Maria Villalobos, Ana; Barraza Saavedra, Francisco Javier; CEDEUS (Chile)
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)
Asymmetric preferences for road safety : evidence from a stated choice experiment among car drivers
(2015) Flugel, Stefan; Elvik, Rune; Veisten, Knut; Rizzi Campanella, Luis Ignacio; Frislid Meyer, Sunniva; Ramjerdi, Farideh; Ortúzar Salas, Juan de Dios; CEDEUS (Chile)
Benchmarking the Covid-19 pandemic across countries and states in the USA under heterogeneous testing
(2020) Asahi Kodama, Kenzo Javier; Undurraga Fourcade, Eduardo Andrés; Wagner, Rodrigo; CEDEUS (Chile)
Public health officials need to make urgent decisions to reduce the potential impact of the CoVID-19 pandemic. Benchmarking based on the increase in total cases or case fatality rates is one way of comparing performance across countries or territories (such as states in the USA), and could inform policy decisions about COVID-19 mitigation strategies. But comparing cases and fatality across territories is challenging due to heterogeneity in testing and health systems. We show two complementary ways of benchmarking across countries or US states. First, we used multivariate regressions to estimate the test-elasticity-of-COVID-19-case-incidence. We found a 10% increase in testing yielded ~9% (95% CI:4.2–3.4%; p<0.001) increase in reported cases across countries, and ~2% (95%CI:0.1-3.4%; p=0.03) increase across US states during the week ending April 10th, 2020. We found comparable negative elasticities for fatality rates (across countries: β =-0.77, 95%CI:-1.40– -0.14; p=0.02; US states: β=-0.15, 95%CI:-0.30-0.01; p=0.06). Our results were robust to various model specifications. Second, we decomposed the growth in cases into test growth and positive test ratio (PTR) growth to intuitively visualize the components of case growth. We hope these results can help support evidence-based decisions by public health officials as more consistent data hopefully becomes available.
Big data and policy making: between real time management and the experimental dimension of policies
(2019) Concilio, Grazia; Pucci, Paola; Vecchio, Giovanni; Lanza, Giovanni; Misra, Sanjay; Gervasi, Osvaldo; Murgante, Beniamino; Stankova, Elena; Korkhov, Vladimir; Torre, Carmelo; Rocha, Ana Maria A.C.; Taniar, David; Apduhan, Bernady O.; Tarantino, Eufemia; CEDEUS (Chile)
Chemical speciation and source apportionment of fine particulate matter in Santiago, Chile, 2013
(2015) Villalobos, A.; Barraza Saavedra, Francisco Javier; Jorquera, Héctor; Schauer, J.; CEDEUS (Chile)
Combining Cluster Analysis of Air Pollution and Meteorological Data with Receptor Model Results for Ambient PM2.5 and PM10
(2020) Jorquera, Héctor; Villalobos, Ana María; CEDEUS (Chile)
Air pollution regulation requires knowing major sources on any given zone, setting specific controls, and assessing how health risks evolve in response to those controls. Receptor models (RM) can identify major sources: transport, industry, residential, etc. However, RM results are typically available for short term periods, and there is a paucity of RM results for developing countries. We propose to combine a cluster analysis (CA) of air pollution and meteorological measurements with a short-term RM analysis to estimate a long-term, hourly source apportionment of ambient PM2.5 and PM10. We have developed a proof of the concept for this proposed methodology in three case studies: a large metropolitan zone, a city with dominant residential wood burning (RWB) emissions, and a city in the middle of a desert region. We have found it feasible to identify the major sources in the CA results and obtain hourly time series of their contributions, effectively extending short-term RM results to the whole ambient monitoring period. This methodology adds value to existing ambient data. The hourly time series results would allow researchers to apportion health benefits associated with specific air pollution regulations, estimate source-specific trends, improve emission inventories, and conduct environmental justice studies, among several potential applications.
Dealing with collinearity in travel time valuation
(2015) Ortúzar Salas, Juan de Dios; De Grange, L.; Farina, P.; CEDEUS (Chile)
Designing incentive packages for increased density and social inclusion in the neighbourhood of mass transit stations
(2016) Waintrub, N.; Greene, Margarita; Ortúzar Salas, Juan de Dios; 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.
