Environmental Risk Factors In Latin America & The Caribbean

Abstract

Background: Environmental risk factors contribute to the burden of disease through a variety of pathways, including exposure to toxins via unsafe water, food, and air. This exposure can take place in the home, in the workplace, or almost anywhere outside through ambient levels of pollution. Quantifying this risk around the world is paramount to understanding the problem in order to design effective interventions. Methods: Diverse methodology was applied across the range of environmental risks that are known to be quantifiable. First, the data landscape was scoured in order to create rich datasets across time and space for the set of risks. Then, Bayesian statistical methods and a large database of covariates were used in order to predict for all risk factors, geographic locations, sexes, age groups, and time periods in order to create a comprehensive and comparable set of estimates. Results: Over the past two decades - 1990 to 2013 - the proportion of total disease burden attributable to environmental risk factors in Latin America and the Caribbean has been halved, shrinking from 12% to 6%. A large part of this can be explained through large improvements to water and sanitation infrastructure in the region. However, environmental risks still present a significant challenge to local health. Various forms of air pollution caused more than 150,000 deaths in the region, with particularly large levels of exposure in Brazil. Conclusion: These results provide the opportunity for regional decision-makers to target proposed interventions towards areas and risk factors that are proportionate to the levels of burden that are currently being experienced. Great strides have been made over the past two decades in this region, but continued improvement will require an increasingly deft understanding of the situation that can be driven by the application of quantitative methodology.