Typical characteristics of the slaughterhouse wastewater.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"9477",leadTitle:null,fullTitle:"Muscular Dystrophy - Research Updates and Therapeutic Strategies",title:"Muscular Dystrophy",subtitle:"Research Updates and Therapeutic Strategies",reviewType:"peer-reviewed",abstract:"Muscular Dystrophy - Research Update and Therapeutic Strategies is for students, researchers, and clinicians interested in muscular dystrophies who want to improve their knowledge of these complex genetic diseases. The book includes information about the genetics of various types of muscular dystrophies as well as explores new and current therapeutic strategies that aim to ameliorate symptoms and improve patients’ quality of life and life expectancy. In addition, this book reviews information on current clinical trials for muscular dystrophies and presents a framework for what to consider during the design of these trials.",isbn:"978-1-83968-475-3",printIsbn:"978-1-83968-474-6",pdfIsbn:"978-1-83968-476-0",doi:"10.5772/intechopen.87261",price:119,priceEur:129,priceUsd:155,slug:"muscular-dystrophy-research-updates-and-therapeutic-strategies",numberOfPages:116,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"dd601de843019d51e1769a26cf7e1acc",bookSignature:"Gisela Gaina",publishedDate:"December 23rd 2020",coverURL:"https://cdn.intechopen.com/books/images_new/9477.jpg",numberOfDownloads:3652,numberOfWosCitations:0,numberOfCrossrefCitations:1,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:2,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:3,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"December 3rd 2019",dateEndSecondStepPublish:"March 9th 2020",dateEndThirdStepPublish:"May 8th 2020",dateEndFourthStepPublish:"July 27th 2020",dateEndFifthStepPublish:"September 25th 2020",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"242747",title:"Dr.",name:"Gisela",middleName:null,surname:"Gaina",slug:"gisela-gaina",fullName:"Gisela Gaina",profilePictureURL:"https://mts.intechopen.com/storage/users/242747/images/system/242747.jpg",biography:"Florina Gisela Gaina, PhD, currently works at 'Victor Babes” National Institute of Pathology, Bucharest, Romania. She received her PhD in Biology from the University of Bucharest, Romania, in 2009 with a thesis project based on the study of the proteins involved in muscular dystrophies. She is a research scientist working in the field of skeletal muscle. The primary focus of her research activities is on skeletal muscle regeneration. She has been involved in a number of research projects funded by regional, national, and international public agencies. She is an author and/or co-author of more than twenty scientific papers and conference abstracts and three book chapters.",institutionString:'Institutul National "Victor Babeș"',position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Institutul National Victor Babes",institutionURL:null,country:{name:"Romania"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"980",title:"Tissue Engineering and Regenerative Medicine",slug:"tissue-engineering-and-regenerative-medicine"}],chapters:[{id:"72410",title:"Duchenne Muscular Dystrophy (DMD) Treatment: Past and Present Perspectives",doi:"10.5772/intechopen.92765",slug:"duchenne-muscular-dystrophy-dmd-treatment-past-and-present-perspectives",totalDownloads:720,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Duchenne muscular dystrophy (DMD) is one of the fatal X-linked disorders that are characterized by progressive muscle weakness and occur due to mutation in the largest human gene known as the DMD gene which encodes dystrophin protein that is mandatory for keeping the muscles structurally and functionally intact. The disease always affects boys (1 from every ~5000), and in some cases the female carriers are symptomatic. The disease usually leads to impairment in cardiac and pulmonary functions leading to the death of the patients in very young ages. Understanding DMD through precise molecular diagnosis will aid in determining the suitable therapeutic approach for the cases like designing exon-skipping antisense oligonucleotides (AOs) or stem cell-based therapies in conjunction with gene editing techniques (CRISPR/Cas9). Such therapies can correct the genetic defect in the DMD gene and ameliorate the symptoms. In this chapter, we will illustrate the past and current strategies for DMD disease treatment.",signatures:"Nahla O. Mousa, Ahmed Osman, Nagia Fahmy, Ahmed Abdellatif and Waheed K. Zahra",downloadPdfUrl:"/chapter/pdf-download/72410",previewPdfUrl:"/chapter/pdf-preview/72410",authors:[null],corrections:null},{id:"72334",title:"Facioscapulohumeral Muscular Dystrophy: Genetics and Trials",doi:"10.5772/intechopen.92672",slug:"facioscapulohumeral-muscular-dystrophy-genetics-and-trials",totalDownloads:501,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"A complex combination of molecular pathways and cell interactions causes facioscapulohumeral muscular dystrophy (FSHD). Several new therapies pose a promising solution to this disease with no cure. This chapter aims to explain the genetics of facioscapulohumeral muscular dystrophy, and review the current clinical trials for the treatment of FSHD.",signatures:"Robin Warner",downloadPdfUrl:"/chapter/pdf-download/72334",previewPdfUrl:"/chapter/pdf-preview/72334",authors:[{id:"317312",title:"M.D.",name:"Robin",surname:"Warner",slug:"robin-warner",fullName:"Robin Warner"}],corrections:null},{id:"73081",title:"miRNAs and Muscle Stem Cells",doi:"10.5772/intechopen.92851",slug:"mirnas-and-muscle-stem-cells",totalDownloads:566,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Skeletal muscle represents between 30 and 38% of the human body mass. Both the maintenance and repair of adult muscle tissue are directed by satellite cells (SCs). SCs are located beneath the basal lamina of the skeletal muscle myofiber. They are quiescent for most of their life but, in response to physiological stimuli or muscle trauma, they activate, proliferate, and enter the myogenic program via generating myogenic progenitors (myoblasts) that fuse to existing myofibers or de novo myofibers. MicroRNAs (miRNAs or miRs) play a critical role in regulating muscle regeneration and stem cell behavior. In this chapter, we review the pivotal role in the regulation of SC quiescence, activation, and differentiation in the context of muscular dystrophies.",signatures:"Francisco Hernandez-Torres, Lara Rodriguez-Outeiriño, Lidia Matias-Valiente, Estefania Lozano-Velasco, Diego Franco and Amelia Aranega",downloadPdfUrl:"/chapter/pdf-download/73081",previewPdfUrl:"/chapter/pdf-preview/73081",authors:[null],corrections:null},{id:"72431",title:"Role of Growth Factors and Apoptosis Proteins in Cognitive Disorder Development in Patients with Duchenne Muscular Dystrophy",doi:"10.5772/intechopen.92543",slug:"role-of-growth-factors-and-apoptosis-proteins-in-cognitive-disorder-development-in-patients-with-duc",totalDownloads:428,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease; it occurs due to a mutation in the dystrophin protein gene; as a result, the protein is not synthesized and muscle tissue dies. On the one hand, we can say that this disease has been sufficiently studied; however, it is still incurable, and there are a number of issues remaining unclear in terms of the development of progressive dementia as a symptom in 30% of patients with Duchenne muscular dystrophy. We conducted a study at the intersection of molecular genetic, neurological, and enzyme-linked immunosorbent patients’ blood tests and experiments in organotypic culture, which allowed us to determine important points in the development of cognitive disorders in patients with Duchenne muscular dystrophy and identify a significant effect of growth factor concentration in patients. The chapter will present data on neurotrophic regulation in patients with Duchenne muscular dystrophy (by the best-studied neurotrophins), demonstrate special aspects of neuron-myocyte interaction, and broaden the understanding of the role of apoptosis and synthase proteins in the development of this disease. We would like to highlight the importance of prognostic criteria for the development of cognitive impairment and possible therapeutic measures to prevent progressive dementia",signatures:"Mariia Georgievna Sokolova and Ekaterina Valentinovna Lopatina",downloadPdfUrl:"/chapter/pdf-download/72431",previewPdfUrl:"/chapter/pdf-preview/72431",authors:[null],corrections:null},{id:"72849",title:"Mesenchymal Stem Cells for Regenerative Medicine for Duchenne Muscular Dystrophy",doi:"10.5772/intechopen.92824",slug:"mesenchymal-stem-cells-for-regenerative-medicine-for-duchenne-muscular-dystrophy",totalDownloads:816,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Mesenchymal stem cells (MSCs) are multipotent stem cells that can be isolated from both foetal and adult tissues. Several groups demonstrated that transplantation of MSCs promoted the regeneration of skeletal muscle and ameliorated muscular dystrophy in animal models. Mesenchymal stem cells in skeletal muscle, also known as fibro-adipogenic progenitors (FAPs), are essential for the maintenance of skeletal muscle. Importantly, they contribute to fibrosis and fat accumulation in dystrophic muscle. Therefore, MSCs in muscle are a pharmacological target for the treatment of muscular dystrophies. In this chapter, we briefly update the knowledge on mesenchymal stem/progenitor cells and discuss their therapeutic potential as a regenerative medicine treatment of Duchenne muscular dystrophy.",signatures:"Ahmed Elhussieny, Ken’ichiro Nogami, Fusako Sakai-Takemura, Yusuke Maruyama, AbdElraouf Omar Abdelbakey, Wael Abou El-kheir, Shin’ichi Takeda and Yuko Miyagoe-Suzuki",downloadPdfUrl:"/chapter/pdf-download/72849",previewPdfUrl:"/chapter/pdf-preview/72849",authors:[null],corrections:null},{id:"72293",title:"The Impact of Payer and Reimbursement Authorities Evidence Requirements on Healthcare Solution Design for Muscular Dystrophies",doi:"10.5772/intechopen.92553",slug:"the-impact-of-payer-and-reimbursement-authorities-evidence-requirements-on-healthcare-solution-desig",totalDownloads:622,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"For rare diseases that start early and are slowly degenerative, despite the desire to create solutions that benefit the patient, healthcare system realities can be prohibitive to generate an affordable and effective solution. The optimal care pathway for muscular dystrophy, similar to all degenerative diseases, would be a rapid and accurate diagnosis, pathophysiological confirmation and application of therapeutics that slowly replaces damaged tissue with healthy tissue, supported by adjuvant solutions that stimulate the tissue to repair and reduce inflammation and fibrosis. This would increase the lifespan and quality of life in an affordable way. For all diseases, two key stakeholders, the paying entity and the patient, fundamentally define whether revenue can be generated. Healthcare decision-making commissioners who agree to pay for the product and patient-reported outcomes jointly inform whether the intervention increases the quality of life related to existing standards of care and, therefore, if it should be paid for. This chapter explains why this has not yet happened and efforts initiated to correct this and addresses how the components and data used in this decision-making process could be updated, adapted and integrated into every stage of the development of solutions and how organisational innovation may enable the field.",signatures:"Maximilian Lebmeier, Fleur Chandler, Josie Godfrey and Jonathan Dando",downloadPdfUrl:"/chapter/pdf-download/72293",previewPdfUrl:"/chapter/pdf-preview/72293",authors:[null],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3348",title:"Tissue Engineering",subtitle:null,isOpenForSubmission:!1,hash:"39bb39271df3b373edb7d5e2cdeffb18",slug:"tissue-engineering",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/3348.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3361",title:"Regenerative Medicine and Tissue Engineering",subtitle:null,isOpenForSubmission:!1,hash:"fe914d49a96b3dcd00d27292ae23536e",slug:"regenerative-medicine-and-tissue-engineering",bookSignature:"Jose A. 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Early recognition is critical for prevention in clinical practice. So far, the mechanisms of MCI are still largely unknown, despite evidence from pathological studies, genetic studies, biomarker studies, and molecular biology studies offering some clues for us. Thus, the prevention and treatment of MCI is still a complicated task with great challenges.
