Gestational and Neonatal Outcomes in Cities in the Largest Coal Mining Region in Brazil.

Brazil has one of the largest mineral coal reserves in the world. More than 40% of this ore is in the Candiota Mine, in the extreme south of Brazil, which was previously identified as a hotspot of environmental pollution. In addition, an important part of Brazil's population suffers from socioeconomic vulnerability. Since there is no information on unfavorable gestational and neonatal outcomes associated with these problems, we conducted a cross-sectional study with 1950 mother-child binomials, aiming to evaluate the association between these outcomes and air pollution as well as socioeconomic, demographic and health variables in seven cities in the region. Of the total births, 11.6% were preterm and 9.5% of neonates had low birth weight (<2500 g). These conditions were also associated with skin color, previous abortions, birth type and prenatal care, as well as exposure to higher levels of coarse particulate matter (PM10) during the first trimester of pregnancy. Regarding air pollutants, although the daily limits for PM10 were exceeded on less than 5% of days, the annual average overtook the values proposed by WHO. Thus, we concluded that prematurity and low birth weight in this region are related to air pollution, and to socioeconomic variables and health care.

Lung function among residents from the largest coal region in Brazil.

Coal mining and burning activities in coal-fired power plants are among the most polluting activities in developing countries. In Brazil, the Candiota coal deposit concentrates 40% of the national mineral coal. Although, previous studies indicate several negative health outcomes to residents of this coal region, there is no information about lung function. Thus, this study aimed to evaluate lung function by spirometry among residents from the largest coal mining region of Brazil and its related factors. It was carried out a cross-sectional study with 300 male adults residing in four cities from this region. Socioeconomic, demographic, life style, and health conditions were collected through a structured questionnaire, and lung function was assessed by spirometry. Almost 18% of the residents have disorders in pulmonary function. There was significant statistical difference in the spirometry main parameters between the cities. Candiota city (host city of coal exploration activities) have the highest prevalence of obstructive ventilatory disorder. Curiously, upper economic class had significant higher risk of altered lung function (P<0.001), as well as inappropriate sewage destination (P<0.001). Residents of Candiota city had 20% higher risk of altered lung function. Regarding air quality, the PM10, SO2, and NO2 of the region were 20.6± 3.9, 7.0± 2.2, and 6.0± 1.6, respectively. Two air quality stations exceed the limit of 20 µg/m3 to PM10 proposed by Brazilian legislation and WHO, and three stations had PM10 quite close to the limit. This study points out the need for urgent action to protect residents from this coal mining region.

Maternal, neonatal and socio-economic factors associated with intellectual development among children from a coal mining region in Brazil.

Coal is the most aggressive energy sources in the environment. Several adverse outcomes on children's health exposure to coal pollutants have been reported. Pollutants from coal power plants adversely affect the intellectual development and capacity. The present study aimed to evaluate the intellectual development and associated factors among children living a city under the direct influence (DI) and six neighboring municipalities under the indirect influence (II) of coal mining activity in the largest coal reserve of Brazil. A structured questionnaire was completed by the child's guardian, and Raven's Progressive Color Matrices were administered to each child to assess intellectual development. A total of 778 children participated. In general, no significant difference was observed between the two cities. The DI city had better socioeconomic conditions than the II municipalities according to family income (< 0.001). The prevalence of children who were intellectually below average or with intellectual disabilities was 22.9%, and there was no significant difference (p > 0.05) between municipalities. In both unadjusted and adjusted analyses, intellectual development was associated with maternal age, marital situation and maternal education level, birth weight, breast feeding, frequent children's daycare, paternal participation in children's care and child growth. Living in the DI area was not associated with intellectual disability. The results suggest that socioeconomic conditions and maternal and neonatal outcomes are more important than environmental factors for intellectual development of children living in a coal mining area.

Blood markers among residents from a coal mining area.

