Crowding: risk factor or protective factor for lower respiratory disease in young children?

Abstract Background To study the effects of household crowding upon the respiratory health of young children living in the city of São Paulo, Brazil. Methods Case-control study with children aged from 2 to 59 months living within the boundaries of the city of São Paulo. Cases were children recruited from 5 public hospitals in central São Paulo with an acute episode of lower respiratory disease. Children were classified into the following diagnostic categories: acute bronchitis, acute bronchiolitis, pneumonia, asthma, post-bronchiolitis wheezing and wheezing of uncertain aetiology. One control, crudely matched to each case with regard to age (<2, 2 years old or more), was selected among healthy children living in the neighborhood of the case. All buildings were surveyed for the presence of environmental contaminants, type of construction and building material. Plans of all homes, including measurements of floor area, height of walls, windows and solar orientation, was performed. Data were analysed using conditional logistic regression. Results A total of 313 pairs of children were studied. Over 70% of the cases had a primary or an associated diagnosis of a wheezing illness. Compared with controls, cases tended to live in smaller houses with less adequate sewage disposal. Cases and controls were similar with respect to the number of people and the number of children under five living in the household, as well the number of people sharing the child's bedroom. After controlling for potential confounders, no evidence of an association between number of persons sharing the child's bedroom and lower respiratory disease was identified when all cases were compared with their controls. However, when two categories of cases were distinguished (infections, asthma) and each category compared separately with their controls, crowding appeared to be associated with a 60% reduction in the incidence of asthma but with 2 1/2-fold increase in the incidence of lower respiratory tract infections (p = 0.001). Conclusion Our findings suggest that household crowding places young children at risk of acute lower respiratory infection but may protect against asthma. This result is consistent with the hygiene hypothesis.

Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Abstract Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.

Critical analysis of the regulations regarding the disposal of medication waste

Expired or unused medication at people's homes is normally disposed of in normal garbage, sewage system or, in certain cases, returned to the public health system. There is still no specific legislation regarding this leftover medication to regulate and orient the handling and correct disposal of medication waste. However, there is defined regulation regarding health services' solid waste. This article has the objective of discussing management models for the disposal of medication waste and the recommendations made by pertinent national and international legislation. By means of literature reviews, the management structure for medication waste of international legislation and the regulations regarding the environment, as well as the national legislation for the solid waste from health services was analyzed. Through the analysis it was possible to present better clarifications as to the possible impacts to the environment, to the public's health and alternatives in order to obtain the efficient disposal of medication, reducing and/or avoiding sanitary risk, guaranteeing the quality and safety of public health.

Distribution of sewage input in marine sediments around a maritime Antarctic research station indicated by molecular geochemical indicators

Sediments from Admiralty Bay, Antarctica were collected during the austral summers of 2002/2003 and 2003/2004 in order to assess the distribution and concentration of sewage indicators originating from Comandante Ferraz Brazilian Antarctic Station. Fecal sterols (coprostanol + epicoprostanol) and linear alkylbenzenes (LABs) ranged from <0.01 to 0.95 mu g g(-1) and <1.0 to 23 ng g(-1) dry weight, respectively. In general, the higher concentrations were found only locally in the vicinity of Ferraz station at Martel Inlet. Baseline values for fecal sterols and coprostanone were calculated as 0.19 and 0.40 mu g g(-1), respectively. According to fecal sterols concentrations, sewage contribution to Martel Inlet has increased more than twice since 1997, as result of the increase in the number of researchers at the station especially during the last decade. A low correlation was found between total LABs and fecal steroids, which could be attributed to the contribution of the natural sources of steroids. (C) 2010 Elsevier B.V. All rights reserved.

