Research into Mercury Exposure and Health Education in Subsistence Fish-Eating Communities of the Amazon Basin: Potential Effects on Public Health Policy

The neurotoxic effects of fish-methylmercury (meHg) consumed regularly are considered hazardous to fetuses and newborn infants; as a result fish consumption advisories are an important asset to control meHg exposure in affluent societies. These concerns are now part of health promotion programs for Amazon subsistence villagers. While urban dwellers in affluent societies can choose an alternative nutritious diet, traditional and subsistence communities are caught up in controversial issues and lifestyle changes with unintended health consequences. Traditional fish-eating populations of industrialized and non-industrialized regions may be exposed to different neurotoxic substances: man-made pollutants and environmentally occurring meHg. Additionally, in non-industrialized countries, pregnant women and infants are still being immunized with thimerosal-containing vaccines (TCVs) which degrade to ethylmercury (etHg). Therefore, the complexity involving fish-meHg associated with wild-fish choices and Hg exposure derived from TCVs is difficult to disentangle and evaluate: are villagers able to distinguish exposure to differently hazardous chemical forms of Hg (inorganic, fish-meHg, and injected etHg)? Is it possible that instead of helping to prevent a plausible (unperceived) fish-meHg associated neurocognitive delay we may inadvertently arouse panic surrounding Hg exposure and disrupt subsistence fish-eating habits (necessary for survival) and life-saving vaccination programs (required by public health authorities)? These questions characterize the incompleteness of information related on the various chemical forms of Hg exposure and the need to convey messages that do not disrupt nutritional balance and disease prevention policies directed at Amazonian subsistence communities

Bioethics and mass childhood vaccination

As vacinas são consideradas como uma das maiores conquistas da humanidade no controle e erradicação de doenças infectocontagiosas e também uma das técnicas biomédicas mais polêmicas e de maior controvérsia considerando os riscos de efeitos adversos e a sua forma compulsória de utilização em milhões de crianças saudáveis. O atual paradigma preventivo de vacinação em massa tem sido desafiado nas últimas décadas por mudanças nas relações com a imunização, melhoria das condições sanitárias das populações e pelo surgimento de declarações universais de proteção do ser humano. Com isso, o presente artigo pretende analisar a vacinação infantil em massa sob a ótica da bioética no contexto individual e coletivo e criar um ambiente de discussão para reflexão ética sobre os programas de vacinação. Concluímos que a bioética em sua nova concepção conceitual propõe novos referenciais teóricos e metodológicos que podem ser utilizados para o debate ético das atuais políticas sanitárias.Vaccines are considered one of the greatest achievements of mankind in the control and eradication of infectious diseases and also one of the most controversial biomedical techniques and greater controversy considering the risks of side effects and their compulsory use in millions of healthy children. The current paradigm of preventive mass vaccination has been challenged in recent decades by changes in relationships with immunization, improvement of sanitary condition of populations and the emergence of universal declarations for human protection. Thus, the present work aims to analyze the mass childhood vaccination from the perspective of bioethics in the individual and collective context and create an environment for discussion of ethical reflection on vaccination programs. We conclude that de new bioethics’ approach proposes a new theoretical and methodological framework that can be used for the ethical debate of current health policies.Las vacunas son uno de los mayores logros de la humanidad en el control y erradicación de las enfermedades infecciosas y también una de las técnicas biomédicas más discutidas y de mayor controversia teniendo em cuenta los riesgos de efectos adversos y su obligatoriedad de uso en millones de niños sanos. El paradigma actual de la vacunación masiva preventiva ha sido cuestionada en las últimas décadas por los cambios en lãs relaciones con la inmunización, la mejora de la salud de la población y la aparición de las declaraciones universales de protección humana. Por lo tanto, este artículo tiene como objetivo analizar la vacunación infantil masiva desde la perspectiva de la bioética en el contexto individual y colectivo y crear un ambiente propicio para la discusión de la reflexión ética sobre los programas de vacunación. Llegamos a la conclusión de que La bioética en su nuevo concepto propone nuevos marcos teóricos y metodológicos que se pueden utilizar para el debate ético de las políticas de salud actuales

O PRESÉPIO SERTANEJO de Crispina dos Santos

O artigo trata da obra da ceramista feirense Crispina dos Santos, em particular, dos presépios

Neurodevelopment of Amazonian Infants: Antenatal and Postnatal Exposure to Methyl- and Ethylmercury

Neurodevelopment as Gesell development scores (GDSs) in relation to mercury exposure in infants (<6 months of age) of one urban center and two rural villages, respectively, of fisherman and cassiterite miners. Mean total hair-Hg (HHg) concentrations of infants from Itapuã (3.95 ± 1.8 ppm) were statistically (P = 0.0001) different from those of infants from Porto Velho (3.84 ± 5.5 ppm) and Bom Futuro (1.85 ± 0.9 ppm). Differences in vaccine coverage among these populations resulted in significantly higher (P = 0.0001) mean ethylmercury (EtHg) exposure in urban infants (150 μg) than in infants from either village (41.67 μg, Itapuã; 42.39 μg, Bom Futuro). There was an inverse significant (Spearman r = −0.2300; P = 0.0376) correlation between HHg and GDS for infants from Porto Velho, but not for the rural infants from Bom Futuro (Spearman r = 0.1336; P = 0.0862) and Itapuã (Spearman r = 0.1666; P = 0.5182). Logistic regression applied to variables above or below the median GDS showed that EtHg exposure (estimated probability = −0.0157; P = 0.0070) and breastfeeding score (estimated probability = −0.0066; P = 0.0536) score were significantly associated with GDS. Conclusion. In nurslings whose mothers are exposed to different levels of fish-MeHg (HHg), a higher score of neurological development at six months was negatively associated with exposure to additional TCV-EtHg. Results should be interpreted with caution because of unaccounted variables