Coal extraction and processing generate environmental contamination, which has several negative impacts on human health. Hematological and biochemical parameters are effective biomarkers of the exposure of a population to air pollutants. Thus, this study aimed to evaluate hematological and biochemical parameters in adult residents in a coal mining region in the largest national reserve in Brazil, as well as to investigate their relations with air quality. The study included three cities in the south of Brazil, which are located near an important power plant and coal mine. The air quality was analyzed by PM10, NOx, and SO2 at five air quality monitoring stations, socioeconomic and demographic characteristics were evaluated with a questionnaire, and biochemical parameters were assessed in blood samples. The mean PM10 in the study area was 19.18 µg/m3. The air quality varied among the five monitoring stations, and the Candiota station exceeded the reference limit by 63.3%. In general, participants had lived more than 10 years in the municipality and had hepatic and renal parameters within the reference values. A higher prevalence of alterations was found in hematological parameters (43.1%) and liver function (30%). Among the three cities, the population of Pedras Altas seems to have a greater impairment of the blood parameters evaluated. The only parameter that was correlated with PM10 was the hematocrit level (r = 0.33; P < 0.001).

Antinociceptive and anti-inflammatory effects of cellular and extracellular extracts from microalga Chlamydomonas pumilioniformis on mice

Microalga species have attracted interest as a source of bioactive compounds with several pharmacological activities. Previous studies reported that microalgae from the genus Chlamydomonas have anti-inflammatory and antioxidant properties. In this study, antinociceptive and anti-inflammatory activities of two extracts from microalga Chlamydomonas pumilioniformis were investigated. Cellular and extracellular extracts were prepared from a 14 day-batch culture in WC medium at the end of exponential growth and their carbohydrate contents were determined. Antinociceptive effects of extracts were evaluated by writhing and formalin-induced nociception tests, while the anti-inflammatory activity was analyzed by formalin-induced paw edema in mice. The analysis of dissolved carbohydrates detected amounts of 90 and 20 µg mL-1 of total carbohydrate in cellular and extracellular extracts, respectively. Cellular extract was mainly composed of glucose, but with significant proportions of arabinose, galactose and mannose and/or xylose and minor ones of fucose, rhamnose, amino sugars and uronic acids. Extracellular extract was composed of a similar proportion of glucose, galactose and mannose/xylose, besides significant ones of arabinose, fucose and galacturonic acid. Intraperitoneal administration of extracts significantly reduced writhing response in mice. In the formalin test, the extracellular extract inhibited both formalin phases, while the cellular extract was only effective in the late phase. Furthermore, extracts reduced the formalin-induced paw edema. In sum, we showed, for the first time, that C. pumilioniformis can be an important source of polysaccharides with anti-inflammatory and antinociceptive effects.

Qualidade de vida do trabalhador portuário no Sul do Brasil: influência de agravos à saúde oriundos do meio laboral / Quality of life of dock workers in the Southern Brazil: influence of health problems from the workplace / La calidad de vida de los trabajadores portuarios en el Sur de Brasil: influencia de los problemas de salud derivados del entorno de trabajo

Objetivo: Avaliar a qualidade de vida de trabalhadores portuários identificando os fatores associados a esse desfecho.Métodos: Trata-se de um estudo transversal desenvolvido com 226 trabalhadores de estiva e de capatazia de um porto no sul do Brasil. A coleta ocorreu em 2014, abrangendo dados sobre qualidade de vida no trabalho (QVT), atividade física, estresse e sintomas osteomusculares relacionados ao trabalho; utilizando-se, respectivamente, o Questionário de Qualidade de Vida no Trabalho, o Questionário Internacional de Atividade Física, a Job Stress Scale e o Questionário Nórdico de Sintomas Osteomusculares. Resultados: Dos trabalhadores analisados, identificou-se 73% (n=165) com nível de estresse médio ou alto, 68,2% (n=154) com sobrepeso e/ou obesidade e 50% (n=113) com sintomas osteomusculares, sendo a região lombar a mais prevalente (31,9% - n=72). Este estudo mostrou associação do desfecho QVT com as variáveis independentes: idade, renda e sintomas osteomusculares relacionados ao trabalho. Encontrou-se a prevalência de 46% (n=104) para QVT desfavorável. O risco para o desfecho aumentou na presença de sintomas osteomusculares relacionados ao trabalho (RP=1,37) e, diminuiu gradativamente nas maiores faixas etárias: 45-59 anos (RP=0,70) e 60 anos ou mais (RP=0,53). Conclusão: Identificou-se a necessidade de uma intervenção no ambiente laboral portuário, sobretudo no que se refere aos sintomas osteomusculares que comprometem a qualidade de vida dos trabalhadores e no estímulo à adoção de hábitos de vida mais saudáveis. (AU)

