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Background: contamination of aquatic ecosystems by oil spills associated with petroleum exploitation represents a serious problem of environmental contamination that can affect human health. We developed a spatial model of contamination risk in the Ecuadorian Amazon, and evaluated the model using independent datasets on environmental contamination and clinical indicators of human health risk factors. Methods: the spatial risk of contamination for the Napo River basin was based on the calculation of a friction surface and the accessibility of possible oil contamination. Human health was evaluated using peripheral blood samples from 256 individuals. We used monitoring data on contamination to validate the spatial model of contamination risk and analyzed whether the estimated risk explained the incidence of human health risk factors. Results: our risk model showed a significant association with actual contamination detected in the study area. According to our risk model, around 30% of the territory has some level of contamination. Risk of contamination was associated with an increasing mean incidence in risk factors for human health in resident populations, but elevated contamination risk was not a significant predictor of the incidence of selected health indicators; only the incidence of inflammation was significantly increased. Conclusions: a large proportion of the populations in the Napo River basin has high vulnerability to contamination from petroleum exploitation, and this contamination risk may be traced in some indicators of health risk. Closer examination of health risk factors is warranted, and our spatial model of contamination risk can inform the design and analysis of such studies, as well as risk mitigation and management. Our approach to building the model of contamination risk could be applied in other catchments where petroleum exploitation is contemplated.

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Vulnerability of Human Populations to Contamination from Petroleum Exploitation in the Napo River Basin: An Approach for Spatially Explicit Risk Assessment