Mechanistic insights into temperature-driven retention and speciation changes of heavy metals (HMs) in ash residues from Co-combustion of refuse-derived fuel (RDF) and red mud.

Red mud is a promising candidate for promoting the incineration of Refuse Derived Fuel (RDF) and stabilizing the resulting incineration ash. The combustion conditions, notably temperature, significantly steers the migration and transformation of harmful metal components during combustion, and ultimately affect their retention and speciation in the ash residue. The study attempted to investigate the effect of co-combustion temperature on the enrichment and stability of Cr, Ni, Cu, Zn, Cd and Pb within bottom ashes, and to reveal the underlined promotion mechanism of red mud addition. As temperature increased, red mud's active components formed a robust matrix, helping the formation, melting, and vitrification of silicates and aluminosilicates in the bottom ashes. The process significantly contributed to the encapsulation and stabilization of heavy metals such as Ni, Cu, Zn, Cd, and Pb, with their residual fractions ascending to 71.37%, 55.75%, 74.78%, 84.24%, and 93.54%, respectively. Conversely, high temperatures led to an increase in the proportion of Cr in the extremely unstable acid-soluble fraction of the bottom ashes, reaching 31.52%, posing a heightened risk of environmental migration. Considering the stability of heavy metals in the bottom ashes and the combustion characteristics, 800 °C is identified as the optimal temperature for the co-combustion of RDF and red mud, balancing efficiency and environmental safety. The findings will provide valuable insights for the co-utilization strategy of RDF and red mud, contributing to more informed decision-making in waste-to-energy processes.

Decision-Making Capacity and Authenticity.

There is wide consensus among bioethicists about the importance of autonomy when determining whether or not a patient has the right to refuse life-saving treatment (LST). In this context, autonomy has typically been understood in terms of the patient's ability to make an informed decision. According to the traditional view, decision-making capacity (DMC) is seen as both necessary and sufficient for the right to refuse LST. Recently, this view has been challenged by those who think that considerations of authenticity and putative counterexamples should lead us to revise the traditional account. In this paper, we respond to these revisionist arguments, and we defend the traditional view according to which we have autonomy-based reasons to respect a patient's decision to refuse LST if and only if she has DMC.

Destabilization mechanisms of Semi-aerobic aged refuse biofilters under harsh treatment conditions: Evidence from fluorescence and microbial characteristics.

Semi-aerobic aged refuse biofilters (SAARB) are commonly-used biotechnologies for treating landfill leachate. In actual operation, SAARB often faces harsh conditions characterized by high concentrations of chemical oxygen demand (COD) and Cl-, as well as a low carbon-to-nitrogen ratio (C/N), which can disrupt the microbial community within SAARB, leading to operational instability. Maintaining the stable operation of SAARB is crucial for the efficient treatment of landfill leachate. However, the destabilization mechanism of SAARB under harsh conditions remains unclear. To address this, the study simulated the operation of SAARB under three harsh conditions, namely, high COD loading (H-COD), high chloride ion (Cl-) concentration environment (H-Cl-), and low C/N ratio environment (L-C/N). The aim is to reveal the destabilization mechanism of SAARB under harsh conditions by analyzing the fluorescence characteristics of effluent DOM and the microbial community in aged refuse. The results indicate that three harsh conditions have different effects on SAARB. H-COD leads to the accumulation of proteins; H-Cl- impedes the reduction of nitrite nitrogen; L-C/N inhibits the degradation of humic substances. These outcomes are attributed to the specific effects of different factors on the microbial communities in different zones of SAARB. H-COD and L-C/N mainly affect the degradation of organic matter in aerobic zone, while H-Cl- primarily impedes the denitrification process in the anaerobic zone. The abnormal enrichment of Corynebacterium, Castellaniella, and Sporosarcina can indicate the instability of SAARB under three harsh conditions, respectively. To maintain the steady operation of SAARB, targeted acclimation of the microbial community in SAARB should be carried out to cope with potentially harsh operating conditions. Besides, timely mitigation of loads should be implemented when instability characteristics emerge, and carbon sources and electron donors should be provided to restore treatment performance effectively.

Image capturing, segmentation and data analysis of shredded refuse streams.