Objective: To evaluate the quality of life of casual dock worker identifying the associated factors to this outcome. Methods: This was a cross-sectional study developed with 226 workers stevedore and capatazia of a port in southern Brazil. The collected data occurred in the year 2014, covering data on quality of working life (QWL), physical activity, stress and musculoskeletal symptoms related to work; using, respectively, the Quality of Life at Work Questionnaire, the International Physical Activity Questionnaire, the Job Stress Scale and the Nordic Questionnaire of Musculoskeletal Symptoms. Results: Of workers analyzed, 73% (n=165) were identified with medium or high level of stress, 68.2% (n=154) with overweight and/or obese and 50% (n=113) with musculoskeletal symptoms, being the lumbar region the most prevalent (31.9% - n=72). This study showed an association of quality of life outcome with the independent variables: age, income and musculoskeletal symptoms related to work. The prevalence of 46% (n=104) for unfavorable QWL was found. The risk for the outcome increased in the presence of musculoskeletal symptoms related to work (PR=1.37) and, gradually, decreasing in older age groups: 45-59 years (PR=0.70) and above 60 years (PR=0.53). Conclusion: It was identified the need of intervention in the port work environment, especially with regard to the musculoskeletal symptoms that compromise the quality of life of workers and encouraging the adoption of healthier lifestyles. (AU)

Objetivo: Evaluar la calidad de vida de los trabajadores portuarios temporales e identificar los factores asociados con esta variable de interés. Métodos: Se trata de un estudio transversal desarrollado con 226 trabajadores de estiba y muellaje de un puerto en el sur de Brasil. La recopilación ocurrió en 2014, abarcando datos sobre calidad de la vida laboral (CVL), actividad física, estrés y síntomas musculoesqueléticos relacionados con el trabajo; utilizando, respectivamente, el Cuestionario de Calidad de Vida en el Trabajo, el Cuestionario Internacional de Actividad Física, la Job Stress Scale y el Cuestionario Nórdico de los Síntomas Musculoesqueléticos. Resultados: De los trabajadores analizados, 73% (n=165) fueron identificados con nivel de estrés medio o elevado, 68,2% (n=154) tenían sobrepeso y/u obesidad y 50% (n=113) con síntomas musculoesqueléticos, con la región lumbar la más frecuente (31,9% - n=72). Este estudio mostró una asociación de la variable de interés CVL con las variables independientes: edad, renta y los síntomas musculoesqueléticos relacionados con el trabajo. La prevalencia de la CVL considerada desfavorable fue de 46% (n=104). El riesgo para la variable de interés aumentó en presencia de síntomas musculoesqueléticos relacionados con el trabajo (RP=1,37) y disminuyó gradualmente en grupos de mayor edad: 45-59 años (RP=0,70) y 60 o más años (RP=0,53). Conclusión: Se identificó la necesidad de una intervención en el ambiente de trabajo portuario, especialmente con respecto a los síntomas musculoesqueléticos que comprometen la calidad de vida de los trabajadores y en el estímulo de la adopción de estilos de vida más saludables. (AU)

Association between DNA damage, dietary patterns, nutritional status, and non-communicable diseases in coal miners.

