Health impacts associated with the Fundão tailings dam disaster in Mariana, Minas Gerais, Brazil

We aim to evaluate the health impacts of the Fundão tailings dam disaster by analyzing secondary data collected from various databases of the Brazilian Ministry of Health and conducting a study to assess the burden of disease using years of life lost due to disability and the disability-adjusted life year (DALY) indicator as a summary measure. An ecologic study design was used to compare municipalities affected by the disaster with a group of controls. Based on the incidence of diseases registered in public databases, an assessment of the impact on mental and physical health associated with the disaster was carried out using a burden of diseases approach. DALYs were calculated for all the diseases identified based on the evaluation of the epidemiological parameters: (i) attributable risk (AR) ratio, (ii) ratio of cumulative incidences (CIs) before and after the disaster, and (iii) a plausibility coefficient, idealized in order to express the relevance of the health conditions identified to a set of health conditions plausibly associated with the disaster. Key findings include the estimation of an average loss of 2.39 years of life due to disability for the affected municipalities, considering 75 groups of diseases that had higher CIs and ARs after the disaster, compared with a set of control municipalities, indicating a worsening of health of these populations. We also identified respiratory diseases, various types of cancer, mental disorders, and violence as responsible for a very significant portion of the damage identified. We included a series of public health recommendations that can be implemented to facilitate the resilience of those living in affected municipalities.