Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Prevalence of liver diseases as referred by people living in the Santos and São Vicente Estuary

  • 1393 Accesses

  • 3 Citations


The Santos and São Vicente Estuary has suffered extensively over the years from irregular industrial deposits. The present study aimed to evaluate liver disease prevalence and potential associated risk factors in four of the Estuary’s areas (Pilões and Água-Fria, Cubatão Center, Continental São Vicente, and Guarujá) and a reference area (Bertioga). This study consisted of a cross-sectional study design, in which a questionnaire was used to collect information in 820 households at each of the study areas. The proportion of total liver diseases, hepatitis, cirrhosis, and cancer (liver, biliary tract, and pancreas) per area were estimated. Pearson’s chi-square test and two proportion differences test were applied in order to evaluate associations between disease occurrence and areas and to test differences between two proportions, respectively. Single and multiple logistic regression models were applied to assess associations between disease prevalence and the different study areas. Liver disease prevalence was 1.5 % among all inhabitants and 1.4 % among those without any type of exposure. Among those who reported the presence of liver disease, a higher percentage of the participants that reported hepatitis (27.7 %) or other liver disease (48.7 %) did not report occupational or alcohol exposures. Hepatitis (77.8 %) was the most reported disease, and a statistical association between living in Pilões and Água-Fria and the occurrence of hepatitis was observed (Pearson’s χ 2: z = 18.1; p = 0.001). The consumption of locally-produced groceries (2.88; CI: 1.24–6.70) and water (5.88; CI: 2.24–15.45) were shown to be risk factors for the occurrence of liver disease. Thus, environmental exposure is still a public health problem present in the estuary region.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2


  1. AMBIOS Engenharia e Processos LTDA (2007) Relatory of health risk evaluation due to dangerous waste expsure in Itanhaem and São Vicente/SP. Accessed 21 Oct 2013. (in Portuguese)

  2. Assunção JV, Pesquero CR (1999) Dioxins and furans: origins e risks. Rev Saúde Públ 33(5):523–530 (in Portuguese)

  3. Barros MBA, César CLG, Carandina L, Torre GD (2006) Social inequalities in the prevalence of chronic diseases in Brazil, PNAD-2003. Ciênc Saúde Colet 11:911–926 (in Portuguese)

  4. Brasil. Banco de Dados do Sistema Único de Saúde (DATASUS). Health Information. Mortality CID-10 - List Tabde Tabulação CID-BR. Accessed 27 May 2010. (in Portuguese)

  5. Brasil. Instituto Brasileiro de Geografia e Estatística (IBGE) (2006) Census 2000. Accessed 20 August 2006. (in Portuguese)

  6. Brasil. Instituto Brasileiro de Geografia e Estatística. IBGE starts collecting PNAD 2008 (2008) Brasília. Accessed 25 April 2010. (in Portuguese)

  7. Brasil. Instituto Nacional do Câncer (INCA) (2003) Household survey on risk behaviors and referred morbidity of diseases and non-transmssible grievances. Accessed 13 June 2009. (in Portuguese)

  8. Carpenter DO (2006) Polychlorinated Biphenyls (PCBs): routes of exposure and effects on human health. Rev Environ Health 21:1–23

  9. Center for Disease Control and Prevention (CDC) (2014) Fact sheets - alcohol use and heath. Accessed 21 April 2014

  10. Cesar A, Pereira CDS, Santos AR, Abessa DMS, Fernández N, Choueri RB et al (2006) Ecotoxicological assessment of sediments from the Santos and São Vicente estuarine system Brazil. Braz J Oceanogr 54:55–63

  11. Companhia de Saneamento Básico do Estado de São Paulo (SABESP) (2009) Accessed 12 May 2010

  12. Companhia de Tecnologia de Saneamento Ambiental (CETESB) (2001) Estuarine system santos and São Vicente. São Paulo. Accessed 4 July 2010. (in Portuguese)

