Estimating the Causal Impact of Proximity to Gold and Copper Mines on Respiratory Diseases in Chilean Children: An Application of Targeted Maximum Likelihood Estimation

Abstract

In a town located in a desert area of Northern Chile, gold and copper open-pit mining is carried out involving explosive processes. These processes are associated with increased dust exposure, which might affect children’s respiratory health. Therefore, we aimed to quantify the causal attributable risk of living close to the mines on asthma or allergic rhinoconjunctivitis risk burden in children. Data on the prevalence of respiratory diseases and potential confounders were available from a cross-sectional survey carried out in 2009 among 288 (response: 69%) children living in the community. The proximity of the children’s home addresses to the local gold and copper mine was calculated using geographical positioning systems. We applied targeted maximum likelihood estimation to obtain the causal attributable risk (CAR) for asthma, rhinoconjunctivitis and both outcomes combined. Children living more than the first quartile away from the mines were used as the unexposed group. Based on the estimated CAR, a hypothetical intervention in which all children lived at least one quartile away from the copper mine would decrease the risk of rhinoconjunctivitis by 4.7 percentage points (CAR: −4.7; 95% confidence interval (95% CI): −8.4; −0.11); and 4.2 percentage points (CAR: −4.2; 95% CI: −7.9;−0.05) for both outcomes combined. Overall, our results suggest that a hypothetical intervention intended to increase the distance between the place of residence of the highest exposed children would reduce the prevalence of respiratory disease in the community by around four percentage points. This approach could help local policymakers in the development of efficient public health strategies.

EQ-5D-5L reference values for the German general elderly population

“…The only exception were women aged 70–74 years reporting higher EQ VAS values than their male counterparts. Similar findings were described by Huber et al [ 28 ] for Germany.…”

“…Several studies found that higher age is significantly associated with lower HRQoL as measured by the EQ-5D-5L [ 14 , 19 , 27 ]. Moreover, there is further evidence to suggest that variation in HRQoL is large in the elderly, which is even more pronounced in the oldest old [ 28 , 29 ]. With regard to Germany, two sets of preference-based reference values were identified.…”

Air Quality in the Working Environment and Respiratory Health of Female Congolese Stone Quarry Workers

“…Though there are several sources of air pollutants with an impact on the respiratory health of exposed workers (power plants, cement factories, construction industries, petrochemical industries, mining, etc. ), the emissions of particulates from quarries are quite high [ 3 , 4 , 5 , 6 , 7 ]. Individuals exposed to high particulate matter (PM 2.5 in particular) levels at their working or living environments are at a higher risk of developing a number of respiratory disorders, such as chronic airway inflammatory diseases (bronchitis, emphysema, silicosis) and lung cancer [ 6 , 7 ].…”

“…Furthermore, the health impacts of working in stone quarry settings are well documented [ 4 , 5 ]. For instance, epidemiological studies have supported the association between respiratory impairment and occupational exposure to dust.…”

“…For instance, epidemiological studies have supported the association between respiratory impairment and occupational exposure to dust. Additionally, individuals working in dusty environments have been found to carry the risk of inhaling particulate materials (e.g., silica) that may lead to adverse respiratory effects, such as chronic bronchitis, emphysema, acute and chronic silicosis, and lung cancer, which are disabling and can even be fatal [ 5 , 7 ]. Through its global development agenda, the United Nations’ Sustainable Development Goals (SDGs) are calling to end poverty (SDG1), and promote “decent work and economic growth” (SDG8) and health for all (SDG3) as well.…”