",isbn:"978-1-83768-424-3",printIsbn:"978-1-83768-423-6",pdfIsbn:"978-1-83768-425-0",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"908d319a0cd368c5274419678d293bb1",bookSignature:"Dr. Shuzhen Zhu",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/12165.jpg",keywords:"Prevalence, Risk Factors, Classification, Assessment Tools, Disease Spectrums of MCI, Alzheimer's Disease, Parkinson's Disease, Evidence From Pathological Studies, Evidence From Genetic Studies, Evidence From Biomarker Studies, Non-pharmacological Treatments, Antidementia Drugs",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 17th 2022",dateEndSecondStepPublish:"July 15th 2022",dateEndThirdStepPublish:"September 13th 2022",dateEndFourthStepPublish:"December 2nd 2022",dateEndFifthStepPublish:"January 31st 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"11 days",secondStepPassed:!1,areRegistrationsClosed:!1,currentStepOfPublishingProcess:2,editedByType:null,kuFlag:!1,biosketch:"A member of the International Movement Disorder Association, leading the National Natural Science Foundation of China, and a reviewer for several journals, has in-depth research on neurodegenerative diseases.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"470534",title:"Dr.",name:"Shuzhen",middleName:null,surname:"Zhu",slug:"shuzhen-zhu",fullName:"Shuzhen Zhu",profilePictureURL:"https://mts.intechopen.com/storage/users/470534/images/system/470534.jpg",biography:"Prof. Zhu Shuzhen, Ph.D. in Neurology, is a visiting scholar at the University of Toronto and is currently the Deputy Chief Physician and Associate Professor of the Department of Neurology at Zhujiang Hospital of Southern Medical University. She has been the chair of the National Natural Science Foundation of China and Guangdong Provincial Natural Science Foundation and has published many SCI articles on neurodegenerative diseases. She has authored several SCI papers and served as a reviewer and editor for several journals, for example, Frontiers in Aging Neuroscience, Frontiers in Pharmacology, and Acta pharmacologica Sinica.",institutionString:"Southern Medical University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Southern Medical University",institutionURL:null,country:{name:"China"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"18",title:"Neuroscience",slug:"life-sciences-neuroscience"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"444312",firstName:"Sara",lastName:"Tikel",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/444312/images/20015_n.jpg",email:"sara.t@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. 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Moreover, the global production of beef, pork, and poultry meat has been doubled in the past decade and is projected to grow steadily until 2050. Thus, the number of slaughterhouse facilities is increasing, which results in an expected higher volume of slaughterhouse wastewater (SWW) to be treated [3]. SWWs are classified as one of the most detrimental industrial wastewaters to the environment by the United States Environmental Protection Agency (US EPA) because the inadequate disposal of SWW is one of the reasons for river deoxygenation and groundwater pollution [4]. Thus, SWWs require significant treatment for a safe and sustainable release to the environment, and the treatment and disposal of wastewater from slaughterhouses are an economic and public health necessity [5, 6].
\nThe organic matter concentration in meat processing plant (MPP) effluents is usually high, and the residues are moderately solubilized, leading to a polluting effect due to the high levels of organics and pathogens present in SWW along with detergents used for cleaning purposes. SWWs are typically assessed using bulk parameters because of the various pollutant loads derived from the type and the number of animals slaughtered that fluctuate amid the meat industry [7].
\nAnaerobic treatment is the preferred biological treatment because of its effectiveness in treating high-strength wastewater such as SWW with less complex equipment requirements [8]. Although anaerobic treatment is efficient, anaerobically treated effluents require posttreatment to comply with required discharge limits where the complete stabilization of the organic matter is not possible by anaerobic treatment alone. Anaerobically treated effluents contain solubilized organic matters, which are more suited for treatment using aerobic processes. Therefore, aerobic treatment systems are more frequently used in wastewater treatment systems since they operate at higher rates than conventional anaerobic treatment methods. Taking into account that oxygen requirements and treatment time are directly proportional to an increase in wastewater strength, aerobic treatment is frequently applied as posttreatment of anaerobic effluents as well as for nutrient removal [9].
\nNevertheless, biological processes alone do not produce effluents that comply with current effluent discharge limits when treating high-organic-strength wastewaters. The use of combined anaerobic and aerobic processes is beneficial for its potential resource recovery and high treatment efficiency [10].
\nOn the other hand, some slaughterhouse effluents contain toxic, bioresistant, recalcitrant, and nonbiodegradable substances. Thus, advanced oxidation processes (AOPs) could be used to improve the biodegradability of SWW and inactivate pathogenic microorganisms and viruses, left after biological treatment of the wastewater. Consequently, AOPs are an attractive alternative and a complementary treatment method to biological processes for the treatment of slaughterhouse effluents, especially as a posttreatment method [5–7]. Adopting combined biological treatment and AOPs for the treatment of slaughterhouse effluents is considered operationally and economically advantageous. Combined processes incorporate advantages of diverse technologies to achieve high-quality effluents from industrial and high-strength wastewaters for water reuse and resource recovery purposes [9, 10].
\nIn this chapter, the regulatory frameworks relevant to the SWW management, environmental impacts, and health effects are discussed along with common practices for SWW treatment. Significant progress in the combination of biological treatment and AOPs is emphasized. A case study for the treatment of an actual SWW by integrated anaerobic baffled reactor (ABR)-aerobic activated sludge (AS)-UV/H2O2 processes is presented. The overall treatment efficiency of organics and nutrients, the potential energy recovery from CH₄ production, and the H2O2 residual are discussed. A cost-effectiveness analysis is used to minimize the treatment time as well as the overall incurred treatment costs required for the efficient treatment of slaughterhouse effluents. Finally, the chapter ends with a discussion on the need for an adequate SWW management, resource recovery, and the improvement actions required.
\nMeat processing effluents are considered harmful worldwide due to the SWW complex composition of fats, proteins, fibers, high organic content, pathogens, and pharmaceuticals for veterinary purposes. Slaughterhouse effluents are typically evaluated using bulk parameters because of the broad range of SWW and pollutant loads. SWW contains large amounts of biochemical oxygen demand (BOD), chemical oxygen demand (COD), total organic carbon (TOC), total nitrogen (TN), total phosphorus (TP), and total suspended solids (TSS) [7]. Typical characteristics of an actual SWW are summarized in Table 1.
\nParameter | \nRange | \nMean | \n
---|---|---|
BOD (mg/L) | \n150–8500 | \n3000 | \n
COD (mg/L) | \n500–16,000 | \n5000 | \n
TOC (mg/L) | \n50–1750 | \n850 | \n
TN (mg/L) | \n50–850 | \n450 | \n
TP (mg/L) | \n25–200 | \n50 | \n
TSS (mg/L) | \n0.1–10,000 | \n3000 | \n
K (mg/L) | \n0.01–100 | \n50 | \n
Color (mg/L Pt scale) | \n175–400 | \n300 | \n
Turbidity | \n200–300 | \n275 | \n
pH | \n4.9–8.1 | \n6.5 | \n
Typical characteristics of the slaughterhouse wastewater.
As a result, due to the diverse characteristics of the SWW, it is appropriate to classify and minimize wastewater production at its source. Meat processing effluents are becoming one of the major agribusiness concerns due to the vast amount of water used during slaughtering, processing, and cleaning of the slaughtering facilities.
\nRegulations are necessary to mitigate the environmental impact of slaughterhouses, and the treatment methods are used as the main regulatory requirement [11]. The compliance with current environmental legislation and the state-of-the-art technologies may also provide some economic relief via resource recovery from biogas generation using high-rate anaerobic treatment.
\n\nTable 2 describes current regulations and discharge limits for organics and nutrients in SWW for an adequate release to the environment in different jurisdictions worldwide, including the World Bank Group [12], the Council of the European Communities [13], the US EPA [14], the Environment Canada [15, 16], the Colombian Ministry of Environment and Sustainable Development Colombia [17], the People’s Republic of China Ministry of Environmental Protection [18], the Indian Central Pollution Control Board [19], and the Australian and New Zealand Environment and Conservation Council [20, 21].
