ItemPrograma infantes y salud ambiental con un enfoque ecosistémico (ISA) : informe técnico final (abril 2009 - abril 2013); resumen ejecutivo(Universidad Nacional, IRET-UNA, Heredia, CR, 2013-05) Wendel de Joode, Berna van; Quesada, Rosario ItemInfant environmental health program using an ecosystem approach (ISA) : final technical report (April 2009 - April 2013); executive summary(Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional (UNA), Heredia, CR, 2013-05) Wendel de Joode, Berna van; Quesada, RosarioThe program was created to assess and improve the sustainability of production systems of banana and plantain, using agroecological approaches to human health, particularly with regard to pesticide exposure and neurodevelopment of 0-2 years-old babies. In indigenous communities where plantains are being produced by smallholders, highly toxic pesticides are increasingly used. By analyzing impact of pesticides on children and with implementation of alternatives to pesticides, the project aims to improve pesticide awareness and health of people living in the ‘Huetar Atlántica’ region. ItemPrograma infantes y salud ambiental con un enfoque ecosistémico (ISA) : informe técnico final (abril 2009 - abril 2013)(Universidad Nacional, IRET-UNA, Heredia, CR, 2013-05) Wendel de Joode, Berna van; Quesada, Rosario ItemSocial communication network analysis of the role of participatory research in the adoption of new fish consumption behaviors(Elsevier, 2012) Frédéric Mertens; Johanne Saint-Charles; Donna MerglerThe formulation and communication of fish advisories are highly complex because of the potential conflict between the nutritional and toxicological issues associated with fish consumption. Government and organization-sponsored fish advisories have had limited success in changing behaviors. Participatory approaches may enhance the understanding of complex issues and the adoption of new behaviors. Here we used social network analysis to investigate the adoption of dietary changes within the context of a community participatory research project. In the Brazilian Amazon, many communities are highly exposed to methylmercury from fish consumption. A participatory intervention based on dietary changes aimed at reducing methylmercury exposure while maintaining fish consumptionwas initiated in 1995. In 2001, we collected data on individual participation in the research, on the discussion network regarding mercury issues and on changes in fish consumption from 96 of the 110 village households. More than half of men and women had adopted new fish consumption behavior to reduce mercury exposure. Adoption was associated with participation in the research project for both women and men, and with a higher number of discussion partners about mercury issues for women. Adoption was likewise associated with the presence of a female communication partner in the personal networks of both men and women. At the household level, men and womenwho considered their spouse as a discussion partner were more likely to adopt than those who did not. Opinion le]adership was associated with change in fish consumption only for women. We discuss the contribution of community participation and communication networks to overcome the difficulties in generating complex messages that take into account both health benefits and risks of fish consumption.We also discuss the relevance of building preventive health programs based on participatory research approaches and the roles and relations specific to men and women. ItemOs desafios da geração do conhecimento em saúde ambiental : uma perspectiva ecossistêmica(Associação Brasileira de Saúde Coletiva (ABRASCO), 2013-05) Weihs, Marla; Mertens, FrédéricO artigo explora as oportunidades e as limitações da geração de conhecimento no campo da saúde ambiental. Argumenta que a compreensão da complexidade dos fatores que condicionam a saúde humana e dos ecossistemas demanda redefinições na tradicional distribuição de papéis e responsabilidades na pesquisa científica. Estas práticas de pesquisa encerram enfoques inter e transdisciplinares e a aplicação de uma abordagem ecossistêmica (ecosaúde). Desafios e oportunidades da aplicação da inter e transdisciplinaridade a problemáticas de saúde ambiental são discutidos e ilustrados por meio de dois estudos de caso que utilizam uma abordagem ecosaúde: uma experiência brasileira que trata da contaminação e exposição ao mercúrio na Amazônia, e outra nepalense, sobre a transmissão urbana de equinococose. Concluímos apresentando o potencial de uma abordagem ecosaúde na superação dos limites das práticas unidisciplinares e na valorização dos saberes e da participação local. ItemChronic Pesticide Poisoning from Persistent Low-dose Exposures in Ecuadorean Floriculture Workers: Toward Validating a Low-cost Test Battery(Maney Publishing, 2012) Breilh, Jaime; Pagliccia, Nino; Yassi, AnnaleeChronic pesticide poisoning is difficult to detect. We sought to develop a low-cost test battery for settings such as Ecuador’s floriculture industry. First we had to develop a case definition; as with all occupational diseases a case had to have both sufficient effective dose and associated health effects. For the former, using canonical discriminant analysis we