[Old indicators for new problems: the relationship between sanitation and health].
OBJECTIVE
To review the literature published from 1995-2004 on the relationship between sanitation and health and to identify the main variables analyzed and the diseases or injuries used as markers of effect or environmental health.


METHODS
A search of Medline, SciELO, and LILACS on "sanitation" and "health" and "indicator" and "water" produced 103 articles, 17 of which were considered relevant for the analysis. We identified the study design and the sanitation and health variables analyzed in each of the 17 studies.


RESULTS
The most common study design was ecological and was employed in seven of the 17 studies. In most (10 studies), the health variable was diarrhea and sanitation variable was water quality. Fifteen studies reported a positive association between the health and sanitation variables.


CONCLUSIONS
There are still many gaps in our understanding of sanitation and its role, especially in large urban centers that are dependent on water and sewerage systems and often lack alternative water sources. Ecological studies based on secondary data and specific surveys have been shown to be a good option for analyses correlating sanitation and health.
Instituto Brasileiro de Geografia e Estatística (IBGE) e Fundação Oswaldo Cruz (FIOCRUZ), Escola Nacional de Saúde Pública (ENSP), Rio de Janeiro, RJ, Brasil. manderazzi@terra.com.br
Marco Antonio Ratzsch
MA
Andreazzi
Christovam
C
Barcellos
Sandra
S
Hacon
D006305:Health Status Indicators; D006801:Humans; D012499:Sanitation / Q000592:standards*