Polycyclic aromatic hydrocarbons (PAHs) in a large South American industrial coastal area (Santos Estuary, Southeastern Brazil): Sources and depositional history

Located in southeastern Brazil, the Santos Estuary has the most important industrial and urban population area of South America. Since the 1950`s, increased urbanization and industrialization near the estuary margins has caused the degradation of mangroves and has increased the discharge of sewage and industrial effluents. The main objectives of this work were to determine the concentrations and sources of polycyclic aromatic hydrocarbons (PAHs) in sediment cores in order to investigate the input of these substances in the last 50 years. The PAHs analyses indicated multiple sources of these compounds (oil and pyrolitic origin), basically anthropogenic contributions from biomass, coal and fossil fuels combustion. The distribution of PAHs in the cores was associated with the formation and development of Cubatao industrial complex and the Santos harbour, waste disposal, world oil crisis and the pollution control program, which results in the decrease of organic pollutants input in this area. (C) 2011 Elsevier Ltd. All rights reserved.

Case study: a 3D resistivity and induced polarization imaging from downstream a waste disposal site in Brazil

A contaminated site from a downstream municipal solid waste disposal site in Brazil was investigated by using a 3D resistivity and induced polarization (IP) imaging technique. This investigation purpose was to detect and delineate contamination plume produced by wastes. The area was selected based on previous geophysical investigations, and chemical analyses carried out in the site, indicating the presence of a contamination plume in the area. Resistivity model has successfully imaged waste presence (rho < 20 Omega m), water table depth, and groundwater flow direction. A conductive anomaly (rho < 20 Omega m) outside wastes placement was interpreted as a contamination plume. Chargeability model was also able to imaging waste presence (m > 31 mV/V), water table depth, and groundwater flow direction. A higher chargeability zone (m > 31 mV/V) outside wastes placement and following conductive anomaly was interpreted as a contamination plume. Normalized chargeability (MN = m/rho) confirmed polarizable zone, which could be an effect of a salinity increase (contamination plume), and the clay presence in the environment.

CHEMICAL CHANGES AND ZINC PHYTOAVAILABILITY IN SEWAGE SLUDGE-AMENDED SOIL ESTIMATED BY THE ISOTOPIC METHOD

CHEMICAL CHANGES AND ZINC PHYTOAVAILABILITY IN SEWAGE SLUDGE-AMENDED SOIL ESTIMATED BY THE ISOTOPIC METHOD. Zn availability in Red Latossol (Rhodic Ferralsol) of different pH amended with different rates of sewage sludge was studied by the isotopic Zn-65 L value method. Soil chemical properties were found to be altered by SS addition. Zn concentration and Zn derived from SS (ZnpfSS) in plant, and Zn phytoavailability (L value), were increased with increasing SS rates. The linear correlation coefficient of plant Zn with SS rates and with L value was significant at 1% probability. The L value proved an efficient method for predicting Zn phytoavailability in sewage sludge-amended soil with different pH under the soil conditions studied.

Sewage sludge does not induce genotoxicity and carcinogenesis

Through a series of experiments, the genotoxic/mutagenic and carcinogenic potential of sewage sludge was assessed. Male Wistar rats were randomly assigned to four groups: Group 1 - negative control; Group 2 - liver carcinogenesis initiated by diethylnitrosamine (DEN; 200 mg/kg i.p.); Group 3 and G4-liver carcinogenesis initiated by DEN and fed 10,000 ppm or 50,000 ppm of sewage sludge. The animals were submitted to a 70% partial hepatectomy at the 3rd week. Livers were processed for routine histological analysis and immunohistochemistry, in order to detect glutathione S-transferase positive altered hepatocyte foci (GST-P+ AHF). Peripheral blood samples for the comet assay were obtained from the periorbital plexus immediately prior to sacrificing. Polychromatic erythrocytes (PCEs) were analyzed in femoral bone-marrow smears, and the frequencies of those micronucleated (MNPCEs) registered. There was no sewage-sludge-induced increase in frequency of either DNA damage in peripheral blood leucocytes, or MNPCEs in the femoral bone marrow. Also, there was no increase in the levels of DNA damage, in the frequency of MNPCEs, and in the development of GST-P AHF when compared with the respective control group.

