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.
Asthma and allergic rhinitis were analyzed in a random sample of school children (n = 6174) residing in Ciudad Juarez, Chihuahua, Mexico. The International Study of Asthma and Allergies in Childhood ...methodology was applied through a standardized questionnaire. The sample was obtained with a bietapic design. Cumulative prevalence of asthma and wheezing was 6.8% (95% CI 6.2, 7.4) and 20% (95% of CI 19.7, 21.8) respectively; the prevalence of rhinitis was 5.0% (95% CI 4.5, 5.6). Family history of asthma odds ratio (OR) 2.33 (95% CI 1.78-3.05), respiratory infection after birth (OR) 3.44 (95% CI 2.76-4.29), and exposure to environmental tobacco (OR) 1.35 (95% CI 1.06-1.68) were the strongest risk factors for asthma and allergic rhinitis. The multifactorial etiology of asthma and allergic rhinitis was confirmed, as well as the importance of early exposure to environmental factors.
This study assessed the risk factors for Giardia intestinalis infection in an agricultural population in Mexico. Exposure groups included 2,257 individuals from households exposed to untreated ...wastewater, 2,147 from a group using the effluent from a series of reservoirs, and 2,344 from rain-fed agricultural villages. Stool samples were collected from 6,748 individuals. Wastewater samples were tested for fecal coliforms/100 ml and Giardia sp. cysts/L. Untreated wastewater samples contained 10(8) fecal coliforms/100 ml and up to 300 Giardia sp. cysts/L. Hydraulic retention (3-7 months) in the reservoirs, however, provided an improved effluent quality (10(1)-10(4) fecal coloforms/100 ml and < or = 5 Giardia sp. cysts/L). Children 1-14 years of age had the highest prevalence of infection (20%). Data showed marginal associations between storing drinking water in unprotected containers and lack of facilities for feces disposal and the risk of infection (odds ratios ORs = 1.76 and 1.19, 95% confidence intervals CIs = 0.95-3.23, and 0.97-1.45, respectively). Individuals purchasing vegetables at the city market had higher rates of infection than those buying at the village shop (OR = 2.49, 95% CI = 1.00-6.17). No excess risk was found in individuals exposed to untreated wastewater compared with controls (OR = 1.07, 95% CI = 0.84-1.36); the group using reservoir water was not different from the controls (OR = 1.22, 95% CI = 0.94-1.58). No risk from agricultural activities was detected (OR = 0.83). This pattern of infection may be addressed by primary health care and wastewater treatment.
To develop an environmental health indicator for use as a basis for developing preventive measures against Ascaris lumbricoides infection in children from the rural municipalities of Caparaó and Alto ...Caparaó, in Minas Gerais, Brazil.
A cross-sectional survey was conducted between May and September 1998 among 1171 children under 14 years of age living in 588 dwellings selected from 11 communities. Trained interviewers used a questionnaire to identify risk factors for infection (socioeconomic, sanitation and hygiene variables) and collected stool samples from each child for parasitological tests.
The overall prevalence of A. lumbricoides infection was 12.2%. The results showed the protective effects of availability of water in the washbasin and better hygiene, sanitation and socioeconomic status; the interactive effect of crowding was five times larger in households without water in the washbasin than in those having water. There was a statistically significant association between infection and children's age.
The environmental health indicator, which incorporated the most significant biological, environmental and social factors associated with the risk of A. lumbricoides infection in children from these communities, should contribute to the development of surveillance tools and health protection measures in this population.