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.
Estimating the value of risk reductions for car drivers when pedestrians are involved : a case study in Spain
(2018) Rosa Marina González; Concepción Román; Francisco Javier Amador; Luis Ignacio Rizzi; Juan de Dios Ortúzar; Raquel Espino; Juan Carlos Martín; Elisabetta Cherchi; CEDEUS (Chile)
Estimation of crowding factors for public transport during the COVID-19 pandemic in Santiago, Chile
(2022) Basnak Klajn, Paul Alexander; Giesen Encina, Ricardo; Muñoz Abogabir, Juan Carlos; CEDEUS (Chile)
A sharp decrease in public transport demand has been observed during the COVID-19 pandemic around the world. In this context, it is relevant to understand how mode preferences have changed since the surge of COVID-19.& nbsp;In order to better understand how the pandemic changed mode choice, particularly regarding the impact of crowding and face mask use in public transport, we conducted a stated preference on-line and on-street survey in Santiago, Chile. Our sample is balanced in gender but has a higher proportion of individuals with college degrees and those under 45 years of age than the population of Santiago.& nbsp;The data collected was then used to estimate two multinomial mode choice models, a latent class model and a mixed logit model with latent variables.& nbsp;The models yielded a value of travel time in crowded conditions (4 pax/m2) and low face mask use (50%) of 3.0-5.1 times higher than the case with low crowding (0.5 pax/m2) and 100% face mask use. Moreover, women tend to be more sensitive than men to the use of face masks in public transport. Besides, young and low-income people are relatively less sensitive to crowding.& nbsp;The crowding penalization obtained is higher than in pre-pandemic models calibrated for Santiago for similar passenger densities. Also, as we expected, it grows non-linearly with passenger density. Disinfection of vehicles, as well as the perception of health risk, cleanliness, safety and comfort, were also relevant in explaining mode choice. Further research shall discuss how the change of mode preferences together with new demand patterns influence the operational design of public transport services.
Experiences of insecurity among non-standard workers across different welfare states: A qualitative cross-country study
(2023) Bosmans, Kim; Vignola, Emilia F.; Alvarez-Lopez, Valentina; Julia, Mireia; Ahonen, Emily Q.; Bolibar, Mireia; Gutierrez-Zamora, Mariana; Ivarsson, Lars; Kvart, Signild; Muntaner, Carles; O'Campo, Patricia; Ruiz, Marisol E.; Vanerhagen, Kristian; Cuervo, Isabel; Davis, Letitia; Diaz, Ignacio; Escrig-Pinol, Astrid; Gunnj, Virginia; Lewchuk, Wayne; Ostergren, Per-Olof; Padrosa, Eva; Vilchez, David; Vives Vergara, Alejandra; Vos, Mattias; Zaupa, Alessandro; Bodin, Theo; Baron, Sherry L.; CEDEUS (Chile)
In recent decades, economic crises and political reforms focused on employment flexibilization have increased the use of non-standard employment (NSE). National political and economic contexts determine how employers interact with labour and how the state interacts with labour markets and manages social welfare policies. These factors influence the prevalence of NSE and the level of employment insecurity it creates, but the extent to which a country's policy context mitigates the health influences of NSE is unclear. This study describes how workers experience insecurities created by NSE, and how this influences their health and well-being, in countries with different welfare states: Belgium, Canada, Chile, Spain, Sweden, and the United States. Interviews with 250 workers in NSE were analysed using a multiple-case study approach. Workers in all countries experienced multiple insecurities (e.g., income and employment insecurity) and relational tension with employers/clients, with negative health and well-being influences, in ways that were shaped by social inequalities (e.g., related to family support or immigration status). Welfare state differences were reflected in the level of workers' exclusion from social protections, the time scale of their insecurity (threatening daily survival or longer-term life planning), and their ability to derive a sense of control from NSE. Workers in Belgium, Sweden, and Spain, countries with more generous welfare states, navigated these insecurities with greater success and with less influence on health and well-being. Findings contribute to our understanding of the health and well-being influences of NSE across different welfare regimes and suggest the need in all six countries for stronger state responses to NSE. Increased investment in universal and more equal rights and benefits in NSE could reduce the widening gap between standard and NSE.

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