Laboratory profile after mining dam breach: Brumadinho Health Project results

Maluf, Chams Bicalho; Brito, Fabiano de Almeida; Simões, Taynãna César; Peixoto, Sérgio Viana; Vidigal, Pedro Guatimosim

doi:10.1590/1980-549720220013.supl.2

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Brasil

Revista Brasileira de Epidemiologia

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Original Article • Rev. bras. Epidemiol. 25 (Supl 2) • 2022 • https://doi.org/10.1590/1980-549720220013.supl.2 copy

Laboratory profile after mining dam breach: Brumadinho Health Project results

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate changes in selected laboratory tests in the population included in the Brumadinho Health Project, according to the exposure to the dam failure.

Methods:

Cross-sectional study carried out on representative sample of residents (≥12 years) in Brumadinho, Minas Gerais, including: 1) non-exposed; 2) directly affected by tailings sludge; 3) residents in mining area. The prevalence of abnormal results of blood count, total, HDL and LDL cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, creatinine, urea, estimate of glomerular filtration rate (eGFR) and high-sensitivity C-reactive protein (hs-CRP) were estimated. The Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI) of having an abnormal laboratory finding were estimated using Generalized Linear Models with Poisson probability distribution. Crude and adjusted models were estimated for age range, gender, diabetes, body mass index, smoking, hypertension.

Results:

After adjusting, there was no difference in PR between the three populations for most tests, with the exception of the population residing in an area with mining activity and not directly affected by the mud, with a lower chance of having altered total cholesterol (PR: 0.84; 95%CI 0.74–0.95) and a higher chance of having altered HDL cholesterol (PR: 1.26; 95%CI 1.07–1.50), hs-CRP (PR: 1.19; 95%CI 1.04–1.37), and eGFR <60mL/min/1,73 m² (PR: 1.51; 95%CI 1.05–2.19).

Conclusion:

No significant differences were found in the prevalence of biochemical and hematological alterations between the populations directly exposed and not exposed to tailings. Only the group residing in the mining area had a higher prevalence of alterations related dyslipidemia, renal disease, and inflammation.

