Maternal, neonatal and socio-economic factors associated with intellectual development among children from a coal mining region in Brazil.

Coal is the most aggressive energy sources in the environment. Several adverse outcomes on children's health exposure to coal pollutants have been reported. Pollutants from coal power plants adversely affect the intellectual development and capacity. The present study aimed to evaluate the intellectual development and associated factors among children living a city under the direct influence (DI) and six neighboring municipalities under the indirect influence (II) of coal mining activity in the largest coal reserve of Brazil. A structured questionnaire was completed by the child's guardian, and Raven's Progressive Color Matrices were administered to each child to assess intellectual development. A total of 778 children participated. In general, no significant difference was observed between the two cities. The DI city had better socioeconomic conditions than the II municipalities according to family income (< 0.001). The prevalence of children who were intellectually below average or with intellectual disabilities was 22.9%, and there was no significant difference (p > 0.05) between municipalities. In both unadjusted and adjusted analyses, intellectual development was associated with maternal age, marital situation and maternal education level, birth weight, breast feeding, frequent children's daycare, paternal participation in children's care and child growth. Living in the DI area was not associated with intellectual disability. The results suggest that socioeconomic conditions and maternal and neonatal outcomes are more important than environmental factors for intellectual development of children living in a coal mining area.

Distribution of potentially harmful elements in soils around a large coal-fired power plant.

An understanding of the spatial distribution and contribution of a power plant to local soil contamination is important for the planning of soil use and prioritizing remedial actions for public safety. Consequently, the aim of this study was to map the spatial distribution of potentially hazardous elements (PHEs; Cu, Pb, Zn, Ni, Cr, Fe, Mn, Cd, As, and Se) in soils around a large (796 MW) coal-fired power plant in Brazil. For the purpose, 33 soil samples were collected in the area within a radius of approximately 17.5 km from the plant and subsequently analyzed for PHEs. The frequency and direction of winds were also obtained from a meteorological station in the region. The sampling area was divided into four quadrants (northwest: N-NW; northeast: N-NE; southeast: S-SE; southwest: S-SW), and there were significant negative correlations between the distance and the concentrations of Se in the S-SE quadrant and As in the S-SW and S-SE quadrants. There were positive correlations between distance from the plant and the concentration of Mn in the N-NE quadrant and the concentration of Cd in the S-SW quadrant. The dominant direction of the winds was N-NE. The indexes used in this study showed low-to-moderate enrichment factor, but detailed analysis of the dominant quadrant of the winds showed a correlation with higher concentrations in the soils closer to the power plant for at least seven of the PHEs analyzed, especially with regard to As. Therefore, we conclude that the distribution of the metalloid As can be used as a marker of the spatial distribution of contamination from the thermoelectric plant, but the dynamics of the other elements suggests that the presence of other sources of contamination may also compromise the quality of local soils.

Vulnerability associated with "symptoms similar to those of mercury poisoning" in communities from Xingu River, Amazon basin.

The Brazilian Amazon is known to be a region with high levels of mercury (Hg) in the environment and studies point to an association between high levels of natural mercury in the mother rock and the vast number of clandestine gold mines. Other studies already report the contamination of fish in this region, as well as high levels of Hg in biological material from environmentally exposed populations. On the other hand, this is one of the least developed regions of the planet and it is necessary to understand the vulnerability factors in these populations that may be intoxicated by this element. The purpose of the present study was to investigate the vulnerability factors in communities from Xingu River-Amazon basin probably exposed to Hg. A cross-selection study in two cities localized in Xingu River was conducted, and the sample contained was 268 individuals. sociodemographic questions, lifestyle, diet habits and health conditions were collated. The majority of the sample was female, between 30 and 59 years old, had less than 3 years of educational level and lived in the local of study more than 240 months. There was regular fish consumption (95.9%), principally carnivorous species (80.5%). The visual problem has a highest prevalence (43.3%) between the health problems and about the symptoms of Hg intoxication, memory loss (42.9%), weakness (35.1%), fatigue (34.3%), mood changes (28.7%) and difficulties in concentration (27.2%) was most reported. The female sex, age over 60, educational level below 3 years of study, did not had flush toilet, smoke and least one chronic non-communicable disease represent higher probability to had symptoms of Hg intoxication. Lack of access to health services, low education level and income evidence the susceptibility of this community to diseases and injuries. The vulnerable groups identified in this study should be a priority in public health and environmental health policies.