NUTRITIONAL BALANCE, ESSENTIAL OIL AND WOOD PRODUCTION FROM Corymbia citriodora Hill & Johnson WITH SEWAGE SLUDGE AND MINERAL FERTILIZER APPLICATIONS

The Corymbia citriodora is one of the most important forest species in Brazil and the reason is the diversity of its use, because it produces good quality wood and the leaves may be used for essential oil production. Although, there are not many studies about species and the handling effect in the nutritional balance. This study aimed to evaluate the biomass production and nutrient balance in the conventional production of essential oil and wood of Corymbia citriodora with sewage sludge application. The experiment design established was the randomized blocks, with four replicates and two treatments: 1 - fertilization with 10 tons ha(-1) (dry mass) of sewage sludge, supplemented with K and B, and 2 - mineral fertilization. It was evaluated the aerial biomass production, the nutrient export of the leaves, the essential oil and wood production at four years old. The trees that received application of sewage sludge produced 20 % more leaves biomass than the trees with mineral fertilization, resulting in larger oil production. Besides, the trees with sewage sludge application produced 14.2 tons ha(-1) yr(-1) of woody biomass that was 27 % higher than the treatment with mineral fertilization. For both treatments the N balance was negative, but treatment with sewage sludge application (-45 kg ha(-1)) was four times lower than the observed on mineral fertilization treatment (-185 kg ha(-1)). It may be concluded in this paper that the application of sewage sludge benefits the production of leaves biomass, essential oil and wood, besides result better nutritional balance of the Corymbia citriodora production system.

Treatment of Domestic Sewage in an Anaerobic-Aerobic Fixed-bed Reactor with Recirculation of the Liquid Phase

This study reports the performance of a combined anaerobic-aerobic packed-bed reactor that can be used to treat domestic sewage. Initially, a bench-scale reactor was operated in three experimental phases. In the first phase, the anaerobic reactor was operated with an average organic matter removal efficiency of 77% for a hydraulic retention time (HRT) of 10 h. In the second phase, the reactor was operated with an anaerobic stage followed by an aerobic zone, resulting in a mean value of 91% efficiency. In the third and final phase, the anaerobic-aerobic reactor was operated with recirculation of the effluent of the reactor through the anaerobic zone. The system yielded mean total nitrogen removal percentages of 65 and 75% for recycle ratios (r) of 0.5 and 1.5, respectively, and the chemical oxygen demand (COD) removal efficiencies were higher than 90%. When the pilot-scale reactor was operated with an HRT of 12 h and r values of 1.5 and 3.0, its performance was similar to that observed in the bench-scale unit (92% COD removal for r = 3.0). However, the nitrogen removal was lower (55% N removal for r = 3.0) due to problems with the hydrodynamics in the aerobic zone. The anaerobic-aerobic fixed-bed reactor with recirculation of the liquid phase allows for concomitant carbon and nitrogen removal without adding an exogenous source of electron donors and without requiring any additional alkalinity supplementation.

Parasitological risk assessment from wastewater reuse for disposal in soil in developing countries

The purpose of this work is to analyze the parasitological risks of treated wastewater reuse from a stabilization pond in the city of Piracicaba, in the State of Sao Paulo (Brazil), and the level of treatment required to protect public health. Samples were taken from raw and treated wastewater in stabilization ponds and submitted to a parasitological, microbiological and physicochemical analysis. The study revealed on treated wastewater the presence of Ascaris sp. and Entamoeba coli with an average density of 1 cysts L-1 and 6 eggs L-1, respectively. For Ascaris, the annual risks of infection due to the accidental ingestion of wastewater irrigation were 7.5 x 10(-2) in 208 days and 8.7 x 10(-2) in 240 days. For Total Coliforms and Escherichia coli in treated wastewater, the average density was 1.0 x 10(5) MPN/100 ml and 2.7 x 10(4) MPN/100 ml respectively, representing 99% and 94% removal efficiency, respectively. For BOD, COD, TS and TSS removal efficiency was 69, 80, 50 and 71%, respectively. The removal efficiency for nitrogen; ammonia nitrogen and total phosphate was 24, 19 and 68%, respectively. The average density of helminths eggs in treated wastewater is higher compared to the density of the limit value of <= 1 egg L-1 and tolerable risk is above the level recommended by the World Health Organization. Multiple barriers are necessary for the reduction of organic matter, chemical contaminants and parasites from treated wastewater. Standards for the sanitary control of treated wastewater to be reused in agricultural irrigation areas should be compiled for developing countries in order to minimize public health risks.

