Cancer mortality and premature deaths among hairdressers in Brazil.

Hairdresser is an occupation classified by the International Agency for Research on Cancer as probably carcinogenic (Group 2A) for lung and bladder cancer, but evidence is accumulating on its association with other cancer types. To our knowledge, this is the first study aimed to compare the cancer mortality and premature mortality between hairdressers and other workers in Brazil. METHODS: In this exploratory study, information on deaths by selected cancers that occurred in Brazil, from 1996 to 2020, among workers aged 20-70y, with identified occupation was gathered from the Brazilian Mortality Information System. Sociodemographic characteristics, sex-specific mortality ratio, and Years of Potential Life Lost (YPLL) were compared between hairdressers, service workers, and general workers. We used logistic regression models to estimate crude (ORC) and adjusted (ORADJ) odds ratios. Models were adjusted by age, educational level, and ethnicity. We also used Poisson regression models to compare the YPLL rates across the occupational groups. RESULTS: From 1996 to 2020, 23 557 deaths occurred among hairdressers, 576 428 among service workers, and 13 332 996 among general workers in Brazil. Higher mortality ORs and YPLL were observed for several types of cancer among hairdressers, compared to service and general workers, especially for women. Hairdressers' mortality was significantly higher among whites, women, younger workers, and those who completed high school. Female hairdressers had significantly higher odds of dying from cancer of the digestive, respiratory, reproductive, urinary, and hematological systems, both in crude and adjusted models. For male hairdressers, higher odds were found only for urinary tract and bladder cancer, while other significant associations indicated lower mortality than the comparison groups. YPLL analyses revealed significant premature deaths among Brazilian hairdressers. In women, this was more evident among those who died of neoplasms of salivary glands, bones and articular cartilages, and acute lymphoid leukemia; in men, tongue, pharynx, and thyroid. CONCLUSIONS: Our results suggest that Brazilian female hairdressers are more likely to die from several cancers, with potential consequences on premature deaths. Causal associations to occupational risks, such as exposure to chemicals, should be investigated by observational epidemiologic studies. Meanwhile, it is important to promote public policies, regulations, and Occupational Safety and Health (OSH) strategies to protect hairdressers' health, mitigate occupational risks, and ensure safe workplaces.

A Systematic Review of the geographic distribution of pathogenic Leptospira serovars in the Americas, 1930-2017.

Leptospirosis is an important public health problem caused by Leptospira. The objective is to characterize the geographic distribution of pathogenic leptospira serovars in the Americas through a systematic review of the literature between 1930-2017. Searches were conducted in six scientific databases (PubMed, Web of Science, Embase, Lilacs, Scopus and Cochrane). We included studies conducted unambiguously in the Americas, that investigated infection of Leptospira in humans and animals in their natural environments with serovar identification. 283 articles were included, of which 69 were studies in humans, 86 in wild animals, and 182 in domestic animals. Most of them conducted in Brazil (104, 36.7%) and in rural environments (158, 55.8%). Bovines, equines and dogs where the most frequently studied domestic species. However, a large diversity including 80 species of wild animals were studied. Icterohaemorrhgiae, Canicola, Pomona and Grippotyphosa were the most common serovars, described in 46 (16.2%), 38 (13.3%), 32 (11.3%) and 26 (9%) of the articles, respectively. The Results indicate a large concentration of studies in Latin America, with emphasis on Brazil, in wild mammals and three main domestic animal groups. Our results emphasize the need for studies that delve into the relationships of the epidemiological cycle, environment, and health.

Association of occupational exposure to pesticides with overweight and abdominal obesity in family farmers in southern Brazil.

The association of chronic exposure to pesticides with overweight and abdominal obesity in adult farmers was investigated. This cross-sectional study included a random sample of 122 farmers and their family members of both sexes (61% were male), living in the municipality of Farroupilha, southern Brazil. Pesticide groups and their individual compounds were self-reported and classified according to major functional and chemical classes (never used, 1-20 years, or > 20 years of use). Abdominal obesity and overweight were the outcomes of interest. A multivariate Poisson regression model was analyzed. After confounding factors were controlled, chronic use (>20 years) of insecticides (PR: 1.45; 95% CI: 1.00-2.10) and organophosphorus pesticides (PR: 1.48, 95% CI: 1.02-2.12) was associated with a higher prevalence of overweight but not abdominal obesity. Additional studies are needed to confirm our findings and clarify the specific mechanisms of these pollutants in the etiology of obesity.

Thyroid and reproductive hormones in relation to pesticide use in an agricultural population in Southern Brazil.