Several negative health effects have been associated with environmental pollution. Coal mining activities are related to DNA damage. However, the impact of lifestyle as well as environmental exposure must be considered when evaluating the extent of DNA damage. The aim of this cross-sectional study was to analyze nutritional status, dietary patterns, and the prevalence of non-communicable diseases (CNCDs) among coal miners as well as to investigate the correlation of these variables with DNA damage. We used a questionnaire to assess demographics, health, and dietary habits. The nutritional status was measured in terms of BMI (body mass index) and DNA damage was assessed by the comet assay. The sample population was composed of 158 coal miners from the largest coal mining company in South of Brazil, and majority of them were classified as overweight (51.3%) or obese (28.5%). Hypertension was the most common CNCD (50.6%) and a majority of these workers consumed all groups of foods three or more times a week. There was a significant positive correlation between BMI and DNA damage (r = 0.1646, p = 0.04) and this association was stronger (r = 0.2556, p = 0.04) in coal miners with some CNCD. There was no significant correlation between dietary patterns and DNA damage in coal miners. These results suggest that the nutritional status and CNCD increase the extent of DNA damage in coal miners. Since this population is at high occupational risk, specific strategies should be designed to improve the health of these workers, aiming to achieve health equity.

Distribution of potentially harmful elements in soils around a large coal-fired power plant.

An understanding of the spatial distribution and contribution of a power plant to local soil contamination is important for the planning of soil use and prioritizing remedial actions for public safety. Consequently, the aim of this study was to map the spatial distribution of potentially hazardous elements (PHEs; Cu, Pb, Zn, Ni, Cr, Fe, Mn, Cd, As, and Se) in soils around a large (796 MW) coal-fired power plant in Brazil. For the purpose, 33 soil samples were collected in the area within a radius of approximately 17.5 km from the plant and subsequently analyzed for PHEs. The frequency and direction of winds were also obtained from a meteorological station in the region. The sampling area was divided into four quadrants (northwest: N-NW; northeast: N-NE; southeast: S-SE; southwest: S-SW), and there were significant negative correlations between the distance and the concentrations of Se in the S-SE quadrant and As in the S-SW and S-SE quadrants. There were positive correlations between distance from the plant and the concentration of Mn in the N-NE quadrant and the concentration of Cd in the S-SW quadrant. The dominant direction of the winds was N-NE. The indexes used in this study showed low-to-moderate enrichment factor, but detailed analysis of the dominant quadrant of the winds showed a correlation with higher concentrations in the soils closer to the power plant for at least seven of the PHEs analyzed, especially with regard to As. Therefore, we conclude that the distribution of the metalloid As can be used as a marker of the spatial distribution of contamination from the thermoelectric plant, but the dynamics of the other elements suggests that the presence of other sources of contamination may also compromise the quality of local soils.

Effect of mixing two environmental stressors, pH and metal contaminants, on offspring of rats exposed during gestation and lactation.

In large urban centers, the toxicity of metal mixtures may be enhanced by physicochemical factors and environmental variables, including pH. Rio Grande, a municipality located in the extreme south of Brazil, has soils with high levels of contamination due to urban and industrial activities and a high prevalence of acid rain events. Previous studies have shown that contact with elutriate of these soils can cause physiological and reproductive changes. Thus, the objective of the present study was to evaluate, through animal experimentation, the effects of a metal-contaminated soil, acidified by hydrofluoric acid at two different pH values (5.2 and 3.6), on the health of offspring of rats exposed during gestation and lactation. Female Wistar rats were gavaged daily for 42 days (gestation and breastfeeding) with soil elutriate contaminated with metals, using solvent with different pH values (6.0, 5.2, and 3.6). The following parameters were evaluated in their offspring: body and organ weight, length, appearance of developmental characteristics, and swimming. Experimental groups in which the progenitors were exposed to the solution at pH 3.6 exhibited a delayed increase in weight as well as motor deficit, with a decreased weight (onset) and length (beginning and end), while exposure in association with soil was an aggravating factor for the damages to the body. Exposure to the solution at pH 5.2 decreased the initial weight of the animals, impaired some parameters of weight development, and caused motor deficit on the 14th day. These novel findings reveal that the exposure of progenitors to environmental stressors can compromise the health of the offspring. Special attention should be given to populations living in areas with high prevalence of acid rain.