Refuse sorting is an important cornerstone of the recycling industry, but ever-changing refuse compositions and the desire to increase recycling rates still pose many unsolved challenges. The digitalisation of refuse sorting plants promises to overcome these challenges by optimising and automatically adapting the sorting process. This publication describes a system for image capturing, segmentation-based refuse recognition and data analysis of shredded refuse streams. The image capturing collects multispectral 2D and 3D images of the refuse streams on conveyor belts. The image recognition performs a semantic segmentation of the images to determine the refuse composition from the 2D images, whereas the 3D images approximate the volumes on the conveyor belts. The semantic segmentation is done by a combined convolutional neural network model, consisting of a foreground-background and a refuse class segmentation. Both models rely on synthetic training data to reduce the necessary amount of manually labelled training data, whereas the final segmentation performance reaches an Intersection over Union of up to 75%. The results of the semantic segmentation and volume estimation are combined with data of the shredding machinery by transforming it into a unified representation. This combined dataset is the basis for estimating the processed refuse masses from the semantic segmentation and volume estimation.

Combustion characteristics of refuse-derived fuel pellets having varying plastic compositions.

The plastic fraction of refuse-derived fuel (RDF) pellets influences fuel's physico-chemical, and mechanical properties, which in turn might affect the combustion behavior of RDF. In the present study, the combustion behavior of different plastic fraction-simulated RDF pellets is reported. The simulated pellets were prepared based on the Indian commercial RDF composition. Initially, the plastic content varied from the existing fraction in Indian commercial RDF, i.e., 35% (RDF-1), to a lower plastic content of 5% (RDF-2). Physico-chemical characterization showed that a higher plastic fraction in RDF-1 reduces its pellet density by 25% as compared to RDF-2. The changes in RDF physico-chemical properties due to plastic variation are reflected in the RDF conversion process. Single-particle and packed-bed studies concluded that the lower density for higher plastic RDF-1 leads to lower conversion times (36%), and higher flame front speed (11%), which are desirable conditions for faster conversion. However, packed-bed studies also showed limitations regarding the utilization of high plastic RDF as RDF-1 has a narrow range of operating air mass flux due to the early advent of convective cooling of the bed. Finally, considering the constraints associated with the utilization of high plastic fraction (~ 35%) RDF and to maximize the effective utilization of plastic in RDF, a workable plastic fraction of 15% in RDF was proposed and tested for its combustion properties. RDF with 15% plastic showed faster conversion, higher flame front speed, and a wider range of operating air mass flux before the advent of convective cooling of the bed.

Turning trash into treasure: Torrefaction of mixed waste for improved fuel properties. A case study of metropolitan city.

Solid waste management is one of the biggest challenges of the current era. The combustible fractions in the waste stream turn out to be a good energy source if converted into refuse-derived fuel. Researchers worldwide are successfully converting it into fuel. However, certain challenges are associated with its application in gasifiers, boilers, etc. to co-fire it with coal. These include high moisture content, low calorific value, and difficulty to transport and store. The present study proposed torrefaction as a pretreatment of the waste by heating it in the range of 200 °C-300 °C in the absence of oxygen at atmospheric pressure. The combustible fraction from the waste stream consisting of wood, textile, paper, carton, and plastics termed as mixed waste was collected and torrefied at 225 °C, 250 °C, 275 °C, and 300 °C for 15 and 30 min each. It was observed that the mass yield and energy yield decreased to 45% and 62.96% respectively, but the energy yield tended to increase by the ratio of 1.39. Proximate analysis showed that the moisture content and volatile matter decreased for torrefied samples, whereas the ash content and fixed carbon content increased. Similarly, the elemental analysis revealed that the carbon content increased around 23% compared to raw samples with torrefaction contrary to hydrogen and oxygen, which decreased. Moreover, the higher heating value (HHV) of the torrefied samples increased around 1.3 times as compared to the raw sample. This pretreatment can serve as an effective solution to the current challenges and enhance refuse-derived fuel's fuel properties.

Optimizing refuse-derived fuel production from scheduled wastes through Aspen plus simulation.