Keywords:
Man-made disasters; Mining; Laboratory tests; Brazil

Characteristics		Total population n=3,080 (95%CI)	Not directly affected n=1,562 (95%CI)	Directly affected n=981(95%CI)	With mining activity n=537 (95%CI)	p-value^† † Rao-Scott independence test;	Missing
Gender
	Male	43.35 (41.10–46)	43.16 (40.79–45.54)	48.27 (46.05–50.48)	45.09 (41.99–48.18)	0.006
	Female	56.65 (54.40–59)	56.84 (54.46–59.21)	51.73 (49.52–53.95)	54.91 (51.82–58.01)	0.006
Age range (years)
	12 to 17	6.75 (5.40–8)	6.54 (4.97–8.11)	10.18 (8.25–12.11)	12.31 (9.43–15.19)	<0.001
	18 to 59	64.79 (61.70–68)	64.51(61.35–67.67)	69.41 (66.35–72.48)	72.58 (68.69–76.47)
	60+	28.46 (25.40–32)	28.95 (25.68–32.21)	20.40 (17.32–23.49)	15.11 (11.39–18.83)
	Diabetes	14.01 (12.10–16)	14.06 (12.10–16)	11.18 (9.08–14)	16.45 (13.10–20)	0.102	300
	Hypertension	28.16 (25.60–31)	28.20 (25.50–31)	27.96 (25.20–31)	26.39 (22.60–31)	0.749	3
BMI
	Average	45.58 (42.50–49)	45.67 (42.50–49)	46.56 (43.20–50)	38.19 (33.70–43)	0.003	272
	Overweight	36.59 (33.90–39)	36.73 (33.90–40)	31.69 (28.80–35)	37.32 (33–42)
	Obesity	17.83 (15.50–20)	17.60 (15.20–20)	21.75 (18.90–25)	24.50 (20.50–29)
Smoking
	Never smoked	68 (64.80–71)	67.81 (64.40–71)	70.77 (67.40–74)	74.10 (69.80–78)	0.009	4
	Former smoker	16.65 (14.60–19)	16.88 (14.70–19)	13.40 (11.30–16)	9.65 (7.38–13)
	Smoker	15.35 (13.20–18)	15.32 (13.10–18)	15.83 (13.30–19)	16.25 (13–20)
	Total cholesterol	53.97 (50.80–57)	54.31 (51.03–57.60)	49.31 (45.90–52.72)	43.58 (38.92–48.24)	<0.001	299
	HDL cholesterol	26.49 (23.80–29)	26.15 (23.26–29.04)	30.24 (27.07–33.41)	38.39 (33.91–42.87)	<0.001	299
	LDL cholesterol	30.63 (27.70–34)	30.81 (27.67–33.96)	27.69 (24.73–30.64)	25.69 (21.55–29.84)	0.075	407
	Triglycerides	39.32 (36.10–43)	39.34 (35.86–42.82)	36.83 (33.37–40.30)	42.78 (38.01–47.54)	0.302	299
	Creatinine	8.06 (6.59–10)	8.05 (6.37–9.73	6.95 (5.25–8.66)	10.44 (7.60–13.28)	0.217	298
	Urea	14.96 (13–17)	14.97 (12.77–17.17)	14.04 (11.67–16.42)	16.16 (12.87–19.46)	0.681	299
	HbA_1c	24.83 (22.20–28)	24.89 (22.08–27.70)	22.07 (19.22–24.91)	26.66 (22.38–30.95)	0.284	318
	AST	6.27 (5.03–8)	6.22 (4.79–7.66)	7.30 (5.63–8.96)	6.93 (4.66–9.19)	0.514	298
	ALT	11.14 (9.54–13)	11.02 (9.22–12.81)	14.13 (11.86–16.41)	12.21 (9.46–14.96)	0.066	298
	hs-CRP	33.75 (30.90–37)	33.56 (30.53–36.60)	35.11 (32.12–38.11)	41.72 (36.99–46.45)	0.017	298
	Erythrocytes	6.56 (5.22–8)	6.52 (4.96–8.08)	7.39 (5.67-9.11)	7.54 (5.23–9.86)	0.557	488
	Hemoglobin	25.13 (22.40–28)	25.04 (22.11–27.98)	25.64 (22.65-28.63)	29.10 (24.92–33.28)	0.304	488
	Hematocrit	27.47 (24.80–30)	27.38 (24.51–30.24)	28.60 (25.48-31.73)	30.54 (26.17–34.90)	0.421	488
	Total leukocytes	11.01 (9.19–13)	11.10 (9.03–13.17)	8.98 (7.09-10.87)	9.78 (7.05–12.52)	0.245	488

Tests	Models	Directly affected PR (95%CI)	With mining activity PR (95%CI)
Erythrocytes	1^a a model 1: no adjustment;	1.13 (0.81–1.58)	1.16 (0.78–1.71)
	2^b b model 2: adjusted for gender;	1.03 (0.74–1.43)	1.09 (0.75–1.60)
	3^c c model 3: adjusted by age range and gender;	1.08 (0.78–1.49)	1.19 (0.81–1.74)
Hemoglobin	1^a a model 1: no adjustment;	1.02 (0.87–1.21)	1.16 (0.97–1.40)
	2^b b model 2: adjusted for gender;	0.99 (0.84–1.17)	1.14 (0.95–1.38)
	3^c c model 3: adjusted by age range and gender;	1.01 (0.86–1.19)	1.17 (0.97–1.41)
Hematocrit	1^a a model 1: no adjustment;	1.04 (0.90–1.22)	1.12 (0.93–1.33)
	2^b b model 2: adjusted for gender;	1.06 (0.91–1.23)	1.13 (0.94–1.34)
	3^c c model 3: adjusted by age range and gender;	1.07 (0.92–1.25)	1.14 (0.95–1.36)
Total leukocytes	1^a a model 1: no adjustment;	0.81 (0.61–1.07)	0.88 (0.63–1.23)
	2^b b model 2: adjusted for gender;	0.81 (0.61–1.08)	0.88 (0.63–1.24)
	3^c c model 3: adjusted by age range and gender;	0.81 (0.61–1.09)	0.89 (0.63–1.26)
Platelets	1^a a model 1: no adjustment;	0.92 (0.65–1.31)	0.69 (0.44–1.10)
	2^b b model 2: adjusted for gender;	0.91 (0.64–1.30)	0.69 (0.43–1.09)
	3^c c model 3: adjusted by age range and gender;	0.91 (0.64–1.30)	0.69 (0.43–1.10)