Ações de reorientação da formação profissional em Fisioterapia: enfoque sobre cenários de prática / Reorientation of professional education in Physiotherapy: a focus on practice settings / Acciones de reorientación de la formación profesional en Fisioterapia: enfoque sobre escenarios de práctica

Este artigo buscou identificar, a partir da óptica de docentes e estudantes, ações que evidenciam a reorientação da formação profissional em Fisioterapia, no âmbito do eixo Cenários de Prática, conforme preconizado pelo Programa Pró-Saúde. Trata-se de uma pesquisa qualitativa que seguiu o método de estudo de caso, realizada em uma universidade comunitária com 16 estudantes e 11 docentes do curso de Fisioterapia. A coleta de dados foi conduzida por grupo focal e entrevista. Entre as ações que evidenciam a reorientação da formação profissional estão: realização do diagnóstico situacional, práticas em complexidade crescente, diversificação de práticas nas disciplinas profissionalizantes, vivências interdisciplinares no serviço público de saúde, práticas multiprofissionais e intervenções na Atenção Básica. Para promover avanços no processo de formação profissional, é necessário criar estratégias de ensino-aprendizagem contínuas e planejar as práticas de forma integrada com os serviços de saúde.(AU)

This paper aimed to identify from the perspective of teachers and students, actions that evidence the reorientation of vocational training in physiotherapy happening under the line of practice settings recommended by the Pro-Saude Program. A qualitative research using the case study method, was performed in a Community University, where 16 students and 11 teachers of the Physiotherapy course as participants. Data collection was carried out by focus group and interview. Among the actions that demonstrate the reorientation of vocational training we highlight: achievement the situational diagnosis, practices in growing complexity degrees, diversification of practices in professional disciplines, interdisciplinary experiences in public health service, multidisciplinary practices and interventions in Primary Care. To promote advances in the vocational training process, it is necessary to create teaching-learning continuous strategies and to plan practices settings integrated with health services.(AU)

El objetivo de este artículo fue identificar, a partir de la óptica de docentes y estudiantes, acciones que dejan en evidencia la reorientación de la formación profesional en Fisioterapia, en el ámbito del eje Escenario de Práctica, conforme determinado por el programa Pro-Salud. Se trata de una investigación cualitativa que siguió el método del estudio de caso, realizada en una universidad comunitaria con 16 estudiantes y 11 docentes del curso de Fisioterapia. La colecta de datos se realizó por medio de grupo focal y entrevista. Entre las acciones que dejan en evidencia la reorientación de la formación profesional están las siguientes: realización del diagnóstico situacional, prácticas de complejidad creciente, diversificación de prácticas en las asignaturas profesionalizantes, vivencias interdisciplinarias en el servicio público de salud, prácticas multi-profesionales e intervenciones en la Atención Básica. Para promover avances en el proceso de formación profesional es necesario crear estrategias de enseñanza-aprendizaje continuas y planificar las prácticas de forma integrada con los servicios de salud.(AU)

Vulnerability associated with "symptoms similar to those of mercury poisoning" in communities from Xingu River, Amazon basin.

The Brazilian Amazon is known to be a region with high levels of mercury (Hg) in the environment and studies point to an association between high levels of natural mercury in the mother rock and the vast number of clandestine gold mines. Other studies already report the contamination of fish in this region, as well as high levels of Hg in biological material from environmentally exposed populations. On the other hand, this is one of the least developed regions of the planet and it is necessary to understand the vulnerability factors in these populations that may be intoxicated by this element. The purpose of the present study was to investigate the vulnerability factors in communities from Xingu River-Amazon basin probably exposed to Hg. A cross-selection study in two cities localized in Xingu River was conducted, and the sample contained was 268 individuals. sociodemographic questions, lifestyle, diet habits and health conditions were collated. The majority of the sample was female, between 30 and 59 years old, had less than 3 years of educational level and lived in the local of study more than 240 months. There was regular fish consumption (95.9%), principally carnivorous species (80.5%). The visual problem has a highest prevalence (43.3%) between the health problems and about the symptoms of Hg intoxication, memory loss (42.9%), weakness (35.1%), fatigue (34.3%), mood changes (28.7%) and difficulties in concentration (27.2%) was most reported. The female sex, age over 60, educational level below 3 years of study, did not had flush toilet, smoke and least one chronic non-communicable disease represent higher probability to had symptoms of Hg intoxication. Lack of access to health services, low education level and income evidence the susceptibility of this community to diseases and injuries. The vulnerable groups identified in this study should be a priority in public health and environmental health policies.

