Seroprevalence of SARS-CoV-2 antibodies in schoolchildren in the city of São Paulo, 2020.

OBJECTIVE: To estimate seroprevalence of SARS-CoV-2 antibodies in schoolchildren aged 4 to 14 years living in the city of São Paulo, according to clinical, demographic, epidemiological, and social variables, during the school closure period as a measure against covid-19 spread. METHODS: A serological survey was made in September 2020 with a random sample stratified by school system (municipal public, state public and private) type. A venous blood sample was collected using the Wondfo SARS-CoV-2 Antibody Test (lateral flow method) for detection of total SARS-CoV-2 virus antibodies. Semi-structured questionnaires were applied to collect clinical, demographic, social, and epidemiological data. RESULTS: Seroprevalence of SARS-CoV-2 antibodies in schoolchildren was of 16.6% (95%CI 15.4-17.8). The study found higher seroprevalence in the municipal (18.5%; 95%CI 16.6-20.6) and state (16.2%; 95%CI 14.4-18.2) public school systems compared to the private school system (11.7; 95%CI 10.0-13.7), among black and brown students (18.4%; 95%CI 16.8-20.2) and in the most vulnerable social stratum (18.5 %;95%CI 16.9-20.2). Lower seroprevalence was identified in schoolchildren who reported following the recommended protective measures against covid-19. CONCLUSION: Seroprevalence of SARS-CoV-2 antibodies is found mainly in the most socially vulnerable schoolchildren. This study can contribute to support public policies that reinforce the importance of suspending face-to-face classes and developing strategies aimed at protective measures and monitoring of the serological status of those who have not yet been included in the vaccination schedule.

Genomic analysis of fluoroquinolone-resistant Leclercia adecarboxylata carrying the ISKpn19-orf-qnrS1-ΔIS3-blaLAP-2 module in a synanthropic pigeon, Brazil.

OBJECTIVES: The aim of this study was to perform a genomic investigation of a multiple fluoroquinolone-resistant Leclercia adecarboxylata strain isolated from a synanthropic pigeon in São Paulo, Brazil. METHODS: Whole-genome sequencing was performed using an Illumina platform, and in silico deep analyses of the resistome were performed. Comparative phylogenomics was conducted using a global collection of publicly available genomes of L. adecarboxylata strains isolated from human and animal hosts. RESULTS: L. adecarboxylata strain P62P1 displayed resistance to human (norfloxacin, ofloxacin, ciprofloxacin, and levofloxacin) and veterinary (enrofloxacin) fluoroquinolones. This multiple quinolone-resistant profile was associated with mutations in the gyrA (S83I) and parC (S80I) genes and the presence of the qnrS gene within an ISKpn19-orf-qnrS1-ΔIS3-blaLAP-2 module, previously identified in L. adecarboxylata strains isolated from pig feed and faeces in China. Genes associated with arsenic, silver, copper, and mercury resistance were also predicted. Phylogenomic analysis revealed clustering (378-496 single nucleotide polymorphism differences) with two L. adecarboxylata strains isolated from human and fish sources in China and Portugal, respectively. CONCLUSIONS: L. adecarboxylata is a Gram-negative bacterium of the Enterobacterales order and is considered an emergent opportunistic pathogen. Since L. adecarboxylata has adapted to human and animal hosts, genomic surveillance is highly recommended, in order to identify the emergence and spread of resistant lineages and high-risk clones. In this regard, this study provides genomic data that can help clarify the role of synanthropic animals in the dissemination of clinically relevant L. adecarboxylata within a One Health context.

One health clones of multidrug-resistant Escherichia coli carried by synanthropic animals in Brazil.