This study aimed to assess the association of short- and long-term exposure to pesticides with circulating levels of thyroid and reproductive hormones in an agricultural population in the South of Brazil. Serum specimens from 122 male and female adults residing in small agricultural properties were sampled both in the low and high pesticide use season. A comprehensive questionnaire was used to collect detailed information on recent and cumulative lifetime use of pesticides and other agricultural-related exposures. The difference in serum hormone levels between seasons was assessed by the T-test and Wilcoxon test for paired samples, and associations between pesticide exposure-related variables and hormone values were explored by multivariate linear regression analysis. Levels of total thyroxine (T4) and male testosterone were significantly reduced from the low to high pesticide use season. In the high exposure season, recent use of dithiocarbamate fungicides, not using full personal protection equipment, and use of manual equipment was associated with reduced levels of thyroid-stimulating hormone (TSH). Moreover, recent use of lambda-cyhalothrin (pyrethroid) was associated with reduced total T4 and increased male luteinizing hormone (LH), use of paraquat (herbicide) with reduced free triiodothyronine (T3), and use of phthalamide (fungicide) with increased male LH. We also found associations of lifetime years of agricultural work with reduced total T4 and increased male testosterone; and of lifetime agricultural work and use of various pesticide classes (i.e. insecticides, herbicides, organophosphate insecticides, dithiocarbamate fungicides, and pyrethroids), mancozeb (fungicide), and paraquat with slight changes in free or total levels of T4 and/or T3. Findings suggest that both short- and long-term exposure to agricultural pesticides may alter thyroid hormones and male testosterone levels among farm residents.

Pesticide exposure and thyroid function in an agricultural population in Brazil.

Although numerous pesticides may interfere with thyroid function, however, epidemiological evidence supporting this relationship is limited, particularly regarding modern non-persistent pesticides. We sought to evaluate the association of agricultural work practices, use of contemporary-use pesticides, and OC pesticides residue levels in serum with circulating thyroid hormone levels in an agricultural population. A cross-sectional study was conducted with a random sample of 275 male and female farm residents in Farroupilha, South of Brazil. Information on sociodemographics, lifestyle and agricultural work was obtained through questionnaire. Blood samples were collected on all participants and analyzed for cholinesterase activity, serum residues of OC pesticides, and levels of free T4 (FT4), total T3 (TT3) and TSH. Non-persistent pesticides exposure assessment was based on questionnaire information on current use of pesticides, and frequency and duration of use, among others. Associations were explored using multivariate linear regression models. Total lifetime years of use of fungicides, herbicides and dithiocarbamates in men was associated with increased TSH accompanied by decrease in FT4, with evidence of a linear trend. In addition, there was an association between being sampled in the high pesticide-use season and increased TSH levels. Conversely, farm work and lifetime use of all pesticides were related with slight decrease in TSH and increased TT3 and FT4, respectively. In general, pesticide use was not associated with thyroid hormones in women. Subjects with detected serum concentrations of ß-hexachlorocyclohexane, endrin, dieldrin, heptachlor epoxide B, γ-chlordane, transnonachlor, heptachlor, p,p'-dichlorodiphenylethane and endosulfan II experienced slight changes in TT3; however, associations were weak and inconsistent. These findings suggest that both cumulative and recent occupational exposure to agricultural pesticides may affect the thyroid function causing hypothyroid-like effects, particularly in men.

Factors associated with unsuccessful tuberculosis treatment among homeless persons in Brazil: A retrospective cohort study from 2015 to 2020.

BACKGROUND: Tuberculosis (TB) is a preventable and a curable disease. In Brazil, TB treatment outcomes are particularly worse among homeless populations who are either of black race, malnourished or living with HIV/AIDS and other comorbidities. This study therefore evaluated factors associated with unsuccessful TB treatment among homeless population (HP) compared to those with shelter. METHODOLOGY/PRINCIPAL FINDINGS: The study population was composed of 284,874 people diagnosed with TB in Brazil between 2015 and 2020 and reported in the Information System for Notifiable Diseases (SINAN), among which 7,749 (2.72%) were homeless and 277,125 (97.28%) were sheltered. Cox regression analysis was performed with both populations to identify factors associated with unsuccessful TB treatment, and significant predictors of TB treatment outcomes. Results show that HP are more susceptible to unfavorable outcomes when compared to sheltered people (Hazard Ratio (HR): 2.04, 95% CI 1.82-2.28). Among the HP, illicit drug use (HR: 1.38, 95% CI 1.09-1.74), mental disorders (HR: 2.12, 95% CI 1.08-4.15) and not receiving directed observed treatment (DOT) (HR: 18.37, 95% CI 12.23-27.58) are significant predictors of poor treatment outcomes. The use of illicit drugs (HR: 1.53, 95% CI 1.21-1.93) and lack of DOT (HR: 17.97, 95% CI 11.71-27.59) are associated with loss to follow-up, while lack of DOT (HR: 15.66, 95% CI 4.79-51.15) was associated with mortality among TB patients. CONCLUSION/SIGNIFICANCE: Homeless population living in Brazil are twice at risk of having an unsuccessful treatment, compared to those who are sheltered, with illicit drugs use, mental disorders and lack of DOT as risk factors for unsuccessful TB outcomes. Our findings reinforce the arguments for an intersectoral and integral approach to address these determinants of health among the vulnerable homeless populations.

Simplified sewerage to prevent urban leptospirosis transmission: a cluster non-randomised controlled trial protocol in disadvantaged urban communities of Salvador, Brazil.

