Epidemiologic investigation of an occupational illness of tobacco harvesters in southern Brazil, a worldwide leader in tobacco production.

OBJECTIVES: As part of smoking surveillance, the authors conducted an epidemiologic investigation in southern Brazil to identify the occurrence of Green Tobacco Sickness and risk factors for illness and to recommend control and prevention measures. METHODS: A 1:2 case-control study matched by subjects' smoking habits. The study population was residents of Candelária, Rio Grande do Sul state, who farm tobacco and provided a urine sample for cotinine measurement by high-performance liquid chromatography. Confirmed cases were persons with compatible clinical presentation (headache, nausea, vomit, dizziness or weakness) and cotinine level >10 ng/ml. Controls were persons without compatible signs or symptoms. The association measure was the matched OR with 95% CIs and p<0.05. RESULTS: Of 33 confirmed cases, 64% were men, average age was 33 years (SD ± 11.8 years) and 57% were landowners. Cases have had similar illness in the past and were likelier to be workers hired by farmers-landowners than controls. Multivariate analysis yielded independent association between these variables and illness, controlled for age and sex. Contact with pesticides and working with wet tobacco leaves were not associated with illness. CONCLUSIONS: The authors confirmed Green Tobacco Sickness in southern Brazil; the authors recommend investigation of its prevalence in tobacco-growing regions and monitoring of and education about the disease and its prevention by occupational health authorities.

Monitoring of risk and protective factors for chronic non communicable diseases by telephone survey in Brazilian State Capitals, 2008.

OBJECTIVE: To estimate the prevalence of protective and risk factors for the most important chronic non communicable diseases in all Brazilian capitals, including the Federal District. METHODS: Data used were collected in 2008 through VIGITEL, an ongoing population-based telephone survey surveillance system implemented in all Brazilian State capitals since 2006. In 2008, over 54,000 interviews were completed over the phone with a random sample of individuals living in all 27 capitals. RESULTS: The analyses showed differences in the prevalence of determinants of chronic diseases by demographic characteristics such as gender, age and schooling. Men were more likely to be current smokers, overweight, and consumers of soft drinks, fatty meat and alcohol. They were also more likely to be more active in leisure. Women reported being more likely to eat healthy, but also were more likely to have a physician diagnosis of high blood pressure, dyslipidemia, osteoporosis and overall poor health status. In general, the prevalence of risk factors studied increased with decreasing levels of schooling. DISCUSSION: The VIGITEL system was implemented to monitor changes in the prevalence of determinants of chronic diseases over time to inform public health workers and decision makers to adjust existing programs and policies according to the changing profile of consumers. The ultimate goal is to improve the health of the Brazilian population.