Cytotoxic and oxidative changes in individuals occupationally exposed to recyclable municipal solid waste.

aste collectors are exposed to a wide variety of bacteria, endotoxins, fungi, allergens, particulate matter, irritating inhalants, and vehicle exhaust, making them more prone to development of chronic diseases. Although several studies described the impact of occupational exposure on the overall health of waste collectors, few investigations were conducted regarding cellular and molecular changes that may occur due to exposure. The aim of this study was to assess biomarkers of oxidative stress such as levels of reactive oxygen species (ROS), lipoperoxidation, total antioxidant capacity (TAC), apoptosis, butyrylcholinesterase (BChE) activity and mitochondrial function (MitoTrackerTM Green FM and MitoTrackerTM Red) using the peripheral blood from individuals occupationally exposed to recyclable solid waste in Southern Brazil. The study included 30 waste collectors and 30 control individuals, who did not perform activities with recognized exposure to biological and chemical substances. Waste collectors were found to exhibit in peripheral blood leukocytes (PBL) higher rates of apoptosis, increased production of ROS, and reduced mitochondrial membrane potential (MMP), associated with decreased total antioxidant capacity (TAC) and elevated activity of BChE in plasma. Therefore, evidence indicates that cytotoxicity, oxidative stress, and inflammatory responses may be involved in the multiplicity of adverse health outcomes related to contaminant exposure in waste collectors. It is thus necessary to implement and/or improve occupational health programs aimed at workers as well as mandatory inspections for the use of personal protective equipment.

Avaliação da satisfação dos usuários das farmácias do sistema público de saúde / User satisfaction assessment in pharmacies of the public health system / Evaluación de la satisfacción de los usuarios de las farmacias del sistema público de salud

Objetivo: Avaliar o acesso aos medicamentos e o grau de satisfação dos usuários de farmácias públicas do município de Ijuí, Rio Grande do Sul. Métodos: Trata-se de um estudo observacional, transversal, analítico, de abordagem quantitativa, realizado com usuários das farmácias de 14 unidades de saúde do município em estudo, selecionados aleatoriamente na sala de espera das unidades durante os meses de janeiro e fevereiro de 2013. A coleta de dados aconteceu na unidade de saúde através de questionário semiestruturado, com perguntas referentes a aspectos socioeconômicos, condições de saúde, uso do serviço de saúde e medicamentos. Mensurou-se a satisfação com nota de zero a dez, e os dados foram analisados pelos testes de Mann-Whitney, ANOVA e Kruskal-Wallis. Resultados: Participaram 134 usuários, sendo 75,4%(n=101) do sexo feminino e idade média de 48,95±16,28 anos. A maioria (n=89 - 66,4%) dos participantes relatou fazer uso contínuo de medicamentos, 54,5% (n=73) informou acessar todos os medicamentos na farmácia da respectiva unidade e, na falta destes, 74,6% (n=100) informaram comprá-lo. O principal problema apontado nas farmácias foi a falta de medicamentos (n=50 - 37,3%), seguida pelo atendimento e a falta de recursos humanos (n=17 - 12,6%). A satisfação média com os serviços ofertados pela farmácia foi de 8,7 ±1,5. Verificou-se maior satisfação entre os participantes de menor escolaridade, que têm acesso aos medicamentos e as dúvidas esclarecidas. Conclusão: Os resultados indicam satisfação com os serviços prestados, porém os achados reportam insuficiência no acesso aos medicamentos e necessidade de efetiva qualificação da assistência farmacêutica para a garantia do acesso ao tratamento, com qualidade e resolutividade.

Objective: To assess the access to medicines and the level of satisfaction in users of public pharmacies in the municipality of Ijuí, Rio Grande do Sul. Methods: Quantitative observational and analytical cross-sectional study conducted with users of pharmacies from 14 health care centers who were randomly selected in the waiting room in January and February 2013. Data were collected using a semi-structured questionnaire on socioeconomic aspects, health conditions, and use of health services and medicines. Satisfaction was measured by a score of zero to 10. Data were analyzed using the Mann-Whitney, ANOVA and Kruskal-Wallis tests. Results: Participants were 134 users: 75.4% (n=101) of them were women and mean age was 48.95 ± 16.28 years. Most (n=89 - 66.4%) of the participants reported long term use of medicines, 54.5% (n=73) reported access to all the medicines in the pharmacy of the center, and 74.6% (100) reported buying the medicine if the pharmacy was out of them. The main problem identified was the lack of medicines (n=50 - 37.3%), followed by service and lack of human resources (n=17 - 12.6%). Mean satisfaction with the services was 8.7 ± 1.5. Greater satisfaction was found in those with lower levels of education, those who have access to medicines and those who have their doubts clarified. Conclusion: There is satisfaction with the services provided; however, the findings highlight the poor access to medicines and the need for effective qualification of the pharmaceutical services provided to ensure access to treatment with quality and problem-solving capacity.

Objetivo: Evaluar la accesibilidad a los medicamentos y el grado de satisfacción de los usuarios de las farmacias públicas del municipio de Ijuí/Rio Grande do Sul. Métodos: Se trata de un estudio observacional, transversal, analítico y de abordaje cuantitativo realizado con los usuarios de las farmacias de 14 unidades de salud del municipio del estudio elegidos de manera aleatoria en la sala de espera de las unidades durante los meses de enero y febrero de 2013. La recogida de datos se dio en la unidad de salud a través de un cuestionario semi estructurado con preguntas sobre los aspectos socioeconómicos, las condiciones de salud, el uso del servicio de salud e los medicamentos. La satisfacción fue medida de cero a diez. Los datos fueron analizados por las pruebas de Mann-Whitney, la ANOVA y la de Kruskal-Wallis. Resultados: Participaron 134 usuarios siendo el 75,4%(n=101) del sexo femenino con edad media de 48,95±16,28 años. La mayoría (n=89 - 66,4%) de los participantes ha relatado el uso continuo de medicamentos, el 54,5% (n=73) informó que tuvo la accesibilidad a los medicamentos en la farmacia de la respectiva unidad y que, en su ausencia, el 74,6% (n=100) los compraba. El principal problema de las farmacias fue la falta de medicamentos (n=50 - 37,3%), seguida de la atención y la falta de recursos humanos (n=17 - 12,6%). La satisfacción media con los servicios ofrecidos por la farmacia fue de 8,7 ±1,5. Se verificó más satisfacción entre los participantes con menos escolaridad que tienen el acceso a los medicamentos y que tuvieron sus dudas aclaradas. Conclusión: Los resultados indican la satisfacción con los servicios ofrecidos, sin embargo, los hallazgos señalan la insuficiencia para el acceso a los medicamentos y la necesidad de una efectiva cualificación de la atención farmacéutica para garantizar el acceso al tratamiento de calidad y la solución del problema.