INTRODUCTION: Leptospirosis is a globally distributed zoonotic and environmentally mediated disease that has emerged as a major health problem in urban slums in developing countries. Its aetiological agent is bacteria of the genus Leptospira, which are mainly spread in the urine of infected rodents, especially in an environment where adequate sanitation facilities are lacking, and it is known that open sewers are key transmission sources of the disease. Therefore, we aim to evaluate the effectiveness of a simplified sewerage intervention in reducing the risk of exposure to contaminated environments and Leptospira infection and to characterise the transmission mechanisms involved. METHODS AND ANALYSIS: This matched quasi-experimental study design using non-randomised intervention and control clusters was designed to assess the effectiveness of an urban simplified sewerage intervention in the low-income communities of Salvador, Brazil. The intervention consists of household-level piped sewerage connections and community engagement and public involvement activities. A cohort of 1400 adult participants will be recruited and grouped into eight clusters consisting of four matched intervention-control pairs with approximately 175 individuals in each cluster in baseline. The primary outcome is the seroincidence of Leptospira infection assessed through five serological measurements: one preintervention (baseline) and four postintervention. As a secondary outcome, we will assess Leptospira load in soil, before and after the intervention. We will also assess Leptospira exposures before and after the intervention, through transmission modelling, accounting for residents' movement, contact with flooding, contaminated soil and water, and rat infestation, to examine whether and how routes of exposure for Leptospira change following the introduction of sanitation. ETHICS AND DISSEMINATION: This study protocol has been reviewed and approved by the ethics boards at the Federal University of Bahia and the Brazilian National Research Ethics Committee. Results will be disseminated through peer-reviewed publications and presentations to implementers, researchers and participating communities. TRIAL REGISTRATION NUMBER: Brazilian Clinical Trials Registry (RBR-8cjjpgm).

Occupational exposure to pesticides and hematological alterations: A survey of farm residents in the South of Brazil.

This study sought to investigate the association of exposure to organochlorine (OC) and non-persistent pesticides with hematological parameters in an agricultural population in Southern Brazil. A cross-sectional study was conducted with a random sample of 275 farm workers and their families in Farroupilha-RS. A questionnaire was used to collect information on sociodemographic and lifestyle factors, duration, frequency and type of pesticide used, among others. Blood samples were collected and analyzed for serum concentration of 24 OC pesticides and hematological parameters. Associations were explored through linear regression, controlling for confounders. Lifetime use of chemical classes other than organophosphates and dithiocarbamates were associated with decreased number of lymphocytes, while subjects sampled in the high pesticide use season showed higher number of erythrocytes and hemoglobin level. Detectable serum levels of many OC pesticides were associated with lower counts of white blood cells, particularly eosinophils. Although mostly null associations were observed between pesticide use and hematological parameters, findings may suggest that OC pesticides could lead to hematological alterations among agricultural workers.

Perfil, prevalência e fatores de risco a lesões em corredores amadores do Rio Grande do Sul / profile, prevalence and risk factors for injuries in recreational runners in Rio Grande do Sul / Perfil, prevalencia y factores de riesgo de lesiones en corredores aficionados de Rio Grande do Sul

O objetivo do estudo é avaliar o perfil sociodemográfico, a prevalência e os fatores de risco a lesões em corredores amadores do Rio Grande do Sul. O método de coleta utilizado foi um questionário disponibilizado online. Como critérios de inclusão da pesquisa, foi estabelecido que os sujeitos devessem ser moradores do Estado do Rio Grande do Sul, estar praticando corrida de rua nos últimos 12 meses, ser maior de 18 anos e ter aceitado participar do estudo após leitura dos termos. O estudo foi aprovado pelo comitê de ética da instituição. No total participaram da pesquisa 288 corredores, sendo que 53,5% eram homens, com idade média de 38,6±10,4 anos. Dos 288, 80,5% possuíam curso superior, 66% buscavam qualidade de vida, 54,9% relataram treinar de três a quatro vezes na semana, 28,8% percorreram um volume de treino semanal de 10 a 20 km, sendo 52,1% orientados por um profissional de Educação Física. Quanto a prevalência de lesões a amostra do estudo trouxe um número bastante expressivo, onde 46,5% dos corredores tiveram algum tipo lesão. Dessas lesões, a sua maioria afetou membros inferiores, dentre as mais prevalentes 28,1% foram musculares (panturrilha 30,9% e tibial anterior/canela 23,5%) e 35,8% articulares (joelhos 53,4% e tornozelos/pés 36,9%). Os fatores de risco significativamente associados a ocorrência de lesões (p<0,05) foram ser do sexo masculino, ter uma estatura maior, não possuir doença crônica, maior tempo de prática de corrida, maior quantidade de dias de treino, um maior volume semanal, maior velocidade média, seguir planilha pronta da internet e sentir dor ou desconforto pós treino. Concluiu- se que, por meio da identificação do perfil destes corredores e um controle desses dados, pode ser possível um melhor direcionamento de ações de planejamento para prevenir a ocorrência dessas lesões na modalidade.

