Misreporting of Energy Intake Is Related to Specific Food Items in Low-Middle Income Chilean Adolescents.

BACKGROUND: Misreporting of energy intake (EI) in self-reported dietary assessment is inevitable, and even less is known about which food items are misreported by low-middle income adolescents. We evaluated the prevalence of misreporting of energy intake and its relationship with nutrients and food intake. METHODS: We analyzed 24 h dietary recalls collected from 576 adolescents (52.08% boys) from southeastern Santiago. Anthropometrics measurements and information about sociodemographic characteristics were obtained during clinical visits. The method proposed by McCrory et al. was used to identify under-reporters (UnRs), over-reporters (OvRs), or plausible reporters (PRs). Food items were collapsed into 28 categories and every food item was expressed as a percentage of total EI. Logistic regression models were performed to investigate the factors associated with misreporting, and a two-part model was used to estimate the difference in the percentage of EI between UnRs versus PRs, and OvRs versus PRs in each food item. RESULTS: Half of the participants were classified as UnRs and 9% were OvRs. UnR was higher among boys (62%) and adolescents with overweight and obesity (72%). OvR was higher among adolescents with normal weight. UnRs had a lower intake of energy from cookies/cake, chocolate/confectionery, and a higher intake of vegetables and eggs than PRs. OvRs had a higher intake of cookies/cake, chocolate/confectionery, and a lower intake of fruit, white milk, and yogurt than PRs. CONCLUSIONS: A high frequency of UnR among boys and participants with excess weight was found in this study. Healthy and unhealthy foods are reported differently between UnRs and OvRs of energy intake, indicating that bias is specific for some food items that adolescents commonly eat.

Data management plan for a community-level study of the hidden burden of cutaneous leishmaniasis in Colombia.

OBJECTIVES: Cutaneous leishmaniasis is a vector-borne parasitic disease whose lasting scars can cause stigmatization and depressive symptoms. It is endemic in remote rural areas and its incidence is under-reported, while the effectiveness, as opposed to efficacy, of its treatments is largely unknown. Here we present the data management plan (DMP) of a project which includes mHealth tools to address these knowledge gaps in Colombia. The objectives of the DMP are to specify the tools and procedures for data collection, data transfer, data entry, creation of analysis dataset, monitoring and archiving. RESULTS: The DMP includes data from two mobile apps: one implements a clinical prediction rule, and the other is for follow-up and treatment of confirmed cases. A desktop interface integrates these data and facilitates their linkage with other sources which include routine surveillance as well as paper and electronic case report forms. Multiple user and programming interfaces are used, as well as multiple relational and non-relational database engines. This DMP describes the successful integration of heterogeneous data sources and technologies. However the complexity of the project meant that the DMP took longer to develop than expected. We describe lessons learned which could be useful for future mHealth projects.

Under-Reporting of COVID-19 Cases Among Indigenous Peoples in Brazil: A New Expression of Old Inequalities.

Objective: To estimate the incidence, mortality and lethality rates of COVID-19 among Indigenous Peoples in the Brazilian Amazon. Additionally, to analyze how external threats can contribute to spread the disease in Indigenous Lands (IL). Methods: The Brazilian Amazon is home to nearly half a million Indigenous persons, representing more than 170 ethnic groups. As a pioneer in heading Indigenous community-based surveillance (I-CBS) in Brazil, the Coordination of the Indigenous Organizations of the Brazilian Amazon (COIAB) started to monitor Indigenous COVID-19 cases in March of 2020. Brazil's Ministry of Health (MOH) was the main source of data regarding non-Indigenous cases and deaths; to contrast the government's tally, we used the information collected by I-CBS covering 25 Special Indigenous Sanitary Districts (DSEI) in the Brazilian Amazon. The incidence and mortality rates of COVID-19 were calculated using the total number of new cases and deaths accumulated between the 9th and 40th epidemiological weeks. We studied (a) the availability of health care facilities to attend to Indigenous Peoples; (b) illegal mines, land grabbing, and deforestation to perform a geospatial analysis to assess how external threats affect Indigenous incidence and mortality rates. We used the Generalized Linear Model (GLM) with Poisson regression to show the results. Results: MOH registered 22,127 cases and 330 deaths, while COIAB's survey recorded 25,356 confirmed cases and 670 deaths, indicating an under-reporting of 14 and 103%, respectively. Likewise, the incidence and mortality rates were 136 and 110% higher among Indigenous when compared with the national average. In terms of mortality, the most critical DSEIs were Alto Rio Solimões, Cuiabá, Xavante, Vilhena and Kaiapó do Pará. The GLM model reveals a direct correlation between deforestation, land grabbing and mining, and the incidence of cases among the Indigenous. Conclusion: Through this investigation it was possible to verify that not only the incidence and mortality rates due to COVID-19 among Indigenous Peoples are higher than those observed in the general population, but also that the data presented by the federal government are underreported. Additionally, it was evident that the presence of illegal economic activities increased the risk of spreading COVID-19 in ILs.