Tests	Models	Directly affected PR (95%CI)	With mining activity PR (95%CI)
Total cholesterol	1^a a model 1: no adjustment;	0.91 (0.83–1)	0.80 (0.71–0.91)
	2^b b model 2: adjusted by age range and gender;	0.93 (0.85–1.02)	0.82 (0.73–0.93)
	3^c c model 3: model 2+diabetes mellitus;	0.93 (0.84–1.02)	0.83 (0.74–0.94)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	0.92 (0.84–1.02)	0.84 (0.74–0.95)
HDL cholesterol	1^a a model 1: no adjustment;	1.16 (0.99–1.35)	1.47 (1.25–1.72)
	2^b b model 2: adjusted by age range and gender;	1.07 (0.91–1.24)	1.34 (1.14–1.57)
	3^c c model 3: model 2+diabetes mellitus;	1.07 (0.92–1.25)	1.31 (1.12–1.54)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	1.09 (0.93–1.27)	1.26 (1.07–1.50)
LDL cholesterol	1^a a model 1: no adjustment;	0.90 (0.78–1.04)	0.83 (0.69–1.01)
	2^b b model 2: adjusted by age range and gender;	0.89 (0.77–1.03)	0.81 (0.67–0.98)
	3^c c model 3: model 2+diabetes mellitus;	0.88 (0.75–1.03)	0.83 (0.68–1.01)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	0.88 (0.75–1.03)	0.83 (0.68–1.02)
Triglycerides	1^a a model 1: no adjustment;	0.94 (0.82–1.07)	1.09 (0.94–1.25)
	2^b b model 2: adjusted by age range and gender;	0.94 (0.82–1.07)	1.10 (0.95–1.27)
	3^c c model 3: model 2+diabetes mellitus;	0.94 (0.82–1.06	1.08 (0.93–1.24)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	0.94 (0.82–1.06)	1.02 (0.89–1.18)
eGFR60	1^a a model 1: no adjustment;	0.74 (0.52–1.06)	1.09 (0.73–1.61)
	2^b b model 2: adjusted by age range and gender;	0.95 (0.68–1.34)	1.68 (1.16–2.36)
	3^c c model 3: model 2+diabetes mellitus;	0.96 (0.69–1.34)	1.50 (1.04–2.16)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	0.79 (0.55–1.13)	1.51 (1.05–2.19)
Urea	1^a a model 1: no adjustment;	0.94 (0.75–1.17)	1.08 (0.84–1.39)
	2^b b model 2: adjusted by age range and gender;	0.97 (0.78–1.22)	1.15 (0.89–1.48)
	3^c c model 3: model 2+diabetes mellitus;	0.98 (0.78–1.23)	1.12 (0.87–1.45)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	0.95 (0.75–1.20)	1.14 (0.84–1.54)
ALT	1^a a model 1: no adjustment;	1.17 (0.85–1.62)	1.11 (0.75–1.66)
	2^b b model 2: adjusted by age range and gender;	1.06 (0.77–1.46)	1 (0.67–1.50)
	3^c c model 3: model 2+diabetes mellitus;	1.06 (0.77–1.46)	0.94 (0.63–1.42)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	1.05 (0.76–1.45)	0.92 (0.61–1.40)
AST	1^a a model 1: no adjustment;	1.28 (1.02–1.61)	1.11 (0.84–1.46)
	2^b b model 2: adjusted by age range and gender;	1.24 (0.99–1.55)	1.10 (0.83–1.45)
	3^c c model 3: model 2+diabetes mellitus;	1.24 (0.99–1.55)	1.10 (0.83–1.45)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	1.18 (0.93–1.49)	1 (0.75–1.34)
hs-CRP	1^a a model 1: no adjustment;	1.05 (0.92–1.18)	1.24 (1.08–1.44)
	2^b b model 2: adjusted by age range and gender;	1.10 (0.97–1.24)	1.29 (1.11–1.48)
	3^c c model 3: model 2+diabetes mellitus;	1.10 (0.97–1.24)	1.26 (1.09–1.44)
	4^d d model 4: model 3+body mass index+smoking+hypertension.	1.04 (0.92–1.18)	1.19 (1.04–1.37)

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[1] CORRESPONDING AUTHOR: Pedro Guatimosim Vidigal. Avenida Professor Alfredo Balena, 190, sala 403, Santa Efigênia, CEP: 30130-100, Belo Horizonte (MG), Brasil. E-mail: pedrovidigal@ufmg.br