\nParameter | \nWorld Bank | \nEU | \nUSA | \nCanada | \nColombia | \nChina | \nIndia | \nAustralia | \n
---|---|---|---|---|---|---|---|---|
BOD (mg/L) | \n30 | \n25 | \n16–26 | \n5–30 | \n50 | \n20–100 | \n30–100 | \n5–20 | \n
COD (mg/L) | \n125 | \n125 | \nn.a. | \nn.a. | \n150 | \n100–300 | \n250 | \n40 | \n
TN (mg/L) | \n10 | \n10–15 | \n4–8 | \n1.25 | \n10 | \n15–20 | \n10–50 | \n10–20 | \n
TOC (mg/L) | \nn.a. | \nn.a. | \nn.a. | \nn.a. | \nn.a. | \n20–60 | \nn.a. | \n10 | \n
TP (mg/L) | \n2 | \n1–2 | \nn.a. | \n1.00 | \nn.a. | \n0.1–1.0 | \n5 | \n2 | \n
TSS (mg/L) | \n50 | \n35–60 | \n20–30 | \n5–30 | \n50 | \n20–30 | \n100 | \n5–20 | \n
pH | \n6–9 | \nn.a. | \n6–9 | \n6–9 | \n6–9 | \n6–9 | \n5.5–9.0 | \n5–9 | \n
Temperature (°C change) | \nn.a. | \nn.a. | \nn.a. | \n<1 °C | \nn.a. | \nn.a. | \n<5 °C | \n<2 °C | \n
Comparison of standard limits for slaughterhouse wastewater discharge in different jurisdictions worldwide.
Although it can be seen that Canadian standards are stricter than other international regulations such as those in the European Union (EU), Australia and New Zealand, or the USA, Canada does not have a specific regulation for the meat processing industry. Moreover, Australia and New Zealand and the USA have been incorporating an integrated approach to the regulation of the MPPs, where industry and regulatory sectors are working together to achieve a common goal of reducing the threats caused by the hazardous and high-strength wastewaters produced in slaughterhouses. Finally, emerging economies such as India, China, and Colombia have less strict standards, but their legislation is focused on specific industries to attain certain levels of treatment depending on the wastewater strength. Therefore, the selection of a specific treatment method depends on the characteristics of the SWW being treated, the best available technology economically achievable (BAT), and the compliance with regulations in different political jurisdictions.
\nThe commercialization of animal products for consumption leads to the production of a large volume of SWW. Although the environment can handle a certain amount of pollutants through natural degradation processes, as the SWW concentration increases, these mechanisms come to be overburdened, where contamination problems commence [22].
\nThe discharge of raw SWW to water bodies affects the quality of water particularly by causing a reduction of dissolved oxygen (DO), which may lead to the death of aquatic life [23]. Moreover, macronutrients, such as nitrogen and phosphorus, may cause eutrophication events. The discharge of these nutrients triggers an excessive algae growth and subsequent decay. Thus, the mineralization of the algae may lead to the deterioration of aquatic life due to depletion of DO levels. Finally, SWW may contain compounds, such as chromium and un-ionized ammonia, which are directly toxic to aquatic life [24].
\nAnother source of contamination of the meat processing industry is the addition of surfactants as a result of the cleaning process. Surfactants, major components in detergents, may enter the aquatic environment due to an inadequate SWW treatment, causing short-term and long-term changes in the ecosystem that affect humans, fish, and vegetation [25].
\nThe environmental impact of SWW is not only characterized by pollution via surfactants, nitrate, and chloric anions but also pathogens, which persist in the soil and reproduce continuously. Pathogens from SWW can also be transmitted to humans who are exposed to the water body, making those areas nonsuitable for drinking, swimming, or irrigation purposes [5, 26].
\nThe general public health effects of the meat processing industry are related to the direct interaction of human communities with the slaughterhouse activities and indirect interactions with the environment, which can be previously affected by the inadequate management of the liquid effluents, solid waste, and obnoxious odors [27]. According to Um et al. [28], conventional treatment processes have no major impact on the reduction of antibiotic-resistant
The unsanitary conditions in some slaughterhouses allow the proliferation of pathogens to the final meat product to be consumed. People from developing countries in Africa, Asia, and South America have experienced serious gastrointestinal diseases, bloody diarrhea, liver malfunctions, and, in some cases, death associated with the presence of viruses, protozoa, helminthic eggs, and bacteria in SWW [5, 27]. Furthermore, the presence of hepatitis A and E viruses has been reported in the sewage of animal origin in Spain. Therefore, SWW must be treated efficiently before discharge into water bodies to avoid environmental pollution and human health effects [29].
\nThe freshwater consumption substantially varies in the meat processing sector, and a typical MPP generates a large amount of wastewater from the slaughtering process and cleaning of the facilities. Therefore, the water reuse and the recovery of valuable by-products from the meat processing effluents are the main focus in the agribusiness toward a cleaner production focused on high-quality effluents, biogas production and exploitation, and recovery of nutrients and fertilizers [7].
\nTreatment methods for SWW are comparable to those used in municipal wastewater treatment and include primary, secondary, and tertiary treatment. However, this does not eliminate the need for primary treatment. There are numerous SWW treatment methods after preliminary treatment, which can be divided into four main categories: physicochemical treatment, biological treatment, AOPs, and combined processes [2, 7]. Each method has advantages and disadvantages, which are discussed below.
\nThe purpose of the preliminary treatment is to separate solids and large particles from the liquid portion in SWW and remove up to 30% of the BOD. The most common unit operations for preliminary treatment of SWW include screeners, sieves, and strainers. Thus, large solids with a 10–30 mm diameter are retained while the SWW passes through. Other preliminary treatment methods include homogenization and equalization and flotation, among other systems such as catch basins and settlers [30].
\nAfter preliminary treatment, the effluent should be further treated using primary and secondary treatment. One of the most practical methods of primary treatment for SWW is dissolved air floatation (DAF) for the reduction of fat, oil, grease, TSS and BOD [31]. The most commonly used physicochemical treatment methods are presented below.
\nIn the coagulation process, colloidal particles in the SWW are grouped into larger particles, called flocs. The colloidal particles in SWW are nearly negatively charged which make them stable and resistant to aggregation. For this reason, coagulants with positively charged ions are added to destabilize the colloidal particles to form flocs and facilitate the sedimentation process. Various coagulant types can be found in the market, and the most widely used are inorganic metal based-coagulants such as aluminum sulfate, aluminum chlorohydrate, ferric chloride, ferric sulfate, and poly-aluminum chloride with removal efficiencies of up to 80% for BOD, COD, and TSS [32].
\nThe DAF technology refers to the method of liquid-solid separation by air introduction. The fat and grease along with light solids are moved to the surface creating a sludge blanket. Thus, it can be continuously removed via scum scraping. Furthermore, flocculants and blood coagulants can be added to enhance the effectiveness of the DAF treatment for COD and BOD removals of up to 75%. Nevertheless, common DAF disadvantages include occasional malfunctioning, poor TSS elimination, and moderate nutrient removal [33].
\nThe electrocoagulation (EC) process has been employed as a cost-effective technology for the removal of organics, heavy metals, and pathogens from slaughterhouse effluents by inducing an electric current without chemical addition. The EC process generates M3+ ions, mainly Fe3+ and Al3+, using different electrode materials. Other electrode types including Pt, SnO2, and TiO2 can interact with H+ or OH− ions in acidic or alkaline conditions, respectively. Thus, removal efficiencies of up to 80, 81, 84, 85, and 96% can be achieved for BOD, TSS, TN, COD, and color, respectively [34, 35].
\nMembrane processes are becoming an alternative treatment method for meat processing effluents. Different membrane processes, including microfiltration (MF), ultrafiltration (UF), nanofiltration (NF), and reverse osmosis (RO), have been used for SWW treatment to remove particulates, colloids, macromolecules, organic matter, and pathogens with overall efficiencies of up to 90%. However, membrane processes are required to be coupled with conventional processes for nutrient removal in SWW. Another drawback of membrane processes refers to the membrane fouling when treating high-strength wastewater because of the formation of biofouling layers on the membranes, restricting the permeation rate [36].
\nPrimary treatment and physicochemical processes typically do not treat SWW completely, to a degree of satisfaction set by regulations. Thus, secondary treatment is used for the removal of the remaining soluble organic compounds from primary treatment. Biological processes include lagoons with anaerobic, aerobic, or facultative microorganisms, trickling filters, activated sludge (AS) bioreactors, and constructed wetlands (CWs) for organic and nutrient removal efficiencies of up to 90% [7].
\nAnaerobic digestion is the preferred method for SWW treatment due to its effectiveness in treating highly concentrated industrial effluents since organic compounds are degraded by anaerobic bacteria in the absence of oxygen into CO2 and CH₄. Anaerobic systems have the advantage of achieving low sludge production, minimum energy requirements with potential resource recovery, and high COD removal. Typical anaerobic processes for the treatment of meat processing effluents comprise anaerobic baffled reactor (ABR), anaerobic digester (AD), anaerobic filter (AF), anaerobic lagoon (AL), septic tanks (ST), and up-flow anaerobic sludge blanket (UASB) [30].
\nNevertheless, anaerobic treatment barely complies with current discharge limits. Complete stabilization of the organic compounds is difficult due to the high organic strength of SWW. Therefore, an additional treatment stage is recommended to remove the organics, nutrients, and pathogens that remain after anaerobic treatment. On the other hand, anaerobic treatment requires a higher space and a higher residence time to achieve high overall treatment efficiency, affecting the economic viability of anaerobic treatment alone. Accordingly, the combination of anaerobic and aerobic processes is necessary to achieve a maximum efficiency for the treatment of SWW [37].
\nAerobic processes are frequently employed for nutrient removal and further treatment after primary treatment. The required oxygen and treatment time are directly related to the strength of the SWW, which makes it inadequate as primary treatment of SWW but adequate after anaerobic treatment [38].
\nThere are many advantages of using aerobic wastewater treatment processes, including low odor production, fast biological growth rate, and rapid adjustments to the temperature and loading rate changes. Conversely, the operating costs of aerobic systems are higher than those for anaerobic systems due to the maintenance and energy requirements for artificial oxygenation. There are different aerobic unit operations for SWW treatment, such as aerobic AS, rotating biological contactors (RBCs), and sequencing batch reactors (SBRs) [39].
\nConstructed wetlands (CWs) emulate the degradation mechanisms of natural wetlands for water decontamination, integrating biological and physicochemical processes from the interaction of vegetation, soil, microorganisms, and atmosphere for the adsorption, biodegradation, filtration, photooxidation, and sedimentation of organics and nutrients.