El propósito de la iniciativa Salud Mesoamérica 2015 (SM-2015) es mejorar el estado de salud y nutrición de la población con mayor grado de vulnerabilidad en Mesoamérica. El objetivo de la evaluación ...es generar evidencia sobre la efectividad conjunta de un paquete de intervenciones diseñadas para mejorar las condiciones de salud en la región. Se propone una evaluación de impacto con métodos mixtos, para conocer la magnitud de los cambios atribuibles a la SM-2015, e identificar los significados de estos cambios para la población objetivo, en el contexto de cada país. El eje conductor es un panel de localidades con el que se colectará información de individuos, hogares y unidades de salud de primero y segundo nivel de atención. El diseño que se describe en este documento fue desarrollado entre junio y diciembre de 2009, y su articulación se llevó a cabo en talleres realizados en Cuernavaca (México), Managua (Nicaragua), y San José (Costa Rica). El diseño propuesto permitirá generar evidencia sobre la efectividad conjunta del paquete de intervenciones propuesto en los planes maestros mesoamericanos. El éxito de este diseño radica en la voluntad y en el compromiso político de los países y los donantes.
Although several studies have identified factors associated with bone mineral density (BMD), little research is available on Mexican women.
A cross-sectional study was conducted in 1,622 female ...workers between 20 and 80 years of age at the Mexican Social Security Institute (IMSS), an integral part of the Mexican health system. It was carried out in Morelos, a Mexican state that borders Mexico City. Women were recruited to participate in this study from their workplaces. Body mass index (BMI) was measured and BMD was assessed using dual-energy x-ray absorptiometry of dominant forearm. Predictors of BMD (age, reproductive factors, BMI, diet, and physical activity) in pre- and postmenopausal women were assessed by questionnaire and analyzed using generalized additive models.
In premenopausal women, older age, higher BMI, younger age at menarche, and greater vitamin D intake were associated with higher BMD (
R
2
=
0.06, null deviance reduction
=
6.9%). In postmenopausal women, determinants of BMD were older age, higher BMI, greater height, later initiation of menopause, longer time of use of hormonal replacement therapy (HRT), and greater calcium intake from dairy products (
R
2
=
0.39, null deviance reduction
=
40.7%).
As observed in other populations, age, BMI, height, age at menopause, time of use of HRT, and calcium intake derived from dairy products in these Mexican women are factors associated with higher forearm BMD during postmenopausal period. Age, BMI, age at menarche, and vitamin D are associated with higher forearm BMD in premenopausal women. Some of these factors are not linearly associated with BMD. This was a limited population study carried out in a large group of female healthcare workers whose reproductive and lifestyle factors potentially agreed with those of female workers from urban areas of Mexico.
To assess the effect of tobacco consumption during pregnancy on height and birth weight of newborns.
Two cohort studies on lead exposure conducted in Mexico City between 1993 and 2000 were analyzed. ...Data were analyzed to assess the differences in height and birth weight between children of women who smoked during pregnancy and those who did not, adjusting for other important factors. Statistical analysis consisted of multiple linear regression models.
The proportion of women who smoked during pregnancy was 4.7%. The birth weight of children of mothers who smoked during pregnancy was 154 grams less on average (95% confidence interval CI -284.7, -24.7) and their height was 0.79 cm less (95% CI -1.5, -0.1) than the children of non-smokers during pregnancy.
These findings evidence the deleterious effect of tobacco consumption on children.
To describe the trends in airborne lead levels and their association with the control measures implemented from 1988 to 1998 to phase out lead from gasoline that included the introduction of a ...lead-free gasoline and the use of catalytic converters in automobiles in Mexico City.
Data of atmospheric lead levels were obtained from the 9 field stations included in the local air quality monitoring network (RMMA). Trends for airborne lead are shown by monitor, monitoring area and for the entire metropolitan zone. Analysis of data was performed using linear regression models including auto correlation analysis. The models were validated by standard diagnostic techniques using student residuals analysis.
The introduction of lead-free gasoline and the use of catalytic converters decreased the airborne lead levels by 23% while the slow elimination of lead from gasoline produced a cumulative decrease of 89% during the period and in all areas studied.
The strategy implemented to reduce sources of airborne lead pollution had an important impact on atmospheric lead levels. Health risks of this environmental hazard are now primarily due to less important sources and to particular occupational exposures. The English version of this paper is available at: http://www.insp.mx/salud/index.html.
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