WHO priority pathogens have disseminated beyond hospital settings and are now being detected in urban and wild animals worldwide. In this regard, synanthropic animals such as urban pigeons (Columba livia) and rodents (Rattus rattus, Rattus norvegicus and Mus musculus) are of interest to public health due to their role as reservoirs of pathogens that can cause severe diseases. These animals usually live in highly contaminated environments and have frequent interactions with humans, domestic animals, and food chain, becoming sentinels of anthropogenic activities. In this study, we report genomic data of Escherichia coli strains selected for ceftriaxone and ciprofloxacin resistance, isolated from pigeons and black rats. Genomic analysis revealed the occurrence of international clones belonging to ST10, ST155, ST224 and ST457, carrying a broad resistome to beta-lactams, aminoglycosides, trimethoprim/sulfamethoxazole, fluoroquinolones, tetracyclines and/or phenicols. SNP-based phylogenomic investigation confirmed clonal relatedness with high-risk lineages circulating at the human-animal-environmental interface globally. Our results confirm the dissemination of WHO priority CTX-M-positive E. coli in urban rodents and pigeons in Brazil, highlighting potential of these animals as infection sources and hotspot for dissemination of clinically relevant pathogens and their resistance genes, which is a critical issue within a One Health perspective.

Seroprevalence of SARS-CoV-2 antibodies in schoolchildren in the city of São Paulo, 2020 / Soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares no município de São Paulo, 2020

ABSTRACT OBJECTIVE To estimate seroprevalence of SARS-CoV-2 antibodies in schoolchildren aged 4 to 14 years living in the city of São Paulo, according to clinical, demographic, epidemiological, and social variables, during the school closure period as a measure against covid-19 spread. METHODS A serological survey was made in September 2020 with a random sample stratified by school system (municipal public, state public and private) type. A venous blood sample was collected using the Wondfo SARS-CoV-2 Antibody Test (lateral flow method) for detection of total SARS-CoV-2 virus antibodies. Semi-structured questionnaires were applied to collect clinical, demographic, social, and epidemiological data. RESULTS Seroprevalence of SARS-CoV-2 antibodies in schoolchildren was of 16.6% (95%CI 15.4-17.8). The study found higher seroprevalence in the municipal (18.5%; 95%CI 16.6-20.6) and state (16.2%; 95%CI 14.4-18.2) public school systems compared to the private school system (11.7; 95%CI 10.0-13.7), among black and brown students (18.4%; 95%CI 16.8-20.2) and in the most vulnerable social stratum (18.5 %;95%CI 16.9-20.2). Lower seroprevalence was identified in schoolchildren who reported following the recommended protective measures against covid-19. CONCLUSION Seroprevalence of SARS-CoV-2 antibodies is found mainly in the most socially vulnerable schoolchildren. This study can contribute to support public policies that reinforce the importance of suspending face-to-face classes and developing strategies aimed at protective measures and monitoring of the serological status of those who have not yet been included in the vaccination schedule.

RESUMO OBJETIVO Estimar a soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares de quatro a 14 anos de idade residentes no município de São Paulo, segundo variáveis clínicas, demográficas, epidemiológicas e sociais, durante o período de fechamento das escolas como medida de controle da covid-19. MÉTODOS Realizou-se um inquérito sorológico em setembro de 2020 com amostra aleatória estratificada por tipo de rede de ensino (pública municipal, pública estadual e privada). Foi coletada amostra de sangue venoso utilizando-se o teste de imunoensaio de fluxo lateral da fabricante Wondfo para detecção de anticorpos totais contra o vírus SARS-CoV-2. Aplicaram-se questionários semiestruturados para o levantamento de dados clínicos, demográficos, sociais e epidemiológicos. RESULTADOS A soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares foi de 16,6% (IC95% 15,4-17,8). O estudo encontrou soroprevalências mais elevadas na rede pública municipal (18,5%; IC95% 16,6-20,6) e estadual (16,2%; IC95% 14,4-18,2) em relação à rede privada (11,7; IC95% 10,0-13,7) e entre escolares da raça/cor preta e parda (18,4%; IC95% 16,8-20,2) e no estrato social mais vulnerável (18,5%; IC95% 16,9-20,2). A pesquisa identificou menores soroprevalências nos escolares que relataram seguir as medidas recomendadas de proteção contra a covid-19. CONCLUSÃO A soroprevalência de anticorpos contra o vírus SARS-CoV-2 atinge principalmente os escolares socialmente mais vulneráveis. Este estudo pode contribuir para embasar políticas públicas que reforcem a importância da suspensão das aulas presenciais e da necessidade de estratégias de medidas de proteção e acompanhamento do status sorológico daqueles que ainda não foram contemplados no calendário vacinal.