\nThe performance of CW systems for the treatment of SWW has been evaluated using both horizontal and vertical subsurface flow CWs. Results have shown a wide range of organic and nutrient removal for different vegetation with encouraging maximum removals of 99, 97, 85, and 78% for BOD, COD, TSS, and TN, respectively [40]. As a result, CWs are simple methods with low operation and maintenance costs and few negative impacts on the environment, which make them an attractive alternative to conventional treatment [41].
\nAOPs are an interesting complementary treatment option for primary or secondary treatment of SWW, showing excellent overall treatment efficiencies for water reuse. AOPs are diverse and include gamma radiation, ozonation, ultrasound technology (UST), UV/H2O2, UV/O₃, and photocatalysis, among others, for the oxidation and degradation of organic matter. The disinfection is another benefit of AOPs, which can inactivate pathogens without adding additional chemicals in comparison to other disinfection methods, such as chlorination, preventing the formation of hazardous by-products [5]. Another main advantage of the AOPs is the high reaction rates as well as very low treatment time.
\nPhotocatalysis using photo-Fenton–based processes and photooxidation using UV/H2O2 are the most commonly used AOPs for SWW treatment. Although these processes are usually expensive if applied alone, removal efficiencies of over 90% can be achieved for SWW secondary effluents in terms of TOC and COD as a posttreatment method. Thus, the combination of biological processes and AOPs is recommended for SWW treatment [42, 43].
\nThe implementation of combined processes is operationally and economically beneficial for SWW treatment since it couples the advantages of different technologies to treat high-strength industrial wastewaters. The combined ABR-AS-UV/H2O2 system is recognized as a cost-effective solution for SWW treatment with removal efficiencies of over 95% for organics and nutrients at optimum operating conditions [6, 9, 10].
\nAn overview of the state-of-the-art technologies for SWW treatment, during the last two years, is presented in Table 3. Particular attention is given to organic and nutrient removal, in terms of bulk parameters such as BOD, COD, TOC, TN, and TP. As shown in Table 3, SWW treatment efficiencies vary extensively and depend on the SWW characteristics, the treatment time, and the influent concentration, as well as the type of treatment and BAT to comply with current regulations [7].
\nMethod | \nHRT (h) | \nBODin (mg/L) | \nCODin (mg/L) | \nTOCin (mg/L) | \nTNin (mg/L) | \nBODrem (%) | \nCODrem (%) | \nTOCrem (%) | \nTNrem (%) | \nRef. | \n
---|---|---|---|---|---|---|---|---|---|---|
EC | \n1 | \n1123 | \n2171 | \n– | \n148 | \n– | \n85 | \n– | \n– | \n[44] | \n
ABR-AS-AOP | \n41 | \n4635 | \n– | \n1200 | \n841 | \n100 | \n– | \n100 | \n82 | \n[10] | \n
SBR | \n96 | \n– | \n6580 | \n– | \n3321 | \n– | \n81 | \n– | \n95 | \n[45] | \n
AF | \n46 | \n– | \n15800 | \n– | \n– | \n– | \n60 | \n– | \n– | \n[46] | \n
AL | \n48 | \n5088 | \n9216 | \n– | \n343 | \n73 | \n59 | \n– | \n– | \n[47] | \n
SBR | \n12 | \n– | \n356 | \n– | \n175 | \n– | \n– | \n– | \n91 | \n[48] | \n
EC | \n1 | \n1950 | \n3337 | \n– | \n– | \n– | \n78 | \n– | \n– | \n[49] | \n
SBR | \n161 | \n4240 | \n6057 | \n1436 | \n576 | \n– | \n98 | \n– | \n98 | \n[50] | \n
AF | \n24 | \n– | \n88 | \n– | \n– | \n– | \n80 | \n– | \n90 | \n[51] | \n
AD | \n2640 | \n– | \n18600 | \n– | \n5200 | \n– | \n– | \n– | \n66 | \n[52] | \n
MF | \n48 | \n– | \n480 | \n183 | \n115 | \n– | \n91 | \n45 | \n45 | \n[53] | \n
UST-AF-UF | \n144 | \n– | \n3000 | \n– | \n– | \n– | \n96 | \n– | \n– | \n[54] | \n
CW | \n28 | \n– | \n468 | \n– | \n61 | \n– | \n60 | \n– | \n46 | \n[55] | \n
AF-UF | \n48 | \n– | \n1778 | \n– | \n374 | \n– | \n95 | \n– | \n78 | \n[8] | \n
SBR | \n12 | \n4240 | \n6057 | \n1436 | \n576 | \n– | \n93 | \n– | \n93 | \n[56] | \n
AOP | \n1 | \n– | \n406 | \n– | \n– | \n– | \n84 | \n– | \n– | \n[57] | \n
SBR | \n3 | \n– | \n8604 | \n– | \n1493 | \n– | \n80 | \n– | \n88 | \n[58] | \n
UST-AF-UF | \n343 | \n– | \n5200 | \n– | \n74 | \n– | \n96 | \n– | \n– | \n[59] | \n
AOP | \n2 | \n340 | \n– | \n94 | \n55 | \n– | \n– | \n81 | \n– | \n[42] | \n
UF-RO | \n160 | \n– | \n7970 | \n– | \n– | \n– | \n80 | \n– | \n– | \n[60] | \n
AD-AOP | \n723 | \n658 | \n1494 | \n513 | \n181 | \n98 | \n98 | \n97 | \n31 | \n[43] | \n
ABR-AS-AOP | \n55 | \n1635 | \n2000 | \n1200 | \n841 | \n100 | \n99 | \n100 | \n85 | \n[6] | \n
ABR-AS-AOP | \n10 | \n1831 | \n2043 | \n1691 | \n866 | \n100 | \n99 | \n100 | \n90 | \n[61] | \n
Comparison of different slaughterhouse wastewater treatment methods.
Actual SWW samples with average concentrations of 1950, 1400, 850, 750, 200, and 40 mg/L for COD, BOD, TOC, TSS, TN, and TP, respectively, were taken from selected licensed MPPs in Ontario, Canada [62]. Anaerobic and aerobic sludge inocula in concentrations of 40,000 and 3000 mg/L, respectively, were obtained from the Ashbridges Bay Municipal Wastewater Treatment Plant in Toronto, Canada. The inocula were acclimatized in a period of 60 days.
\nThe combined ABR-AS-UV/H2O2 system consisted of a 36-L ABR with five equal-volume chambers and individual biogas collection, a 12.65-L aerobic AS reactor with controlled air flow to maintain DO concentrations of 2 mg/L, and a 1.35-L UV-C photoreactor with recycle, output power of 6 W, and uniform light distribution (Figure 1).
\nSchematic diagram of the combined ABR-AS-UV/H2O2 system for SWW treatment.
Bulk parameters including BOD, COD, TOC, TN, TP, and TSS were analyzed as the main parameters for the treatment of an actual SWW. Figure 2 shows the obtained maximum removal values of more than 99% for COD (Figure 2a), BOD (Figure 2b), TOC (Figure 2c), TSS (Figure 2d), TN (Figure 2e), and TP (Figure 2f) from the SWW by the combined ABR-AS-UV/H2O2 processes, operated in continuous mode.
\nMaximum removal values of (a) COD, (b) BOD, (c) TOC, (d) TN, (e) TP, and (f) TSS from an actual slaughterhouse wastewater using combined ABR-AS-UV/H2O2 processes.
The ABR process alone achieved high TSS and TN removals, providing an effluent that complies with most of the current standards worldwide (Table 2), with concentrations of 15 and 8 mg/L, respectively. A further treatment with the aerobic AS bioreactor was required to achieve high BOD and TP removals reaching concentrations of 14 and 0.04 mg/L, respectively. However, the COD and TOC concentrations, which are not included broadly as standard parameters, remain with considerable concentrations of 132 and 128 mg/L, respectively. These concentrations are more related to nonbiodegradable organics that can be mineralized using AOPs as a posttreatment process. Thus, after the treatment by the UV/H2O2 process, the effluent concentrations for COD and TOC reached values of less than 0.4 and 0.1 mg/L, respectively, which could be used for water reuse.
\nThe effects of the influent TOC concentration, flow rate, and pH on the TOC and TN removals, H2O2 residual, and CH₄ yield in the combined ABR-AS-UV/H2O2 system were also evaluated. Figure 3 shows that the influent TOC concentration and the flow rate are inversely proportional to both TOC and TN removals. On the other hand, results indicate that an optimum TOC concentration with no pH adjustment and low flow rate are required to achieve a minimum H2O2 residual in the effluent. Finally, results also demonstrate that a high influent TOC concentration is needed to achieve a maximum CH₄ yield with an optimum flow rate and no pH adjustments.
\nIndividual effect of the (a) influent concentration of TOC, (b) flow rate, and (c) pH on the TOC removal, TN removal, H2O2 residual, and CH₄ yield. Dashed lines represent model predicted values, whereas marker points represent experimental values. The y-axis is in percentage (%) units, except H2O2 residual, which is expressed in per mil (%) for scaling purposes.
As a final point, the treatment costs per volume for the individual ABR, AS, and UV/H2O2 processes were compared with those of the combined ABR-AS-UV/H2O2 system for the treatment of an actual SWW and plotted versus the TOC removal for each configuration (Figure 4). Consequently, a minimum overall treatment cost of 0.12 $/m3 for a maximum TOC removal of more than 90 % can be achieved at optimum operating conditions in the combined ABR-AS-UV/H2O2 system for the treatment of an actual SWW.
\nComparison of operational costs per cubic meter of treated actual slaughterhouse wastewater using individual ABR, AS, and UV/H2O2 processes and the combined ABR-AS-UV/H2O2 system.
The meat processing industry needs to incorporate both waste minimization and resource recovery into SWW management strategies considering the portion of the industry’s waste and by-products that have a potential of recovery for direct reuse, including nutrients and methane as biofuel. Figure 5 presents a schematic illustration of the ideal operation of a meat processing plant and supply chain from the animal farming and raw materials to the final product, waste disposal, and recoverable resources [27, 63].
\nSchematic illustration of the ideal operation and supply chain of a meat processing plant.