This study aims to improve the quality of fuel with high calorific value namely Sfuel - a commercial high-quality refuse-derived fuel (RDF) from hazardous waste via modifying the process design and operating parameters of thermal conversion process. The study analyses key parameters of RDF quality, such as calorific value and heavy metal content, before and after process modifications based on the combination of experimental and simulation using Aspen Plus. In this study, the temperature and pressure of the simulation system are varied from 100 to 700 °C and from 1 to 5 bar, respectively. Findings indicate that there are a total of eleven heavy metals and 179 volatile compounds in the "Sfuels". The quality of the targeted product is greatly improved by the metal evaporation at high temperatures and pressures. However, the calorific value of RDF significantly decreases at 700 °C due to a large amount of the carbon content being evaporated. Although the carbon content at high temperatures is significantly lost, the heat from the vapour stream reactor outlet, which is reused to preheat the nitrogen gas stream supplied to the system, reduces energy consumption while improving the thermal conversion efficiency of the system. Besides, low pressure along with high temperature are not the optimal conditions for quality Sfuels improvement by thermal conversion. Results also indicate that electric heating is more economically efficient than natural gas heating.

Microplastics in different municipal solid waste treatment and disposal systems: Do they pose environmental risks?

Microplastic (MP) pollution is a significant worldwide environmental and health challenge. Municipal solid waste (MSW) can be an important source of MPs in the environment if treated and disposed of inappropriately, causing potential ecological risks. MSW treatment and disposal methods have been gradually shifting from landfilling/dumping to more sustainable approaches, such as incineration or composting. However, previous studies on MP characteristics in different MSW treatment and disposal systems have mainly focused either on landfills/dumpsites or composts. The lack of knowledge of multiple MSW treatment and disposal systems makes it difficult to ensure effective MP pollution control during MSW treatment and disposal. Therefore, this study systematically summarizes the occurrence of MPs in different MSW treatment and disposal systems (landfill/dumpsite, compost, and incineration) on the Eurasian scale, and discusses the factors that influence MPs in individual MSW treatment and disposal systems. In addition, the paper assesses the occurrence of MPs in the surrounding environment of MSW treatment and disposal systems and their ecological risks using the species sensitivity distribution approach. The study also highlights recommendations for future research, to more comprehensively describe the occurrence and fate of MPs during MSW treatment and disposal processes, and to develop appropriate pollution control measures to minimize MP pollution.

Effects of biodegradable- and non-biodegradable-rich waste separation on ash deposition behaviour during coal and refuse-derived fuel co-combustion.

The potential impact of ash deposition during the combustion of separated biodegradable- and non-biodegradable-rich waste of refuse-derived fuel (RDF) was evaluated in this study. Theoretical prediction, drop tube furnace experimental combustion, and ash observation were performed to comprehensively investigate their ash deposit behaviour. The results show that high CaO and Cl in RDFs result in severe sintering and rust in the metal surface. The high ash deposit weight and aggregated sticky particles are observed during single-firing RDFs. Furthermore, adding 5 wt% of biodegradable-rich RDF or mixed RDF to coal has a less significant effect on ash deposition. However, several aggregate particles and metal degradation are observed during the combustion of mixed coal with the addition of 5 wt% non-biodegradable-rich RDF. The high Cl in non-biodegradable-rich RDF affects the ash deposition behaviour significantly. This research provides valuable insights into optimising coal-RDF co-combustion, especially with separating biodegradable- and non-biodegradable-rich RDFs.

Municipal solid waste management instruments that influence the use of the refuse as fuel in developing countries: A critical review.

Landfills are the destination of most of the refuse generated whereas composting, material recycling, and Waste-to-Energy (WtE) technologies are not commonly employed in developing countries. However, the destination for energy purposes could be supplied with this refuse, improving the viability of energy use. Thus, this article raises some questions to identify aspects that could encourage its use as refuse-derived fuel (RDF) in these countries. Among them, does environmental education affect the municipal solid waste (MSW) source separation with emphasis on a destination? Can selective collection and extended producer responsibility (EPR) affect the MSW for energy recovery? Is there competition between the recycling market and the energy market for RDF? A systematic review of the literature was conducted to gather data and provide answers to such questions. This enabled to observe that EPR, selective collect expansion and source separation influence the quantity and quality of waste sent for energy use. Both internal and external factors impact on source separation. Additionally, there is evidence to support that despite several studies showing their technical, economic, environmental and social viability, the methods of energy usage of the refuse still need to improve their deployment in developing countries. In addition to identifying the main research gaps to be filled in future studies, the article also identified the instruments of MSW management that are to be applied in developing countries to divert recyclable and organic waste from landfill.

