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.

Conteúdo energético do leite humano administrado em recém nascidos prematuros / Energy content of human milk administered to premature newborns / Contenido energético de la leche humana administrada a recién nacidos prematuros

Objetivo: avaliar e comparar o conteúdo energético do leite humano cru e do leite humano processado de recém-nascidos pré-termo. Método: foram coletadas 68 amostras de leite por meio de ordenha manual e o processamento foi realizado no Banco de Leite Humano. O valor energético foi obtido por meio de cálculos matemáticos específicos. Resultados: foram analisadas 32 amostras de leite humano cru e 28 de leite humano pasteurizado. O percentual médio de creme foi de 3,84±1,3% e mediana de 4,5 % no leite pasteurizado, e no cru de 8,9±4,6% e 8,53%. A média e mediana do conteúdo energético do leite cru foi de 78,91±15,46 kcal/100 ml e 81,07 kcal/100 ml e no leite pasteurizado 65,18±9,67 kcal/ 100 ml e 61,8 kcal/100 ml. Conclusão: o leite humano cru possui percentual de gordura e conteúdo energético maior do que o pasteurizado, mas este ainda é recomendado devido seus benefícios protetores.

Objective: to evaluate and compare the energy content of raw human milk and processed human milk from preterm newborns. Method: 68 milk samples were collected by hand milking and processing was carried out at the Human Milk Bank. The energy value was obtained through specific mathematical calculations. Results: 32 samples of raw human milk and 28 of pasteurized human milk were analyzed. The average percentage of cream was 3.84±1.3% and a median of 4.5% in pasteurized milk, and in raw milk, 8.9±4.6% and 8.53%. The mean and median energy content of raw milk was 78.91±15.46 kcal/100 ml and 81.07 kcal/100 ml and in pasteurized milk 65.18 ± 9.67 kcal/100 ml and 61.8 kcal/100 ml. Conclusion: raw human milk has a higher percentage of fat and energy content than pasteurized milk, but it is still recommended due to its protective benefits.

Objetivo: evaluar y comparar el contenido energético de la leche humana cruda y la leche humana procesada de recién nacidos prematuros. Método: Se recolectaron 68 muestras de leche por ordeño manual y el procesamiento se realizó en el Banco de Leche Humana. El valor energético se obtuvo mediante cálculos matemáticos específicos. Resultados: se analizaron 32 muestras de leche humana cruda y 28 de leche humana pasteurizada. El porcentaje medio de nata fue 3,84±1,3% y una mediana de 4,5% en leche pasteurizada, y en leche cruda 8,9±4,6% y 8,53%. El contenido energético medio y mediano de la leche cruda fue de 78,91±15,46 kcal/100 ml y 81,07 kcal/100 ml y de la leche pasteurizada de 65,18±9,67 kcal/100 ml y 61,8 kcal/100 ml. Conclusión: la leche humana cruda tiene un mayor porcentaje de contenido graso y energético que la leche pasteurizada, pero aun así es recomendada por sus beneficios protectores.

Tin speciation in the blood plasma of workers occupationally exposed in a cassiterite ore processing industry / Especiação de estanho no plasma sanguíneo de trabalhadores expostos ocupacionalmente em uma indústria de processamento de minério de cassiterita

ABSTRACT Mining is a high-risk activity due to its dangerous processes. Tin (Sn) is obtained from cassiterite ore and mining activities expose workers to the metal. Chronic exposure to Sn may cause pneumoconiosis, gastrointestinal and hematological effects, among others. This work aimed to assess the exposure of workers to tin in a cassiterite ore processing industry, using the speciation analysis in blood plasma. Twelve subjects donated the blood samples; six were occupationally exposed to Sn. Size exclusion chromatography separated proteins in blood plasma; a graphite furnace atomic absorption spectrometer determined total tin in the plasma and eluted fractions, while SDS-PAGE determined molecular masses of proteins. Tin levels in the workers' plasma were four times higher than in the reference individuals. After fractionation, the metal only appeared in the total inclusion volume, not being possible to confirm the binding of tin to proteins, which certainly modifies their functions and impair workers' health. Despite that, the work process needs to change since Sn levels in the workers' plasma pointed to metal exposure. Further works are necessary to clarify whether the metal is free or bound to small proteins in blood plasma and understand the true impact of tin on workers' health.