A cleaner production should be the focus of meat processing plants due to the increasing interest in environmental initiatives and demands for green practices. Thus, it is appropriate to classify and minimize waste generation at the source, and on-site treatment is the preferred option for water reuse and potential energy recovery. As a result, there are some considerations to be made for the adequate treatment of SWW effluents. Figure 6 presents a proposed layout of the pretreatment, treatment, and disinfection of slaughterhouse wastes for a typical meat processing plant, as well as the potential resource recovery for water reuse and products recycling [63, 64].
\nProposed layout of the pretreatment, treatment, and disinfection of slaughterhouse wastes for a typical meat processing plant.
Meat processing effluents are usually pretreated using screeners, settlers, and blood collection systems, followed by physicochemical treatment methods, such as coagulation, flocculation, sedimentation, DAF, or secondary biological treatment. Although biological treatment is able to provide high organic and nutrient removal efficiencies, further treatment by AOPs, or other BAT, is required for a high-quality effluent.
\nThe presented case study provided an example of the application of a combined ABR-AS-UV/H2O2 system for the treatment of an actual SWW. Maximum organic and nutrient removal reached over 90% in terms of TOC and TN, respectively. Moreover, a potential resource recovery achieved a maximum CH₄ yield of up to 56%, and minimization of residual by-products from disinfection was attained in terms of H2O2 residual of less than 2% at the effluent. Finally, the cost-effectiveness analysis found a minimum overall treatment cost of 0.12 $/m3 for the treatment of an actual SWW using the combined ABR-AS-UV/H2O2 system at optimum operating conditions.
\nAll types of waste, liquid, solid, or gaseous, must be treated prior to their release into the environment. Whereas the use of recoverable resources is recommended as a feasible and practical alternative to conventional energy sources in the long term, costs associated to the application of these technologies will be offset by the reduction in local electricity consumption and by-product recycling and reuse. Thus, the potential of biogas production as an energy source, the use of fertilizers from nutrient recovery, and the SWW high-quality treated effluents for water reuse are to be considered toward a sustainable and cleaner production in the meat processing industry.
\nConsequently, the use of combined processes as an alternative to conventional methods has become a cost-effective approach for the treatment of meat processing effluents to comply with applicable current regulations worldwide.
\nThe financial support of the Natural Sciences and Engineering Research Council of Canada (NSERC), the Ontario Trillium Scholarship (OTS) program, Colciencias (Colombian Research Funding Agency), and Ryerson University is greatly appreciated.
\nABR | anaerobic baffled reactor |
AD | anaerobic digester |
AF | anaerobic filter |
AL | anaerobic lagoon |
AOP | advanced oxidation process |
AS | activated sludge |
BAT | best available technology economically achievable |
BOD | biochemical oxygen demand |
COD | chemical oxygen demand |
CW | constructed wetland |
DAF | dissolved air floatation |
DO | dissolved oxygen |
EC | electrocoagulation |
EU | European Union |
MF | microfiltration |
MPP | meat processing plant |
NF | nanofiltration |
RO | reverse osmosis |
SBR | sequencing batch reactor |
ST | septic tank |
SWW | slaughterhouse wastewater |
TOC | total organic carbon |
TN | total nitrogen |
TP | total phosphorus |
TSS | total suspended solids |
UF | ultrafiltration |
UASB | up-flow anaerobic sludge blanket |
US EPA | United States Environmental Protection Agency |
UST | ultrasound technology |
Suicide is an intentional act to end one’s own life, which usually occurs in the face of such intense suffering that the people only see their death as a relief. In general, a self-inflicted death occurs after the individual has already demonstrated various types of suicidal behavior, ranging from
Suicide is among the ten leading causes of death globally - more than 800,000 people take their own lives each year. This is the second leading cause of death among 15-to-29-year-olds and the first for girls in the world [3]. The global mortality rate in 2012 was 11.4 per 100 thousand inhabitants, and was higher in Asia (17.7/100 thousand inhabitants), followed by European countries (12/100 thousand inhabitants). The Americas have a mortality rate of 6.1/100 thousand inhabitants. Brazil ranks eighth in the number of suicides and has, on average, 24 self-inflicted deaths daily. According to international consensus, the number of attempts is 10 to 20 times higher than the number of deaths. There is evidence that only 25% of those who try come into contact with hospitals, and those who reach these institutions are in a severe condition [3]. The reported cases are the tip of the iceberg, and most of those with suicidal behavior remain anonymous: this can be seen by underreporting in any searched official source.
Besides the adverse effects that a suicidal event generates to the community and society, its psychological impact is intense, even for those who have no direct connection with the individual who died. From the viewpoint of economic costs, millions of dollars are spent due to completed suicide, attempts, and ideas (around the equivalent of 1.8% of the total expenditure on diseases in the world or the operational cost of war). Gender, age, culture, and ethnicity have important implications for the epidemiology of suicide, as will be seen in this review. Several risk factors are associated with different causes that interact with each other, including medical, biological, environmental, psychiatric, psychological problems, and existential-philosophical and social motivations.
Among the biological factors, some research reveals genetic traits that predispose people from the same family to self-destructive behavior, showing altered levels of serotonin metabolites in the cerebrospinal fluid of people who committed suicide. However, the WHO [1] considers that suicidal behavior may be an inherited psychiatric disorder and not a genetic predisposition. The most common psychiatric and psychological risk factors are depression, bipolar mood and affective state issues, schizophrenia, anxiety and personality disorders, alcohol abuse, hopelessness and loneliness, and comorbidities. Depressive diseases in their varied complexity, etiology and clinical presentation [4] are the most relevant risk factor for suicide.
Poisoning with stimulants such as cocaine, amphetamines, or alcohol are frequent predisposing factors for suicide and aggravating when someone is depressed. Anticonvulsants can also be associated with suicide and suicide attempts when there is a broad-spectrum indication for patients with psychiatric problems with or without psychiatric comorbidities, as has been warned by drug control global agencies, including the FDA [5].
The most relevant micro social factors for suicidal behavior are some life events that emotionally affect the individual: personal losses, violence, social isolation, interpersonal conflicts, interrupted or disturbed relationships, and legal or work issues. Also, physical and sexual abuse and problems with sexual orientation weigh heavily in childhood and adolescence. Authors point out the difficulties in relationships with parents, fights with boyfriends, and loneliness among young people, as will be seen in this review.
In his classic book “Suicide”, published in 1897, Durkheim [6] highlights the social reasons for this act. He believes suicide is a symptom of social pathology and social disintegration. This phenomenon exists in all societies, although it differs from country to country, from time to time, and from an urban to a rural environment. The WHO [1, 3] divides the environmental factors associated with suicide into three categories: (1) life stressors: interpersonal conflicts, separations, rejections, losses, financial and work problems, and shame for something socially disapproved of; (2) ease of access to means that enable hanging, drowning, falling from a height, the use of firearms, and abuse of medications and poisons; and (3) exposure to spectacular cases, due to neighborhood or media effects.
The study on suicide and attempts by Brazilian researchers and especially by public health grew significantly in the first decade of the 2000s. In a survey carried out by Minayo et al. [7] on the country’s production – related to violence and including self-inflicted deaths – until 1989, papers and theses on suicide did not reach ten publications. A second general review also on violence and health identified 32 works on suicide [8] from the 1990s to 1999. Many similar results are observed comparing the findings of a comprehensive review of 2017 [2] with the two previous studies of 1990 and 2003, such as the signs of self-destructive situations, the risk factors, and the methods used to trigger the self-inflicted death or for attempts to do so. However, advances are observed, particularly concerning the number of studies (73), a trend towards increasingly complex analyses and groups analyzed. Regarding professional categories, the highlights of the review presented in this chapter are police officers, bank workers, and rural producers, while medical students, domestic workers, and workers in the electrical network were found in the previous study. Most publications (40.8% of the total) address an overview of the issue, bringing its magnitude by age groups through local or national statistics; studies on risk factors, including socio-demographic factors, alcohol use, and mental disorders.
Data from the Surveillance System for Violence and Accidents (VIVA), the Forensic Medicine Institute (IML), health services, and epidemiological surveys are the primary sources of information. The second group of texts addresses children and adolescents (23.7%), where practically all publications concern adolescents. Next are documents about older adults (19.7%) and adults (15.8% of the total).
Besides the strong presence of epidemiology in studies on suicide and suicidal behavior, the following thematic lines are found in all groups analyzed in the collection: (1) attention from health services facing the problem, also addressing prevention strategies; (2) the biological component related to the suicide attempt; (3) the consequences of the phenomenon for health (in the case of attempts) and the suicide’s family; and (4) the methodological aspects to study the theme.
The study on the magnitude and risk factors is the main focus of investigations. However, it is noteworthy that publications in public health and psychiatry journals suggest an interdisciplinary theoretical framework that covers clinical, environmental, and social aspects in understanding the phenomenon.
While Brazil is not a country with high suicide rates, when looking at the general data, we observe a growing trend and several niches in which this phenomenon is troubling: among young males, young adults, and older men. The problem is also more concentrated in some places, particularly in the south of the country, with the preeminence of municipalities in the inland Rio Grande do Sul and Santa Catarina. The rates are also relatively high in the Northeast, particularly in Piauí and in some cities in the region. The scarcely studied indigenous group deserves special attention, as the fatal suicide rate among young people reaches 17 cases per 100,000 inhabitants [2].
Given the theoretical framework exposed, this chapter aims to describe the magnitude of suicide self-inflicted injuries and suicide attempts and suicide mortality in Brazil, and point out prevention policies concerning this event, as recommended by the World Health Organization [3].
A descriptive study was conducted with data referring to self-inflicted injury (which includes self-harm and suicide attempts) and suicide mortality in Brazil. The notifications of self-inflicted injuries were taken from the Surveillance System for Violence and Accidents – continuous component, which is registered in the Notification System for Notifiable Violence (VIVA SINAN) from 2011 to 2019. In Brazil, the notification of interpersonal and self-inflicted violence became compulsory in 2011.
Data referring to the Mortality Information System (SIM) from 2000 to 2019, whose source is the Death Certificate, were used to analyze suicide mortality. Were selected deaths whose underlying cause was related to codes X60 to X84 (intentional self-harm) according to the International Classification of Diseases – 10thversion (ICD-10).