  13. Connecticut Department of Public Health - Drinking Water Section. Recommended Sanitary Procedures when Making Unscheduled and Emergency Repairs of Water Mains. Accessed 17 June 2010

  14. Costa JSD, Silveira MF, Gazalle FK, Oliveira SS, Hallal PC, Menezes AMB et al (2004) Heavy alcohol consumption and associated factors: a population-based. Rev Saúde Públ 38:284–291

  15. D’Amato C, Torres JPM, Malm O (2002) DDT (dichlorodiphenyltrichloroethane): toxicity and environmental contamination – A. Quim Nova 25(6):995–1002 (in Portuguese)

  16. Fitzgerald EF, Hwang SA, Lambert G, Gomez M, Tarbell A (2005) PCB exposure and in vivo CYP 1A2 activity among Native Americans. Environ Health Perspect 113:272–277

  17. Guimarães VV, Florindo AA, Stopa SR, César CLG, Barros MBA, Carandina L et al (2010) Alcohol abuse and dependence in adults in the State of São Paulo. Braz Rev Bras Epidemiol 13:314–325 (in Portuguese)

  18. Haris RH, Rodricks JV, Clarch CS, Papadopulos SS (1990) Adverse health effect at tennessee hazardous waste disposal site. In: Andelman JB, Underhil DW. Health effects from hazardous waste sites. Chelsea, Michigan. 12:221–40

  19. Hu H. Human Health and Heavy Metal Exposure (2002) In: Mac Cally M (ed) Life support: the environment and human health. 14:65–81

  20. Luiz-Silva W, Matos RHR, Kristosch GC (2002) Geochemistry and index of geoaccumulation of Mercury in surface sediments from Santos-Cubatão Estuary, State of São Paulo, Brazil. Quim Nova 25:753–756 (in Portuguese)

  21. Oliveira MLJ, Vidal-Torrado P, Otero JL, Ferreira JR (2007) Total mercury in mangrove soils of the Baixada Santista and Cardoso Island, São Paulo State. Quim Nova 30:519–524 (in Portuguese)

  22. Penteado JCP, Vaz JM (2001) The legacy of the polychlorinated (PCBs). Química Nova 24:390–398 (in Portuguese)

  23. Rezende J, Carakushansky G (2005) Congenital anomalies: etiology and prevention. In: Rezende J, Obstetrícia, ed. Rio de Janeiro, RJ (eds) Guanabara-Koogan 1034–51. (in Portuguese)

  24. Santos Filho E, Silva RS, Barretto HHC, Inomatan ONK, Lemes VRR, Sakuma AM et al (1993) Heavy metal and organochlorine pesticide blood levels in children aged between 1 and 10. Rev Saúde Públ 27:59–67 (in Portuguese)

  25. Santos Filho E, Silva RS, Barretto HHC, Inomatan ONK, Lemes VRR, Kussumi TA et al (2003) Levels of exposure to organochlorine pesticides in open-air dump. Rev Saúde Públ 37:515–522

  26. Silva AS (1998) Environmental contamination and occupational and urban exposure to hexachlorobenzene in Baixada Santista., SP, Brazil. São Paulo. Accessed 4 May 2010. (in Portuguese)

  27. Vrijheid M (2000) Health effects of residence near hazardous landfill sites: a review of epidemiologic literature. Environ Health Perspect 108:101–112

  28. World Health Organization (WHO) (2000) International guide for monitoring alcohol consumption and related harm

Download references

Author information

Correspondence to Daniele Fernandes Pena Carvalho.

Additional information

Responsible editor: Philippe Garrigues

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Carvalho, D.F.P., Guimarães, M.T., Ribeiro, T.S. et al. Prevalence of liver diseases as referred by people living in the Santos and São Vicente Estuary. Environ Sci Pollut Res 22, 14579–14588 (2015).

Download citation


  • Cross-sectional studies
  • Estuary pollution
  • Environmental pollution
  • Liver diseases
  • Hepatitis
  • Liver cirrhosis