Jose_Centeno.pdf

Medical GeologyImpact of the Natural Environment

on Public HealthJose A. CentenoEmail: [email protected]

Dept. of Environmental and Infectious Disease SciencesArmed Forces Institute of Pathology, Washington, DC, USA

Medical GeologyAn Outline of this Presentation

• A Definition

• A Range of Issues

• Examples of Current Research Areas

• Milestones and Future Directions

Our Natural Environment and Health

“High levels of arsenic in drinking water has caused Severe health problems in many countries. In West Bengal alone, over 50 million people are at risk of developing arsenic poisoning”

Lake Nyos, CameroonEnvironmental

Tragedy

Our Natural Environment and Health

Impact of Geologic Events on Human and Environmental Health

TsunamiDecember 2004

Photos: Associated Press

Courtesy of Dr. Dale Griffin, USGS

Animation – NASA.JSC

Global Dust Storm Mobilization

Medical Geology: is defined as the science dealing with the relationship between geological materials and geologic processesand their impacts on health problems in man and animals.

Medical GeologyA Working Definition

The scope and range of Medical Geology include:

identifying and characterizing natural sources of harmful materials in the environment;

learning how to predict the movement and alteration of chemical, infectious, and other disease-causing agents;

and understanding how people may be exposed to such materials.

MEDICAL GEOLOGY

GeographySpatial analysis

Distribution

MedicineExposureHealth effects

GeologyRocks, soils, waterMinerals, Dust, volcanic emissionsEarthquakes

A Multidisciplinary Discipline

• Trace Element Exposure - As, Hg, F, Se, Zn, Al• Dust - Asbestos, African, Valley Fever, Silicosis • Organics - VOCs, PAHs, Antibiotics, Pesticides• Radionuclides - Radon, Radium, Uranium• Microbes, Pathogens - West Nile Encephalitis,

LaCrosse Encephalitis, Plague, Hantavirus, Rift Valley Fever, Lyme disease, etc.

• Global Climate Change

Medical GeologyRange of Issues

Medical Geology and the Natural Environment

Medical Geology and

Diseases Developed from Trace Element

Deficiency and Excess

All rights reserved/JACenteno/AFIP

Global Prevalence of I Deficiency Diseases

0123456789

%

Afr Med LAm Asia Pac

• >2 B at risk• 740 M with goiter• 20 M mentally

retarded• 6 M infants with

cretinism (half in SE Asia) each yr


Medical Geology and Trace Elements

ARSENIC EXPOSURE : GLOBAL IMPACT

PEOPLE AFFECTED BY NATURALLY

CONTAMINATED WATER AND SOILS

Selinus O, Alloway B, Centeno JA et al. “Essentials of Medical Geology” (Elsevier-AcademicPress, 2005)

LaguneraLagunera, , MexicoMexico, 30,000 , 30,000 affectedaffected; 0.5 ; 0.5 millonmillon atat riskrisk

Antofagasta, Chile 0.8 mg/L in water, 20,000 affected

Cordoba, Argentina 10,000 contaminated

Bangladesh Bangladesh upup to 2.0 to 2.0 mgmg/L, 200,000 /L, 200,000 affectedaffected; 50 ; 50 millionmillionatat riskrisk

Taiwan Taiwan upup to 0.6 to 0.6 mgmg//20,000 20,000 contaminatedcontaminated

MongoliaMongolia50,000 50,000 contaminatedcontaminatedCornwal, England up

to 2% As in soil


Arsenic Contamination of Groundwater in India and Bangladesh

First reported in mid-1980’sTube wells screened (~3000) in West BengalOf 18 state districts, 9 are affectedIn Bangladesh, 50 of 64 districts are affected (As levels <10 - > 10,000 µg/L)150 million people may be at risk in Bangladesh and in West Bengal alone


Health Effects Associated with Arsenic Exposure

• Cancer: skin, lung, bladder, liver, kidney• Cardiovascular disease• Peripheral vascular disease• Developmental effects• Neurologic & neurobehavioral effects• Diabetes Mellitus• Hearing loss• Portal fibrosis of the liver• Lung fibrosis• Hematological effects (e.g., anemia)

Tchounwou PB, Patlolla AK, Centeno JA. ToxicologicPathology 31:575-588 (2003).


Medical GeologyOther Geologic Links to

Human Diseases

Natural and Mineral Dust

Water-Borne Diseases

Emerging Infectious Diseases

Volcanic Emissions


The Health Effects of Dusts• Some aspects have been well known for decades• General effects of industrial

/ commercial asbestos• Silicosis (hard rock mining)• Black lung (coal mining)

• New issues and problems are arising• Effects of mineral dust (ie,

trace asbestos)• Valley fever• Trans-oceanic dust

transport

Intercontinental dust transport• Increasing evidence from satellite imagery and other means that significant dust

transport can occur between continents across large expanses of oceans• This exotic dust is increasingly viewed as a key component of some terrestrial

and marine ecosystems, as well as a potentially significant source of pathogens and environmental contaminants

• For example, atmospheric transport of dust from North Africa to the western Atlantic Ocean region has increased substantially in recent decades due to desertification of grasslands in the Sahara region

• 100’s of millions of tons annually

A huge cloud of African dust covers the Caribbean

Wind-lain quartz particles - ChinaSilicon (Si) makes up

more than one quarter of the element composition of the earth’s crust. It is highly reactive, readily combining with oxygen to form free silica (SiO2), the commonest form of which is quartz.