RESUMO A mineração é uma atividade de alto risco devido aos seus processos perigosos. O estanho (Sn) é obtido do minério de cassiterita e as atividades da mineração expõem os trabalhadores ao metal. A exposição crônica ao Sn pode causar pneumoconiose, gastrointestinal e hematológica entre outros efeitos. Este trabalho avaliou a exposição de trabalhadores ao estanho em uma indústria de processamento de minério de cassiterita, utilizando a análise de especiação no plasma sanguíneo. Doze indivíduos doaram amostras de sangue, sendo seis expostos ocupacionalmente ao Sn. A SEC separou as proteínas do plasma sanguíneo, a GFAAS determinou a concentração total de estanho no plasma sanguíneo e frações eluídas, enquanto o SDS-PAGE determinou as massas moleculares das proteínas. O plasma dos trabalhadores apresentou níveis quatro vezes maiores do que os indivíduos de referência. Após fracionamento, Sn só apareceu no volume de inclusão, não sendo possível confirmar sua ligação às proteínas. Contudo, o processo de trabalho precisa mudar, pois os níveis de Sn no plasma dos trabalhadores apontam para exposição ao metal. Outros trabalhos são necessários para esclarecer se o metal está livre ou ligado a pequenas proteínas do plasma e entender o verdadeiro impacto do estanho na saúde dos trabalhadores.

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.

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.

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.

Data relating neurodevelopment of exclusively breastfed children of urban mothers and pre- and post-natal mercury exposure.

A cohort of 100 exclusively breastfed children was formed to study association between neurodevelopment and Hg exposure [1]. Detailed questionnaires were administered by trained interviewers to the mothers, and measurements of early child development were collected at 6, 36 and 60 months by trained nurses and psychologists using the Gesell Developmental Schedules. The association between prenatal and postnatal organic Hg (methyl-Hg from fish consumption and ethyl-Hg from Thimerosal-containing vaccine) exposures with Gesell scores of the four domains [Adaptive ability, Language development, Motor abilities (gross motor), and Personal-social ability] were studied in preschool children.

Data on pesticide exposure and mental health screening of family farmers in Brazil.

This dataset is part of a risk assessment project that evaluated the human health effects of pesticide exposure in São José de Ubá, State of Rio de Janeiro. This region is one of the greatest tomato producers in Brazil, and pest control is commonly based on the use of pesticides. We interviewed 78 smallholder family farmers about sociodemographic characteristics, pesticide use and exposure, assessed blood cholinesterase as biomarkers (n = 70), and screened all participants for probable common mental disorders through the Self-Reporting Questionnaire (SRQ-20).

Maternal mercury exposure and neuro-motor development in breastfed infants from Porto Velho (Amazon), Brazil.

Fish is an important item in the diet of Amazonians, and per se is their best single source of essential nutrients. Rapid urbanization and migration are bringing changes in dietary habits of Amazonians. Exposure to fish-Hg during pregnancy and lactation were studied in 100 women and newborns from Porto Velho. Tissue-Hg concentrations and neurodevelopment (Gesell Developmental Schedules) were assessed at birth and at 6 months in exclusively breastfed infants. Maternal mean frequency of fish consumption was low (<2 meals/week; range 0->7 meals/week) compared to Amazonian standards. Women consuming <2 fish meals/week showed less median hair-Hg (3.5 microgg-1) than women that consumed 2 fish meals/week (5.7 microgg). Median total Hg in maternal hair (5.4 microgg-1) was higher than in newborns (1.6 microgg-1). Significant correlation was observed between maternal hair-Hg and infant hair-Hg at birth (r=0.353; p<0.01) and at six months (r=0.510; p<0.01). Placenta-Hg was also significantly correlated to maternal hair-Hg (r=0.321; p<0.01), newborn hair-Hg (r=0.219; p<0.05), maternal blood-Hg (r=0.250; p<0.01) and to umbilical cord-Hg (r=0.857; p<0.01). Most infants (74%) had normal Gesell Schedules but among the 26% showing neuro-motor development delays only six (7%) had multiple (motor, language, and adaptative) delays. The infants with multiple delays were born from mothers with range of hair-Hg comparable to mothers of normally developed infants. Coincidentally, mothers of infants with multiple delays also showed the lowest range of income and level of education. Fish consumption, income, and level of education varied greatly among these breastfeeding urban mothers. It seems that development delays of exclusively breastfed infants are a component of the health inequalities that accompanies socioeconomic disadvantages.