The authors conducted a survey during 1992 to evaluate blood levels of lead and mercury in Inuit adults of Nunavik (Arctic Quebec, Canada). Blood samples obtained from 492 participants (209 males and 283 females; mean age = 35 yr) were analyzed for lead and total mercury; mean (geometric) concentrations were 0.42 micromol/l (range = 0.04-2.28 micromol/l) and 79.6 nmol/l (range = 4-560 nmol/l), respectively. Concentrations of omega-3 fatty acid in plasma phospholipids--a biomarker of marine food consumption--were correlated with mercury (r = .56, p < .001) and, to a lesser extent, with blood lead levels (r = .31, p < .001). Analyses of variance further revealed that smoking, age, and consumption of waterfowl were associated with lead concentrations (r2 = .30, p < .001), whereas age and consumption of seal and beluga whale were related to total mercury levels (r2 = .30, p < .001). A significant proportion of reproductive-age women had lead and mercury concentrations that exceeded those that have been reportedly associated with subtle neurodevelopmental deficits in other populations.
BackgroundOne of the consequences of climate change is the increased frequency and intensity of heat waves which can cause serious health impacts. In Québec, July 2010 was marked by an unprecedented heat wave in recent history. The purpose of this study is to estimate certain health impacts of this heat wave.MethodsThe crude daily death and emergency department admission rates during the heat wave were analyzed in relation to comparison periods using 95% confidence intervals.ResultsDuring the heat wave, the crude daily rates showed a significant increase of 33% for deaths and 4% for emergency department admissions in relation to comparison periods. No displacement of mortality was observed over a 60-day horizon.ConclusionsThe all-cause death indicator seems to be sufficiently sensitive and specific for surveillance of exceedences of critical temperature thresholds, which makes it useful for a heat health-watch system. Many public health actions combined with the increased use of air conditioning in recent decades have contributed to a marked reduction in mortality during heat waves. However, an important residual risk remains, which needs to be more vigorously addressed by public health authorities in light of the expected increase in the frequency and severity of heat waves and the aging of the population.
BackgroundA school absenteeism surveillance system was implemented in the province of Quebec, Canada during the second wave of the 2009 H1N1pandemic. This paper compares this surveillance approach with other available indicators.MethodAll (3432) elementary and high schools from Quebec were included. Each school was required to report through a web-based system any day where the proportion of students absent for influenza-like illness (ILI) exceeded 10% of current school enrolment.ResultsBetween October 18 and December 12 2009, 35.6% of all schools met the 10% absenteeism threshold. This proportion was greater in elementary compared to high schools (40% vs 19%) and in smaller compared to larger schools (44% vs 22%). The maximum absenteeism rate was reached the first day of reporting or within the next two days in 55% and 31% of schools respectively. The first reports and subsequent peak in school absenteeism provincially preceded the peak in paediatric hospitalization by two and one weeks, respectively. Trends in school surveillance otherwise mirrored other indicators.ConclusionDuring a pandemic, school outbreak surveillance based on a 10% threshold appears insufficient to trigger timely intervention within a given affected school. However, school surveillance appears well-correlated and slightly anticipatory compared to other population indicators. As such, school absenteeism warrants further evaluation as an adjunct surveillance indicator whose overall utility will depend upon specified objectives, and other existing capacity for monitoring and response.
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