Growth and nitrogen fixation in soybean treated with doses of composted sewage sludge

The use of sewage sludge is a highly promising practice for the development of sustainable agricultural systems. The objective of this study was to evaluate doses of sewage sludge composted with and without Rhizobium inoculation in leaf N content, nodule number, nodule dry weight and plant during flowering. The experiment was conducted in the greenhouse of the Department of Soil Science and Natural Resources College of Agricultural Sciences of Botucatu, using as substrate used in vessels of 30 liters a Red Yelow Latosol sandy texture with experimental design adopted was randomized blocks constituted for 10 treatments and five doses of composted sewage sludge (0, 10, 20, 30, 40 t ha(-1)) with or without inoculation Bradyrhizobium japonic with three replications. There was an increase in the number and dry weight of nodules and shoot dry mass of soybeans due to the increase of the dose of sludge up to a dose of 20 t ha(-1) and after this dose there was a decrease of these parameters. At a dose of 10 t ha(-1) sludge compost inoculated seeds showed higher for foliar concentrations of N and number of nodules compared with uninoculated seeds. At a dose of 30 t ha(-1) inoculated seeds were higher compared to uninoculated in all parameters.

Soil properties in a sugarcane plantation after the application of treated sewage effluent and phosphogypsum in Brazil

In a field experiment performed in Lins County (Sao Paulo State, Brazil), treated sewage effluent (TSE) irrigation increased sugarcane yield but caused an excessive increase in the exchangeable sodium percentage (ESP) and clay dispersion after 16 months due to an intense irrigation regime (2500 mm/16 months) with sodium rich effluents. After two additional complete cycles with lower TSE irrigation rates (1200 mm year(-1)), 1700 kg ha(-1) of phosphogypsum was added to a section of the irrigated plots to evaluate its residence time and its implications on Na+ dynamics and other soil properties. Undisturbed soil cores were taken 2 years after phosphogypsum application to verify soil physical properties up to 0.2 m depth, and disturbed soil samples were taken every year up to 1 m depth for chemical analyses. After 5 years of consecutive TSE irrigation (2005-2010), soil acidity (pH approximate to 5) and basic cations (Ca approximate to 12, Mg approximate to 6 and K approximate to 2 mmol(c) kg(-1)) were maintained in adequate conditions for plant development without the necessity of liming, while acidity was increased (pH approximate to 4.5) and Ca (approximate to 9 mmol(c) kg(-1)), and the Mg (approximate to 4.5 mmol(c) kg(-1)) concentration decreased in the rainfed without phosphogypsum treatment. An increase in water retention capacity at -30 (from 0.14 to 0.17 m(3) m(-3)) and -1500 kPa (from 0.08 to 0.12 m(3) m(-3)) potentials was also observed in all TSE irrigated treatments. The plots with a phosphogypsum treatment showed average increases of 2 mmol(c) kg(-1) of Ca2+ and 7 mg kg(-1) of S-SO42- in all soil profiles and an average reduction of 2 mmol(c) kg(-1) of Na+ up to 0.4 m from 2008 to 2009. However, the extent of the chemical effects was greater after the first year compared to the second year. The high concentration of Na+ found in previous studies performed in the same area returned to low concentrations after continued TSE irrigation at lower rates, even without the phosphogypsum application. An unusual phosphorus migration was observed to the 0.4-0.8 m soil layer as a result of TSE irrigation, most likely due to a high pH and a Na carbonate-dominated TSE. (C) 2012 Elsevier B.V. All rights reserved.