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, or, for early-life exposures, may increase risk for obesity and metabolic dysfunction, which are growing problems in Latin America that coexist with severe malnutrition.

Project Description

The high exposure risk and differences in nutritional vulnerability suggest significant health impacts from early life chemical exposures in the Amazon, which this project team will investigate.

At the request of the Peruvian Government, we will assist in drafting a strategic plan to reduce heavy metal exposure. We will help 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.

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

Fieldwork will involve visiting communities to conduct informal interviews with community leaders, health workers and residents, collect a random sample of hair from residents who visited a local health post in the prior year, conduct a community market and infrastructure survey and collect samples of food.

Anticipated Outcomes

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


Fall 2016 – Fall 2017

October-December 2016: Overview of project goals; Module 1– Toxicology of metals exposure; Team building exercises; Read over current strategic plans in Cusco and Pasco (the only 2 regions of Peru that have plans). January-April 2017: Weekly meetings – Module 2: Qualitative Research Methods and Module 3: Environmental Policy; IRB requirements, CITI training and certificates, arrange for shipping of human and food samples from Peru and Ecuador. May-August: Visiting offices of Regional Ministries of Health for each selected region.  Identify 2-4 communities to visit in each region to conduct informal interviews, market surveys and community infrastructure assessments; Visit office of regional Ministries of Health in Ecuador and visit 2-4 communities per region. September-December 2017: Run toxicology screens for data collected; draft summary of results from interviews and community data collection; compile any ancillary data collected from national databases.

This Team in the News

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See earlier related team, 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, Nicholas School - PhD in Environment
Elizabeth Monahan, Master of Science in Global Health
Rachel Whitson, Nicholas School - Master of Environmental Mgmt.

Undergraduate Team Members

Jennifer Callejas, Global Health (AB), Environmental Sciences (BS2)
Delaney Dryfoos, Global Health (AB), Neuroscience (BS2)
Liane Emerson, Global Health (AB), Biology (BS2)
Joshua Grubbs, Chemistry (BS)
Anson MacKinney
Karina Martinez Romo
Luiza Perez, Global Health (AB), Sociology (AB2)

* denotes team leader