Estimation of COVID-19 Under-Reporting in the Brazilian States Through SARI.

Due to its impact, COVID-19 has been stressing the academy to search for curing, mitigating, or controlling it. It is believed that under-reporting is a relevant factor in determining the actual mortality rate and, if not considered, can cause significant misinformation. Therefore, this work aims to estimate the under-reporting of cases and deaths of COVID-19 in Brazilian states using data from the InfoGripe. InfoGripe targets notifications of Severe Acute Respiratory Infection (SARI). The methodology is based on the combination of data analytics (event detection methods) and time series modeling (inertia and novelty concepts) over hospitalized SARI cases. The estimate of real cases of the disease, called novelty, is calculated by comparing the difference in SARI cases in 2020 (after COVID-19) with the total expected cases in recent years (2016-2019). The expected cases are derived from a seasonal exponential moving average. The results show that under-reporting rates vary significantly between states and that there are no general patterns for states in the same region in Brazil. The states of Minas Gerais and Mato Grosso have the highest rates of under-reporting of cases. The rate of under-reporting of deaths is high in the Rio Grande do Sul and the Minas Gerais. This work can be highlighted for the combination of data analytics and time series modeling. Our calculation of under-reporting rates based on SARI is conservative and better characterized by deaths than for cases.

Under-reporting of the energy intake in patients with type 2 diabetes.

BACKGROUND: In patients with type 2 diabetes mellitus (DM), an accurate assessment of food intake is essential for clinical nutritional management. Tools such as the food frequency questionnaire (FFQ) and 24-h food record (24HR) identify dietary habits in support of dietary planning. However, it is possible that these tools have reporting errors with respect to assessing food intake, particularly energy intake (EI). METHODS: A cross-sectional study was conducted in patients with type 2 DM. EI was assessed by the FFQ and 24HR tools. Resting energy expenditure (REE) was measured by indirect calorimetry. Data were analysed using a kappa test, t-test and Spearman's correlation coefficients. Under-reporting was assessed using the EI/REE ratio. Patients with values <1.18 and <1.10 for FFQ and 24HR, respectively, were considered as under-reporting. RESULTS: We evaluated 55 patients [mean (SD) 62.7 (5.3) years old, duration of diabetes 11.2 (7.3) years, 52.7% female]. The mean (SD) EI assessed by FFQ was 1797.7 (641.3) and as assessed by 24HR was 1624 (484.8) kcal day-1 . The mean (SD) REE was 1641.3 (322.3) kcal day-1 . The mean (SD) ratios FFQ/REE and 24HR/REE were 1.11 (0.38) and 1.01 (0.30), respectively. The tools showed a moderate agreement for under-reporting of EI (kappa = 0.404; P = 0.003). Moderate and positive correlations between REE were observed with FFQ (r = 0.321; P = 0.017) and 24HR (r = 0.364; P = 0.006). According to the tools, the under-reporting was observed in approximately 65% of patients. CONCLUSIONS: The majority of patients with type 2 DM under-reported their calorie intake, as assessed by FFQ and 24HR. REE showed a positive correlation with both tools.

Bayesian modeling of COVID-19 cases with a correction to account for under-reported cases.

