Impact of large industrial emission sources on mortality and morbidity in Chile: A small-areas study.
Chile suffers significant pollution from large industrial emitters associated with the mining, metal processing, paper production, and energy industries. The aim of this research was to determine whether the presence of large industrial facilities (i.e. coal- and oil-fired power plants, pulp and paper mills, mining facilities, and smelters) affects mortality and morbidity rates in Chile. For this, we conducted an ecological study that used Chilean communes as small-area observation units to assess mortality and morbidity. Public databases provided information on large pollution sources relevant to Chile. The large sources studied were oil- and coal-fired power plants, copper smelters, pulp and paper mills, and large mining facilities. Large sources were filtered by first year of production, type of process, and size. Mortality and morbidity data were acquired from public national databases, with morbidity being estimated from hospitalization records. Cause-specific rates were calculated for the main outcomes: cardiovascular, respiratory, cancer; and other more specific health outcomes. The impact of the large pollution sources was estimated using Bayesian models that included spatial correlation, overdispersion, and other covariates. Large and significant increases in health risks (around 20%-100%) were found for communes with power plants and smelters for total, cardiovascular, respiratory, all-cancer, and lung cancer mortality. Higher hospitalization rates for cardiovascular disease, respiratory disease, cancer, and pneumonia (20-100%) were also found for communes with power plants and smelters. The impacts were larger for men than women in terms of both mortality and hospitalizations. The impacts were also larger when the sources were analyzed as continuous (production volume) rather than dichotomous (presence/absence) variables. In conclusion, significantly higher rates of total cardiovascular, respiratory, all-cancer and lung cancer mortality and cardiovascular, respiratory, cancer and pneumonia hospitalizations were observed in communes with power plants and smelters.
Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile. Electronic address: pabloruiz@med.uchile.cl.
Pablo
P
Ruiz-Rudolph
Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile; Departamento de Salud Pública, Universidad de Caldas, Carrera 25 N° 48-56, Manizales, Colombia.
Nelson
N
Arias
Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Pedro de Valdivia 641, Providencia, Santiago, Chile.
Sandra
S
Pardo
Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile.
Marianne
M
Meyer
Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile.
Stephanie
S
Mesías
Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile.
Claudio
C
Galleguillos
Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile.
Irene
I
Schiattino
Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile.
Luis
L
Gutiérrez
D000328:Adult; D001499:Bayes Theorem; D002318:Cardiovascular Diseases / Q000401:mortality; D002677:Chile; D004781:Environmental Exposure; D018876:Environmental Illness; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000633:toxicity*; D004787:Environmental Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D007220:Industrial Waste; D008297:Male; D009017:Morbidity; D009369:Neoplasms / Q000401:mortality; D012140:Respiratory Tract Diseases / Q000401:mortality
D004785:Environmental Pollutants; D007220:Industrial Waste
Cancer; Cardiovascular; Copper smelter; Mining facilities; Power plants; Respiratory