found that adding measures of protection and overall environmental stressors to occupational category and duration of exposure was useful. For the latter, factor analysis suggested three distinct manifestations of pesticide poisoning. We then determined sensitivity and specificity of various combinations of symptoms and simple neurotoxicity tests from the Pentox questionnaire, and found that doing so increased sensitivity and specificity compared to use of acethylcholinesterase alone—the current screening standard. While sensitivity and specificity varied with different case definitions, our results support the development of a low-cost test battery for screening in such settings. ItemDiffusion d'informations en santé environnementale : le rôle des chemins différenciés selon le sexe et le genre(2012) Saint-Charles, Johanne; Rioux-Pelletier, Marie Eve; Mongeau, Pierre; Mertens, FrédéricCe chapitre présente des aspects de la prise en compte du sexe et du genre qui nous apparaissent déterminants pour la recherche et l’intervention en santé environnementale. Nos réflexions sont issues de nos recherches sur la diffusion de nouvelles connaissances et pratiques en Amérique latine dans le cadre de problématiques de santé relatives à des contaminants environnementaux. Ces recherches s’inscrivent dans une approche écosystémique de la santé. Considérée comme un jalon de la santé publique au Canada (Webb et al., 2010), cette approche a émergé dans les dernières années en réponse à la complexité de nombreux problèmes alliant santé et environnement. L’équité de genre en est l’un des piliers; ce qui appelle à la prise en compte du sexe et du genre dans la recherche et dans l’intervention. Nous employons l’expression sexe/genre pour faire référence aux différences hommes-femmes tant au niveau biologique que social, considérant la difficulté de distinguer l’un et l’autre (Messing, 2007). Dans nos recherches, nous avons tenté de mieux comprendre le rôle du sexe/genre dans la diffusion d’informations et l’adoption de pratiques favorables à la santé. Deux études sont particulièrement intéressantes à cet égard : l’une portait sur l’adoption de nouvelles pratiques d’alimentation diminuant l’exposition au mercure en Amazonie brésilienne (Mertens, Saint-Charles, Mergler, Passos & Lucotte, 2005) et l’autre sur l’adoption de comportements contribuant à diminuer l’exposition aux pesticides des agriculteurs et de leur famille au Costa Rica (Rioux-Pelletier, Saint-Charles, Barraza & van Wendel de Joode, 2009). Dans les deux cas, nous avons eu recours à des méthodes mixtes incluant l’analyse des réseaux sociaux et l’analyse de contenu d’entrevues ou de groupes de discussion. ItemIndigenous children living nearby plantations with chlorpyrifos-treated bags have elevated 3,5,6-trichloro-2-pyridinol (TCPy) urinary concentrations(Elsevier, 2012-08) Barraza, Douglas; Ruepert, Clemens; Mora, Ana María; Córdoba, LeonelResults suggest that the general living environment of children from the banana village is contaminated with chlorpyrifos, detected in air, soil, surface water, mattress and house dust samples, and in all the hand and foot wash samples. Chlorpyrifos is a chlorinated organophosphate (OP) insecticide, a neurotoxinant which inhibits plasma and red blood cell (RBC) acetylcholinesterase. Three US children’s cohort studies have reported neurodevelopmental deficits in relation to prenatal exposures to organophosphates in general. The substitution of the chlorpyrifos-treated bags with agro-ecological pest control methods, are likely to improve children’s health and environment in banana and plantain growing regions. ItemPesticide use in banana and plantain production and risk perception among local actors in Talamanca, Costa Rica(Elsevier, 2011-07) Barraza, Douglas; Jansen, Kees; Wendel de Joode, Berna van; Wesseling, CatharinaThe Talamanca County in Costa Rica has large-scale banana and small-scale plantain production, probably causing pesticide exposure in indigenous children. We explored to what extent different community actors are aware of children's pesticide hazards and how their awareness related to socio-economical and cultural conditions. Methods comprised eight focus groups with fathers and mothers separately, 27 semi-structured interviews to key actors, and field observations. As a whole, the indigenous plantain farmers and banana plantation workers had some general knowledge of pesticides concerning crop protection, but little on acute health effects, and hardly any on exposure routes and pathways, and chronic effects. People expressed vague ideas about pesticide risks. Inter-community differences were related to pesticide technologies used in banana and plantain production, employment status on a multinational plantation versus smallholder status, and gender. Compared to formalized practices on transnational company plantations, where workers reported to feel protected, pesticide handling by plantain smallholders was not perceived as hazardous and therefore no safety precautions were applied. Large-scale monoculture was perceived as one of the most important problems leading to pesticide risks in Talamanca on banana plantations, and also on neighboring small plantain farms extending into large