[Opportunities for physical therapy contributions to primary health care in the South of Brazil]. / Situações com potencialidade para atuação da fisioterapia na atenção básica no Sul do Brasil.

OBJECTIVE: To identify opportunities for physical therapy contributions in an area covered by the Family Health Strategy in the South of Brazil. METHODS: In this cross-sectional study, 629 households were visited and information on 2 316 people was collected using a semi-structured instrument investigating the occurrence of health problems that could benefit from physical therapy (diabetes, hypertension, musculoskeletal diseases, neurological disorders, respiratory diseases in adults and children). When health problems were identified, we investigated whether the families or patients had received guidance to improve quality of life, and which professionals had provided advice. Finally, we investigated whether respondents were familiar with physical therapy and if they had required this type of care in their lifetime or in the past 12 months. RESULTS: The following health problems were reported by 629 participating families: diabetes (11.9%), hypertension (46.9%), musculoskeletal disorders (36.7%), neurological diseases (3.4%), respiratory diseases in adults (18.9%) and children (15.7%) and developmental delay (3.8%). Specific guidance was provided to 57.3% of people with diabetes, 64.1% of people with hypertension, 39.8% of people with musculoskeletal disorders, 45.5% of neurological patients, 26.9% of adults and 60.6% of children with respiratory diseases and 62.5% of children with developmental delay. Regarding knowledge about the profession, 92.4% of respondents were familiar with physical therapy. Of these, 41% reported having had the need for physical therapy, mostly (54.4%) for trauma/orthopedic disorders. CONCLUSIONS: The present results warrant the inclusion of physical therapists as part of the Family Health Strategy team in Brazil.

Self-medication in university students from the city of Rio Grande, Brazil.

BACKGROUND: Self-medication is the use of medication without prescription, orientation, or supervision of a physician or dentist. Self-medication might become a serious health problem. The purpose of this study was to identify the prevalence and factors associated with self-medication among first and last-year students enrolled in healthcare and non-healthcare programs. METHODS: A cross-sectional study was conducted at Universidade Federal do Rio Grande (FURG), state of Rio Grande do Sul, Brazil. Of 830 students in the sample, 95% answered the questionnaire - 789 students enrolled in 10 undergraduate programs. Mean age was 22 ± 6.17 years. The students answered a questionnaire covering socio-economic and demographic variables, use of medication, and medication knowledge. Information was collected on the conditions treated with medication, the medications used, and attitude towards self-medication. RESULTS: Of 789 students, 86.4% self-medicated (88.5% of 446 healthcare students). There were no significant differences in self-medication between healthcare and non-healthcare students, nor between first and last-year students. Bivariate and multivariate analyses showed a significant association between self-medication and having children (p = 0.01), having a home pharmacy (p < 0.001) and adequate medication knowledge (p = 0.01). The most frequently used active ingredients were acetaminophen (paracetamol), dipyrone, aspirin, phytotherapic compounds, and tea. Illicit drug use was significantly associated with self-medication in the multivariate analysis. CONCLUSION: The fact that being a healthcare student was associated with higher medication knowledge, but not with less self-medication, suggests that medication knowledge might contribute to increase self-medication. This should be taken into account when designing educational interventions relating to self-medication.

Health effects of ingestion of mercury-polluted urban soil: an animal experiment.

Rio Grande, the southernmost Brazilian port and industrial center, is marked by mercury-polluted ground cover. This pollution varies spatially, with levels exceeding 1,000 µg kg(-1) in 30% of the urban territory. The risk of Hg impact as a result of deliberate and involuntary geophagy is increased by restrained urban conditions in combination with the large proportion of the population living at low-income levels. Laboratory tests have demonstrated that ingestion of Hg-polluted soil by rats results in significant alterations in animal health such as stagnation in body weight increase, and significant mercury accumulation in the liver and kidney. The consumption of Hg-contaminated urban soil also provoked changes in hematological profiles of experimental animals by increasing the number of platelets. The present study indicates the potential for the local population of Rio Grande living in mercury-polluted districts, specifically young children, to experience health disturbances.

