SYNOPSIS This report summarizes and discusses current knowledge on the impact that climate change can have on occupational safety and health (OSH), with a particular focus on the Americas. Worker safety and health issues are presented on topics related to specific stressors (e.g., temperature extremes), climate associated impacts (e.g., ice melt in the Arctic), and a health condition associated with climate change (chronic kidney disease of non-traditional etiology). The article discusses research needs, including hazards, surveillance, and risk assessment activities to better characterize and understand how OSH may be associated with climate change events. Also discussed are the actions that OSH professionals can take to ensure worker health and safety in the face of climate change.

RESUMEN En este informe se resume y analiza el conocimiento actual sobre el impacto que el cambio climático puede tener sobre la seguridad y la salud laboral, en particular en la Región de las Américas. Se presentan temas clave de salud y seguridad de los trabajadores relacionados con factores de estrés específicos (por ej., temperaturas extremas), impactos asociados al clima (por ej., derretimiento de hielo en el Ártico) y una enfermedad asociada con el cambio climático (enfermedad renal crónica de etiología no tradicional). En el artículo se analizan las necesidades de investigación, incluso los peligros, la vigilancia y las actividades de evaluación de riesgo a fin de caracterizar y comprender mejor cómo la seguridad y la salud laboral se asocial con los sucesos del cambio climático. También se analizan las acciones que pueden emprender los profesionales de este campo para garantizar la salud y la seguridad de los trabajadores ante el cambio climático.

Este artigo examina questões sobre exposição humana ao mercúrio (Hg) e seus efeitos adversos à saúde na Amazônia, com base em extensa revisão da literatura. Diferentes bioindicadores revelam uma ampla faixa de exposição, com teores médios de Hg em cabelo acima de 15µg/g em diversas comunidades amazônicas, situando-as dentre as mais expostas no mundo atualmente. Taxas de ingestão diária de Hg foram estimadas em alguns estudos e situam-se entre 1-2µg/kg/dia, consideravelmente acima das doses de referência estabelecidas pela USEPA (0,1µg/kg/dia) ou pela OMS (0,23µg/kg/dia). Déficits neurocomportamentais e, em alguns casos, sinais clínicos relacionados à exposição mercurial têm sido relatados tanto em adultos quanto em crianças de diversos países amazônicos. Há também evidências de dano citogenético, mudanças imunológicas e toxicidade cardiovascular. Visto que peixe é altamente nutritivo e há diversas fontes de Hg nesta região, existe uma necessidade urgente de encontrar soluções realistas e viáveis capazes de reduzir os níveis de exposição e de risco tóxico, ao mesmo tempo mantendo os hábitos alimentares tradicionais, preservando a biodiversidade píscea e frutífera e melhorando a saúde das populações desfavorecidas e afetadas.

This paper examines issues of human mercury (Hg) exposure and adverse health effects throughout the Amazon region. An extensive review was conducted using bibliographic indexes as well as secondary sources. There are several sources of Hg (mining, deforestation, reservoirs), and exposure takes place through inhalation or from fish consumption. There is a wide range of exposure, with mean hair-Hg levels above 15µg/g in several Amazonian communities, placing them among the highest reported levels in the world today. Dietary Hg intake has been estimated in the vicinity of 1-2µg/kg/day, considerably higher than the USEPA RfD of 0.1µg/kg/day or the World Health Organization recommendation of 0.23µg/kg/day. Neurobehavioral deficits and, in some cases, clinical signs have been reported both for adults and children in relation to Hg exposure in several Amazonian countries. There is also some evidence of cytogenetic damage, immune alterations, and cardiovascular toxicity. Since fish provide a highly nutritious food source, there is an urgent need to find realistic and feasible solutions that will reduce exposure and toxic risk, while maintaining healthy traditional dietary habits and preserving this unique biodiversity.

Este artigo examina questões sobre exposição humana ao mercúrio (Hg) e seus efeitos adversos à saúde na Amazônia, com base em extensa revisão da literatura. Diferentes bioindicadores revelam uma ampla faixa de exposição, com teores médios de Hg em cabelo acima de 15µg/g em diversas comunidades amazônicas, situando-as dentre as mais expostas no mundo atualmente. Taxas de ingestão diária de Hg foram estimadas em alguns estudos e situam-se entre 1-2µg/kg/dia, consideravelmente acima das doses de referência estabelecidas pela USEPA (0,1µg/kg/dia) ou pela OMS (0,23µg/kg/dia). Déficits neurocomportamentais e, em alguns casos, sinais clínicos relacionados à exposição mercurial têm sido relatados tanto em adultos quanto em crianças de diversos países amazônicos. Há também evidências de dano citogenético, mudanças imunológicas e toxicidade cardiovascular. Visto que peixe é altamente nutritivo e há diversas fontes de Hg nesta região, existe uma necessidade urgente de encontrar soluções realistas e viáveis capazes de reduzir os níveis de exposição e de risco tóxico, ao mesmo tempo mantendo os hábitos alimentares tradicionais, preservando a biodiversidade píscea e frutífera e melhorando a saúde das populações desfavorecidas e afetadas.

This paper examines issues of human mercury (Hg) exposure and adverse health effects throughout the Amazon region. An extensive review was conducted using bibliographic indexes as well as secondary sources. There are several sources of Hg (mining, deforestation, reservoirs), and exposure takes place through inhalation or from fish consumption. There is a wide range of exposure, with mean hair-Hg levels above 15µg/g in several Amazonian communities, placing them among the highest reported levels in the world today. Dietary Hg intake has been estimated in the vicinity of 1-2µg/kg/day, considerably higher than the USEPA RfD of 0.1µg/kg/day or the World Health Organization recommendation of 0.23µg/kg/day. Neurobehavioral deficits and, in some cases, clinical signs have been reported both for adults and children in relation to Hg exposure in several Amazonian countries. There is also some evidence of cytogenetic damage, immune alterations, and cardiovascular toxicity. Since fish provide a highly nutritious food source, there is an urgent need to find realistic and feasible solutions that will reduce exposure and toxic risk, while maintaining healthy traditional dietary habits and preserving this unique biodiversity.

The mercury rejected in the water system, from mining operations and lixiviation of soils after deforestation, is considered to be the main contributors to the contamination of the ecosystem in the Amazon Basin. The objectives of the present study were to examine cytogenetic functions in peripheral lymphocytes within a population living on the banks of the Tapajós River with respect to methylmercury (MeHg) contamination, using hair mercury as a biological indicator of exposure. Our investigation shows a clear relation between methylmercury contamination and cytogenetic damage in lymphocytes at levels well below 50 micrograms/gram, the level at which initial clinical signs and symptoms of mercury poisoning occur. The first apparent biological effect with increasing MeHg hair level was the impairment of lymphocyte proliferation measured as mitotic index (MI). The relation between mercury concentration in hair and MI suggests that this parameter, an indicator of changes in lymphocytes and their ability to respond to culture conditions, may be an early marker of cytotoxicity and genotoxicity in humans and should be taken into account in the preliminary evaluation of the risks to populations exposed in vivo. This is the first report showing clear cytotoxic effects of long-term exposure to MeHg. Although the results strongly suggest that, under the conditions examined here, MeHg is both a spindle poison and a clastogen, the biological significance of these observations are as yet unknown. A long-term follow-up of these subjects should be undertaken.