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Non-infectious dermatologic diseases associated with chronic exposure to mining tailings in a Peruvian community   Willy Ramos 1 , Carlos Galarza 1 , Gerardo Ronceros 1 , Ferdinand de Amat 1 , Maria Teran 1  and  Alex G Ortega-Loayza 1,2 .  1  Instituto de Investigaciones Clínicas de la Universidad Nacional Mayor de San Marcos, Hospital Nacional Dos de Mayo, Lima-Peru. 2  Department of Medicine, University of North Carolina at Chapel Hill, USA
INTRODUCTION ,[object Object],[object Object],FIGURES 1 and 2 :  Mining tailings in the exposed population, located near agricultural areas.
[object Object],[object Object]
FIGURE 3: Location of exposed and non-exposed communities to mining tailings in the district of San Mateo de Huanchor (Huarochiri, Lima).
TABLE 1:   Average concentrations of relevant environmental metals in mining tailings and sediments in San Mateo de Huanchor . 3400 mg/kg 2317 mg/Kg 160 mg/Kg 10–300 mg/Kg 100 mg/Kg Zn 1900 mg/Kg 2561 mg/Kg 62 mg/Kg 10–70 mg/Kg 5 mg/Kg Pb 1.21 mg/kg MND 0.11 mg/Kg < 0.050 mg/Kg 0.08 mg/Kg Hg 800 mg/Kg 514 mg/Kg 51 mg/Kg 2–250 mg/Kg 15 mg/Kg Cu > 10000 mg/Kg > 10000 mg/Kg 21 mg/Kg 1–40 mg/Kg 8 mg/Kg As MINING TAILING OF MAYOC (Exposed town) MINING TAILING OF TAMBORAQUE  (Exposed town) SEDIMENTS IN RIO  BLANCO (Non-exposed town) REFERENCE VALUES WHO (SOILS AND SEDIMENTS  REFERENCE VALUES IN SEDIMENTS  ANALYZED METALIC ELEMENT
[object Object],[object Object]
AIM ,[object Object]
PATIENTS and METHODS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],64 71 CHILDREN 109 121 ADULTS NON-EXPOSED EXPOSED
RESULTS
TABLE 2:  Characteristics of the adult population. 37 (33.9) 86 (71.1) Non-infectious dermatologic disease, No. (%) 63 (57.8) 62 (51.2) Feminine, No. (%) 46 (42.2) 59 (48.8) Masculine, No. (%) 21.49 ± 16.71 20.13 ± 18.91 Age (years) 109 121 Sample (n) NON-EXPOSED GROUP EXPOSED GROUP CHARACTERISTICS
TABLE 3:  Non infectious dermatologic diseases in exposed and non-exposed adults to mining tailings.
[object Object],FIGURE 4:  Palmoplantar arsenical keratosis in an adult female exposed to mining tailings. FIGURE 5:  Arsenical hyperpigmentation in a male exposed to mining tailings.
TABLE 4:  Dermatologic lesions and clearance of arsenic in 24-hour urine samples in adult patients with chronic arsenicosis. 33-62 ug/L Plantar, Palmar,  Palmoplantar, Thighs, Thorax 6 Keratosis 58 ug/L Thorax, Abdomen 1 Hyperpigmentation 53-56 ug/L Nails of hands 2 Mee’s lines 31-66 ug/L Plantar 2 Keratosis and  Hyperpigmentation CLEARANCE OF ARSENIC (*)  IN 24-HOUR-URINE LOCALIZATION OF LESIONS NUMBER  OF PATIENTS TYPE OF LESION
TABLE 5:  Statistical analysis of non-infectious dermatologic diseases in the adult population. 0.70 – 52.60 6.05 0.10 Lichen simplex cronicus 0.89 –  4.39 1.98 0.09 Keratosis pilaris 1.13  – 24.60 5.26 0.03 Atopic dermatitis 1.04  – 13.99 3.82 0.04 Contact dermatitis 1.60 –  10.89 4.17 0.01 Seborrheic dermatitis 2.45 – 10.37 5.03 < 0.001 Xerosis 1.52 – 32.10 6.98 0.01 Non-pruritic papulovesicular eruption NC NC 0.03 Arsenicosis CONFIDENCE INTERVAL ODDS  RATIO p  VALUE  DERMATOLOGIC  DIAGNOSIS
TABLE 6:  Characteristics of the pediatric population. 19 (29.6)  49 (69)  Non-infectious dermatologic disease, No. (%) 35 (54.7)  19 (26.8)  Feminine, No. (%) 29 (45.3)  52 (73.2)  Masculine, No. (%) 9.61 ± 4.36  7.51 ± 4.03  Age (years) 64 71 Sample (n) NON-EXPOSED GROUP EXPOSED GROUP CHARACTERISTICS
TABLE 3:  Non infectious dermatologic diseases in exposed and non-exposed children to mining tailings.