Smart-sight: Video-based waste characterization for RDF-3 production.

A material recovery facility (MRF) can transform municipal solid waste (MSW) into a valued commodity called refuse-derived fuel (RDF) as a promising solution to waste-to-energy conversion. The quality of the produced RDF significantly relies on the composition of in-feed waste and waste characterization method applied for auditing purposes, a process that is both time-consuming and fraught with potential hazards. This study focuses to enhance the workflow of the waste characterization process at an MRF. A solution named Smart Sight is proposed to detect and classify waste based on videos recorded after processing MSW through a mechanical sorting line consisting of bag breakers and trommel screens. A comprehensive dataset is created encompassing thirteen mixed waste classes from single and multi-family streams. The dataset is preprocessed with motion compensation techniques and frame differencing methods to extract and refine valuable frames. A one-stage YOLO detector model is then trained over the dataset. The experimental results show that the proposed method works efficiently at detecting and classifying waste objects in indoor MRF environments. Accuracy, precision, recall, and F1 score related to the proposed solution are found to be 0.70, 0.762, 0.69 and 0.72, respectively, with a mAP@0.5 of 0.716. The proposed approach is validated using data collected from local MRF by comparing the estimated waste composition values of the proposed solution with laboratory results obtained through current standardized industrial practices. Comparison reveals that waste characterization estimation obtained is consistent with the laboratory results, inferring that Smart-Sight is a viable tool for estimating waste composition.

The Two Front War on Reproductive Rights-When the Right to Abortion is Banned, Can the Right to Refuse Obstetrical Interventions Be Far behind?

The loss of the federally protected constitutional right to an abortion is a threat to the already tenuous autonomy of pregnant people, and may augur future challenges to their right to refuse unwanted obstetric interventions. Even before Roe's demise, pregnancy led to constraints on autonomy evidenced by clinician-led legal incursions against patients who refused obstetric interventions. In Dobbs v. Jackson Women's Health Organization, the Supreme Court found that the right to liberty espoused in the Constitution does not extend to a pregnant person's right to an abortion. With Roe's demise, the right to request specific types of care has been vitiated. The same argument underpinning that holding may now become ballast for attacks on the traditionally more robust right, the right to refuse. Here we discuss how the elevation of fetal and embryonic rights may lead to a cascade of medical intrusions and deprivations of liberty against pregnant persons, and offer an argument opposing these improprieties.

Refusal of the hospitalization: a distressed dilemma in obstetric practice.

Background: Pregnant women are a special population in which hospitalizations are more recommended due to physiological changes mimicking pathologies and medico-legal concerns. Objectives: We aimed to assess the obstetric outcomes of expectant mothers who were admitted to the obstetrics emergency outpatient clinic and declined the hospitalization advised by doctors. Additionally, we examined the appropriateness of physicians' recommendations. Design: We have retrospectively evaluated the patients admitted to the 'Obstetric Emergency Outpatient Clinic' and refused hospitalization between 1 January 2019 and 31 December 2019. Methods: Cases were classified into three groups based on the trimester, considering the substantial variation between complaints and complications in each trimester. The complaints of pregnant women were categorized as psychosocial causes, obstetric complications, maternal systemic complaints, and suspicion of labor. We evaluated the compatibility of the hospitalization decision with the pregnancy outcome of patients. Results: A total of 958 pregnant women were included in the study. Leading causes for admissions were obstetric complications, maternal systemic complaints, and suspicion of labor in first, second, and third trimesters, respectively. Psychosocial causes were mostly observed in the second trimester. Readmission to the hospital within a week was highest in the third trimester group. According to pregnancy outcomes, 12.5% (94/753) of our recommendations were appropriate in all trimesters. Conclusion: Obstetricians seem overcautious in managing obstetric patients and willing to offer hospitalization more often than the actual requirements.

Optimization of low-grade coal and refuse-derived fuel blends for improved co-combustion behavior in coal-fired power plants.

