Abstract #368532 Frances Garca 2 Authors MPH Biostatistics MPH - - PowerPoint PPT Presentation
Prevalence of respiratory, dermatologic and reproductive conditions in a community exposed to coal ash and other industrial contaminants in Guayama, and a reference community in Fajardo: A cross-sectional study in Puerto Rico Presented by:
Prevalence of respiratory, dermatologic and reproductive conditions in a community exposed to coal ash and other industrial contaminants in Guayama, and a reference community in Fajardo: A cross-sectional study in Puerto Rico
Abstract #368532
Presented by: Frances García
Jorge Albarracín Omar Dávila Carlos Litovich Glorimar Meléndez Eric Miranda Marangelí Olán Maylisa Romero Jonathan Sánchez Dayanara Belén Carol Canales Camille Delgado Gilberto Fernández Viery Franco Frances García Noemí Hernández María Martínez Israel Méndez Daniela Ojeda Inelia Otero Jeremy Pérez Stephany Pérez Fabiola Robles Rafael Ruiz Lilliana Serrano Coralys Soto Camila Villa Wesley Villavicencio
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MPH Biostatistics MPH Epidemiology Mentors: Dr. Rosa Rosario Rosado & Dr. Gilberto Ramos Valencia
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¡ This study served as part of a practicum course required for the completion of a MPH degree in Biostatistics and Epidemiology. ¡ Community leaders were invited to voice their concerns in regards to public health issues in their community.
¡ This study was conducted in response to the community’s concern of coal ash exposure and perceived increased frequency in health conditions:
¡ Respiratory diseases ¡ Dermatological diseases
¡ Currently Guayama has a variety of industries that contribute to environmental contamination, such as:
¡ Coal fired power plant ¡ Various Pharmaceuticals
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¡ According to the Toxic Release Inventory (TRI), the coal fired power plant in Guayama placed second for total air emissions in Puerto Rico for the year 2014.
(EPA, 2016)
¡ The main objective of this study was to compare the prevalence of respiratory, dermatological, and reproductive conditions in two communities. ¡ Guayama: Community exposed to coal ash and
¡ Fajardo: Reference community
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Guayama ¡ Puente de Jobos ¡ Miramar
Communities within a 2-3 Km radius from industrial zone
Fajardo ¡ Santa Isidra ¡ Rafael Bermudez
Communities not proximal to industrial zone
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Guayama Fajardo
Guayama Fajardo
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Guayama ¡ Puente de Jobos ¡ Miramar
Communities within a 2-3 Km radius from industrial zone
Fajardo ¡ Santa Isidra ¡ Rafael Bermudez
Communities not proximal to industrial zone
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Sociodemographic similarities between both populations were taken into consideration.
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Distribution by sex Guayama Fajardo Total Male population 1,054 (42%) 776 (45%) Total Female population 1,427 (58%) 960 (55%) Sociodemographic characteristics Guayama Fajardo Total Population 2,481 1,736 Income median $15,639 $19,409 Total number of families 672 431 Average Family size 3.25 3.93
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Are the respiratory and dermatological disease prevalence greater in Guayama in comparison to those in Fajardo?