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020-2021.

OBJECTIVE: To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS: This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS: In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9-11.8%) to 25.0% (95%CI: 21.7-28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION: The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020-2021

ABSTRACT OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9-11.8%) to 25.0% (95%CI: 21.7-28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

Rodenticide efficacy in sewers in São Paulo, Brazil.

Rodents infest urban environments, causing damage and acting as vectors for disease transmission. Currently, anticoagulants are the most widely used chemical rodenticides, and their extensive and widespread use can contaminate the environment. To ensure effectiveness and avoid accumulation of rodent baits in the environment, it is important to evaluate how long rodent baits maintain their palatability and efficacy. In rodent control programs, rodent baits are placed in locations such as sewers, but after a few days, baits appear altered, causing doubts about the control efficacy. For this reason, baits are replaced periodically, which increases costs and generation of chemical waste. The objective of this study was to evaluate the palatability and efficacy of commercial paraffin-type rodent bait blocks placed in sewers in São Paulo City over a period of 90 days. Bait blocks were placed in sewers and collected after 30, 60, and 90 days. Additionally, in a laboratory two-choice test, wild-caught urban Norway rats were offered 40-60 g of bait and an equal volume of standard rat pellets. The amount of bait and rat pellet consumed was registered, the palatability was calculated, and the efficacy was measured as the percentage mortality over 14 days. The results showed that, even when they had an altered appearance, bait blocks remained palatable to the rats and were effective after at least 90 days. Leaving bait blocks for longer periods could be an effective strategy for reducing costs and could help to ensure the control of urban rodents in an environmentally sustainable way.

Suicide and meteorological factors in São Paulo, Brazil, 1996-2011: a time series analysis

Objective: Considering the scarcity of reports from intertropical latitudes and the Southern Hemisphere, we aimed to examine the association between meteorological factors and suicide in São Paulo. Method: Weekly suicide records stratified by sex were gathered. Weekly averages for minimum, mean, and maximum temperature (°C), insolation (hours), irradiation (MJ/m2), relative humidity (%), atmospheric pressure (mmHg), and rainfall (mm) were computed. The time structures of explanatory variables were modeled by polynomial distributed lag applied to the generalized additive model. The model controlled for long-term trends and selected meteorological factors. Results: The total number of suicides was 6,600 (5,073 for men), an average of 6.7 suicides per week (8.7 for men and 2.0 for women). For overall suicides and among men, effects were predominantly acute and statistically significant only at lag 0. Weekly average minimum temperature had the greatest effect on suicide; there was a 2.28% increase (95%CI 0.90-3.69) in total suicides and a 2.37% increase (95%CI 0.82-3.96) among male suicides with each 1 °C increase. Conclusion: This study suggests that an increase in weekly average minimum temperature has a short-term effect on suicide in São Paulo.

Suicide and meteorological factors in São Paulo, Brazil, 1996-2011: a time series analysis.

OBJECTIVE:: Considering the scarcity of reports from intertropical latitudes and the Southern Hemisphere, we aimed to examine the association between meteorological factors and suicide in São Paulo. METHOD:: Weekly suicide records stratified by sex were gathered. Weekly averages for minimum, mean, and maximum temperature (°C), insolation (hours), irradiation (MJ/m2), relative humidity (%), atmospheric pressure (mmHg), and rainfall (mm) were computed. The time structures of explanatory variables were modeled by polynomial distributed lag applied to the generalized additive model. The model controlled for long-term trends and selected meteorological factors. RESULTS:: The total number of suicides was 6,600 (5,073 for men), an average of 6.7 suicides per week (8.7 for men and 2.0 for women). For overall suicides and among men, effects were predominantly acute and statistically significant only at lag 0. Weekly average minimum temperature had the greatest effect on suicide; there was a 2.28% increase (95%CI 0.90-3.69) in total suicides and a 2.37% increase (95%CI 0.82-3.96) among male suicides with each 1 °C increase. CONCLUSION:: This study suggests that an increase in weekly average minimum temperature has a short-term effect on suicide in São Paulo.