Self-inflicted injury notifications were analyzed by gender, ethnicity/skin color, age, the federal unit of occurrence, whether the attempt had already happened before, suspected alcohol abuse, place of occurrence, and means used for self-harm.
The completed suicides were analyzed by gender, age group, ethnicity/skin color, federated unit, and place of occurrence. Moreover, mortality rates (per 100 thousand inhabitants) were calculated employing the population data (Projected Brazilian Population by gender and simple age: 2000–2060), extracted from the website of the Informatics Department of the Unified Health System (DATASUS). All analyzed data is in the public domain.
A total of 2,185,782 suspected or confirmed cases of violence (interpersonal and self-inflicted) were reported in Brazil from 2011 to 2019. Twenty-one percent (460,611) of these referred to self-inflicted violence (Figure 1).
Distribution of notifications of interpersonal and self-inflicted violence by year of notification. Brazil, 2011 to 2019. Number of notifications, year of notification, self-inflicted, interpersonal, Total notifications. Source: VIVA/SINAN, Ministry of Health.
During this period, cases of self-inflicted violence increased from 14,940 in 2011 to 126,678 in 2019, equivalent to a percentage variation of 728% (Figure 2). This increase in the phenomenon was observed in all Federative Units in the country (Figure 3) is due to ongoing work by the Ministry of Health’s Coordination of Surveillance of Non-Communicable Diseases and Injuries to improve the notification process. Therefore, it suggests greater sensitivity and training of local teams to record injuries caused by violent events, including suicide attempts.
Distribution of notifications of self-inflicted violence by year of notification. Brazil, 2011 to 2019. Number of notifications, year of notification. Source: VIVA/SINAN, Ministry of Health.
Distribution of notifications of self-inflicted violence by Federal Unit and year of notification. Brazil, 2011, 2015, and 2019. Source: VIVA/SINAN, Ministry of Health.
Throughout the period analyzed, self-inflicted violence involved mostly female individuals, corresponding to 64.9% of the cases reported in 2011 and 71.3% in 2019 (Figure 4).
Distribution of notifications of self-inflicted violence by gender and year of notification. Brazil, 2011 to 2019. Year of notification, male, female. Source: VIVA/SINAN, Ministry of Health.
Until 2015, about 50% of self-inflicted violence reported corresponded to individuals aged 20–39. From 2017 onwards, the most frequent age of cases involved adolescents aged 10–19, corresponding to 32.7% of notifications in 2019 (Table 1). Records of self-inflicted violence by older adults aged 60 or over showed an increase up to 2014, a year in which they accounted for 4.7% of the total. However, since then, a decline was observed, reaching 3.0% of notifications of self-inflicted violence in 2019 (Table 1).
Year of notification | |||||||||
---|---|---|---|---|---|---|---|---|---|
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | |
Age (years) | |||||||||
0–9 | 0.0 | 0.0 | 0.0 | 0.1 | 1.8 | 2.3 | 2.2 | 1.3 | 0.6 |
10–19 | 24.6 | 24.8 | 24.8 | 23.9 | 22.5 | 23.6 | 27.9 | 29.8 | 32.7 |
20–29 | 29.1 | 27.6 | 27.6 | 26.8 | 26.5 | 25.8 | 26.1 | 27.1 | 28.2 |
30–39 | 22.5 | 22.5 | 22.3 | 23.1 | 22.4 | 21.9 | 19.6 | 19.2 | 18.1 |
40–49 | 13.5 | 14.1 | 13.9 | 14.5 | 14.5 | 14.5 | 13.2 | 13.0 | 11.7 |
50–59 | 6.4 | 6.7 | 7.0 | 7.0 | 7.6 | 7.4 | 7.0 | 6.3 | 5.5 |
60 and over | 3.8 | 4.4 | 4.3 | 4.7 | 4.6 | 4.3 | 4.0 | 3.3 | 3.0 |
Unknown | 0.0 | 0.0 | 0.0 | 0.0 | 0.1 | 0.2 | 0.0 | 0.0 | 0.3 |
Ethnicity | |||||||||
White | 50.3 | 51.3 | 50.0 | 49.7 | 47.9 | 48.5 | 50.0 | 49.4 | 47.1 |
Black and brown | 31.8 | 35.9 | 36.0 | 36.2 | 36.8 | 37.6 | 39.4 | 40.3 | 42.6 |
Yellow | 0.8 | 0.8 | 0.6 | 0.7 | 0.6 | 0.6 | 0.7 | 0.7 | 0.7 |
Indigenous | 0.3 | 0.4 | 0.8 | 0.7 | 0.7 | 0.6 | 0.6 | 0.6 | 0.6 |
Unknown/Missing | 16.7 | 11.7 | 12.6 | 12.6 | 14.0 | 12.6 | 9.3 | 9.0 | 9.0 |
Distribution of self-inflicted violence reported by age group and ethnicity/skin color. Brazil, 2011 to 2019.
Source: VIVA/SINAN, Ministry of Health.
White people have the highest proportions of self-inflicted violence throughout the period, corresponding to 50.3% of the cases reported in 2011 and 47.1% in 2019. However, flaws are observed in the registration of events. The percentage of cases with data on ethnicity/skin color registered as “unknown” represents more than 10% in the period (Table 1).
The record of repeated self-inflicted violence by the same individuals increased throughout the period, ranging from 27.2% in 2011 to over 40% of cases in 2019. Also, suspected alcohol use was identified in about 10% of the reported cases. The home was the most frequent place of suicide attempts, reaching 84.5% in 2019; this event on public highways had a declining trend in its frequency in the period, ranging from 7.6% in 2011 to 3.9% in 2019. The most frequent means of self-harm was poisoning, followed by sharp objects and hanging, which concentrated, respectively, 66.3%, 18.1%, and 7.0% of the cases reported in 2019 (Table 2).
Year of notification | |||||||||
---|---|---|---|---|---|---|---|---|---|
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | |
27.2 | 29.0 | 28.9 | 30.2 | 30.8 | 32.3 | 35.0 | 37.2 | 41.0 | |
18.8 | 19.3 | 19.5 | 18.2 | 17.3 | 17.1 | 15.2 | 13.5 | 12.4 | |
Home/collective housing | 76.9 | 78.8 | 78.7 | 81.1 | 80.9 | 80.7 | 82.2 | 84.1 | 84.5 |
Public highway | 7.6 | 7.8 | 7.4 | 6.4 | 6.1 | 6.1 | 5.3 | 4.0 | 3.9 |
School/sports venue | 1.0 | 1.0 | 1.0 | 0.9 | 0.9 | 0.9 | 1.1 | 1.2 | 1.4 |
Others* | 5.6 | 5.2 | 5.7 | 5.2 | 5.0 | 4.8 | 4.2 | 3.3 | 3.1 |
Unknown/Missing | 8.9 | 7.2 | 7.2 | 6.4 | 7.1 | 7.5 | 7.1 | 7.4 | 7.2 |
Poisoning | 39.7 | 41.6 | 41.0 | 43.2 | 45.6 | 50.1 | 52.6 | 59.1 | 66.3 |
Hanging | 6.6 | 7.0 | 7.1 | 8.0 | 7.1 | 6.8 | 6.8 | 6.9 | 7.0 |
Sharp object | 10.1 | 9.8 | 10.1 | 9.9 | 10.3 | 11.4 | 14.6 | 16.0 | 18.1 |
Substance/Hot object | 1.8 | 1.6 | 1.6 | 1.4 | 1.5 | 1.5 | 1.2 | 1.1 | 1.0 |
Firearm | 1.9 | 1.9 | 2.1 | 1.9 | 1.5 | 1.4 | 1.1 | 0.6 | 0.6 |
Bodily force | 13.9 | 13.1 | 13.5 | 13.1 | 10.0 | 8.8 | 7.0 | 1.8 | 1.7 |
Blunt object | 1.8 | 1.5 | 1.7 | 1.5 | 1.5 | 1.5 | 1.6 | 1.3 | 1.5 |
Threat | 3.2 | 2.9 | 2.9 | 3.2 | 3.0 | 2.2 | 1.9 | 0.3 | 0.1 |
Distribution of self-inflicted violence reported by event-related characteristics. Brazil, 2011 to 2019.
Other = Bars or similar; Trade/Services; Industries/construction; Others.
Source: VIVA/SINAN, Ministry of Health.
A total of 195,047 deaths by suicide were recorded in Brazil from 2000 to 2019. The increase in the number of deaths of suicide was observed in all Federation Units (Figure 5). The rate of suicide deaths shows a slow but persistent growth between 2000 and 2019, ranging from 3.9 to 6.4 per 100,000 inhabitants, equivalent to a variation of 64% or more. When observed by gender, the rates for men are higher than for women and higher than the overall rate for the country, reaching 10.2 deaths per 100,000 inhabitants in 2019 (Figure 6).
Distribution of completed suicide notifications by Federal Unit and year of notification. Brazil, 2011, 2015, and 2019. Source: SIM, Ministry of Health.
Number of deaths and suicide mortality rate, by sex and year. Brazil, 2000–2019. Number of deaths, mortality rate/100 thousand inhabitants, year of death, suicides, rate – Male, rate – Female, rate – Brazil. Source: SIM, Ministry of Health.
To better understand the characteristics of these deaths, an analysis was carried out for the beginning (2000), the middle (2010), and the end of the observation period (2019). In 2000, the country had a mortality rate of 3.9 deaths per 100,000 inhabitants. In 2010, it increased to 4.8 deaths per 100,000 inhabitants and 6.4 per 100,000 inhabitants in 2019. The highest frequency of deaths occurred among males at the beginning, middle, and end of the period. In 2019, the risk of suicide was 3.6 times higher among men than women.
The age group with the highest frequency of deaths from suicide in 2000, 2010 and 2019 was 20–29 years and concentrated 21% of all self-inflicted deaths in 2019. However, observing the rates by age, the rates among older adults aged 60 and over are expressive in 2000 and 2010 (7.0 and 7.3 deaths/100 thousand inhabitants, respectively), as well the rates among individuals aged 50–59 years in 2019 (reached 8.6 deaths/100 thousand inhabitants).