The novel of COVID-19 disease started in late 2019 making the worldwide governments came across a high number of critical and death cases, beyond constant fear of the collapse in their health systems. Since the beginning of the pandemic, researchers and authorities are mainly concerned with carrying out quantitative studies (modeling and predictions) overcoming the scarcity of tests that lead us to under-reporting cases. To address these issues, we introduce a Bayesian approach to the SIR model with correction for under-reporting in the analysis of COVID-19 cases in Brazil. The proposed model was enforced to obtain estimates of important quantities such as the reproductive rate and the average infection period, along with the more likely date when the pandemic peak may occur. Several under-reporting scenarios were considered in the simulation study, showing how impacting is the lack of information in the modeling.

Estimation and prediction for a mechanistic model of measles transmission using particle filtering and maximum likelihood estimation.

Disease incidence reported directly within health systems frequently reflects a partial observation relative to the true incidence in the population. State-space models present a general framework for inferring both the dynamics of infectious disease processes and the unobserved burden of disease in the population. Here, we present a state-space model of measles transmission and vaccine-based interventions at the country-level and a particle filter-based estimation procedure. Our dynamic transmission model builds on previous work by incorporating population age-structure to allow explicit representation of age-targeted vaccine interventions. We illustrate the performance of estimators of model parameters and predictions of unobserved states on simulated data from two dynamic models: one on the annual time-scale of observations and one on the biweekly time-scale of the epidemiological dynamics. We show that our model results in approximately unbiased estimates of unobserved burden and the underreporting rate. We further illustrate the performance of the fitted model for prediction of future disease burden in the next one to 15 years.

The under-reporting of energy intake influences the dietary pattern reported by obese women in the waiting list for bariatric surgery / A subnotificação do consumo energético influencia os resultados de padrão alimentar relatado por mulheres obesas na fila de espera para cirurgia bariátrica

ABSTRACT Objective To verify the interference of the energy intake under-reporting in the determination of the dietary patterns and nutrient intakes reported by obese women in the waiting list for bariatric surgery. Methods The study included 412 women aged 20 to 45 years with a body mass index ranging from 35 to 60kg/m2 who were on waiting list for bariatric surgery. Data from three reported food intake and physical activity, body weight, and height were used for estimating the reported energy intake, physical activity level, and resting energy expenditure. Subsequently, it was checked the biological plausibility of the reported energy intakes, classifying all participants as plausible reporters or under-reporters. Exploratory factor analysis was used to determine the participants' dietary patterns. The Mann-Whitney test assessed the reported energy and nutrient intakes between plausible reporters and under-reporters groups. The Z-test assessed the variables of plausible reporters or under-reporters in relation to all participants of the study. Results Six dietary patterns were determined for all participants of study. After excluding information from under-reporting women, only two dietary patterns remained similar to those of all participants, while three other dietary patterns presented different conformations from food subgroups to plausible reporters. The reported energy intake did not present difference for the subgroups of fruits, leaf vegetables and vegetables. However, the energetic value reported for the other food subgroups was higher for the plausible reporters. Conclusion The under-reporting of energy intake influenced the determination of dietary patterns of obese women waiting for bariatric surgery.

RESUMO Objetivo Esta pesquisa buscou verificar a interferência da subnotificação do consumo energético na determinação do padrão alimentar e consumo de nutrientes, relatados por mulheres obesas na fila de espera para cirurgia bariátrica. Métodos Participaram do estudo 412 mulheres com idade entre 20 e 45 anos e índice de massa corporal entre 35 e 60 kg/m2, que aguardavam na fila de espera de cirurgia bariátrica. Foram utilizadas informações de três registros do consumo alimentar, da atividade física de 24 horas e do peso corporal e altura, para estimativa da Ingestão Energética Relatada, Nível de Atividade Física e Gasto Energético de Repouso das participantes e subsequente verificação da plausibilidade biológica do consumo energético. As mulheres foram agrupadas em notificadoras plausíveis e subnotificadoras. A análise fatorial exploratória foi utilizada para classificar os padrões alimentares. Os valores relatados de energia e nutrientes entre os grupos de notificadoras plausíveis e subnotificadoras foram avaliados por meio do teste de Mann-Whitney. O Teste de hipótese Z avaliou as variáveis das notificadoras plausíveis ou subnotificadoras em relação a todas as participantes do estudo. Resultados Seis padrões alimentares foram determinados para todas as participantes do estudo. Após excluir as informações das mulheres subnotificadoras, apenas dois padrões alimentares mantiveram-se similares aos de todas as participantes, ao passo que outros três padrões alimentares apresentaram diferentes conformações de subgrupos alimentares para as notificadoras plausíveis. A ingestão energética relatada não apresentou diferença para os subgrupos das frutas, hortaliças e legumes. Porém, o valor energético relatado para os demais subgrupos alimentares foi maior para as notificadoras plausíveis. Conclusão A subnotificação do consumo energético influenciou a determinação de padrões alimentares de mulheres obesas na lista de espera para cirurgia bariátrica.