Decrease in mortality rate and hospital admissions for acute myocardial infarction after the enactment of the smoking ban law in São Paulo city, Brazil.

BACKGROUND: Smoking restriction laws have spread worldwide during the last decade. Previous studies have shown a decline in the community rates of myocardial infarction after enactment of these laws. However, data are scarce about the Latin American population. In the first phase of this study, we reported the successful implementation of the law in São Paulo city, with a decrease in carbon monoxide rates in hospitality venues. OBJECTIVE: To evaluate whether the 2009 implementation of a comprehensive smoking ban law in São Paulo city was associated with a reduction in rates of mortality and hospital admissions for myocardial infarction. METHODS: We performed a time-series study of monthly rates of mortality and hospital admissions for acute myocardial infarction from January 2005 to December 2010. The data were derived from DATASUS, the primary public health information system available in Brazil and from Mortality Information System (SIM). Adjustments and analyses were performed using the Autoregressive Integrated Moving Average with exogenous variables (ARIMAX) method modelled by environmental variables and atmospheric pollutants to evaluate the effect of smoking ban law in mortality and hospital admission rate. We also used Interrupted Time Series Analysis (ITSA) to make a comparison between the period pre and post smoking ban law. RESULTS: We observed a reduction in mortality rate (-11.9% in the first 17 months after the law) and in hospital admission rate (-5.4% in the first 3 months after the law) for myocardial infarction after the implementation of the smoking ban law. CONCLUSIONS: Hospital admissions and mortality rate for myocardial infarction were reduced in the first months after the comprehensive smoking ban law was implemented.

Palatability and efficacy of bromadiolone rodenticide block bait previously exposed to environmental conditions.

BACKGROUND: In São Paulo city, rodent infestation is considered to be a serious public health problem and is the object of a municipal rodent control programme. One of the most important routine methods involves baiting in sewers, using bromadiolone block bait in a pulsed baiting strategy. It has been observed that, after each pulse, bait is not always consumed, and its appearance is altered, which has led to concerns about efficacy. We assessed whether exposure to sewer conditions influences the palatability and efficacy of rodenticide baits to Norway rats (Rattus norvegicus). Baits containing bromadiolone as active ingredient were placed in sewers, removed after 30 days and offered to rats in a two-choice food trial and a no-choice food trial. RESULTS: The appearance of the rodenticide baits changed after 30 days exposure to sewer conditions, but they continued to be palatable and effective against rats. The level of mortality was considered to be satisfactory, 75% in the two-choice food trial and 100% in the no-choice food trial. CONCLUSION: Results support the reuse of rodenticide block bait in rodent control. It seems to be justified to continue using/reuse baits even when their appearance has changed after 30 days exposure in sewer systems.

Análise de intervenção em séries temporais de dengue e leptospirose da cidade de São Paulo: influência de fatores políticos, administrativos, técnicos e ambientais / Intervention analysis in time series of dengue and leptospirosis of the city of São Paulo: political, administrative, technical and environmental factor impact