This study is aimed at utilizing three waste materials, i.e., solid refuse fuel (SRF), tire derived fuel (TDF), and sludge derived fuel (SDF), as eco-friendly alternatives to coal-only combustion in co-firing power plants. The contribution of waste materials is limited to ≤5% in the composition of the mixed fuel (coal + waste materials). Statistical experimental design and response surface methodology are employed to investigate the effect of mixed fuel composition (SRF, TDF, and SDF) on gross calorific value (GCV) and ash fusion temperature (AFT). A quadratic model is developed and statistically verified to apprehend mixed fuel constituents' individual and combined effects on GCV and AFT. Constrained optimization of fuel blend, i.e., GCV >1,250 kcal/kg and AFT >1,200 °C, using the polynomial models projected the fuel-blend containing 95% coal with 3.84% SRF, 0.35% TDF, and 0.81% SDF. The observed GCV of 5,307 kcal/kg and AFT of 1225 °C for the optimized blend were within 1% of the model predicted values, thereby establishing the robustness of the models. The findings from this study can foster sustainable economic development and zero CO2 emission objectives by optimizing the utilization of waste materials without compromising the GCV and AFT of the mixed fuels in coal-fired power plants.

Transport of pollutants in groundwater of domestic waste landfills in karst regions and its engineering control technologies.

Domestic waste produces leachate with a high concentration of pollutants in the landfill process due to biochemical degradation stages like compaction and fermentation. A large number of cases show that anti-seepage membranes widely used in refuse landfills tend to rupture under long-term tension and corrosion, causing leachate to enter the groundwater system and pollute the environment. To reveal the phenomenon of groundwater contamination in refuse landfills, typical domestic waste landfills in karst regions were examined, on the basis of a summary of hydrogeological conditions and hydrochemical characteristics, a three-dimensional groundwater flow model and solute transport model were constructed to analyze the pattern of pollutant diffusion, and its controlling factors, under the current conditions and massive rupture of anti-seepage membrane. The results show that with a minor rupture of the anti-seepage membrane, the area of the low pollution region increases first and then decreases while that of the slight pollution region continuously increases; When a massive rupture of the anti-seepage membrane appears, the ranges of heavy pollution region and total pollution regions continue to grow; Pollutant migrates along the same direction as the groundwater flow and diffuse from high concentration region to low concentration regions under the differential concentration effect. Based on the temporal-spatial distribution characteristics of groundwater pollutants, two engineering control schemes, namely, curtain grouting blocking and group well pumping, were established. A comparison of the two control schemes shows that group well pumping stably maintains water quality safety over the long term, pollutants overflow from both sides of the curtain after they have accumulated to a certain point of concentration, causing damage to the groundwater environment in the conservation area.

Fatal injuries associated with rear step riding among municipal solid waste collection workers (United States, 1984-2020).

BACKGROUND: United States solid waste workers suffer a high fatal injury rate due to their frequent exposures to refuse-vehicle-related hazards. The Occupational Safety and Health Administration (OSHA) allows workers to ride on the rear steps of a garbage truck (exterior riding) if employers abide by American National Standard Z245.1 (ANSI Z245.1). The State of California (CA) has banned exterior riding since 1984, and the City of New York (NYC) has implemented its own initiatives to prevent exterior riding deaths. METHODS: Fatal exterior riding incidents were identified from two online databases. Variables relating to deceased workers, employers, and injury circumstances were analyzed. RESULTS: The study identified 181 exterior riding deaths from 604 refuse-vehicle-related fatal incidents (deaths either directly caused by a refuse vehicle or one in which the victim was performing a refuse-vehicle-related task) in the United States (1984-2020). A total of 50 (27.6%) of the exterior riding deaths had no ANSI Z245.1 violations. Risk factors other than those addressed by ANSI Z245.1 contributed to these worker deaths. CONCLUSIONS: Exterior riding deaths identified by this study were all preventable. Temporary workers and workers in the public sector may be at higher risk for exterior riding deaths. Both CA and NYC had taken measures to prohibit the practice of exterior riding, and both had lower numbers of exterior riding deaths. ANSI Z245.1 and current OSHA enforcement policy do not address the inherent dangers of falling off a moving heavy vehicle while standing on a small and elevated platform, and are not effective in preventing fatal exterior riding incidents.

Crime and victimization outcomes following civil rights limits to the use of compulsory treatment.