Vital registration and under-reporting of maternal mortality in Jamaica.

OBJECTIVE: To identify why vital registration under-reports maternal deaths in Jamaica. METHODS: A cross-sectional study was undertaken to identify all maternal deaths (during pregnancy or ≤42 days after pregnancy ended) occurring in 2008. Data sources included vital registration, hospital records, forensic pathology records, and an independent maternal mortality surveillance system. Potential cases were cross-referenced to registered live births and stillbirths, and hospital records to confirm pregnancy status, when the pregnancy ended, and registration. Medical certificates were inspected for certification, transcription, and coding errors. Maternal mortality ratios (MMRs) for registered and/or unregistered deaths were calculated. RESULTS: Of 50 maternal deaths identified, 10 (20%) were unregistered. Eight unregistered deaths were coroners' cases. Among 40 registered deaths, pregnancy was undocumented in 4 (10%). Among the other 36, 24 (67%) had been misclassified (59% direct and 89% indirect deaths). Therefore, only 12 (30%) registered maternal deaths had been coded as maternal deaths, yielding an MMR of 28.3 per 100 000 live births (95% confidence interval [CI] 12.3-48.3), which was 76% lower than the actual MMR of 117.8 (95% CI 85.2-150.4). CONCLUSION: Under-reporting of maternal deaths in Jamaica in 2008 was attributable to delayed registration of coroners' cases and misclassification. Timely registration of coroners' cases and training of nosologists to recognize and code maternal deaths is needed.

Under-reporting of food intake and body fatness in independent older people: a doubly labelled water study.

BACKGROUND: there are no accurate methods for the assessment of food intake in older populations, under-reporting of intake being highly prevalent. There is controversy about which dietary assessment method and what person's characteristics are associated with greater under-reporting rates. OBJECTIVE: to assess the correlation between under-reporting of energy intake (EI) and different percentages of body fat in independent older people. DESIGN: cross-sectional study. SETTTING: area assisted by the Family Health Program of the Ribeirão Preto Medical School, University of São Paulo, Brazil. SUJECTS: one hundred volunteers aged 60-70 years. METHODS: all volunteers had their body composition assessed by dual-energy x-ray absorptiometry. In second phase, 41 volunteers were evaluated, representing the four quartiles of fat percentage. Total energy expenditure (TEE) was measured by the doubly labelled water method, and EI was assessed by 24-h recalls and a food frequency questionnaire (FFQ). TEE and EI values, EI-to-TEE ratios and EI-TEE values were compared. RESULTS: TEE was 2,220 ± 601 kcal, while the EI was 1,919 ± 602 kcal (24-h recall) and 2,119 ± 670 kcal (FFQ). The proportion of under-reporters was 31 and 40.5%, respectively. Under-reporting was more frequent in subjects with higher percentage of body fat and in females (P < 0.05). CONCLUSION: under-reporting was more frequent among older persons with higher percentage of body fat in both methods of assessment of food intake. Older persons follow the same profile of under-reporting as younger adults.

Accuracy of self-reported weight and height in women from Bogotá, Colombia.

