Health conditions and occupational risks in a novel group: waste pickers in the largest open garbage dump in Latin America.

BACKGROUND: The inadequate management of solid waste impacts populations' health and quality of life, and disproportionately affects developing countries. This study aims to describe a protocol for epidemiological diagnosis, the purpose being to estimate the prevalence of chronic and communicable and non communicable diseases in waste pickers, and the occupational and environmental risk factors to which these are exposed. METHODS: This is a cross-sectional study, based on survey design in an area of extreme social vulnerability - the largest garbage dump in Latin America. Using a multidimensional research protocol, divided in three stages: 1- The identification of the subjects, and the scheduling of tests; 2- Situational diagnosis through interviews, anthropometric evaluation, measuring blood pressure, collecting hair and nail samples to detect exposure to heavy metals and undertaking laboratory tests; 3- The return of the waste pickers to receive the test results, followed by referral to the health team and to report occupational accidents. RESULTS: One thousand twenty-five waste pickers undertook tests and interviews. The majority were women (67.0%), with 36-45 years old (45.7%), and 96.0% had children. In total, 27.3% of the participants did not attend to any school and 47.7% were educated only up to primary level. The majority of waste pickers (68.70%) reported accidents and most of them (89.69%) were related to sharp objects. The mean time working in this open dump was 15 years. According the anthropometric measure, 32.6% were overweight and 21.1% were obese. The most common reported diseases were: osteomuscular disorders (78.7%); arboviruses (28.6%); episodic diarrhea (24.9%); hypertension (24.2%); bronchitis (14.3%); intestinal worms (12.6%) and diabetes (10.1%). According to the blood tests, the values outside the reference limits were: Uric acid (23.89%); creatinine (54.06%); GGT range (16.04%); SGOT - Serum Glutamic Oxaloacetic Transaminase (5.29%); SGPT - serum Glutamic-Pyruvic Transaminase (35.52%). CONCLUSIONS: This study is the first to evaluate multiple risks and diseases in the majority of waste pickers working in the largest garbage dump of a continent. These findings highlight the importance to address urgently the environmental, social and health impacts related to the management of solid waste in developmental countries to protect these workers and their families.

A criança hospitalizada e a ludicidade / The hospitalized child and ludicity / El niño hospitalizado y la ludicidad

Objetivo: compreender o lúdico no contexto hospitalar da criança. Método: estudo de abordagem qualitativa, caráter exploratório-descritivo, realizado em hospital público do Distrito Federal, entre janeiro e abril de 2017. Foram realizadas entrevistas com 17 responsáveis de crianças hospitalizadas. Todos os depoimentos foram gravados, transcritos e submetidos à análise de conteúdo temático. Resultados: os dados coletados incidiram em duas temáticas, entre as quais o sentimento do cuidador em relação à hospitalização e a atitude da criança durante a hospitalização. Compreendeu-se que o impacto biopsicossocial da criança hospitalizada interfere no seu restabelecimento e a estratégia do emprego dos recursos lúdicos oportuniza espaço para expressar seus sentimentos. Considerações finais: o lúdico constituiu-se em uma estratégia que permitiu reconhecer a maneira como a criança lida com suas emoções bem como num mecanismo para auxiliar seu enfrentamento à nova situação.(AU)

Objective: to understand the ludic interaction in the context of a child's hospitalization. Methods: a qualitative exploratory-descriptive study carried out in a public hospital of the Distrito Federal(BR) between January and April 2017. Interviews were conducted with 17 parent proxy of hospitalized children. The interviews were recorded, transcribed, and submitted to content analysis. Results: two themes emerged from the analysis of the data collected: the caregiver's feelings related to the hospitalization and the child's attitude during the hospitalization. The results showed that the biopsychosocial impact of hospitalization on a child affects its health improvement. The use of ludic activities creates an environment for the child to express its feelings. Final considerations: the use of ludic activities was a strategy that enabled the discovery of how a child handles its emotions. This strategy also served as a coping mechanism to help the child manage the new situation.(AU)

Objetivo: entender lo lúdico en el contexto hospitalario del niño. Método: estudio de enfoque cualitativo, descriptivo, exploratorio realizado entre enero y abril de 2017 en un hospital público del Distrito Federal. Metodología: se llevaron a cabo entrevistas a 17 responsables de niños ingresados. Los testimonios se grabaron, trascribieron y analizaron según su contenido temático. Resultados: los datos recogidos coincidían en dos temas: el sentimiento del cuidador hacia la hospitalización y la actitud del niño durante la internación. Se entendió que el impacto biopsicosocial del niño ingresado interfiere en su restablecimiento y la estrategia de uso de recursos lúdicos le permite expresar sus sentimientos. Consideraciones finales: lo lúdico se ha vuelto una estrategia que permite descubrir la manera cómo el niño maneja sus emociones y un mecanismo que lo ayuda a afrontar la nueva situación.(AU)