Community treatment orders (CTOs) have been associated with reduced crime/victimization-risk. Australia's ratification of the U.N. Convention on the Rights of Persons with Disabilities (CRPD) enabled patient-rights-advocacy to limit CTO-assignment to persons lacking decision-making-capacity. This effort was accompanied by a 15% reduction in CTO-utilization. Has this change affected crime/victimization-involvements of patients with schizophrenia-diagnoses? In Victoria Australia, the study considers crime/victimization-involvement among three patient-groups recruited with the same sampling-algorithm in the decade before (2000-2009, N = 14,711) and after (2010-2019, N = 10,702) CRPD-ratification. Each group is its own-control. Each group's positive-outcome across decades would be "no increase" in crime/victimization-involvement or in the ratio of the group's incident-rates to the State's. Following CRPD-ratification, first-hospitalized-patients with at least one CTO-assignment doubled their involvement in major crime-perpetrations (from 13% to 27%), non-CTO-hospitalized-patients almost doubled (from 10% to 18%), and 11% of outpatients were involved when none were before. Overall, a third (34%) were victimized-by-major-crime up from 28%, with 25% of outpatients experiencing victimization when none had before. Increases were most evident in major-crimes, led by assaults/abductions. Capacity-constraints on compulsory-treatment are associated with increases in crime/victimization-involvement, a transfer of responsibility for patients with schizophrenia-diagnoses from the mental-health-system to the criminal-justice-system, validation of dangerousness stereotypes, and growing negative family impact.

A Rapid Review of Sociocultural Dimensions in Nigeria's Solid Waste Management Approach.

Against the background of an arguable dearth of scholarship on the sociocultural dimensions of Nigeria's solid waste management strategies and practices, this rapid review searched for evidence in the literature. A rapid evidence review and qualitative meta-summary procedure were implemented to utilize the rigor of systematic literature review that met the timelines and limited funding available for this study. It is more appropriate to identify, extract, and synthesize a mixture of qualitative and/or quantitative empirical evidence in the literature. This rapid review found little substantive evidence of scholarly sociocultural approaches in Nigeria's solid waste management. It also discovered constant factors of inadequate and weak multidisciplinary or non-holistic approaches to driving innovation and effective social impact in Nigeria's solid waste management practices. The results were interpreted vis-à-vis the need to leverage the social sciences, particularly the range and scope of social work practice configurations and possibilities, to scientifically advance and substantially accelerate the implementation of evidence-based policy and practice in Nigeria's solid waste management system. This rapid review concluded that the negative results are due to the insufficient conceptual and theoretical bases for Nigeria's solid waste management strategies and/or practices.

Mass concentration and distribution characteristics of microplastics in landfill mineralized refuse using efficient quantitative detection based on Py-GC/MS.

Landfilling is the most traditional disposal method of domestic waste. Plastic waste in landfill sites could degrade to microplastics (MPs) and diffuse to the surrounding environment with leachate. However, MPs pollution in landfill mineralized refuse has not been well recognized. In the present research, a detection method for mixed MPs of polyethylene (PE), polypropylene (PP), and polystyrene (PS) based on Py-GC/MS was established and verified. The method is suitable for the rapid quantitative detection of large-batch of complex solid matrix samples, with an average deviation of less than 10%. Based on the method, samples from a landfill site in South China were studied, where PE was found to be the main component. The total concentration of MPs in mineralized refuse was 7.62 kg/t in the old area and 5.49 kg/t in the young area. Further analysis showed that the content of MPs was correlated with that of plastic waste and the landfill age, indicating that a considerable proportion was secondary MPs. The reserves of MPs in landfill sites may have reached an alarming number. In the absence of adequate safeguards, quantities of MPs may spread from the landfill sites, resulting in serious pollution of the surrounding soil and groundwater.