A dengue e a leptospirose estão entre as principais zoonoses de ocorrência no mundo. A primeira pelo elevado potencial epidêmico e a segunda pela alta letalidade. Na cidade de São Paulo, anualmente ocorrem dezenas de casos de leptospirose e centenas de casos de dengue, fazendo desses agravos alguns dos eventos de maior interesse da vigilância em saúde do município. Para melhor compreender o efeito de fenômenos climáticos e o impacto de medidas de prevenção e controle sobre a transmissão desses agravos ao longo do tempo, dois diferentes modelos estatísticos de estudo de séries temporais foram usados: 1) Função de Transferência, com erros dados por modelos ARIMA (ARIMAX), os quais foram modelados segundo a filosofia de Box-Jenkins e 2) Modelos Aditivos Generalizados (GAM) de regressão de Poisson, com estrutura de defasagem dada por funções polinômios PDL (Polynomial Distributed Lags). Os principais fatores climáticos associados ao aumento do número de casos de dengue na cidade de São Paulo foram a elevação da temperatura mínima do ar, dos níveis de precipitação pluviométrica, da densidade do vetor e a entrada de casos importados da doença, estimulada pelo feriado de carnaval. A chegada de frentes frias (temperatura < 16°C) e valores extremos de precipitação (<7mm ou > 70mm) reduzem o número de casos de dengue. Medidas de prevenção adotadas pelas equipes de vigilância em saúde do município também contribuem com a redução do número de casos. Os fatores associados ao aumento do número de casos de leptospirose foram o aumento da precipitação pluviométrica e da temperatura máxima do ar. O aumento das horas de brilho do sol reduz o número de casos. Os métodos adotados foram adequados aos objetivos do estudo e conseguiram captar as relações defasadas entre os fatores de interesse e a transmissão de dengue e de leptospirose na cidade de São Paulo. Tais técnicas também parecem adequadas como ferramentas a serem incorporadas à rotina da vigilância em...

Dengue and leptospirosis are among the major zoonosis of occurrence in the world; the first because of the epidemic potential and the second due to high lethality. In São Paulo, dozens of leptospirosis cases and hundreds of dengue fever cases are registered annually, being some of the most important events to the municipal public health surveillance system. To understand the effect of climatic conditions and the impact of measures of prevention and control over the transmission of such diseases in the time context, two time series approaches were used: 1) Transfer Functions, with ARIMA error structure (ARIMAX), modeled by Box-Jenkins methods and 2) Additive Generalized Models (GAM) of Poisson regressions, with time structure given by Polynomial Distributed Lags (PDL). The most important climatic factors that increased the number of cases of dengue fever in the city of São Paulo were the elevation in air temperature, precipitation, vector density and the number of imported cases, which increased after carnival holiday (an important calendar event). The arrival of cold fronts from the south (air temperature < 16°C) and extreme precipitations (< 7mm or >70mm) are factors that decrease the number of new dengue cases. The public health preventive interventions adopted by the municipality were effective in diminishing the dengue occurrence. The most important factors that increased the number of leptospirosis cases in São Paulo were elevation in maximum air temperature and precipitation. Largest amount of hours of sunshine decreased the number of new cases of leptospirosis. The methods used were adequate to the study objectives, the relations among the interest lagged factors and dengue and leptospirosis transmission in the city of São Paulo were satisfactorily modeled. Such techniques also seem appropriate as tools to be incorporated into the municipal health surveillance system, allowing the prediction of the number of future disease cases and understanding...

Condições urbanas e exposição dos trabalhadores sob aplicação de malationa 12 / Urban conditions and exposure of workers under malathion application

