Environmental Epidemiology in Latin America: Research and Policy Development to Reduce Chemical Exposures (2016-2017)

Pollutant chemicals in Latin America have largely been unregulated for decades, resulting in high environmental exposures early and throughout one’s life, particularly in areas where large-scale development projects and extractive industries exist, such as road and dam construction, logging, mining, oil exploration and extraction. Chemical exposures during early life development can increase risk of adverse health outcomes. Pollutants such as mercury and select pesticides may be absorbed more readily in malnourished individuals and increase risk for obesity and metabolic dysfunction, which are growing problems in Latin America that coexist with severe malnutrition.

The high exposure risk and differences in nutritional vulnerability suggest significant health impacts from early-life chemical exposures in the Amazon. At the request of the Peruvian Government, this Bass Connections project team is contributing to a strategic plan to reduce heavy metal exposure. The team is helping to design a rapid assessment of heavy metal exposure in select regions of Peru, consisting of formative interviews, community market surveys, assessment of potential routes of exposure and obtaining of samples from humans and potential environmental sources of exposure.

Due to oil exploration, Ecuador has a longstanding chemical exposure problem that has existed in the Andes-Amazon region since the 1970s. The contrast between Ecuador and Peru will offer unique comparisons due to culture, politics, environmental justice and genetic predisposition. 

Team members conducted informal interviews with community leaders, health workers and residents; collected a random sample of hair from residents who visited a local health post in the prior year; conducted a community market and infrastructure survey; and collected samples of food.

Summarized assessment of qualitative data collection; completed evaluation of heavy metals across the regions; a report (in Spanish) to be shared with the Ecuadorian and Peruvian Ministries of Health and Environment; recommendations for mitigation of heavy metals exposure to stakeholders

In Fall 2016, team members reviewed the toxicology of metals exposure and current strategic plans in Cusco and Pasco, Peru. Focus areas in Spring 2017 were qualitative research methods; environmental policy; IRB requirements and CITI training and certificates; and preparation for shipping human and food samples from Peru and Ecuador.

In Summer 2017 the team is visiting regional ministries of health in Peru and identifying two to four communities to visit in each region in order to conduct informal interviews, market surveys and community infrastructure assessments. The team is also visiting regional ministries of health in Ecuador and two to four communities per region. In Fall 2017 team members will run toxicology screens for the collected data, draft a summary of results from the interviews and community data collection and compile ancillary data collected from national databases.

Team member Luiza Perez received a follow-on grant to develop a study on the efficacy of different insecticide-treated bed nets in repelling anopheles and the occupational risk factors associated with leishmaniasis in the Peruvian Amazon.

Timing

Fall 2016 – Fall 2017

Team Outcomes

Exploring the Eco-epidemiology of Cutaneous Leishmaniasis through an Interdisciplinary, Inter-institutional and international collaboration (poster by Bruno Valan, Jennifer Callejas, Pamela Sanchez, Maggie Skiles, Justin Lana)

Evaluation of a Dietary Intervention for Chronic Methylmercury Exposure Among Communities in Madre de Dios, Peru (poster by Delaney Dryfoos, Joshua Grubbs, Anson MacKinney, Karina Martinez Romo, William Pan, Joel Meyer, Ernesto Ortiz)

Evaluación de una Intervención Dietética para Exposición Crónica al Metilmercurio entre Comunidades en Madre de Dios, Perú (Jennifer Callejas, Delaney Dryfoos, Liane Emerson, Joshua Grubbs, Anson MacKinney, Karina Martinez Romo, Luiza Perez, William Pan, Joel Meyer, Ernesto Ortiz)

An Environmental Approach to Global Health (presentation by Justin Lana and Luiza Perez, Bass Connections Showcase, April 24, 2017)

Bass Connections Follow-on Student Research Award (Luiza Perez)

Reflections

Mercury and Masato: Deliberations from the Peruvian Amazon (Joshua Grubbs)

This Team in the News

Interdisciplinary Collaboration Drives Change for Mercury Toxicity in the Peruvian Amazon

Meet the Members of the 2017-18 Student Advisory Council

Bass Connections Students Win Poster and Photo Awards for Research in Uganda, Honduras, Nepal and Peru

Turning Learning into Livesaving in Peru

Three Bass Connections Faculty Leaders Receive Honors

Student Laurels and Honors for 2017

Students Present Their Research and Learn from Each Other at the Bass Connections Showcase

Student Research Shared, Awards Announced at Bass Connections Showcase

Twelve Students Receive Grants to Take Their Bass Connections Research Further

Can a Dietary Intervention Reduce Mercury Toxicity Among Native Communities in Peru?

Hidden Casualties of War: Cutaneous Leishmaniasis and the Syrian Civil War

Reflections on Mentoring from Bass Connections Graduate Students

Fostering a Collaborative Research Environment in Peru

See related teams, Environmental Epidemiology in Latin America: Impact of an Oil Spill in the Peruvian Amazon (2017-2018) and Environmental Epidemiology in Latin America: Leishmania (2015-2016).

Faculty/Staff Team Members

Heileen Hsu-Kim, Pratt School - Civil & Environmental Engineering*
Joel Meyer, Nicholas School - Environmental Sciences & Policy*
Ernesto Ortiz, Duke Global Health Institute
William Pan, Nicholas School - Environmental Sciences & Policy*
Alexander Pfaff, Sanford School of Public Policy*
Elizabeth Turner, School of Medicine - Biostatistics & Bioinformatics*

Graduate Team Members

Justin Lana, Environment-PHD
Elizabeth Monahan, Global Health - MS
Rachel Whitson, Master of Environmental Management, Ecotoxicolgy & Environmental Health

Undergraduate Team Members

Jennifer Callejas, Environmental Sciences (BS), Global Health (AB2)
Delaney Dryfoos, Neuroscience (AB), Global Health (AB2)
Liane Emerson, Biology (BS), Global Health (AB2)
Joshua Grubbs, Chemistry (BS), Global Health (AB2)
Anson MacKinney
Karina Martinez Romo
Luiza Perez, Sociology (AB), Global Health (AB2)

* denotes team leader

Status

Active