Cobertura vacinal e o movimento antivacina: o impacto na saúde pública no Brasil / Vaccination coverage and anti-vaccine movement: the impact on public health in Brazil / Cobertura de vacunación y movimiento antivacuna: el impacto en la salud pública en Brasil

A vacina constitui um dos principais métodos de prevenção contra doenças. Em 1973, o Brasil criou o Programa Nacional de Imunizações a fim de promover a imunização gratuita para a população, o que mais tarde tornou o país em referência mundial em vacinação. No entanto, a recusa vacinal ainda é um grande problema de saúde pública, sendo o movimento antivacina um dos destaques dessa realidade. Dessa forma, o objetivo deste artigo é avaliar como o movimento antivacina impacta na saúde pública no Brasil através da diminuição da cobertura vacinal. Trata-se de uma pesquisa de metodologia mista, com uma primeira etapa qualitativa, composta de uma revisão integrativa nas plataformas PubMed, LILACS e SciELO, no período de 2010 a 2020, e uma pesquisa documental em portais de movimentos antivacina; e uma segunda etapa quantitativa, em que foi realizado um estudo epidemiológico do tipo ecológico, com consulta nas bases eletrônicas do Datasus e no Sistema de Informações do Programa Nacional de Imunizações (SI-PNI), no período de 2010 a 2022. No período investigado, apenas em 2015 o Brasil alcançou a meta preconizada de cobertura vacinal, diferentemente dos anos seguintes, que apresentaram oscilações preocupantes. As publicações apresentam argumentos utilizados pelos grupos antivacina, evidenciados entre 2015 e 2019, período em que os dados de cobertura vacinal oscilaram. Assim, conclui-se que a ascensão do movimento antivacina é um dos fatores que influenciaram na queda da vacinação no Brasil, a exemplo do sarampo e da febre amarela.

The vaccine is one of the main methods of preventing diseases. Since 1973, Brazil created the National Immunization Program to ensure free immunization to the population, which later made the country a world reference in vaccination. However, vaccine refusal is still a great public health issue, and the anti-vaccine movement stand out in this reality. Thus, the purpose of this article is to evaluate how the anti-vaccine movement affects public health in Brazil with vaccination coverage reduction. This is a mixed methodology study, with first a qualitative step, composed of an integrative review in the platforms PubMed, LILACS, and SciELO, in the period from 2010 to 2020,and a documental research in portals of anti-vaccination movements; and a second quantitative step, where an epidemiological study of the ecological type was carried out, with consultation in the electronic databases of DATASUS and in the Information System of the National Immunization Program (SI-PNI) in the period of 2010 to 2022. In the investigative period, only in 2015 Brazil managed to reach the recommended vaccination coverage goal, unlike in the following years, which showed worrying fluctuations. The publications summarize arguments used by the anti-vaccination groups, evidenced between 2015 and 2019, a period in which the vaccination coverage data fluctuated. Therefore, it is clear that the rise of the anti-vaccination movement is a factor that influenced the drop in vaccination numbers in Brazil, with yellow fever and measles as examples.

La vacuna es uno de los principales métodos de prevención de enfermedades. En 1973, Brasil creó el Programa Nacional de Inmunización con el fin de promover la inmunización gratuita para la población, lo que luego convirtió al país en un referente mundial en vacunación. Sin embargo, la negativa de la vacuna sigue siendo un problema importante en la salud pública, y el movimiento antivacunas es uno de los aspectos más destacados de esta realidad. Así, el objetivo de este artículo es evaluar cómo el movimiento antivacunas impacta en la salud pública en Brasil mediante la disminución de la cobertura de vacunación. Se trata de un estudio epidemiológico mixto, con una primera etapa cualitativa, consistente en una revisión integradora en las plataformas PubMed, Lilacs y SciELO, en el período de 2010 a 2020, y una investigación documental en portales de movimientos antivacunas; y una segunda etapa cuantitativa, en la que se realizó un estudio epidemiológico de tipo ecológico, con consulta en las bases de datos electrónicas de DATASUS y en el Sistema de Información del Programa Nacional de Inmunización (SI-PNI), en el período de 2010 a 2022. Entre eses años, solo el año 2015 logró alcanzar la meta recomendada, a diferencia de los años siguientes, que mostraron fluctuaciones preocupantes en la cobertura de vacunación. Las publicaciones mostraron los argumentos utilizados por los grupos antivacina, evidenciados entre 2015 y 2019, período en que los datos de cobertura de la vacuna fluctuaron. Así, se concluye que la asunción del movimiento antivacunación es uno de los factores que influye en la caída de la vacunación en Brasil, como en el sarampión y la fiebre amarilla.