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¡ Subjects in each community were selected using a probabilistic stratified cluster design:
¡ Guayama= 276 ¡ Fajardo= 195
¡ Non-institutionalized residents ¡ Sample size adjusted for: no-response rates, absent residents, and uninhabited units
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¡ Interviewers were trained on study protocol to reduce interviewer bias ¡ Instrument: Standardized Questionnaire
¡ Home interview ¡ Duration: 25-30 minutes
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¡ Head of the household or person with the most knowledge about household
¡ one person (≥ 21 years) from each household was interviewed, regarding family members
¡ Resident of the community for at least 5 years
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¡ Data Entry:
¡ RED Cap
¡ Quality Control
¡ Double data entry ¡ Randomized selection of questionnaires (20%) for revision
¡ Data was exported to SPSS 17.0 for statistical analysis
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Univariable
distribution
tendency and dispersion measures Bivariable
Multivariable
Regression
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¡ Total number of households interview: 176
¡ Guyama: 102 ¡ Fajardo: 74
¡ Total sample size: 471
¡ Guayama: 276 ¡ Fajardo: 195
¡ Response Rate
¡ Guayama: 81% ¡ Fajardo: 64%
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25.1 34.8 24.1 16.0 25.0 37.4 25.8 11.8
5 10 15 20 25 30 35 40
0 a 17 years 18 a 44 years 45 a 64 years ≥ 65 years
Porcentage (%)
Age group
Age group distribution in weighted population
Guayama (N=2,561) Fajardo (N=1,802)
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Sample Description
Guayama Fajardo Male 42.6% 45.6% Female 57.4% 54.4% Smoker in household 4.7% 7.4% Education level < 12th grade 15% 16.5% 12th grade < Bachelor’s 75% 52.8% ≥ Bachelor’s 10% 30.7%
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1.4 10.9 21.0 62.2 16.0 21.6 53.4 9.0
10 20 30 40 50 60 70
None Slight Moderate Severe
Porcentage (%) Perceived Environmental Pollution
Perceived environmental contamination in the weighted population
Guayama (N=2445) Fajardo (N=1008)
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63.4 33.8 2.8 33.4 [VALUE].0 15.6
10 20 30 40 50 60 70
Poor Good Excellent
Porcentage (%) Air quality perception
Air quality perception in the weighted population
Guayama (N=2,561) Fajardo (N=1,802)
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Disease or Condition Prevalence (%) Guayama Fajardo
Any Respiratory Disease 35.5 15.7 Sinusitis 20.0 10.2 Asthma 16.8 1.1 Chronic Bronchitis 5.1 1.0 Any Dermatologic Disease 4.1 1.8 Rash 2.3 0.2 Spontaneous Abortions (15-49 years old) 22.4 3.6
Adjusted by age
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Crude OR CI 95% Adjusted OR CI 95% Any Respiratory Disease 2.51 1.57 - 4.00 2.24 1.86 – 3.64
Adjusted by age, smoker in household & education level
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Crude OR CI 95% Adjusted OR CI 95% Asthma 2.5 1.3 - 4.7 2.3 1.19 – 4.45
Adjusted by: age, smoker in household & education level
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Crude OR CI 95% Adjuste d OR CI 95% Sinusitis 2.2 1.2 - 3.9 1.93 1.07 – 3.48
Adjusted by age, smoker in household & education level
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Crude OR CI 95% Adjusted OR CI 95% Chronic Bronchitis 3.2 1.2 - 8.5 3.87 1.22 – 3.48
Adjusted by age, smoker in household & education level
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Crude OR CI 95% Adjusted OR CI 95% Any Dermatological Disease 3.7 1.2 – 11.2 2.94 0.95 – 9.01
Adjusted by age, smoker in household & education level
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Crude OR CI 95% Adjusted OR CI 95% Rash 7.6 1.6 - 35.9 7.5 3.0 – 16.2
Adjusted by: age
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OR CI 95% Spontaneous Abortions (15-49 years old) 7.8 0.9 - 69.3
¡ A clear temporal relationship between exposure and outcome cannot be determined. ¡ Time and resources were limited
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¡ Study findings suggest that the prevalence of respiratory, dermatologic, and reproductive conditions are significantly higher in the exposed community of Guayama than in the reference community. ¡ Findings seem to confirm the community’s concern
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¡ Control, regulation and industrial waste management compliance. ¡ Early screening and treatment of diseases associated with exposure. ¡ Improve quality of life and reduce preventable diseases and mortality
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¡ Keep community active and engaged in the pursue
initiatives and empowerment. ¡ Conduct analytical studies to establish a clear temporal relationship between exposure and
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Photo from: Periódico Primera Hora