Regarding ethnicity/skin color, more than 50% of deaths in 2000 and 2010 involved white individuals. However, in 2019, this frequency drops to 48.8% and is similar to the group of blacks and browns (48.7%). Moreover, the preferred place for committing suicide in Brazil has historically been the home (Table 3).
Year of death | ||||||
---|---|---|---|---|---|---|
2000 | 2010 | 2019 | ||||
n | Rate | n | Rate | n | Rate | |
Male | 79.6 | 6.3 | 78.1 | 7.6 | 78.4 | 10.2 |
Female | 20.4 | 1.6 | 21.9 | 2.1 | 21.6 | 2.7 |
Unknown | 0.0 | — | 0.0 | — | 0.0 | — |
0–9 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |
10–19 | 9.0 | 1.7 | 7.5 | 2.1 | 9.0 | 3.7 |
20–29 | 23.8 | 5.2 | 23.4 | 6.3 | 21.0 | 8.4 |
30–39 | 21.5 | 5.6 | 21.1 | 6.6 | 20.4 | 8.0 |
40–49 | 18.4 | 6.3 | 19.5 | 7.3 | 17.8 | 8.3 |
50–59 | 12.3 | 6.6 | 13.1 | 6.7 | 14.8 | 8.6 |
60 and over | 14.7 | 7.0 | 15.1 | 7.3 | 17.0 | 8.1 |
Unknown | 0.3 | — | 0.3 | — | 0.1 | — |
White | 59.5 | — | 51.3 | — | 48.8 | — |
Black and brown | 30.8 | — | 42.8 | — | 48.7 | — |
Yellow | 0.6 | — | 0.4 | — | 0.2 | — |
Indigenous | 0.7 | — | 1.0 | — | 1.0 | — |
Unknown/white | 8.3 | — | 4.6 | — | 1.3 | — |
Home | 54.3 | — | 56.8 | — | 63.0 | — |
Hospital/other health establishments | 23.0 | — | 21.4 | — | 14.7 | — |
Public highway | 6.4 | — | 6.8 | — | 5.9 | — |
Others | 14.2 | — | 14.3 | — | 16.1 | — |
Unknown | 2.0 | — | 0.7 | — | 0.3 | — |
Proportion and mortality rate from suicide by gender, age group, ethnicity/skin color, and place of occurrence. Brazil, 2000, 2010, and 2019.
Source: SIM, Ministry of Health.
The results presented in this chapter show the magnitude of suicidal behavior in Brazil, which is known to have abuse and homicide among the most frequent types of violence. However, the sharp increase in attempted rates and the progressive increase in completed suicides raise a warning for the national situation. The data are somewhat similar to other countries, such as the male primacy of accomplished acts and the prevalence of attempts among women [1, 3]. Also, the underreporting of suicides and suicide attempts is recognized globally, mainly because of religious taboos and family conveniences underpinning its dynamics. Data from VIVA/SINAN show that notifications tend to increase year by year, which may help in an increasingly reliable analysis of this phenomenon in the country.
Aiming at preventing fatal acts, specialists point out that, both regarding attempted suicides and completed suicides, we should pay attention to (1) the complex nature of the phenomenon encompassing social, micro-social, psychological, medical, and environmental factors; (2) the predisposing factors such as severe and degenerative diseases, physical dependence, mental disorders and suffering, severe depression, violence, and social isolation; and (3) the differentiation of risk factors by gender and age. Given the abovementioned factors, we should reflect on some specificities related to the life cycle, mainly because they provide clues for the health sector’s design of prevention and care strategies.
In childhood, suicidal behavior is rare in most societies. The World Health Organization reports worldwide death rates of 1.7 per 100,000 people for boys aged 5–14 years and 2 per 100,000 for girls in 2000 [1]. While the occurrences are few, the social dimension underlying the reasons that lead people in the formative stage and at such a young age to seek death is impactful. The importance of some associated factors is highlighted: conflicts between father and mother or between partners, deaths, separations, violent family environment in which there is a lack of communication and expression of feelings, social isolation, living with mental problems, living in a domestic space with alcohol and drug abuse, receiving corporal punishment and humiliation at home and school – even if it is to educate. In general, living in a communicative, affective family and community environment, respecting rights and feelings, loving and responsible reference adults protect children [2, 9].
In adolescence, suicide and attempts grow significantly against the childhood period, especially after 15. The main risk factors for both attempts and self-inflicted death are: suffering physical violence, sexual abuse, and threats from peers or others; depression; having gender identity problems; experiencing unrequited love; being in social isolation; having problems with school performance and communication with teachers and peers; suffering emotional, family, social and cultural frustration; having contact with cases of relatives, neighbors, and colleagues who killed themselves [2, 10, 11, 12]. In general, in the attempts, medication intake is the most used means to self-harm, and the age for the most significant risk is 14.
Twenty-two suicides per day occur in the country among adults. The proportion of men (79.79%) is much higher than women, and the young adult age group is the most vulnerable. The most important risk factors for women are marital nd sexual violence, rape, unwanted pregnancy, depression, and mental disorders [2, 13, 14]. Men’s predisposing factors are associated with the world of work, alcoholism, loneliness, isolation, and mental problems [2, 15]. Regarding labor activity, cases of poisoning by pesticides among farmers [16] and medication among physicians and medical students are known [2, 17], caused by firearm among police officers [2, 18, 19] and by several means among bank employees [2, 20].
In old age, almost five deaths per day were found in 2018. A significant underreporting of suicide is observed in this period of life, as when the number of attempts is lower than that of completed suicide in that same year. According to national and international studies, there is at least a ratio of four attempts for each suicide committed in this stage of life [21]. As associated factors, the authors cite, in general, severe depression, social isolation, loss of meaning in life, loss of children and spouses, severe and degenerative diseases, economic and affection deprivation, inactivity, and experiences of violence in the past and current life [2, 22, 23, 24].
Suicide prevention strategies and suicidal behavior are very recent in Brazil. These were not considered a relevant problem for the Ministry of Health, although local groups, particularly in mental health, have been active regarding this issue that requires a multidisciplinary approach [25]. In 2005, the Ministry of Health began a series of actions to reduce the number of deaths, attempts, and associated harm, driven by the WHO guidance, which has committed to reducing the number of suicides in the world since 1990.
The National Strategy for the Prevention of Suicide (ENPS) stands out among the Brazilian initiatives. It was established by Ordinance N° 1.876, of August 14, 2006, and its guidelines follow the recommendations of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS) directed to health professionals. Some of the outstanding recommendations for caring for people at risk of suicide are: (1) establishing a relationship of trust and listening cordially to individuals in a self-destruction crisis; (2) treating individuals with respect and empathy and keeping their manifestations confidential; (3) having a compassionate attitude to recognize signs of hopelessness and past attempts; (4) identifying that people with a family history of suicide, previous attempts, psychiatric disorder, depression, alcoholism are at risk; (5) talking openly to individuals who express a desire to kill themselves, believing what they express; and (6) becoming technically capable of distinguishing between low, medium, and high-risk levels.
WHO emphasizes one should not ignore the situation and signs of suicide attempts, be in a state of shock or panic at hearing these manifestations, put in mitigations, say that everything will be fine and that the problem will resolve itself, challenge individuals to go ahead, give false assurances, swear to secrecy, and leave high-risk individuals alone.
The document on the National Strategy for the Prevention of Suicide (ENPS), which can be found at http://www.portaldasaude.pt/NR/rdonlyres/BCA196AB-74F4-472B-B21E, recommends: (1) increasing information and social awareness about the problem; (2) training health professionals to provide comprehensive care in PHC units and Psychosocial Care Centers, in Urgent and Emergency Care Services, and in General Hospitals; (3) expanding access of the population at most significant risk to SUS health services; (4) encouraging studies and research on the subject; (5) improving reporting on mortality and attempts; (6) fostering and supporting local primary and secondary prevention programs; and (7) reducing access to lethal means.
The Ministry of Health also encourages and supports civil society initiatives that carry out actions to protect and prevent suicide, such as those developed by the Center for the Valorization of Life (CVV) has been operating since 1962, offering care to people who are suffering and try to kill themselves through the telephone number 141 and the website: www.cvv.org.br. Given the delicacy of the problem and the taboos that surround it, the safety network for people at risk for suicide should constantly be in the process of formation and action. National and international surveys show that at least two-thirds of people who attempted or committed suicide had communicated their intention to take their own life in some way to friends, family, acquaintances, or healthcare professionals.
Brazil has several guidance materials for the most distinguished professionals to work in suicide prevention. Besides the two mentioned above, we mention a few that follow the WHO guidelines: (1) the National Plan for the Prevention of Suicide by the Ministry of Health; (2) a manual for Mental Health professionals; (3) a manual for teachers and educators; (4) a manual for general practitioners; (5) a media orientation manual; (6) a manual for the prevention of suicide in older adults. However, concrete prevention initiatives that usually mobilize all social forces and public authorities are only available in the country’s southern region, where self-inflicted deaths are dire. In other locations, suicide prevention is still in its infancy and does not sensitize social conscience.
The situation presented here shows that it is impossible to underestimate suicide, a severe public health issue, which is violence that kills the most globally. However, it is noteworthy that both the studies and the prevention actions focusing on this problem are very preliminary, unspecific, and not focused on practical action. Future studies should care on situational analyses of locations where the risk is higher and discuss preventive and intersectional care strategies between health, social assistance, family support, and public safety services.
It is important to emphasize that, even with the availability of various types of guidance, we observed in the evaluation of services that Brazilian health professionals are still very poorly prepared to act effectively in the prevention of suicidal behavior and thus avoid so many deaths and injuries. Therefore, it is crucial to invest in training agents and the proper organization of PHC, mental health, and specialized services.