areas. Plantain farmers have adopted use of highly toxic pesticides following banana production, but in conditions of extreme poverty. Aerial spraying in banana plantations was considered by most social actors a major determinant of exposure for the population living nearby these plantations, including vulnerable children. We observed violations of legally established aerial spraying distances. Economic considerations were most mentioned as the underlying reason for the pesticide use: economic needs to obtain the production quantity and quality, and pressure to use pesticides by other economic agents such as middlemen. Risk perceptions were modulated by factors such as people's tasks and positions in the production process, gender, and people's possibilities to define their own social conditions (more fatalistic perceptions among banana workers). The challenge for the future is to combine these insights into improved health risk assessment and management that is culturally adequate for each particular community and agricultural context. ItemDiffusion of environmental health information : the role of sex- and gender-differentiated pathways(CIHR Institute of Gender and Health, 2012) Saint-Charles, Johanne; Rioux-Pelletier, Marie Eve; Mongeau, Pierre; Mertens, FrédéricChapter 9 of “What a Difference Sex and Gender Make: A Gender, Sex and Health Research Casebook” presents important aspects of incorporating sex and gender into environmental health research and interventions. By applying an approach that included network analysis, the research concluded that diffusion pathways are distinct according to sex/gender. The extent to which access to information is limited to one sex/gender reduces the likelihood of reaching the entire community. Places where men’s and women’s discussion networks can connect are essential for the diffusion of health and environmental knowledge and practices. ItemBiomarcadores de exposição ao zinco em Amphistegina lessonii (Amphisteginidae, Foraminifera) do Arquipélago de Fernando de Noronha, PE, Brasil(2011-02) de Freitas Prazeres, Martina; Bianchini, Adalto, Dr.; Oceanografia Biológica da Universidade Federal do Rio GrandeThe aim of the study is to evaluate populations of the symbiont-bearing foraminifer Amphistegina lessonii both by using established visual assessment methods and by adapting cellular diagnostic methods for use on these protists. Findings suggest that an activation of some components of the antioxidant system occurred in A. lessonii to counteract the oxidative stress induced by Zn exposure, and consequently avoid a possible complete loss of the symbiont. (English translation begins at page 18) ItemUtility of Tissue Residues for Predicting Effects of Metals on Aquatic Organisms(SETAC, Pensacola, FL, 2010-07) Adams, William J; Blust, Ronny; Borgmann, Uwe; Brix, Kevin V; DeForest, David KAs part of a SETAC Pellston Workshop, we evaluated the potential use of metal tissue residues for predicting effects in aquatic organisms. This evaluation included consideration of different conceptual models and then development of several case studies on how tissue residues might be applied for metals, assessing the strengths and weaknesses of these different approaches.We further developed a new conceptual model in which metal tissue concentrations from metal-accumulating organisms (principally invertebrates) that are relatively insensitive to metal toxicity could be used as predictors of effects in metal-sensitive taxa that typically do not accumulate metals to a significant degree. Overall, we conclude that the use of tissue residue assessment for metals other than organometals has not led to the development of a generalized approach as in the case of organic substances. Species-specific and site-specific approaches have been developed for one or more metals (e.g., Ni). The use of gill tissue residues within the biotic ligand model is another successful application. Aquatic organisms contain a diverse array of homeostatic mechanisms that are both metal- and species-specific. As a result, use of whole-body measurements (and often specific organs) for metals does not lead to a defensible position regarding risk to the organism. Rather, we suggest that in the short term, with sufficient validation, species- and site-specific approaches for metals can be developed. In the longer term it may be possible to use metal-accumulating species to predict toxicity to metal-sensitive species with appropriate field validation. ItemInfluence of ecological factors and of land use on mercury levels in fish in the Tapajós River basin, Amazon(Elsevier, 2009) Sampaio da Silva, D.; Lucotte, M.; Paquet, S.; Davidson, R. ItemRostros del reciclaje : una experiencia de investigación con enfoque ecosalud en Lima - Perú(Consorcio por la Salud, Ambiente y Desarrollo (ECOSAD), 2011) Márquez Quispe, Carlos Jesús; Vallejos Dávalos, Julio ItemCommunity and household socioeconomic factors associated with pesticide-using, small farm household members’ health : a multi-level, longitudinal analysis(BioMed Central, London, GB, 2011) Cole, Donald C.; Orozco, Fadya A.; Ibrahim, Selahadin; Wanigaratne, SusithaThe study explored socio-economic gradients in health among smallholder member participants