Silica is the most significant cause of dust-associated morbidity and mortality

Asian Dust Storm – April 2001

African Dust-Event – St. Thomas, USVI, August 8, 2001Atmospheric dust - Human and ecosystem health

• Dust as a trigger for harmful algae blooms

• Death of marine organisms

• Human illness – respiratory stress, skin rash, paralysis and memory loss from consumption of contaminated seafood

• Dust as a carrier of toxins

• pesticides, herbicides, hydrocarbons, metals, industrial emissions…

• implications – direct (exposure = death/acute illness) or indirect (exposure = immune suppression)

• Dust as a carrier of microorganisms

•Pathogenic = disease outbreaks

• Non–pathogenic = ecological change

•Respiratory stress from inhalation of soil particles

Dusts and the origin of Valley Fever (Coccidioidomycosis)

• Coccidiomycosis is a reemerging infectious disease

• C. immitis is the etiological agent of coccidioidomycosis

• C. immitis is a soil inhabiting fungus found in North, Central, and South America. • Given proper conditions, infectious spores

are released when soil is disturbed• ie, storms, construction, earthquakes

• Acknowledgments to • Mark Bultman ([email protected]); Randy

Jibson ([email protected]), Robert B. Finkelman (UTexas-Dallas)Geoffrey Plumlee, USGS

mailto:[email protected]

Dominant dust source regions around the world (in brown)

Natural dusts provide a striking example of the global paradigms required to understand many current environmental health issues.

Medical Geology Tools and Solutions to

Environmental Health Problems

Integrating earth and health sciencesTools of the trail

• Mineralogical, chemical characterization of earth materials (EM), pathological samples (SEM, TEM, XRD, ICP-MS, XAAFS, etc.)

• Techniques to characterize particle surface chemistry, morphology, redox state of elements

• Techniques to measure generation of reactive oxygen species

Integrating earth and health sciences Toxicological/geochemistry/clinical

• Chemical speciation and reaction-path modeling of EM - body fluid interactions

• In vitro physiologically-based extraction tests of well-characterized EM

• In vitro toxicity tests• In vivo toxicity tests• Biomonitoring (Blood, urine, tissues)

of human populations exposed to potential toxicants in EM

• Epidemiological studies of disease occurrence in human populations exposed to potential toxicants in EM

Geographic Information System (GIS)

Analysis of Disease Risk:

Where are the potential areasof disease?;

Who are the populations at riskNow and in the future?;

When might an outbreak occur?

How can outbreaks be mitigated?

National age-adjusted rates of asbestosis-related mortality by county for U.S. residents age 15 and over, 1970-1999. Reproduced from

NIOSH (2006)

What Occupations Can Medical Geology Benefit?

OCCUPATION HEALTH ISSUES

• Mining- Hard Rock Silicosis- Coal CWP, Silicosis,- Asbestos Asbestosis, Mesothelioma- Uranium Lung cancer (radon)

• Utility plants Coal dust and fly ash

• Ore processing plants Metal exposure

• Cement plants Mineral dusts

• Construction Mineral dust

• Farming Dust

• Sanitary and Env. Eng. Metals, water-borne diseases

Medical Geology Milestones and Future Activities

• International Medical Geology Association (www.medicalgeology.org)

• Conferences, symposia,

workshops, technical sessions

• Worldwide Short Courses

• Associate degree (GWU,WAU, etc.)

• Book (“Essentials of Medical

Geology”, Elsevier & Academic Press, 2005)

• Medical Geology Registry (AFIP)

• Centers of Excellence on Medical Geology

• National Academy of Sciences-NRC

(Committee on Earth Science and Public Health)

• United Nations – Planet Earth 2006-2007

SummaryIntegration among Earth Sciences and Public Health is a multidisciplinary approach able to span the breadth of geological (basic, applied, environmental), medical (clinical, epidemiological, toxicology, sociological), and political sciences.

Geoscientists have unique training and perspective about the magnitude and nature of natural environmental problems.

The present public interest in natural and climate changes therefore offers the environmental geoscientist extraordinary opportunity for technical investigation and for direct communication with the community and local environmental and public health managers.

An Invitation

We welcome the opportunity to explore with Convención Minera

and EXTEMIN 2007, with the Institute of Mining Engineers of

Peru and you, possible collaborative ventures in Medical

GeologyIMGA Website: http://www.medicalgeology.org

Thank You!

Jose_Centeno.pdf

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