title: Prevalence of liver diseases as referred by people living in the Santos and São Vicente Estuary.
abstract: The Santos and São Vicente Estuary has suffered extensively over the years from irregular industrial deposits. The present study aimed to evaluate liver disease prevalence and potential associated risk factors in four of the Estuary's areas (Pilões and Água-Fria, Cubatão Center, Continental São Vicente, and Guarujá) and a reference area (Bertioga). This study consisted of a cross-sectional study design, in which a questionnaire was used to collect information in 820 households at each of the study areas. The proportion of total liver diseases, hepatitis, cirrhosis, and cancer (liver, biliary tract, and pancreas) per area were estimated. Pearson's chi-square test and two proportion differences test were applied in order to evaluate associations between disease occurrence and areas and to test differences between two proportions, respectively. Single and multiple logistic regression models were applied to assess associations between disease prevalence and the different study areas. Liver disease prevalence was 1.5 % among all inhabitants and 1.4 % among those without any type of exposure. Among those who reported the presence of liver disease, a higher percentage of the participants that reported hepatitis (27.7 %) or other liver disease (48.7 %) did not report occupational or alcohol exposures. Hepatitis (77.8 %) was the most reported disease, and a statistical association between living in Pilões and Água-Fria and the occurrence of hepatitis was observed (Pearson's χ (2): z = 18.1; p = 0.001). The consumption of locally-produced groceries (2.88; CI: 1.24-6.70) and water (5.88; CI: 2.24-15.45) were shown to be risk factors for the occurrence of liver disease. Thus, environmental exposure is still a public health problem present in the estuary region.
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil. daniele.pena@gmail.com.
authors.forename: Daniele Fernandes Pena
authors.initials: DF
authors.lastname: Carvalho
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil.|Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.
authors.forename: M T
authors.initials: MT
authors.lastname: Guimarães
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil.|Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.
authors.forename: T S
authors.initials: TS
authors.lastname: Ribeiro
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil.
authors.forename: N N
authors.initials: NN
authors.lastname: Campina
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil.
authors.forename: M R
authors.initials: MR
authors.lastname: Lobarinhas
authors.affiliation: Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.
authors.forename: A L J
authors.initials: AL
authors.lastname: Lopes
authors.affiliation: Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.
authors.forename: M G
authors.initials: MG
authors.lastname: Cunha
authors.affiliation: Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.
authors.forename: I B
authors.initials: IB
authors.lastname: Souza
authors.affiliation: Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.
authors.forename: V L F
authors.initials: VL
authors.lastname: Oliveira
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil.|Contemporary Cultural Studies Centre (CEDEC), São Paulo/SP, Brazil. R. Airosa Galvão, 64. Água Branca, CEP 05002-070, São Paulo, SP, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Braga E Braga
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil.|Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.
authors.forename: L C
authors.initials: LC
authors.lastname: Martins
authors.affiliation: Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.|Contemporary Cultural Studies Centre (CEDEC), São Paulo/SP, Brazil. R. Airosa Galvão, 64. Água Branca, CEP 05002-070, São Paulo, SP, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Gomes
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil.|Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.|Contemporary Cultural Studies Centre (CEDEC), São Paulo/SP, Brazil. R. Airosa Galvão, 64. Água Branca, CEP 05002-070, São Paulo, SP, Brazil.
authors.forename: L A A
authors.initials: LA
authors.lastname: Pereira
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, São Paulo/SP, Brazil. Av. Dr. Arnaldo, 455, 1° floor, room 1304, Cerqueira Cézar, Cep 01246-903, São Paulo, SP, Brazil.|Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Santos/SP, Brazil. Av Conselheiro Nébias, 300. Vila Mathias, CEP 11015-002, Santos, SP, Brazil.|Contemporary Cultural Studies Centre (CEDEC), São Paulo/SP, Brazil. R. Airosa Galvão, 64. Água Branca, CEP 05002-070, São Paulo, SP, Brazil.
authors.forename: A L F
authors.initials: AL
authors.lastname: Braga
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000032:analysis; D063366:Estuaries; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D014873:Water Pollutants / Q000633:toxicity; D055815:Young Adult
chemical_list: D014873:Water Pollutants
keywords: Cross-sectional studies; Environmental pollution; Estuary pollution; Hepatitis; Liver cirrhosis; Liver diseases