Gestational and Neonatal Outcomes in Cities in the Largest Coal Mining Region in Brazil.

Brazil has one of the largest mineral coal reserves in the world. More than 40% of this ore is in the Candiota Mine, in the extreme south of Brazil, which was previously identified as a hotspot of environmental pollution. In addition, an important part of Brazil's population suffers from socioeconomic vulnerability. Since there is no information on unfavorable gestational and neonatal outcomes associated with these problems, we conducted a cross-sectional study with 1950 mother-child binomials, aiming to evaluate the association between these outcomes and air pollution as well as socioeconomic, demographic and health variables in seven cities in the region. Of the total births, 11.6% were preterm and 9.5% of neonates had low birth weight (<2500 g). These conditions were also associated with skin color, previous abortions, birth type and prenatal care, as well as exposure to higher levels of coarse particulate matter (PM10) during the first trimester of pregnancy. Regarding air pollutants, although the daily limits for PM10 were exceeded on less than 5% of days, the annual average overtook the values proposed by WHO. Thus, we concluded that prematurity and low birth weight in this region are related to air pollution, and to socioeconomic variables and health care.

Lung function among residents from the largest coal region in Brazil.

Coal mining and burning activities in coal-fired power plants are among the most polluting activities in developing countries. In Brazil, the Candiota coal deposit concentrates 40% of the national mineral coal. Although, previous studies indicate several negative health outcomes to residents of this coal region, there is no information about lung function. Thus, this study aimed to evaluate lung function by spirometry among residents from the largest coal mining region of Brazil and its related factors. It was carried out a cross-sectional study with 300 male adults residing in four cities from this region. Socioeconomic, demographic, life style, and health conditions were collected through a structured questionnaire, and lung function was assessed by spirometry. Almost 18% of the residents have disorders in pulmonary function. There was significant statistical difference in the spirometry main parameters between the cities. Candiota city (host city of coal exploration activities) have the highest prevalence of obstructive ventilatory disorder. Curiously, upper economic class had significant higher risk of altered lung function (P<0.001), as well as inappropriate sewage destination (P<0.001). Residents of Candiota city had 20% higher risk of altered lung function. Regarding air quality, the PM10, SO2, and NO2 of the region were 20.6± 3.9, 7.0± 2.2, and 6.0± 1.6, respectively. Two air quality stations exceed the limit of 20 µg/m3 to PM10 proposed by Brazilian legislation and WHO, and three stations had PM10 quite close to the limit. This study points out the need for urgent action to protect residents from this coal mining region.

[Factors associated with delay in children development, Rio Grande, Rio Grande do Sul, Brazil]. / Fatores associados ao atraso no desenvolvimento em crianças, Rio Grande, Rio Grande do Sul, Brasil.

This analytical study aims to evaluate the factors associated to developmental delay in 8-12 months aged children, indicated as at risk at birth in Rio Grande, Rio Grande do Sul Brazil. The instruments used were the Denver Development Screening Test II, anthropometric evaluation and questionnaires. Two hundred and twenty children (both at risk and out of risk) participated. It was found a prevalence of o20.5% of potential delay in psychomotor development. Children who presented a risk of a suspicious DDST II were part of lower income families; their mothers had not been to more than six prenatal visits; and had inappropriate weight-age indicator The data suggest the need of a rethinking of policies on child health, given that other criteria could be included in the risk conditions to the child at birth.

Blood markers among residents from a coal mining area.

Coal extraction and processing generate environmental contamination, which has several negative impacts on human health. Hematological and biochemical parameters are effective biomarkers of the exposure of a population to air pollutants. Thus, this study aimed to evaluate hematological and biochemical parameters in adult residents in a coal mining region in the largest national reserve in Brazil, as well as to investigate their relations with air quality. The study included three cities in the south of Brazil, which are located near an important power plant and coal mine. The air quality was analyzed by PM10, NOx, and SO2 at five air quality monitoring stations, socioeconomic and demographic characteristics were evaluated with a questionnaire, and biochemical parameters were assessed in blood samples. The mean PM10 in the study area was 19.18 µg/m3. The air quality varied among the five monitoring stations, and the Candiota station exceeded the reference limit by 63.3%. In general, participants had lived more than 10 years in the municipality and had hepatic and renal parameters within the reference values. A higher prevalence of alterations was found in hematological parameters (43.1%) and liver function (30%). Among the three cities, the population of Pedras Altas seems to have a greater impairment of the blood parameters evaluated. The only parameter that was correlated with PM10 was the hematocrit level (r = 0.33; P < 0.001).

