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Review Article | DOI: https://doi.org/
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Copyright: © ssia dos Santos Nery. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 30 November -0001 | Accepted: 27 March 2018 | Published: 01 January 1970
Keywords: Epidemiological Surveillance; Environmental Health; Notification of Chemical Substances; Epidemiological Investigation; Environmental Factors.
According to the World Health Organization (WHO), 25% of the disease burden and 23% of deaths worldwide are related to environmental factors. This paper is an update of an earlier work "Epidemiological Evaluation of Notifications of Environmental Events in the State of São Paulo, Brazil - 2011-2012." The paper describes the characteristics of contaminated areas and of the accidents which involved chemical substances, methods used, types of substances, exposed population, and measures adopted. The online notification of environmental events increases the analysis of the main events associated with diseases related to environmental chemicals. Thus, it facilitates the adoption of public policies to prevent environmental health problems. Period covered is January 2013 to January 2015.
According to the World Health Organization (WHO), 25% of the disease burden and 23% of deaths worldwide are related to environmental factors (1,2). In this sense, epidemiology is one of the main tools to identify and quantify these situations and their impacts on human health. The most vulnerable populations are the most affected and there is need to address this situation: To identify health risks and injuries related to environmental impacts is essential to addressing these issues.
The health profile of the population in Brazil has become. Studies, analyzes and observations highlight a transition. The way of life in all its stages, directly impact the quality of life, health and way of dying of a population. It is arguable that the rapid changes generated by current models of values, attitudes, consumption patterns of society, associated with the form of public management, are reflected across the globe, Brazil inclusive, and in São Paulo, a highly industrialized state. São Paulo, with an estimated population of over 44 million people, has about 5,000 registered contaminated areas. People are living or working in areas contaminated with exposure to chemical contaminants arising from various sources, compromising the quality of life. Set Action models require identification of situations and problems. Epidemiology enhances these actions.
The online notification of environmental events increases the analysis of the main events associated with diseases related to environmental chemicals; thus, it facilitates the adoption of public policies to prevent environmental health problems.
This is a descriptive study of the activities, including the notification of environmental events, training and necessary technical definitions of programs for environmental health in the State of Sao Paulo. It analyzes the notifications received between January 2013 to January 2015 and reports the number of notifications received in accordance with the event classification system and analyzes accidents or events related to chemical substances.
The analyses are performed by professionals, including doctors, engineers and biologists.
Parameters and working methodology
3. Results and Discussion
3.1. Health Surveillance of Populations Exposed to Contaminated Areas
The identification of contaminated areas is performed by an environmental agency. The number of contaminated areas in the State of Sao Paulo has grown substantially (Figures 1 and 2). In response, the health agencies have created the corresponding entries in the program. The areas are classified by characteristics. (Figures 3 and 4).
To work with this, then for the Health sector, it is necessary to do periodic Training for the Health Technicians. Presencial capacitation were made on period 2006-2015 for several professionals. Total of 2.289 people in this period (Figure 5).
The population exposed or potentially exposed in contaminated areas in the state of Sao Paulo in 2014 year was: 3.063.103 people. The evolution is on Figure 5.
3.2: Environmental Event Notification and Chemical Emergencies
Analyzed data presented in official reports of the World Bank, the World Health Organization and others, show that the frequency of disasters is increasing and will increase as a result of many factors but especially due to extreme weather linked to climate change (3). The geological events with chemical emergencies are notified by CETESB (Company of Environmental state of SP)(4) from period 01/01/2010 until 12/31/2015. There were 2,402 accidents (Figure 6).
Routine notification of environmental events is held in the state of São Paulo since 2011, as Ministerial Ordinances. The notifications are made by the Civil Defense Institute too. In this case 51% had victims.
Natural disasters have a major impact on public health. Urbanization has been occurring in Brazil, especially in the state of SP. It is reflected in large clusters in areas without urban infrastructure and occupied predominantly by people of lower socioeconomic status, generating vulnerable areas. The state of SP, accounts for about 23.2% of households characterized as subnormal agglomerates (Brazil is 5.6%).It is important to mention that about 10% of SP city's population resides in the nearby areas to dams and environmental protection facilities
near the Billings and Guarapiranga (Source: IBGE).
Natural phenomena generate direct impacts on human health. In Brazil hydrological events have the highest mortality and morbidity (Source: PAHO). The natural origin disaster number in the world has grown significantly in recent decades, causing thousands of injuries and deaths every year and mainly harming the physical and mental health of millions of people (2). Drought is presented as a major Type of natural disaster, with major impacts on poor or developing countries. The SP state lived important period recently, water crisis (years 2014 and 2015). At figure 7, the volume of Cantareira water’s sistem is showed.
Environmental events with vitims
(*) january – may Source: SIDEC/Def. Civil-SP e ADANs/SUS-SP
Table I – Environmental Events notified São Paulo State, 2011-2015*
Figure 18: Events Notified Years : 2011 - 2015
Lightning related deaths in the state of SP are concentrated in the summer months (6). In Figure 19, the deaths by lightning are presented considering data from the summer operation (December 01 to March 31) per year. In the period December / 14 - March 2015, 12 deaths were reported.
(*) january -may
Source: SIDEC/Def. Civil-SP e ADANs/SUS-SP
Table II – Events notified according to characteristics of impacts: Homeless, Evacuees and Deaths São Paulo State, 2011-2015*
Figure 8 – Year 2011: Number ofEvents notified according to characteristics of impacts: Homeless, Evacuees and Deaths. 1=Homeless; 2=Evacuees; 3=Deaths Source: SES/SP
Figure 9 - Year: 2012: Number ofEvents notified according to characteristics of impacts: Homeless, Evacuees and Deaths. 1=Homeless; 2=Evacuees; 3=DeathsSource: SES/SP
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