AIM: To identify correlates of bias in self-reported anthropometry among reproductive-aged Colombian women and to correct overweight/obesity and obesity prevalence based on self-reported data using two calibration techniques. SUBJECTS AND METHODS: Self-reported and objectively measured anthropometry were obtained from 597 women aged 21-55 years from Bogotá, Colombia. This study identified correlates of reporting bias (self-reported minus measured anthropometry) by examining its distribution across categories of sociodemographic characteristics, objectively measured anthropometry and body shape perception using linear regression. Next, weight status misclassification was assessed using self-reported anthropometry. Finally, multivariable linear regression and ROC curves were used to calibrate weight status misclassification from self-reported data; these techniques were applied in half of the study population and validated in the remaining half. RESULTS: Women under-estimated weight by 2.0 ± 5.0 kg and over-estimated height by 0.6 ± 4.0 cm. Correlates of bias included objectively measured anthropometry and marital status. Self-reported BMI yielded spuriously low prevalences of overweight/obesity and obesity. The ROC approach effectively corrected overweight/obesity prevalence, while the regression method provided a more accurate estimate of obesity prevalence. CONCLUSIONS: Bias in self-reported anthropometry varied with respect to objectively measured anthropometry and sociodemographic characteristics. BMI from self-reported anthropometry under-estimates overweight/obesity and obesity prevalence; calibration methods can effectively correct reporting bias.

Pharmacovigilance in oncology: pattern of spontaneous notifications, incidence of adverse drug reactions and under-reporting

The high toxicity and narrow therapeutic window of antineoplastic agents makes pharmacovigilance studies essential in oncology. The objectives of the current study were to analyze the pattern of spontaneous notifications of adverse drug reactions (ADRs) in oncology patients and to analyze the incidence of ADRs reported by outpatients on antineoplastic treatment in a tertiary care teaching hospital. To compose the pattern of ADR, the notification forms of reactions in oncology patients in 2010 were reviewed, and the reactions were classified based on the drug involved, mechanism, causality, and severity. To evaluate the incidence of reactions, a questionnaire at the time of chemotherapy was included, and the severity was classified based on the Common Terminology Criteria. The profiles of the 10 responses reported to the Pharmacovigilance Sector were type B, severe, possible, and they were primarily related to platinum compounds and taxanes. When the incidence of reactions was analyzed, it was observed that nausea, alopecia, fatigue, diarrhea, and taste disturbance were the most frequently reported reactions by oncology patients, and the grade 3 and 4 reactions were not reported. Based on this analysis, it is proposed that health professionals should be trained regarding notifications and clinical pharmacists should increasingly be brought on board to reduce under-reporting of ADRs.

Estudos de farmacovigilância são imprescindíveis em oncologia, pois os antineoplásicos possuem alta toxicidade e estreita janela terapêutica. Os objetivos deste estudo foram analisar o perfil das notificações espontâneas de reações adversas a medicamentos (RAM) em pacientes oncológicos e a incidência de RAM ao tratamento antineoplásico em um hospital terciário e universitário. Para compor o perfil de RAM, revisaram-se os formulários de notificação de reações em pacientes oncológicos do ano de 2010 e classificaram-se as reações conforme o medicamento envolvido, mecanismo, causalidade e gravidade. Para avaliar a incidência de reações, aplicou-se um questionário no momento da quimioterapia e a gravidade foi classificada pelos Critérios Comuns de Toxicidade. Apenas 10 reações foram notificadas ao Setor de Farmacovigilância, cujo perfil encontrado foi tipo B, grave, possível, e foram principalmente relacionadas aos compostos de platina e taxanos. Na análise da incidência das reações, observou-se que náusea, alopecia, fadiga, diarreia e distúrbio do paladar foram as reações mais frequentes relatadas por pacientes oncológicos, e as reações grau 3 e 4 não foram notificadas. De acordo com essas análises, propõe-se que os profissionais da saúde sejam treinados quanto às notificações e que farmacêuticos clínicos sejam cada vez mais inseridos neste contexto para redução da subnotificação de RAM.

Avaliação de estratégia para identificação e mensuração dos acidentes de trabalho fatais / Evaluation of the strategy for identification and measurement of the fatal accidents at work