Gaps must also be filled, as is the case with the deteriorating phenomenon by groups of age and gender (including the LGBTQ+ population) because suicide affects childhood and adolescents and decimates Indigenous youth. Unconventional sexual orientation is often a risk factor for self-harm and death. As Hannah Arendt [26] recalls, violence (which includes suicide) dramatizes social causes that are unbearable for those trying to kill themselves. However, it is essential to stick with the World Health Organization’s call: “It is imperative to prevent suicide!” [3].
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These reactions occur through a regular radical chain causing growth of polymer by three steps, namely, initiation, propagation, and termination. To understand ionizing radiation-induced polymerization, the water radiolysis must be taken into consideration. This chapter explores the mechanism of water molecules radiolysis paying especial attention to the basic regularities of solvent radicals’ interaction with the polymer molecules for forming the crosslinked polymer. Water radiolysis is the main engine of the polymerization processes, especially the “free-radical polymerization.” The mechanisms of the free-radical polymerization and crosslinking will be discussed in detail later. Since different polymers respond differently to radiation, it is useful to quantify the response, namely in terms of crosslinking and chain scission. A parameter called the G-value is frequently used for this purpose. It represents the chemical yield of crosslinks, scissions and double bonds, etc. For the crosslinked polymer, the crosslinking density increases with increasing the radiation dose, this is reflected by the swelling degree of the polymer while being immersed in a compatible solvent. If crosslinking predominates, the crosslinking density increases and the extent of swelling decreases. If chain scission predominates, the opposite occurs. A further detailed discussion of these aspects is presented throughout this chapter.",book:{id:"6149",slug:"ionizing-radiation-effects-and-applications",title:"Ionizing Radiation Effects and Applications",fullTitle:"Ionizing Radiation Effects and Applications"},signatures:"Mohamed Mohamady Ghobashy",authors:[{id:"212371",title:"Dr.",name:"Mohamed",middleName:null,surname:"Mohamady Ghobashy",slug:"mohamed-mohamady-ghobashy",fullName:"Mohamed Mohamady Ghobashy"}]},{id:"53504",doi:"10.5772/66925",title:"Applications of Ionizing Radiation in Mutation Breeding",slug:"applications-of-ionizing-radiation-in-mutation-breeding",totalDownloads:3482,totalCrossrefCites:9,totalDimensionsCites:13,abstract:"As a predicted result of increasing population worldwide, improvements in the breeding strategies in agriculture are valued as mandatory. The natural resources are limited, and due to the natural disasters like sudden and severe abiotic stress factors, excessive floods, etc., the production capacities are changed per year. In contrast, the yield potential should be significantly increased to cope with this problem. Despite rich genetic diversity, manipulation of the cultivars through alternative techniques such as mutation breeding becomes important. Radiation is proven as an effective method as a unique method to increase the genetic variability of the species. Gamma radiation is the most preferred physical mutagen by plant breeders. Several mutant varieties have been successfully introduced into commercial production by this method. Combinational use of in vitro tissue culture and mutation breeding methods makes a significant contribution to improve new crops. Large populations and the target mutations can be easily screened and identified by new methods. Marker assisted selection and advanced techniques such as microarray, next generation sequencing methods to detect a specific mutant in a large population will help to the plant breeders to use ionizing radiation efficiently in breeding programs.",book:{id:"5451",slug:"new-insights-on-gamma-rays",title:"New Insights on Gamma Rays",fullTitle:"New Insights on Gamma Rays"},signatures:"Özge Çelik and Çimen Atak",authors:[{id:"147362",title:"Dr.",name:"Özge",middleName:null,surname:"Çelik",slug:"ozge-celik",fullName:"Özge Çelik"},{id:"147364",title:"Prof.",name:"Çimen",middleName:null,surname:"Atak",slug:"cimen-atak",fullName:"Çimen Atak"}]},{id:"32846",doi:"10.5772/36950",title:"Current Importance and Potential Use of Low Doses of Gamma Radiation in Forest Species",slug:"current-importance-and-potential-use-of-low-doses-of-gamma-radiation-in-forest-species",totalDownloads:5281,totalCrossrefCites:2,totalDimensionsCites:13,abstract:null,book:{id:"1590",slug:"gamma-radiation",title:"Gamma Radiation",fullTitle:"Gamma Radiation"},signatures:"L. G. Iglesias-Andreu, P. Octavio-Aguilar and J. Bello-Bello",authors:[{id:"110581",title:"Dr.",name:"Lourdes",middleName:null,surname:"Iglesias-Andreu",slug:"lourdes-iglesias-andreu",fullName:"Lourdes Iglesias-Andreu"}]},{id:"58410",doi:"10.5772/intechopen.72074",title:"Radiation-Induced Degradation of Organic Compounds and Radiation Technologies for Purification of Aqueous Systems",slug:"radiation-induced-degradation-of-organic-compounds-and-radiation-technologies-for-purification-of-aq",totalDownloads:1419,totalCrossrefCites:8,totalDimensionsCites:12,abstract:"Environmental application of radiation technologies is an important part of radiation processing. Radiation treatment of aqueous systems contaminated with organic compounds is a promising method of water and wastewater purification and corresponding technologies are being developed. In this chapter, the following aspects of radiation treatment process are considered: sources of contamination and major contaminants of water and wastewater; primary processes in aqueous systems initiated by ionizing radiation; principal ways of contaminant conversion as consequences of primary processes (complete mineralization of organic compounds, partial decomposition of organic molecules resulted in detoxification, decolorization, disinfection of polluted water, and improvement in biological degradation of contaminant, polymerization of monomers’ contaminants, oxidation-reduction processes, and coagulation of colloids); sources of ionizing radiation; and main equipment applied in radiation technologies of aqueous system purification.",book:{id:"6149",slug:"ionizing-radiation-effects-and-applications",title:"Ionizing Radiation Effects and Applications",fullTitle:"Ionizing Radiation Effects and Applications"},signatures:"Igor E. Makarov and Alexander V. 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These reactions occur through a regular radical chain causing growth of polymer by three steps, namely, initiation, propagation, and termination. To understand ionizing radiation-induced polymerization, the water radiolysis must be taken into consideration. This chapter explores the mechanism of water molecules radiolysis paying especial attention to the basic regularities of solvent radicals’ interaction with the polymer molecules for forming the crosslinked polymer. Water radiolysis is the main engine of the polymerization processes, especially the “free-radical polymerization.” The mechanisms of the free-radical polymerization and crosslinking will be discussed in detail later. Since different polymers respond differently to radiation, it is useful to quantify the response, namely in terms of crosslinking and chain scission. A parameter called the G-value is frequently used for this purpose. 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A further detailed discussion of these aspects is presented throughout this chapter.",book:{id:"6149",slug:"ionizing-radiation-effects-and-applications",title:"Ionizing Radiation Effects and Applications",fullTitle:"Ionizing Radiation Effects and Applications"},signatures:"Mohamed Mohamady Ghobashy",authors:[{id:"212371",title:"Dr.",name:"Mohamed",middleName:null,surname:"Mohamady Ghobashy",slug:"mohamed-mohamady-ghobashy",fullName:"Mohamed Mohamady Ghobashy"}]},{id:"53780",title:"Gamma-Ray Spectrometry and the Investigation of Environmental and Food Samples",slug:"gamma-ray-spectrometry-and-the-investigation-of-environmental-and-food-samples",totalDownloads:2501,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Gamma radiation consists of high‐energy photons and penetrates matter. This is an advantage for the detection of gamma rays, as gamma spectrometry does not need the elimination of the matrix. The disadvantage is the need of shielding to protect against this radiation. Gamma rays are everywhere: in the atmosphere; gamma nuclides are produced by radiation of the sun; in the Earth, the primordial radioactive nuclides thorium and uranium are sources for gamma and other radiation. The technical enrichment and use of radioisotopes led to the unscrupulously use of radioactive material and to the Cold War, with over 900 bomb tests from 1945 to 1990, combined with global fallout over the northern hemisphere. The friendly use of radiation in medicine and for the production of energy at nuclear power plants (NPPs) has caused further expositions with ionising radiation. This chapter describes in a practical manner the instrumentation for the detection of gamma radiation and some results of the use of these techniques in environmental and food investigations.",book:{id:"5451",slug:"new-insights-on-gamma-rays",title:"New Insights on Gamma Rays",fullTitle:"New Insights on Gamma Rays"},signatures:"Markus R. Zehringer",authors:[{id:"311750",title:"Dr.",name:"Markus R.",middleName:null,surname:"Zehringer",slug:"markus-r.-zehringer",fullName:"Markus R. Zehringer"}]},{id:"54118",title:"Gamma Rays from Space",slug:"gamma-rays-from-space",totalDownloads:2052,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"An overview of gamma rays from space is presented. We highlight the most powerful astrophysical explosions, known as gamma-ray bursts. The main features observed in detectors onboard satellites are indicated. In addition, we also highlight a chronological description of the efforts made to observe their high energy counterpart at ground level. Some candidates of the GeV counterpart of gamma-ray bursts, observed by Tupi telescopes, are also presented.",book:{id:"5451",slug:"new-insights-on-gamma-rays",title:"New Insights on Gamma Rays",fullTitle:"New Insights on Gamma Rays"},signatures:"Carlos Navia and Marcel Nogueira de Oliveira",authors:[{id:"189908",title:"Dr.",name:"Carlos",middleName:null,surname:"Navia",slug:"carlos-navia",fullName:"Carlos Navia"},{id:"243084",title:"MSc.",name:"Marcel",middleName:null,surname:"De Oliveira",slug:"marcel-de-oliveira",fullName:"Marcel De Oliveira"}]}],onlineFirstChaptersFilter:{topicId:"227",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:318,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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\r\n\tScientists have long researched to understand the environment and man’s place in it. The search for this knowledge grows in importance as rapid increases in population and economic development intensify humans’ stresses on ecosystems. Fortunately, rapid increases in multiple scientific areas are advancing our understanding of environmental sciences. Breakthroughs in computing, molecular biology, ecology, and sustainability science are enhancing our ability to utilize environmental sciences to address real-world problems.
\r\n\tThe four topics of this book series - Pollution; Environmental Resilience and Management; Ecosystems and Biodiversity; and Water Science - will address important areas of advancement in the environmental sciences. They will represent an excellent initial grouping of published works on these critical topics.