[System of meanings about the purpose of family health work: a qualitative analysis]. / Sistema de significados sobre a finalidade do trabalho na saúde da familia: uma abordagem qualitativa.

This exploratory study was performed to understand the system of meanings about the purpose of the nursing and medical work performed by Family Health teams, in the cities of Rio Grande and Pelotas (Brazil). Data collection was performed by semi-directed individual interviews. The interviews of 82 participants were recorded, and analyzed. The nuclear meaning of the purpose, as an end transmuted into the product of collective work, was in agreement with the possibility of the community implementing changes and acquiring healthy individual and collective behaviors. This gives evidence of the component of ethics in the process, by means of categories such as solidarity and compassion. This led to a marker, in the text production, of the human condition in the construction of the work purpose. Through the analysis and critical discussion of the theme, this study contributes to the macro-dimension of developing competencies and adjustment to the health needs of society.

Association between DNA damage, dietary patterns, nutritional status, and non-communicable diseases in coal miners.

Several negative health effects have been associated with environmental pollution. Coal mining activities are related to DNA damage. However, the impact of lifestyle as well as environmental exposure must be considered when evaluating the extent of DNA damage. The aim of this cross-sectional study was to analyze nutritional status, dietary patterns, and the prevalence of non-communicable diseases (CNCDs) among coal miners as well as to investigate the correlation of these variables with DNA damage. We used a questionnaire to assess demographics, health, and dietary habits. The nutritional status was measured in terms of BMI (body mass index) and DNA damage was assessed by the comet assay. The sample population was composed of 158 coal miners from the largest coal mining company in South of Brazil, and majority of them were classified as overweight (51.3%) or obese (28.5%). Hypertension was the most common CNCD (50.6%) and a majority of these workers consumed all groups of foods three or more times a week. There was a significant positive correlation between BMI and DNA damage (r = 0.1646, p = 0.04) and this association was stronger (r = 0.2556, p = 0.04) in coal miners with some CNCD. There was no significant correlation between dietary patterns and DNA damage in coal miners. These results suggest that the nutritional status and CNCD increase the extent of DNA damage in coal miners. Since this population is at high occupational risk, specific strategies should be designed to improve the health of these workers, aiming to achieve health equity.

[Temporary workers' perceptions of occupational risks in the port of Rio Grande, Rio Grande do Sul State, Brazil]. / Percepção dos trabalhadores avulsos sobre os riscos ocupacionais no porto do Rio Grande, Rio Grande do Sul, Brasil.

This was a cross-sectional, descriptive, quantitative study in the port of Rio Grande, Rio Grande do Sul, Brazil, aimed at identifying occupational risk perceptions in a sample of 306 temporary dockworkers. Most temporary dockworkers (93.46%) acknowledged the existence of health risks on the job, independently of schooling (p = 0.44) and job activity (p = 0.47). Risks identified by temporary workers as a whole included falling of suspended objects (8.43 +/- 2.47), noise (8.06 +/- 2.32), and bad weather conditions (8.05 +/- 2.48). Risks that varied significantly between jobs were: noise (p = 0.00), lifting loads manually (p = 0.00), work tools (p = 0,00), insufficient number of work team members (p = 0.03), extra wages based on productivity (p = 0.00), work pace (p = 0.01), working on scaffolding and other high areas (p = 0.00), workers moving on top of cargo (p = 0.00), and ship's ladders and gangways (p = 0.00). The study corroborated that temporary dock work is unhealthy and hazardous, and that the risks affect workers according to the specific jobs they perform.

Effect of mixing two environmental stressors, pH and metal contaminants, on offspring of rats exposed during gestation and lactation.

