sustainable development 20 years on from the ... - José Eli da Veiga

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One of the greatest health risks in urban areas comes from atmospheric pollution. In some highrisk
cities (such as Mexico City, São Paulo and Santiago) the emission of pollutants is managed to some
extent. But the growth of many other cities has been accompanied by an increase in both stationary and
mobile sources of pollutants and this has significantly affected health indicators in the respective
populations. PAHO estimates that close to 100 million of the region’s inhabitants are exposed in their
daily lives to concentrations of ambient air pollutants in excess of the maximum permissible levels
established in the air quality guidelines published by the World Health Organization. It is calculated that,
annually, air pollution costs the lives of around 35,000 people and the loss of 276,000 life <strong>years</strong> (Romieu
and others, <strong>20</strong>10).
(e)
Reducing health risks from environmental pollution and hazards
In addition to air pollution, chemical contamination is a serious problem in the region. Chapter II
discusses progress made in managing chemical products. Some of the main health problems are caused by
the use of dichlorodiphenyltrichloroethane (DDT) and by chemical and technological incidents. DDT has
also commonly been used to control malaria. Between <strong>20</strong>04 and <strong>20</strong>07 an innovative scheme was carried
out to combat malaria without the use of toxic insecticides —and eliminating DDT— in the countries of
Central America and Mexico with support from PAHO, the National Public Health Institute of Mexico
and the Global Environment Facility. This scheme reduced malaria transmission by 63% in the
participating communities and eradicated the use of persistent organic pollutants —and therefore their
effects on ecosystems (PAHO, <strong>20</strong>08b). Even so, preventive measures and risk minimization efforts have
been insufficient. As a subregion, Central America has historically been one of the world’s greatest
importers of insecticides (Bravo and others, <strong>20</strong>11).
Chemical and technological incidents are not isolated events in Latin America and the Caribbean.
Some have caused major human health impacts, such as the gasoline spill in the sewer system of
Guadalajara (Mexico) in 1992 and the chemical spill in the port of La Guaira (Bolivarian Republic of
Venezuela) in 1999 (Haddad, Aguilar and Nobre Gouveia, <strong>20</strong>10).
(f)
Emerging health issues
The region is undergoing an epidemiological transition (see figure I.12): on the one hand, longstanding
risks have not been adequately reduced while, on the other, newer problems are on the rise,
including tobacco addiction, alcoholism, physical inactivity and poor diet, uncoordinated public transport,
un<strong>sustainable</strong> agriculture, uneven socioeconomic <strong>development</strong> and environments which discourage
healthy behaviours. Another issue that has gained importance in recent <strong>years</strong> is the impact of climate
change on health. This is discussed in chapter II. Other global environmental changes that raise health
concerns for the region are loss or deterioration of ecosystems and the degradation of water sources
caused by environmental exploitation and worsened by climate change. Land-use change, for example,
may lead to malnutrition in local populations; biodiversity loss can result in changes in the natural
regulation of some infectious diseases; and water shortage has direct health implications where people use
polluted water and indirect effects where it is lacking for local agricultural use (WHO, <strong>20</strong>05).