The objective of the study is to evaluate the sociodemographic profile, prevalence and risk factors for injuries in amateur runners in Rio Grande do Sul. The collection method used was a questionnaire available online. As research inclusion criteria, it was established that the subjects should be residents of the State of Rio Grande do Sul, be practicing street running in the last 12 months, be over 18 years old and have accepted to participate in the study after reading the terms. The study was approved by the institution's ethics committee. In total, 288 runners participated in the research, 53.5% of which were men, with a mean age of 38.6±10.4 years. Of the 288, 80.5% had a college degree, 66% were looking for quality of life, 54.9% reported training three to four times a week, 28.8% covered a weekly training volume of 10 to 20 km, with 52 .1% guided by a Physical Education professional. As for the prevalence of injuries, the study sample brought a very expressive number, where 46.5% of the runners had some type of injury. Of these injuries, most affected lower limbs, among the most prevalent, 28.1% were muscular (calf 30.9% and tibialis anterior/shin 23.5%) and 35.8% were articular (knees 53.4% and ankles/feet 36.9%). The risk factors significantly associated with the occurrence of injuries (p<0.05) were being male, having a higher stature, not having chronic disease, longer running practice, more training days, a greater volume of week, higher average speed, following a ready-made worksheet from the internet and feeling pain or discomfort after training. It was concluded that, through the identification of the profile of these runners and a control of this data, it may be possible to better target planning actions to prevent the occurrence of these injuries in the modality.

El objetivo del estudio es evaluar el perfil sociodemográfico, la prevalencia y los factores de riesgo de lesiones en corredores aficionados de Rio Grande do Sul. El método de recogida utilizado fue un cuestionario disponible en línea. Como criterios de inclusión de la investigación, se estableció que los sujetos debían ser residentes del Estado de Rio Grande do Sul, estar practicando carreras de calle en los últimos 12 meses, tener más de 18 años y haber aceptado participar en el estudio después de leer los términos. El estudio fue aprobado por el comité de ética de la institución. En total, 288 corredores participaron en la investigación, siendo el 53,5% hombres, con una edad media de 38,6±10,4 años. De los 288, el 80,5% tenía titulación universitaria, el 66% buscaba calidad de vida, el 54,9% decía entrenar de tres a cuatro veces por semana, el 28,8% realizaba un volumen de entrenamiento semanal de 10 a 20 km, siendo el 52,1% guiado por un profesional de la Educación Física. En cuanto a la prevalencia de las lesiones, la muestra del estudio arrojó una cifra muy expresiva, ya que el 46,5% de los corredores tuvo algún tipo de lesión. De estas lesiones, la mayoría afectó a los miembros inferiores, entre las más prevalentes el 28,1% fueron musculares (pantorrilla 30,9% y tibia anterior/espinilla 23,5%) y el 35,8% articulares (rodillas 53,4% y tobillos/pies 36,9%). Los factores de riesgo asociados significativamente a la aparición de lesiones (p<0,05) fueron ser varón, ser más alto, no tener una enfermedad crónica, llevar más tiempo corriendo, más días de entrenamiento, mayor volumen semanal, mayor velocidad media, seguir una hoja de entrenamiento preparada en Internet y sentir dolor o molestias después del entrenamiento. Se concluye que, por medio de la identificación del perfil de estos corredores y un control de estos datos, puede ser posible una mejor dirección de las acciones de planificación para prevenir la aparición de estas lesiones en la modalidad.

Occupational exposure to pesticides, reproductive hormone levels and sperm quality in young Brazilian men.

The association of occupational exposure to current-use pesticides with reproductive hormones, semen quality, and genital measures was investigated among young men in the South of Brazil. A cross-sectional study was conducted in 99 rural and 36 urban men aged 18-23 years. Information on pesticide use was obtained through questionnaire. Serum and semen samples were analyzed for sex hormones and sperm parameters, respectively, and measurement of anogenital distance (AGD) and testis volume (TV) were performed. Associations were explored using multivariate linear regression. Rural men had poorer sperm morphology, higher sperm count, and lower LH levels relative to urban subjects. Lifetime use of pesticides, especially herbicides and fungicides, was associated with poorer morphology and reduced LH and prolactin, with evidence of a linear pattern. Maternal farming during pregnancy was associated with larger AGD and TV. Chronic occupational exposure to modern pesticides may affect reproductive outcomes in young men.

