Jenny Pronczuk de Garbino: A Global Champion for Children’s Health

Landrigan, Philip J.; Suk, William A.

doi:10.1289/ehp.1408293

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…In Brazil, the association between heat exposure and hospitalization was strongest in young children, which may reflect their having an immature automatic thermoregulatory response relative to older children and adults (eg, greater heat absorption per unit of mass and immature ability to lose heat through sweating). 30 , 31 The temporal increase in heat susceptibility for children is in agreement with previous findings that have reported children to have lower capacity of acclimatization compared with adults. 32 The risk of hospitalization associated with heat exposure was also greater among individuals aged 80 years or older, possibly owing to age-associated physiological deterioration in body systems rendering them more susceptible to early heat.…”

Section: Discussionsupporting

confidence: 90%

“…Our study adds to the limited knowledge regarding the demographic and geographic characteristics of heat susceptibility over the course of the hot season. In Brazil, the association between heat exposure and hospitalization was strongest in young children, which may reflect their having an immature automatic thermoregulatory response relative to older children and adults (eg, greater heat absorption per unit of mass and immature ability to lose heat through sweating) . The temporal increase in heat susceptibility for children is in agreement with previous findings that have reported children to have lower capacity of acclimatization compared with adults .…”

Section: Discussionsupporting

confidence: 87%

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Assessment of Intraseasonal Variation in Hospitalization Associated With Heat Exposure in Brazil

Zhao

Coelho

et al. 2019

JAMA Netw Open

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Key Points Question During the hot season, is timing of heat exposure associated with varied risk of hospitalization in the Brazilian population? Findings In this time-stratified case-crossover study, the association between heat exposure and hospitalization was greatest in the early hot season, particularly for residents living in the northeast and central west regions of Brazil. Exposure to early heat was associated with the highest risk of hospitalization for children and elderly individuals, and for admissions for endocrine, nutritional, and metabolic diseases. Meaning Preventive strategies to mitigate the association of high temperature with population health should focus on extreme high temperatures occurring early in the hot season.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Assessment of Intraseasonal Variation in Hospitalization Associated With Heat Exposure in Brazil

Zhao

Coelho

et al. 2019

JAMA Netw Open

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“…Brazils’ Unified Health System, which provides universally free access to health services for the Brazilian population, may largely explain this phenomenon [49]. Consistent with findings from other countries [50,51], children and the elderly in Brazil, particularly the population ≥70 years old, were more affected by heatwaves than adults. Both children and the elderly have lower thermoregulatory capacity compared with young and middle-aged adults [48].…”

Section: Discussionmentioning

confidence: 53%

The association between heatwaves and risk of hospitalization in Brazil: A nationwide time series study between 2000 and 2015

Zhao

Coelho

et al. 2019

PLoS Med

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Background To our knowledge, no study has assessed the association between heatwaves and risk of hospitalization and how it may change over time in Brazil. We quantified the heatwave–hospitalization association in Brazil during 2000–2015. Methods and findings Daily data on hospitalization and temperature were collected from 1,814 cities (>78% of the national population) in the hottest five consecutive months during 2000–2015. Twelve types of heatwaves were defined with daily mean temperatures of ≥90th, 92.5th, 95th, or 97.5th percentiles of year-round temperature and durations of ≥2, 3, or 4 consecutive days. The city-specific association was estimated using a quasi-Poisson regression with constrained distributed lag model and then pooled at the national level using random-effect meta-analysis. Stratified analyses were performed by five regions, sex, 10 age groups, and nine cause categories. The temporal change in the heatwave–hospitalization association was assessed using a time-varying constrained distributed lag model. Of the 58,400,682 hospitalizations (59% women), 24%, 34%, 21%, and 19% of cases were aged <20, 20–39, 40–59, and ≥60 years, respectively. The city-specific year-round daily mean temperatures were 23.5 ± 2.8 °C on average, varying from 26.8 ± 1.8 °C for the 90th percentile to 28.0 ± 1.6 °C for the 97.5th percentile. We observed that the risk of hospitalization was most pronounced for heatwaves characterized by high daily temperatures and long durations across Brazil, except for the minimal association in the north (the hottest region). After controlling for temperature, the association remained for severe heatwaves in the south and southeast (cold regions). Children 0–9 years, the elderly ≥70 years, and admissions for perinatal conditions were most strongly associated with heatwaves. Over the study period, the strength of the heatwave–hospitalization association declined substantially in the south, while an apparent increase was observed in the southeast. The main limitations of this study included the lack of data on individual temperature exposure and measured air pollution. Conclusions There are geographic, demographic, cause-specific, and temporal variations in the heatwave–hospitalization associations across the Brazilian population. Considering the projected increase in frequency, duration, and intensity of heatwaves, future strategies should be developed, such as building early warning systems, to reduce the health risk associated with heatwaves in Brazil.

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“…There is a great need to generate data that will support a better understanding of how children interact with their environment, medicine, and food [ 32 , 33 ]. When placed in a risk assessment context, the ability to consider a child-specific exposure can be hampered by this lack of data.…”

Section: Discussionmentioning

confidence: 99%

Development of an observational exposure human biomonitoring study to assess Canadian children’s DEET exposure during protective use

Gibson

Marro²,

Borghese³

et al. 2022

PLoS ONE

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Biomonitoring data of N,N-diethyl-meta-toluamide (DEET) in children is scarce and limited to controlled exposure and surveillance studies. We conducted a 24-hour observational exposure and human biomonitoring study designed to estimate use of and exposure to DEET-based insect repellents by Canadian children in an overnight summer camp setting. Here, we present our study design and methodology. In 2019, children between the ages of 7 and 13 took part in the study (n = 126). Children controlled their use of DEET-based insect repellents, and provided an account of their activities at camp that could impact insect repellent absorption. Children provided a total of 389 urine samples throughout the study day, and reported the time that they applied insect repellent, which allowed us to contextualize urinary DEET and metabolite concentrations with respect to the timing of insect repellent application. DEET (2.3% <Limits of detection (LOD)) and two metabolites, N,N-diethyl-m-(hydroxymethyl)benzamide (DHMB) (0% <LOD) and 3-diethylcarbamoyl benzoic acid (DCBA) (0% <LOD), were measured in urine samples. Three time difference scenarios were established for the data and analysed to account for these complex time-dependent data, which demonstrated the need for DEET biomonitoring to be done in context with the timing of a known DEET exposure or over the course of at least 14 to 24 hours to better capture the excretion curve. To our knowledge, this is the first field-based study of real-world exposure to DEET in children. Our experience and results suggest that this type of real-world observational exposure study with a human biomonitoring component can generate data reflective of actual exposure, but is not without significant logistic, practical, and analytical challenges.

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Jenny Pronczuk de Garbino: A Global Champion for Children’s Health

Cited by 4 publications

References 6 publications

Assessment of Intraseasonal Variation in Hospitalization Associated With Heat Exposure in Brazil

Assessment of Intraseasonal Variation in Hospitalization Associated With Heat Exposure in Brazil

The association between heatwaves and risk of hospitalization in Brazil: A nationwide time series study between 2000 and 2015

Development of an observational exposure human biomonitoring study to assess Canadian children’s DEET exposure during protective use

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