Objetivando avaliar a estratégia da Secretaria Municipal de Saúde de Belo Horizonte (SMSA/BH) na redução do sub-registro de mortes por acidentes de trabalho de 2008 a 2010, realizou-se relacionamento determinístico de dados de mortes por acidentes de trabalho notificadas no SINAN e no SIM. Como estratégia complementar ao relacionamento determinístico foram analisadas as Fichas de Investigação e as Declarações de Óbito nas quais se suspeitava tratar-se de mortes por acidentes de trabalho, porém elas não estavam declaradas. O óbito por acidente de trabalho era confirmado quando se tratava do mesmo acidentado, mesmo acidente, com nexo temporal entre o acidente e o óbito. A estratégia complementar utilizada na SMSA permitiu reduzir a sub-registro identificado pelo relacionamento determinístico, com incremento de 45 mortes. Evidenciou-se maior sub-registro de óbitos no SINAN (n = 117) do que no SIM (n = 70). Conclui-se que o relacionamento de dados SIM/SINAN é uma estratégia necessária para redução da sub-registro das mortes por acidentes de trabalho. Porém, consideradas as limitações ainda presentes nos dois sistemas o relacionamento de dados não é suficiente e que a estratégia complementar adotada na SMSA/BH - simples e de fácil execução, tem bons resultados.

In order to evaluate the strategy used by the Municipal Health Department of Belo Horizonte (SMSA/BH) for reducing the under-reporting of deaths from work-related accidents during the years of 2008 to 2010, a deterministic comparison of data on deaths from work-related accidents as reported in SINAN and SIM was conducted. As a complementary strategy to the deterministic comparison, the Investigation Data Sheets and Death Certificates were analyzed, which although not clearly declared, were suspected of involving death by work-related accident. Death from work accident was confirmed when the same victim, same accident, with a temporal connection between accident and death, were matched. The complementary strategy used by SMSA reduced the under-reporting identified by deterministic linking, with an increase of 45 deaths. Higher rates of under-reporting of deaths in the SINAN (n = 117) were found than in the SIM (n = 70). Although data linkage between SIM/SINAN is a necessary strategy to reduce the under-reporting of deaths from accidents, it is still insufficient, considering the limitations still present in both systems. The complementary strategy adopted by SMSA/BH, which is simple and easy to perform, yields good results.

Estudo da subnotificação dos casos de Aids em Alagoas (Brasil), 1999-2005 / Study of the under-reporting of Aids cases in Alagoas (Brazil), 1999-2005

A subnotificação dos casos de Aids dificulta e até mesmo impossibilita o planejamento de ações para o controle da epidemia. Este estudo foi realizado com o objetivo de verificar a subnotificação dos casos de Aids no período de 1999 a 2005 em Alagoas. Analisaram-se as declarações de óbito (DO) por Aids, registradas no Sistema de Informação sobre Mortalidade (SIM) comparando-as com o Sistema de Informação de agravos de notificação (Sinan), utilizando a técnica de relacionamento entre bancos de dados em Alagoas. O percentual de subnotificação no período foi de 12,4 por cento. Entre os 49 óbitos estudados, 67 por cento (33) ocorreram no sexo masculino e 33 por cento (16) no feminino, observando-se uma razão entre os sexos de 2:1. Com relação à escolaridade, 4,08 por cento (2) e 6,12 por cento (3) estavam relacionadas às faixas de 1 a 3 e de 4 a 7 anos de estudo, respectivamente. A faixa etária que apresentou o maior número de óbitos foi entre 20 e 49 anos, tanto no sexo feminino (11; 68,7 por cento) como no masculino (23; 69,6 por cento). A subnotificação revelada pela diferença entre óbitos por Aids registrados no SIM e ausentes no Sinan como casos da doença alerta para a necessidade de serem implementadas políticas públicas dirigidas ao problema.

The under-reporting of Aids (Acquired Immune Deficiency Syndrome) cases makes it difficult and even impossible to plan means to control the epidemic. This study aims to check out the under-reporting of Aids cases from 1999 to 2005 in Alagoas (Brazil). The deaths certificates causes by Aids stored at the Mortality Data System (SIM) in comparison to the Data System of Notification Diseases (Sinan), has been analyzed using the technique of relationship between these two data systems in Alagoas. According to the study, the proportion of under-reporting of Aids cases during this period was of 12.4 percent. Among the 49 deaths studied, 67 percent (33) were men and 33 percent (16) were women configuring a gender rate of 2:1. As to education level, 4,08 percent (2) and 6,12 percent (3) of the deaths by Aids were of people having 1 to 3 and from 4 to 7 years of study, respectively. The age group that presented the largest number of deaths was from 20 to 49 years old, either female (11; 68,7 percent) or male gender (23; 69,6 percent). The comparison between the Mortality Data System and Data System for Disease Notification revealed a high proportion of under-reporting of deaths by Aids, stressing the need for a specific public policy on the matter.