Associação entre prevalência de dor musculoesquelética e variáveis do treinamento de força / Association between prevalence of musculoskeletic pain and strength training variables / Asociación entre prevalencia de dolor musculoesquelético y variable del entrenamiento de fuerza

O objetivo foi medir a prevalência de dor musculoesquelética em praticantes de treinamento de força (TF) e sua associação com diferentes variáveis do treino. A amostra foi composta por 175 adultos praticantes de TF. Foram utilizados como instrumentos de avaliação um questionário geral e o Questionário Nórdico de Dor. Os resultados apresentaram que 73,7% da amostra investigada indicaram dor em, pelo menos, um ponto anatômico. Em relação às variáveis do TF, os sujeitos que praticam treinamento há mais tempo (>3 anos) e que utilizaram cargas moderadas ou pesadas apresentaram maior prevalência de dor quando comparado aos seus pares. Conclui-se, portanto, que a prevalência de dor entre praticantes de TF é elevada, uma vez que o tempo de prática e o uso de cargas leves potencializam sua ocorrência.

The objective was to measure the prevalence of musculoskeletal pain in strength training practitioners (ST) and their association with different training variables. The sample consisted of 175 practicing adults. A general questionnaire and the Nordic Pain Questionnaire were used as evaluation instruments. The results showed that 73.7% of the investigated sample indicated pain in at least one anatomic site. In relation to the variables of the ST, those subjects who had trained a longer period of time (> 3 years) and who used moderate or high loads, presented higher prevalence of pain when compared to their peers. It is concluded that the prevalence of pain among ST practitioners is high, where the time of practice and the use of light loads increases its occurrence.

El objetivo fue medir prevalencia de dolor musculoesquelético en practicantes de entrenamiento de fuerza (EF) y asociación con diferentes variables del entrenamiento. Muestra fue compuesta por 175 adultos practicantes de EF. Se utilizaron como instrumentos de evaluación un cuestionario general y el Cuestionario Nórdico de Dolor. Los resultados mostraron que el 73,7% de la muestra indicó dolor en al menos un punto anatómico. En cuanto a las variables del EF, aquellos sujetos que entrenaron hace más tiempo (> 3 años) y que utilizaron cargas moderadas o pesadas, presentaron mayor prevalencia de dolor cuando comparado a sus pares. Se concluye que la prevalencia de dolor entre practicantes de TF es elevada, donde el tiempo de práctica y el uso de cargas leves potencializa su ocurrencia.

Padrões alimentares e fatores associados em docentes de uma instituição privada de ensino superior / Dietary patterns and factors associated in teachers of a private institution of higher education

Resumo Introdução O padrão alimentar adotado pelos indivíduos parece estar relacionado a fatores sociodemográficos, hábitos de vida e parâmetros antropométricos, podendo refletir também nos desfechos de saúde deles. Objetivo Identificar padrões alimentares e verificar os fatores associados entre docentes do ensino superior. Método Estudo transversal com docentes de instituição privada de ensino superior do Sul do Brasil. Foi avaliado o consumo alimentar pelo Formulário de Marcadores de Consumo Alimentar e foram coletados dados sociodemográficos, alimentares, comportamentais e antropométricos. Foi feita análise fatorial de componentes principais para identificação dos padrões alimentares, e foram realizados os testes do qui-quadrado e de Regressão de Poisson para verificar a associação entre exposição e desfecho. Resultados Quatro padrões alimentares descreveram o consumo alimentar dos 250 indivíduos, sendo dois considerados saudáveis (saudável e proteico), constituídos por alimentos protetores à saúde, e dois classificados como mistos e de risco à saúde (ocidental e lanche), por apresentarem tanto alimentos saudáveis como alimentos marcadores de uma alimentação não saudável, com predomínio dos últimos. Docentes com características de estilo de vida saudável tiveram maior adesão aos padrões saudável e proteico e relação inversa com o ocidental. Aqueles com maior atuação nos cursos da área da saúde tiveram alta adesão ao padrão proteico. Conclusão A maior adesão de profissionais com aspectos positivos à saúde aos padrões alimentares saudáveis e a relação inversa ao padrão ocidental, provavelmente, relacionam-se ao perfil socioeconômico e demográfico, característico da população.

Abstract Background Dietary pattern adopted by individuals seems to be related to sociodemographic factors, lifestyle and anthropometric parameters, and it may also reflect their health outcomes. Objective To identify dietary patterns and verify the associated factors among higher education teachers. Method Cross-sectional study with teachers from a South Brazil higher education private institution was carried out. It was evaluated the food consumption by a Food Consumption Markers Form and were collected sociodemographic, food, behavioral and anthropometric data. Factorial analysis of major components was performed to identify dietary patterns, and chi-square test and Poisson Regression to verify the association between exposure and outcome. Results Four dietary patterns described the food consumption of the 250 individuals, being two considered healthy (healthy and protein), constituted by health protector foods, and two (Western and snack), classified as mixed and of health risk, because it present both healthy food as those markers of an unhealthy eating, with predominance of the last. Teachers with characteristics of healthy life style showed larger adherence to healthy and protein patterns, and inverse relation with the Western. Those with greater actuation at the health area courses had larger adherence to protein pattern. Conclusion The large adherence of those with positive health aspects to healthy dietary patterns and their inverse relation to the Western pattern, they are probably related to the socioeconomic and demographic profile, characteristic of the population.