A cidade de São Paulo caracteriza-se pelo acentuado crescimento, o que favoreceu a formação de áreas com diferentes condições sociais, econômicas e ambientais. Várias doenças transmitidas por vetores apresentam frequências diferentes nos diversos sítios da cidade, mas o programa de controle de vetores é o mesmo para todos os locais. O controle do Aedes aegypti, mosquito vetor da dengue, envolve entre outras ações a realização de nebulização de malationa GT 96% em óleo de soja (1:2, v/v) quando há casos confirmados da doença. Durante o procedimento dois ou mais funcionários (batedores) informam os munícipes para sair de suas casas e retornarem após 15 minutos do término do procedimento e, então, o aplicador acompanhado do funcionário que atua como apoio entra nas residências e aplicam o inseticida. O produto é aplicado dentro da residência do caso positivo, na sua área externa e nas residências do entorno. Embora os locais sejam diferentes e o procedimento de nebulização seja o mesmo, não se sabe se as características urbanas podem influenciar a exposição dos funcionários. Assim, este trabalho avaliou a presença de malationa sobre as vestimentas dos funcionários em três diferentes locais. A área A era um local de baixo poder aquisitivo com casas pequenas ou assobradas com pouca ou nenhuma área externa. A área B se constituía em condomínios com prédios de até cinco andares onde foi nebulizado somente a garagem e o saguão do primeiro andar. E a área C era uma favela com edificações improvisadas e pequenas vielas.A e B eram áreas regulares com sistema viário e calçadas, mas C era um aglomerado de construções e barracos de madeira permeados por vielas. Em todas as áreas a atividade foi realizada em seis dias sob as mesmas condições climáticas Para avaliar a quantidade de malationa recebido durante a nebulização, oito absorventes higiênicos femininos foram colocados sobre a vestimenta do equipamento de proteção individual de cada funcionário. Após a nebulização, cada absorvente era removido e submetido à extração com 60 mL de hexano sob agitação mecânica por 30 min e os extratos analisados por cromatografia gasosa para detecção e quantificação do malationa. Nas áreas A e C não se observou diferença na quantidade de malationa nos absorventes do aplicador e do apoio, mas em B a quantidade de malationa foi maior. Por outro lado observou-se maior quantidade de malationa nos batedores no sítio. Os resultados permitiram concluir que as condições ambientais podem influenciar o grau de exposição dos funcionários.

Condições urbanas e exposição dos trabalhadores sob aplicação de malationa 12 / Urban conditions and exposure of workers under malathion application

A cidade de São Paulo caracteriza-se pelo acentuado crescimento, o que favoreceu a formação de áreas com diferentes condições sociais, econômicas e ambientais. Várias doenças transmitidas por vetores apresentam frequências diferentes nos diversos sítios da cidade, mas o programa de controle de vetores é o mesmo para todos os locais. O controle do Aedes aegypti, mosquito vetor da dengue, envolve entre outras ações a realização de nebulização de malationa GT 96% em óleo de soja (1:2, v/v) quando há casos confirmados da doença. Durante o procedimento dois ou mais funcionários (batedores) informam os munícipes para sair de suas casas e retornarem após 15 minutos do término do procedimento e, então, o aplicador acompanhado do funcionário que atua como apoio entra nas residências e aplicam o inseticida. O produto é aplicado dentro da residência do caso positivo, na sua área externa e nas residências do entorno. Embora os locais sejam diferentes e o procedimento de nebulização seja o mesmo, não se sabe se as características urbanas podem influenciar a exposição dos funcionários. Assim, este trabalho avaliou a presença de malationa sobre as vestimentas dos funcionários em três diferentes locais. A área A era um local de baixo poder aquisitivo com casas pequenas ou assobradas com pouca ou nenhuma área externa. A área B se constituía em condomínios com prédios de até cinco andares onde foi nebulizado somente a garagem e o saguão do primeiro andar. E a área C era uma favela com edificações improvisadas e pequenas vielas.A e B eram áreas regulares com sistema viário e calçadas, mas C era um aglomerado de construções e barracos de madeira permeados por vielas. Em todas as áreas a atividade foi realizada em seis dias sob as mesmas condições climáticas Para avaliar a quantidade de malationa recebido durante a nebulização, oito absorventes higiênicos femininos foram colocados sobre a vestimenta do equipamento de proteção individual de cada funcionário. Após a nebulização, cada absorvente era removido e submetido à extração com 60 mL de hexano sob agitação mecânica por 30 min e os extratos analisados por cromatografia gasosa para detecção e quantificação do malationa. Nas áreas A e C não se observou diferença na quantidade de malationa nos absorventes do aplicador e do apoio, mas em B a quantidade de malationa foi maior. Por outro lado observou-se maior quantidade de malationa nos batedores no sítio. Os resultados permitiram concluir que as condições ambientais podem influenciar o grau de exposição dos funcionários.