In large urban centers, the toxicity of metal mixtures may be enhanced by physicochemical factors and environmental variables, including pH. Rio Grande, a municipality located in the extreme south of Brazil, has soils with high levels of contamination due to urban and industrial activities and a high prevalence of acid rain events. Previous studies have shown that contact with elutriate of these soils can cause physiological and reproductive changes. Thus, the objective of the present study was to evaluate, through animal experimentation, the effects of a metal-contaminated soil, acidified by hydrofluoric acid at two different pH values (5.2 and 3.6), on the health of offspring of rats exposed during gestation and lactation. Female Wistar rats were gavaged daily for 42 days (gestation and breastfeeding) with soil elutriate contaminated with metals, using solvent with different pH values (6.0, 5.2, and 3.6). The following parameters were evaluated in their offspring: body and organ weight, length, appearance of developmental characteristics, and swimming. Experimental groups in which the progenitors were exposed to the solution at pH 3.6 exhibited a delayed increase in weight as well as motor deficit, with a decreased weight (onset) and length (beginning and end), while exposure in association with soil was an aggravating factor for the damages to the body. Exposure to the solution at pH 5.2 decreased the initial weight of the animals, impaired some parameters of weight development, and caused motor deficit on the 14th day. These novel findings reveal that the exposure of progenitors to environmental stressors can compromise the health of the offspring. Special attention should be given to populations living in areas with high prevalence of acid rain.

Antinociceptive effects of the aqueous extract of Brugmansia suaveolens flowers in mice.

The infusion of Brugmansia suaveolens, popularly known as trombeteira or cartucheira, has been used to treat pain in Brazil. The present study was conducted to test for its antinociceptive effects using the abdominal-writhing, formalin, tail-flick, and hot-plate tests in mice. The aqueous extract from B. suaveolens flowers administered intraperitoneally at doses of 100 and 300 mg/kg body weight significantly inhibited acetic acid-induced abdominal constrictions. An increase in hot-plate latency was also observed in animals receiving both doses (100 and 300 mg/kg). In the formalin test, both doses from the aqueous extract inhibited the first (0-5 min) and second phase (20-25 min). Tail-flick assays demonstrated that treatment of animals with plant extract induced attenuation of the response. These results suggest that the aqueous extract from B. suaveolens flowers produced antinociceptive effects, as demonstrated in the experimental models of nociception in mice. This supports popular medicinal uses of this plant as an analgesic.

Nursing, environment and health conceptions: an ecosystemic approach of the collective health production in the primary care.

The present study aimed to understand the meanings of the conceptual environment category, produced by nurses acting in the primary health care. A total of 30 nurses participated in the study. Data were collected through semi-directed interviews. The analysis was performed through the thematic method of the empirical meanings, based on the ecosystemic approach of work. The study showed the meanings of environment in the space limits of the human relations, whether they are produced at work, in the family scope or in the general community, in a transversal system that allows relationships of mutual exchange by the human condition itself in the society. Concluding, the development in the nursing area, in an ecosystemic approach of the human health, demands the construction of management strategies integrated to the environment for the promotion of health. The nursing science can be an ally in the construction of healthy and sustainable environments.

[Intersectorial policy concerning medicinal plants of the State of Rio Grande do Sul: as viewed by faculty members]. / Politica intersetorial de plantas medicinais do Estado do Rio Grande Do Sul: visão docente.

This survey aimed detecting the knowledge of university faculty members of the southern region of the state of Rio Grande do Sul, Brazil, in the Intersectorial Policy of Medicinal Plants of the State of Rio Grande do Sul. This quantitative survey used a sample size of 185 professors (61.7%). It was found that 91.50% of the interviewed professors did not know this policy. This suggests that, despite the existence of a policy on medicinal plants in the state of Rio Grande do Sul, is not well disseminated in the academia, which hinders its knowledge among faculty members.

Genotoxicity in adult residents in mineral coal region-a cross-sectional study.