Occupational exposure to pesticides and hematological alterations: A survey of farm residents in the South of Brazil / Exposição ocupacional a agrotóxicos e alterações hematológicas: Estudo transversal em moradores rurais do Sul do Brasil

Abstract This study sought to investigate the association of exposure to organochlorine (OC) and non-persistent pesticides with hematological parameters in an agricultural population in Southern Brazil. A cross-sectional study was conducted with a random sample of 275 farm workers and their families in Farroupilha-RS. A questionnaire was used to collect information on sociodemographic and lifestyle factors, duration, frequency and type of pesticide used, among others. Blood samples were collected and analyzed for serum concentration of 24 OC pesticides and hematological parameters. Associations were explored through linear regression, controlling for confounders. Lifetime use of chemical classes other than organophosphates and dithiocarbamates were associated with decreased number of lymphocytes, while subjects sampled in the high pesticide use season showed higher number of erythrocytes and hemoglobin level. Detectable serum levels of many OC pesticides were associated with lower counts of white blood cells, particularly eosinophils. Although mostly null associations were observed between pesticide use and hematological parameters, findings may suggest that OC pesticides could lead to hematological alterations among agricultural workers.

Resumo O objetivo deste estudo foi investigar a associação entre a exposição a organoclorados (OC) e agrotóxicos não persistentes e os parâmetros hematológicos em uma população agrícola de Farroupilha-RS. Foi utilizado um questionário para coletar informações sobre fatores sociodemográficos e de estilo de vida, duração, frequência e tipo de pesticidas utilizados, entre outros. Amostras sanguíneas foram coletadas e analisadas quanto a concentração sérica de 24 pesticidas OC e parâmetros hematológicos. As associações foram exploradas através de regressão linear, controlando por confundidores. O uso cumulativo de classes químicas diferentes de organofosforados e ditiocarbamatos associou-se com diminuição do número de linfócitos enquanto indivíduos que tiveram suas coletas sanguíneas realizadas na estação de maior uso de agrotóxicos tinham contagem de eritrócitos e hemoglobina maiores. Níveis séricos de diversos pesticidas organoclorados foram associados com contagens mais baixas de células brancas do sangue, particularmente eosinófilos. Embora as associações com o uso de agrotóxicos tenham sido, em geral, nulas, os resultados podem sugerir que os pesticidas OCs poderiam levar a alterações hematológicas entre os trabalhadores agrícolas.

Sintomas depressivos em gestantes da atenção básica: prevalência e fatores associados / Depressive symptoms in primary care pregnant women: prevalence and associated factors

INTRODUÇÃO: O aparecimento de transtornos emocionais no início da gestação é frequente, entre eles estão os sintomas depressivos (SD), como sentimento de culpa, falta de apetite e de energia. OBJETIVO: Medir a prevalência de sintomas depressivos e fatores associados em gestantes atendidas na Atenção Básica. MÉTODOS: Estudo epidemiológico observacional transversal, constituído por gestantes, usuárias da Atenção Básica de Caxias do Sul/RS. Os SD foram avaliados por meio Patient Health Questionnaire (PHQ-9). Realizou-se a análise bruta, onde calculou-se as razões de prevalência (RP) e respectivos intervalos de confiança (IC 95%). A comparação de variáveis categóricas ocorreu por meio do teste de Qui-Quadrado. A análise ajustada foi realizada por regressão de Poisson, utilizou-se a técnica de backwards, onde o modelo final foi construído a partir das variáveis com p ≤0,20 na análise bruta. RESULTADOS: A amostra constituiu-se de 76 gestantes, destas 46,1% apresentaram SD. A média de idade foi de 26,6 anos (±5,95) e 72,4% estavam casadas ou em união estável. Houve associação significativa entre SD e estado civil (RP: 1,54; IC 95% 1,00-2,37; p=0,045) e a ocorrência de aborto em outras gestações (RP: 1,72; IC 95% 1,08-2,74; p=0,022). CONCLUSÃO: Observou-se uma elevada prevalência de SD, comparando a estudos regionais, nas gestantes investigadas. Identificou-se como fatores associados ao desfecho, o estado civil e histórico de aborto, podendo trazer problemas na gestação e no pós-parto. Assim, percebe-se a necessidade de instrumentos e estratégias para identificar a presença de SD na fase inicial da gestação, para que sejam diagnosticados e tratados.

INTRODUCTION: The onset of emotional disorders early in pregnancy is frequent, including depressive symptoms (DS) such as guilt, lack of appetite and energy. OBJECTIVE: To measure the prevalence of depressive symptoms and associated factors in pregnant women attending primary care. METHODS: Cross-sectional observational epidemiological study of pregnant women, who attend primary care in Caxias do Sul, Rio Grande do Sul, Brazil. Depressive symptoms were assessed using Patient Health Questionnaire (PHQ-9). Gross analysis was performed, in which prevalence ratios (PR) and respective confidence intervals (CI 95%) were calculated. The comparison of categorical variables occurred through the Chi-square test. The adjusted analysis was performed by Poisson regression, using the backwards technique, where the final model was constructed from the variables with p≤0.20 in the gross analysis. RESULTS: The sample consisted of 76 pregnant women, of these 46.1% had depressive symptoms. The average age was 26.6 years (±5.95) and 72.4% were married or in a stable union. There was a significant association between depressive symptoms and marital status (PR: 1.54; 95% CI 1.00-2.37; p=0.045) and the occurrence of abortion in other pregnancies (PR: 1.72; 95% CI 1, 08-2.74; p=0.022). CONCLUSION: There was a high prevalence of depressive symptoms compared to regional studies in the pregnant women investigated. Factors associated with the outcome were marital status and history of abortion, which may cause problems during pregnancy and postpartum. Thus, there is a need for tools and strategies to identify the presence of depressive symptoms in early pregnancy, so that they can be diagnosed and treated.