of a pesticide-related health and agriculture program in highland Ecuador. Twenty-four communities were profiled using key informant interviews, secondary data (percent of population with unsatisfied basic needs), and intervention implementation indicators. The paper examines determinants of health inequities in neurobehavioral performance among households in the 24 participating communities. A significant improvement was noted in the proportion of household managers that reported wearing gloves to wash clothing used in spraying. ItemAgriculture and health inter-sectorial research process to reduce hazardous pesticide health impacts among smallholder farmers in the Andes(BioMed Central, London, GB, 2011) Cole, Donald C.; Orozco, Fadya; Pradel, Willy; Suquillo, Jovanny; Mera, XavierWork with multiple actors is needed to shift agriculture away from pesticide use, and towards greater sustainability and human health, particularly for vulnerable smallholder farmers. This research in potato and vegetable farming communities in the Andean highlands worked with partners from various sectors over several projects. Increased involvement in organic agriculture was associated with greater household food security and food sovereignty. More diversified, moderately developed agricultural systems had lower pesticide use and better child nutrition. The Ecuadorian Ministry of Health has rolled out pesticide poisoning surveillance modeled on this research. ItemMonitoring adherence to the international code of conduct : highly hazardous pesticides in Central Andean agriculture and farmers’ rights to health(2009) Orozco, Fadya A.; Cole, Donald C.; Forbes, Greg; Kroschel, Jürgen; Wanigaratne, Susitha; Arica, Denis ItemNeurotoxic sequelae of mercury exposure : an intervention and follow-up study in the Brazilian Amazon(Springer, 2011) Fillion, Myriam; Philibert, Aline; Mertens, Frédéric; Lemire, Mélanie; José, CarlosThe Caruso Project used an Ecosystem Approach to Human Health to examine mercury (Hg) exposure in fish-eating communities in the Brazilian Amazon, and developed interventions to maximise nutrition from traditional diet while minimizing toxic risk. This article describes the village context and intervention strategies over time, and examines the evolution of fish consumption practices, exposure and health outcomes for persons who participated in the studies. A decrease in Hg exposure is attributed to the intervention and socio-economic changes in the village. ItemProceedings of the IDRC-organised panels at the 8th International Conference on Urban Health, ICUH 2009, Nairobi, Kenya, October 18 - 23, 2009(IDRC, 2010) IDRCWorkshop papers focus on waste management in informal settlements and urban slum conditions. Neglect by local leaders/government is key to an ongoing poorly functioning system. Urban authorities continue to leave beneficiary communities as ‘passive’ service consumers. To improve the urban environment and health status of the urban poor, affected communities should be involved in problem identification and proposed solutions. Unsafe water, poor drainage and garbage disposal, inadequate latrines and air pollution are key urban environmental problems. ItemKathmandu urban ecosystem health project a model approach(2009) Joshi, D.D.; Sharma, MinuInternational Development Research Centre (IDRC) supported research study on Echinococcosis/Hydatidosis which was carried out between 1992 and 2001 in Kathmandu Metropolitan City Nepal. The research work was carried out in two distinct project stages in wards 19 and 20 of KMC one from 1992-1996(applying a traditional epidemiology approach) and a second was Urban Ecosystem Health Project (UEHP) Approach from 1998-2006. Overall, there were three main step of activities in the development of the UEHP in Nepal: First is an exploratory/analytical systemic steps focusing on linkages between social, ecological, and health variables (1998-2001); The second a community action step employing a variety of systemic, narrative, and participatory-action research tools (2003-2006); and the third phase of urban ecosystem health project started from 2007 to 2009 which is now running. Community participation or participatory action research is a key element of ecosystem health programmes. Participatory Action Research approaches have three main goals. The first step is to describe what is there? What are the physical and socio-economic possibilities of this person or place? If we use the analogy of a person. The Second step, for ecosystems as for individuals, health is not just a physical state, but what we might call a spiritual state. It has been said that in any part of the world no solutions will be sustainable in the long run unless they are rooted in the communities where the problems occur, drawing on the people in these communities and their many skills, resources, and important knowledge, and those communities feel empowered and supported by higher levels of government. If such approaches can be worked out between local communities in Indian Subcontinent, non-government organizations, businesses, regional institutions of government and university, and with outside input only as necessary, then truly sustainable solutions will be found, and Kathmandu.