Prevalence of congenital malformations from 2015 up to 2019, in Rondônia (RO), Amazon, Brazil / Prevalência de malformações congênitas entre 2015 e 2019 em Rondônia (RO), Amazônia, Brasil

Abstract Objectives: to determine and characterize the prevalence of congenital malformations among live births in Rondônia, from 2015 to 2019. Methods: an ecological study was conducted using publicly available data at Sistema de Informações sobre Nascidos Vivos collected in January 2021. The prevalence of congenital malformation and possible associations were calculated. The strength of the association between variables was measured using the odds ratio. Variables that were statistically significant at the 5% level were selected for adjusted odds ratio calculation using logistic regression models. The R programming language was used for all analyses and interactions with the database. A 95% confidence interval was considered. Results: a total of 1,110 records were analyzed. The overall prevalence of congenital malformation was 8.36, with higher rates observed among mothers over 35 years, those with low educational levels, unmarried status, and preterm birth. Infants with low birth weight and low Apgar scores also had higher prevalence rates of congenital malformations. Conclusion: the prevalence of congenital malformations in the state was similar to the national average, but regional disparities were observed and warrant further investigation.

Resumo Objetivos: determinar e caracterizar a prevalência de malformações congênitas entre nascidos vivos em Rondônia, no período de 2015 a 2019. Métodos: estudo ecológico, com dados públicos disponíveis no Sistema de Informações sobre Nascidos Vivos coletados em janeiro de 2021. Foi calculada a prevalência das malformações e as possíveis associações. A força de associação entre as variáveis foi medida pela razão de odds. Aquelas variáveis consideradas estatisticamente significante ao nível de 5% foram selecionadas para o cálculo de razão de odds ajustada, usando modelo de regressão logística. A linguagem de programação R foi usada para todas as análises e interação com o banco de dados. O Intervalo de Confiança considerado foi de 95%. Resultados: foram analisados 1.110 registros. A prevalência geral de malformação congênita foi de 8,36, sendo maior entre mães com idade acima de 35 anos, baixa escolaridade, solteiras, com partos prematuros; crianças com baixo peso ao nascer e baixos escores de Apgar. Conclusão: a prevalência de malformação congênita no estado foi próxima da nacional, mas houve discrepâncias entre as regiões de saúde que merecem uma investigação futura.

Conhecimentos, atitudes e práticas de agricultores familiares brasileiros sobre a exposição aos agrotóxicos / Knowledge, attitudes and practices of the Brazilian family farmers on exposure to pesticides

Resumo O artigo discute conhecimentos, atitudes e práticas (CAP) de agricultores familiares brasileiros a respeito dos impactos na saúde e no ambiente gerados pelo uso de agrotóxicos. Trata-se de um estudo transversal misto, realizado em 2014 em São José de Ubá, RJ. A pesquisa é composta por uma etapa qualitativa, baseada em observações em campo e entrevistas com 25 participantes sobre CAP, no que se refere ao uso de agrotóxicos. A etapa quantitativa abrange avaliação sociodemográfica e de exposição aos agrotóxicos de 78 agricultores. Apesar de reconhecerem parcialmente os perigos dos agrotóxicos, os agricultores enfrentam os riscos da exposição e comumente adotam práticas laborais inadequadas. Fatores como a carência de apoio técnico e treinamento laboral, baixa escolaridade, dificuldade de compreensão das orientações de bulas e rótulos dos agrotóxicos, valor elevado e desconforto causado pelo equipamento de proteção individual (EPI), além da crença da dependência do uso de agrotóxicos, explicam parcialmente as atitudes não seguras. É preciso promover práticas agrícolas mais sustentáveis, fortalecer o apoio técnico e treinamento laboral, melhorar a comunicação e o gerenciamento dos riscos e reduzir as desigualdades de gênero entre os agricultores brasileiros, como a forma mais eficaz e imediata de prevenir os agravos relacionados ao trabalho com agrotóxicos.

Abstract This paper discusses the knowledge, attitudes, and practices (KAP) of the Brazilian family farmers regarding the impact of pesticides on health and the environment. This mixed cross-sectional study was conducted in 2014 in São José de Ubá, Rio de Janeiro. It encompasses two stages: a qualitative one, based on field observations and interviews with 25 participants on KAP about the use of pesticides; and a quantitative one, assessing sociodemographic data and exposure to pesticides among 78 farmers. Despite partially recognizing the danger of pesticides, farmers face the risks of exposure and usually adopt inappropriate work practices. Lack of technical support and occupational training, low schooling, difficulty in understanding the instructions on pesticides labels and package inserts, high price and discomfort caused by the use of Personal Protective Equipment (PPE), and the belief in the need for using pesticides, partially explain the unsafe attitudes. Effective and immediate prevention of pesticides-related injuries and diseases requires promoting more sustainable agricultural practices, strengthening technical support and occupational training, improving communication and pesticides risk management, and reducing gender inequalities among the Brazilian farmers.

Occupational exposure to pesticides and health symptoms among family farmers in Brazil

ABSTRACT OBJECTIVE: To explore the association of occupational pesticide exposure with acute and mental health symptoms. METHODS: Cross-sectional survey carried out with 78 Brazilian family farmers, who were pesticide applicators and helpers conveniently selected. Symptoms and exposure data were collected by interviews, and mental health outcomes by the Self-Reporting Questionnaire. Blood samples were analyzed to assess cholinesterase levels. Exposure indicators and symptoms were compared between applicators and helpers, and Poisson regression was performed to estimate prevalence ratios. RESULTS: Farmers reported exposure to multiple pesticides from early ages; they worked without safety training, technical support, and full protective equipment, and they had a high prevalence of acute and mental health symptoms (e.g., headache, mucosal irritation, tachycardia, and depressive signs). Applicators had more cholinesterase changes than helpers, but less symptoms. Helpers used less personal protection and had significantly higher prevalence ratio of headache, dyspnea, wheezing, cough, poor digestion, tiredness, and feeling worthless, after adjustment. CONCLUSIONS: Acute and mental health symptoms were observed, both among farmers and helpers. Thus, surveillance actions must be reinforced in Brazil, technical support and safety training improved, focused on applicators and helpers, who are occupationally and environmentally exposed to pesticides. Agricultural practices of these groups with less pesticide use should receive incentive.