Pesticide consumption, central nervous system and cardiovascular congenital malformations in the South and Southeast region of Brazil.

OBJECTIVES: To investigate the association between per capita pesticide consumption and infant mortality rates from CNS and CVS congenital malformations in microregions in the South and Southeast Region of Brazil. MATERIAL AND METHODS: An ecological study was conducted using data on pesticide expenditure in 1985 and 1996, and deaths caused by CNS and CVS malformations in infants under 1 year old in 1986-1990 and 1997-2001, respectively. Per capita pesticide consumption and infant mortality rates were calculated for each microregion. Microregions were grouped according to quintiles of pesticide consumption, taking the first quintile as reference. The association between pesticide consumption and infant mortality was examined by calculating Spearman correlation coefficients (r) and mortality rate ratios (RR), stratifying by gender and type of microregion (urban or rural). RESULTS: Significant and positive correlations between per capita pesticide consumption and rates of mortality due to CNS and CVS defects were observed in rural but not urban microregions. In general, mortality RRs for the 2 types of malformations in rural microregions were significantly higher in each quintile of pesticide consumption compared to the lowest quintile in the 2 study periods, with elevations ranging between 10% and 30%. Likewise, mortality RRs in these microregions showed significant trends of increase across quintiles of pesticide consumption in both study periods. In urban areas, however, mortality RRs from both CNS and CVS malformations were weak and not statistically significant, and a trend of increase of mortality with increasing pesticide usage was not observed. CONCLUSIONS: The results show the relevance of pesticide exposure in rural areas with intense agricultural activity, suggesting that such prenatal exposures may be related with the occurrence of certain congenital defects.

[Pesticide exposure and adverse pregnancy events, Southern Brazil, 1996-2000]. / Exposição a agrotóxicos e eventos adversos na gravidez no Sul do Brasil, 1996-2000.

Brazil is the world's largest consumer of pesticides. Epidemiological studies have shown an association between maternal exposure to pesticides and adverse pregnancy events. An ecological study was conducted to investigate potential relations between per capita pesticide consumption and adverse events in live born infants in micro-regions in the South of Brazil (1996-2000). The data were obtained from the Brazilian Institute of Geography and Statistics (IBGE) and the Health Information Department of the Unified National Health System (DATASUS). Micro-regions were grouped into quartiles of pesticide consumption, and prevalence ratios (PR) were calculated. Linear trend p-values were obtained with the chi-square test. Premature birth (gestational age < 22 weeks) and low 1 and 5-minute Apgar score (< 8) in both boys and girls showed a significantly higher PR in the upper quartile of pesticide consumption. No significant differences were observed for low birth weight. The findings suggest that prenatal pesticide exposure is a risk factor for adverse pregnancy events such as premature birth and inadequate maturation.

Síndrome metabólica em idosos de Nova Roma do Sul, RS: prevalência e fatores associados / Metabolic syndrome in elderly from Nova Roma do Sul, RS: prevalence and associated factors

INTRODUÇÃO: Síndrome metabólica (SM) é um transtorno complexo caracterizado por um conjunto de alterações fisiopatológicas simultâneas, como alteração no perfil glicêmico, lipídico, nos níveis pressóricos e obesidade central. OBJETIVO: Identificar a prevalência de síndrome metabólica em idosos e fatores sociodemográficos, socioeconômicos e comportamentais associados. MÉTODOS: Realizou-se um estudo transversal com 293 idosos, residentes no município de Nova Roma do Sul (RS), Brasil. Dados foram coletados por meio de questionário, medidas antropométricas e exames bioquímicos. Determinou-se a síndrome metabólica segundo a National Cholesterol Education Program/Adult Tratment Panel III. Aplicou-se estatística descritiva e teste do χ2, além da Regressão de Poisson. RESULTADOS: A prevalência geral foi de 37,2%. Na análise ajustada, a baixa escolaridade (RP=1,40; IC95% 1,07­1,82), o excesso de peso (RP=4,36; IC95% 2,47­7,68) e o consumo frequente de doces (RP=0,74; IC95% 0,57­0,97) estiveram associados ao desfecho. CONCLUSÃO: A prevalência de SM apresentou-se elevada, principalmente entre idosos com excesso de peso e com baixa escolaridade. Resultado preocupante, principalmente diante dos agravos que esse distúrbio metabólico pode causar à saúde. Evidencia-se a necessidade de ações, ainda em fase adulta, visando à elaboração de estratégias que atentem integralmente à saúde do idoso.