The present study assessed the DNA damage in environmentally exposed volunteers living in seven municipalities in an industrial coal region, through the use of the comet assay with blood cells and the micronucleus test with buccal cells. Blood and buccal smears were collected from 320 male volunteers living in seven cities inserted in a coal region. They were ages of 18 and 50 years and also completed a questionnaire intended to identify factors associated with DNA damage through a Poisson regression analysis. The comet assay detected significant differences in DNA damage in volunteers from different municipalities, and neighboring cities (Pedras Altas, Aceguá, and Hulha Negra) had a higher level of DNA damage in relation to control city. Some of the risk factors associated with identified DNA lesions included residence time and life habits. On the other hand, the micronucleus test did not identify differences between the cities studied, but the regression analysis identified risk factors such as age and life habits (consumption of mate tea and low carbohydrates diet). We conclude that there are differences in the DNA damage of volunteers from different cities of the carboniferous region, but the presence of micronuclei in the oral mucosa does not differ between the same cities. Furthermore, we alert that some related factors may increase the risk of genotoxicity, such as residence location and time, and living and food habits. Finally, we suggest the need for continuous biomonitoring of the population, as well as for investing in health promotion in these vulnerable populations.

Musculoskeletal disorders and their influence on the quality of life of the dockworker: A cross-sectional study.

BACKGROUND: Dockworkers are subjected to intense physical labor which leads to frequent occurrence of musculoskeletal disorders. OBJECTIVE: This study aims to measure the prevalence of work-related musculoskeletal disorders (WMSD) of temporary dockworkers and its influence on their quality of life. METHODS: This was a cross-sectional study developed with temporary dockworkers in Brazil. Recruitment was done by inviting workers when they presented themselves for work at the trade union. The Nordic Musculoskeletal Questionnaire and the Short-Form Health Survey were used. The association between the outcome and the different investigated factors was analyzed through Poisson Regression with robust variance. The Mann-Whitney test was used to compare the data from the Short-Form Health Survey scale among the groups both with and without work-related musculoskeletal disorders. RESULTS: The sample was composed of 318 temporary dockworkers with a mean age of 48 years. WMSD prevalence was 37.4%. WMSD was associated with not practicing physical activity (PR = 2.03; p = 0.005), participation in housework (PR = 1.88; p = 0.029), taking care of preschool children (PR = 1.65; p <  0.000) and handling heavy objects (PR = 1.83; p = 0.007). The lumbar spine was the most frequently mentioned area of the body (22.5%) in the WMSD analysis. Workers without WMSD had higher (p <  0.00) quality of life scale scores in relation to functional capacity, physical and social aspects, pain and vitality. CONCLUSIONS: The results highlight the relevance of developing action plans regarding the needs of this specific population of workers, especially concerning the reduction of risk factors.

Antinociceptive and anti-inflammatory effects of cellular and extracellular extracts from microalga Chlamydomonas pumilioniformis on mice

Microalga species have attracted interest as a source of bioactive compounds with several pharmacological activities. Previous studies reported that microalgae from the genus Chlamydomonas have anti-inflammatory and antioxidant properties. In this study, antinociceptive and anti-inflammatory activities of two extracts from microalga Chlamydomonas pumilioniformis were investigated. Cellular and extracellular extracts were prepared from a 14 day-batch culture in WC medium at the end of exponential growth and their carbohydrate contents were determined. Antinociceptive effects of extracts were evaluated by writhing and formalin-induced nociception tests, while the anti-inflammatory activity was analyzed by formalin-induced paw edema in mice. The analysis of dissolved carbohydrates detected amounts of 90 and 20 µg mL-1 of total carbohydrate in cellular and extracellular extracts, respectively. Cellular extract was mainly composed of glucose, but with significant proportions of arabinose, galactose and mannose and/or xylose and minor ones of fucose, rhamnose, amino sugars and uronic acids. Extracellular extract was composed of a similar proportion of glucose, galactose and mannose/xylose, besides significant ones of arabinose, fucose and galacturonic acid. Intraperitoneal administration of extracts significantly reduced writhing response in mice. In the formalin test, the extracellular extract inhibited both formalin phases, while the cellular extract was only effective in the late phase. Furthermore, extracts reduced the formalin-induced paw edema. In sum, we showed, for the first time, that C. pumilioniformis can be an important source of polysaccharides with anti-inflammatory and antinociceptive effects.