Um breve estudo acerca do cotidiano do trabalho de produtores rurais: intoxicações por agrotóxicos e subnotificação / A brief study on the rural producers daily routines: poisoning by pesticides and under-reporting

Pesquisas na área da Saúde no Trabalho têm revelado a preocupação com os agravos à saúde de trabalhadores rurais decorrentes da utilização de defensivos agrícolas. Diante disso, este estudo objetivou conhecer o cotidiano de trabalho de produtores rurais de uma cooperativa agrícola localizada no interior do estado de São Paulo, bem como avaliar a exposição deles quando da utilização de agrotóxicos no desenvolvimento de suas atividades. Esperamos, com base nos resultados, estar contribuindo com discussões sobre o tema relacionado à saúde dos trabalhadores no contexto considerado. Para coleta de dados,utilizamos entrevistas semi-estruturadas, aplicadas de formas individual e coletiva.Participaram do estudo cinqüenta produtores rurais que desenvolvem atividades nas lavouras de café, soja, trigo e milho. Os dados foram agrupados em cinco categorias e analisados qualitativamente. Os resultados expõem as características da atividade agrícola na região, a utilização dos equipamentos de proteção individual, as técnicas no uso dos agrotóxicos, o sofrimento psíquico e a produção rural e maneiras de lidar com as situações de intoxicação e alertar os órgãos competentes para o problema da subnotificação.

The harmful effects of pesticides on the rural workers health have been causing concern within the Occupational Health area. Due to this fact, our research aims not only at getting acquainted with the rural producers daily routine in an agricultural co-operative society located in the countryside of São Paulo, but also at evaluating the amount of pesticide they are exposed to while carrying out their tasks. We hope the results will offer a contribution to the discussions on this issue. The data was collected through semi-structured interviews conducted either individually, or in groups. Fifty coffee, soy, wheat and corn producers were researched. The resulting datum were classified in five categories and analyzed qualitatively. They show the features of the rural activities in the area, the use of Personal Protective Equipment, the different techniques in applying pesticides, psychological damages, rural production, ways of dealing with poisoning and warning the involved governmental and non-governmental organizations about under-reporting.

Acidentes de trabalho referidos por trabalhadores moradores em área urbana no interior do Estado de Säo Paulo em 1994 / Referred work related accidents in workers resident in an urban area of the interior of the State of São Paulo in 1994

O presente artigo apresenta alguns dos resultados de um inquérito domiciliar realizado para estudo das condições de vida da população residente em áreas urbanas de municípios com mais de 80.000 habitantes do interior do Estado de São Paulo. Os resultados aqui apresentados referem-se à prevalência e a algumas características de acidentes de trabalho ocorridos em um ano. Foram informados 41,20 acidentes de trabalho por 1.000 trabalhadores ocupados. Destes, 34,93 foram acidentes típicos e 6,28 foram acidentes de trajeto. As taxas de prevalência são analisadas com relação a características demográficas (sexo e idade) e socioeconômicas (renda, escolaridade e posição na ocupação) dos trabalhadores e também a condições de trabalho (atividade, vínculo, jornada, desgaste e estressores). Discute-se ainda a subnotificação de acidentes de trabalho comparando-se as informações de acidentes para os quais houve a emissão de CAT com os demais. Para os assalariados do setor formal a subnotificação atinge 42% e para a população economicamente ativa, como um todo, chega a 71%.

The present article introduces some of the results of a domiciliary survey designed to study the life conditions of the resident population of urban areas of São Paulo interior districts with more than 80.000 inhabitants, in 1994. A prevalence rate of 41.2 work accidents per 1.000 employed workers was estimated. The prevalence rates for typical work accidents and itinerary accidents were of 34.93 and 6.28 per 1.000 employed workers, respectively. The prevalence rates were analyzed with relation to demographic (sex and age) and socioeconomic (income, education and position in the occupation) characteristics of the workers as well as, for work conditions (activity, entail, hours work per day, waste and stressors). Under reporting of work accidents are discussed based on accident information for which there was the emission of CAT, with other information sources. For formal employees the under reporting reaches 42% and for the economically active population as a whole, it reaches 71%.