INTRODUCTION: Metabolic syndrome (MS) is a complex disorder characterized by a set of simultaneous pathophysiological changes, including glycemic levels, lipid profile, pressure levels, and central obesity. OBJECTIVE: To identify the prevalence of MS in an elderly population and to point out sociodemographic, socioeconomic and behavioral factors associated. METHODS: A cross-sectional study was carried out with 293 elderly people living in the city of Nova Roma do Sul (RS), Brazil. Data were collected by questionnaire, anthropometric measurements, and biochemical tests. MS was determined according to the National Cholesterol Education Program/Adult Treatment Panel III. Descriptive statistics, χ2, and Poisson regression tests were applied. RESULTS: The prevalence of MS was 37.2%. In the adjusted analysis, low educational level (PR=1.40; 95%CI 1.07­1.82), overweight (PR=4.36; 95%CI 2.47­7.68), and frequent sugar intake (PR=0.74; 95%CI 0.57­0.97) were shown to be associated with MS. CONCLUSION: The prevalence of MS was high, especially among overweight and low-educated elderly. This is a worrying result, especially because MS diagnosis could be associated with higher risk for health. This is evidence of the need of actions to be taken in adulthood still, and elaboration of strategies that improve the health of the elderly.

[Association between psychosocial factors and self-reported overweight in Brazilian adults]. / Associação entre aspectos psicossociais e excesso de peso referido em adultos de um município de médio porte do Sul do Brasil.

The objective of this study was to investigate the association between psychosocial factors and self-reported overweight. A cross-sectional study was carried out with 1,100 adults in a Brazilian city. Structured interviews were conducted using a standard pre-tested questionnaire. Overweight was self-reported by participants and defined as body mass index (BMI) > 25kg/m². Psychosocial factors were quality of life (WHO-8: EUROHIS) and social support (Medical Outcomes Study). Crude and adjusted prevalence ratios (PR) were obtained by modified Poisson regression. After controlling for socio-demographic and behavioral variables, prevalence of overweight among individuals reporting low quality of life and low social support was 19% (PR = 1.19; 95%CI: 1.03-1.38) and 12% (PR = 1.12; 95%CI: 0.96-1.31), respectively, and was higher in those reporting high/moderate quality of life and high/moderate social support, respectively. The findings suggest that psychosocial factors can play a role in self-assessment of overweight.

Neighborhood sociodemographic and environmental contexts and self-rated health among Brazilian adults: a multilevel study.

The aim of this study was to investigate the association between sociodemographic and environmental contexts on self-rated health. A population-based cross-sectional study with a random sample of 38 neighborhoods (census tracts) and 1,100 adults was carried out. Data analysis used multilevel logistic regression. Data from the Brazilian Census of 2000, mean income, years of study of the head of household and mean number of residents per tract were R$955 (SD = 586), 8 years (SD = 3), and 746 residents (SD = 358) respectively. Higher prevalences of fair/poor self-rated health were found in neighborhoods with greater populations and lower income/schooling levels. After control for individual variables, the odds for fair/poor self-rated health was twice as high in more populous (OR = 2.04; 95%CI: 1.15-3.61) and lower-income neighborhoods (OR = 2.29; 95%CI: 1.16-4.50) compared to less populous, higher-income ones. Self-rated health depends on individual characteristics and the sociodemographic context of neighborhoods.

[Prevalence of poor self-rated mastication and associated factors in Brazilian elderly]. / Prevalência de capacidade mastigatória insatisfatória e fatores associados em idosos brasileiros.

We estimated the prevalence of poor self-rated mastication and associated factors among Brazilian elders. The study used data from a national survey of 5,124 Brazilian elderly in 250 cities. Data collection included dental examinations and household interviews with the elderly. The outcome was self-rated mastication. Data analyses used Poisson regression, and the prevalence of poor self-rated mastication was 49.7% (95%CI: 47.5-51.8). Adjusted analyses showed that increased prevalence was associated with: black color/race (PR = 1.13; 95%CI: 1.02-1.26); low income (PR = 1.22; 95%CI: 1.12-1.33.); high rates of tooth loss (PR = 1.66; 95%CI: 1.02-2.66); untreated caries (PR = 1.16; 95%CI: 1.08-1.25); never having visited a dentist (PR = 1.26; 95%CI: 1.10-1.44); toothache (PR = 1.47; 95%CI: 1.39-1.57); use of partial (PR = 0.87; 95%CI: 0.76-0.99) or total prostheses (PR = 0.81; 95%CI: 0.75-0.88); and need for partial (PR = 1.13; 95%CI: 1.03-1.25) or total prostheses (PR = 1.27; 95%CI: 1.16-1.39). The high prevalence emphasizes the dental care needs of this older group. Policies to deal with the problem should take the associated factors into account.