ABSTRACT
This study describes the use of pesticides mixtures and their potential association with comet assay results in 223 rice field workers in Colombia. Thirty-one pesticides were quantified in blood, serum, and urine (15 organochlorines, 10 organophosphorus, 5 carbamates, and ethylenethiourea), and the comet assay was performed. Twenty-four (77.42%) pesticides were present in the workers. The use of the maximum-likelihood factor analysis identified 8 different mixtures. Afterwards, robust regressions were used to explore associations between the factors identified and the comet assay. Two groups of mixtures--α-benzene hexachloride (α-BHC), hexachlorobenzene (HCB), and ß-BHC (ß: 1.21, 95% confidence interval [CI]: 0.33-2.10) and pirimiphos-methyl, malathion, bromophos-methyl, and bromophos-ethyl (ß: 11.97, 95% CI: 2.34-21.60)--were associated with a higher percentage of DNA damage and comet tail length, respectively. The findings suggest that exposure to pesticides varies greatly among rice field workers.
Subject(s)
Agriculture , DNA Damage/drug effects , Occupational Exposure/adverse effects , Oryza , Pesticides/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Carbamates/adverse effects , Carbamates/analysis , Colombia , Comet Assay , Cross-Sectional Studies , Ethylenethiourea/adverse effects , Ethylenethiourea/analysis , Female , Humans , Hydrocarbons, Chlorinated/adverse effects , Hydrocarbons, Chlorinated/analysis , Male , Middle Aged , Occupational Exposure/analysis , Organophosphorus Compounds/adverse effects , Organophosphorus Compounds/analysis , Pesticides/blood , Young AdultABSTRACT
Objetivo: Caracterizar la calidad técnica de los servicios que en el área de medicina del trabajo ofertan las instituciones prestadoras de servicios de salud ocupacional (IPSSO) en las principales ciudades del país. Métodos: Corresponde a un estudio descriptivo de corte transversal (2009-2010) de cobertura nacional (15 ciudades) en el que mediante la aplicación de una encuesta diagnóstica se obtuvo información de 192 Instituciones Prestadoras de Servicios de Salud Ocupacional (IPSSO). Resultados: El estudio evidenció que el 74,7 % de las IPSSO cuentan con licencia vigente para la prestación de servicios en el área de medicina del trabajo, que la oferta de servicios se realiza sobre la base de la subcontratación tanto de profesionales como de equipos y que el uso de las guías de atención integral en salud ocupacional basadas en la evidencia (GATISO), es muy incipiente. Conclusiones: Se identificaron, entre otras, deficiencias técnicas, administrativas, de gestión, de infraestructura y de personal, que afectan la calidad de los servicios de medicina del trabajo ofertados por las IPSSO, las cuales no permiten asegurar que se estén estudiando a profundidad y con suficiencia los efectos de los factores de riesgo en la salud de los trabajadores.
Objective: Characterizing the technical quality of occupational medicine services being provided by occupational health supply providing institutions (OHSPI) in Colombia’s main cities. Materials and Methods: This was a national descriptive cross-sectional study (2009- 2010) in which a diagnostic survey was used for obtaining data regarding 192 OHSPI. Results: The study demonstrated that 76 % of the OHSPI had a license for offering occupational medicine services. Institutions provide services by subcontracting professionals and the necessary equipment. It also revealed infrequent use of integral attention for evidence-based occupational health guidelines (EBOHG). Conclusion: Deficiencies affecting the quality of occupational medicine services were identified. Such deficiencies hampered in-depth studies about the effects of the risk factors on workers’ health, meaning that monitoring and controlling occupational health care services offered by the OHSPI must be reinforced to assure the availability of resources and the execution of disease prevention programs to maintain and improve workers’ state of health.
Subject(s)
Humans , Occupational Health Services/standards , Quality of Health Care , Colombia , Cross-Sectional StudiesABSTRACT
OBJECTIVE: Characterizing the technical quality of occupational medicine services being provided by occupational health supply providing institutions (OHSPI) in Colombia's main cities. MATERIALS AND METHODS: This was a national descriptive cross-sectional study (2009- 2010) in which a diagnostic survey was used for obtaining data regarding 192 OHSPI. RESULTS: The study demonstrated that 76 % of the OHSPI had a license for offering occupational medicine services. Institutions provide services by subcontracting professionals and the necessary equipment. It also revealed infrequent use of integral attention for evidence-based occupational health guidelines (EBOHG). CONCLUSION: Deficiencies affecting the quality of occupational medicine services were identified. Such deficiencies hampered in-depth studies about the effects of the risk factors on workers' health, meaning that monitoring and controlling occupational health care services offered by the OHSPI must be reinforced to assure the availability of resources and the execution of disease prevention programs to maintain and improve workers' state of health.