TABLE 7:  Statistical analysis of non-infectious dermatologic diseases in the pediatric population. 0.36 – 2.74 0.99 0.980 Keratosis pilaris 0.64 – 18.15 3.41 0.151 Non-pruritic papulovesicular eruption 0.97 – 69.47 8.20 0.054 Contact dermatitis 1.04 – 24.92 5.08 0.045 Atopic dermatitis 1.59 – 8.51 3.68 0.002 Xerosis CONFIDENCE INTERVAL ODDS  RATIO p  VALUE  DERMATOLOGIC  DIAGNOSIS
CONCLUSIONS ,[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object]
[object Object]
THANK YOU

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Non-infectious dermtologic diseases and chronic exposure to mining tailings in a peruvian community

  • 1. Non-infectious dermatologic diseases associated with chronic exposure to mining tailings in a Peruvian community Willy Ramos 1 , Carlos Galarza 1 , Gerardo Ronceros 1 , Ferdinand de Amat 1 , Maria Teran 1 and Alex G Ortega-Loayza 1,2 . 1 Instituto de Investigaciones Clínicas de la Universidad Nacional Mayor de San Marcos, Hospital Nacional Dos de Mayo, Lima-Peru. 2 Department of Medicine, University of North Carolina at Chapel Hill, USA
  • 2.
  • 3.
  • 4. FIGURE 3: Location of exposed and non-exposed communities to mining tailings in the district of San Mateo de Huanchor (Huarochiri, Lima).
  • 5. TABLE 1: Average concentrations of relevant environmental metals in mining tailings and sediments in San Mateo de Huanchor . 3400 mg/kg 2317 mg/Kg 160 mg/Kg 10–300 mg/Kg 100 mg/Kg Zn 1900 mg/Kg 2561 mg/Kg 62 mg/Kg 10–70 mg/Kg 5 mg/Kg Pb 1.21 mg/kg MND 0.11 mg/Kg < 0.050 mg/Kg 0.08 mg/Kg Hg 800 mg/Kg 514 mg/Kg 51 mg/Kg 2–250 mg/Kg 15 mg/Kg Cu > 10000 mg/Kg > 10000 mg/Kg 21 mg/Kg 1–40 mg/Kg 8 mg/Kg As MINING TAILING OF MAYOC (Exposed town) MINING TAILING OF TAMBORAQUE (Exposed town) SEDIMENTS IN RIO BLANCO (Non-exposed town) REFERENCE VALUES WHO (SOILS AND SEDIMENTS REFERENCE VALUES IN SEDIMENTS ANALYZED METALIC ELEMENT
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 12. TABLE 2: Characteristics of the adult population. 37 (33.9) 86 (71.1) Non-infectious dermatologic disease, No. (%) 63 (57.8) 62 (51.2) Feminine, No. (%) 46 (42.2) 59 (48.8) Masculine, No. (%) 21.49 ± 16.71 20.13 ± 18.91 Age (years) 109 121 Sample (n) NON-EXPOSED GROUP EXPOSED GROUP CHARACTERISTICS
  • 13. TABLE 3: Non infectious dermatologic diseases in exposed and non-exposed adults to mining tailings.
  • 14.
  • 15. TABLE 4: Dermatologic lesions and clearance of arsenic in 24-hour urine samples in adult patients with chronic arsenicosis. 33-62 ug/L Plantar, Palmar, Palmoplantar, Thighs, Thorax 6 Keratosis 58 ug/L Thorax, Abdomen 1 Hyperpigmentation 53-56 ug/L Nails of hands 2 Mee’s lines 31-66 ug/L Plantar 2 Keratosis and Hyperpigmentation CLEARANCE OF ARSENIC (*) IN 24-HOUR-URINE LOCALIZATION OF LESIONS NUMBER OF PATIENTS TYPE OF LESION
  • 16. TABLE 5: Statistical analysis of non-infectious dermatologic diseases in the adult population. 0.70 – 52.60 6.05 0.10 Lichen simplex cronicus 0.89 – 4.39 1.98 0.09 Keratosis pilaris 1.13 – 24.60 5.26 0.03 Atopic dermatitis 1.04 – 13.99 3.82 0.04 Contact dermatitis 1.60 – 10.89 4.17 0.01 Seborrheic dermatitis 2.45 – 10.37 5.03 < 0.001 Xerosis 1.52 – 32.10 6.98 0.01 Non-pruritic papulovesicular eruption NC NC 0.03 Arsenicosis CONFIDENCE INTERVAL ODDS RATIO p VALUE DERMATOLOGIC DIAGNOSIS
  • 17. TABLE 6: Characteristics of the pediatric population. 19 (29.6) 49 (69) Non-infectious dermatologic disease, No. (%) 35 (54.7) 19 (26.8) Feminine, No. (%) 29 (45.3) 52 (73.2) Masculine, No. (%) 9.61 ± 4.36 7.51 ± 4.03 Age (years) 64 71 Sample (n) NON-EXPOSED GROUP EXPOSED GROUP CHARACTERISTICS
  • 18. TABLE 3: Non infectious dermatologic diseases in exposed and non-exposed children to mining tailings.
  • 19. TABLE 7: Statistical analysis of non-infectious dermatologic diseases in the pediatric population. 0.36 – 2.74 0.99 0.980 Keratosis pilaris 0.64 – 18.15 3.41 0.151 Non-pruritic papulovesicular eruption 0.97 – 69.47 8.20 0.054 Contact dermatitis 1.04 – 24.92 5.08 0.045 Atopic dermatitis 1.59 – 8.51 3.68 0.002 Xerosis CONFIDENCE INTERVAL ODDS RATIO p VALUE DERMATOLOGIC DIAGNOSIS
  • 20.
  • 21.
  • 22.
  • 23.