Genotoxicity in adult residents in mineral coal region-a cross-sectional study.

The present study assessed the DNA damage in environmentally exposed volunteers living in seven municipalities in an industrial coal region, through the use of the comet assay with blood cells and the micronucleus test with buccal cells. Blood and buccal smears were collected from 320 male volunteers living in seven cities inserted in a coal region. They were ages of 18 and 50 years and also completed a questionnaire intended to identify factors associated with DNA damage through a Poisson regression analysis. The comet assay detected significant differences in DNA damage in volunteers from different municipalities, and neighboring cities (Pedras Altas, Aceguá, and Hulha Negra) had a higher level of DNA damage in relation to control city. Some of the risk factors associated with identified DNA lesions included residence time and life habits. On the other hand, the micronucleus test did not identify differences between the cities studied, but the regression analysis identified risk factors such as age and life habits (consumption of mate tea and low carbohydrates diet). We conclude that there are differences in the DNA damage of volunteers from different cities of the carboniferous region, but the presence of micronuclei in the oral mucosa does not differ between the same cities. Furthermore, we alert that some related factors may increase the risk of genotoxicity, such as residence location and time, and living and food habits. Finally, we suggest the need for continuous biomonitoring of the population, as well as for investing in health promotion in these vulnerable populations.

Fatores associados à dor na coluna vertebral em adolescentes de escolas públicas de um município do extremo sul do Brasil / Factors associated with back pain in adolescents from public schools in one city from South Brazil / Factores asociados con dolor en la espalda en adolescentes de escuelas públicas en una ciudad del sur de Brasil

RESUMO Objetivo Investigar a prevalência de dor na coluna vertebral e fatores associados em escolares do ensino público do extremo sul do Brasil. Métodos Estudo transversal, realizado entre maio e julho de 2014, com amostra aleatória de 619 adolescentes entre 10 e 17 anos de idade. A prevalência de dor na coluna foi pesquisada utilizando o Questionário Nórdico de Sintomas Osteomusculares e as variáveis independentes (demográficas, biológicas, forma de transporte do material escolar e de dor durante e após a caminhada) obtidas via questionário padronizado. Utilizou-se modelo de regressão de Poisson para estimar as razões de prevalência bruta e ajustada da associação da dor na coluna com os fatores investigados. Resultados A prevalência do desfecho foi de 45,2 %. Destes, 64,6 % referiram dor em uma região, 27,1 % em duas e 8,3 % em três regiões da coluna. Quando avaliadas separadamente, verificou-se a maior prevalência na região dorsal (26,2 %). Os fatores significantemente associados ao desfecho foram: sexo feminino (RP=1,43; IC95 %=1,19-1,74; p<0,01), idade entre 14 e 17 anos (RP=1,22; IC95 %=1,03-1,45; p=0,02) e cor da pele preta/parda (RP=1,20; IC95 %=1,01-1,43; p=0,04). Conclusão os resultados ressaltam a necessidade de uma maior atenção aos adolescentes que referem dor na coluna, visando prevenir a presença deste distúrbio de forma crônica ainda na adolescência e posteriormente na vida adulta. Para tanto, é necessário que ocorra a educação dos adolescentes e de seus responsáveis para o estímulo a adoção de práticas saudáveis para manutenção da integridade musculoesquelética.(AU)

ABSTRACT Objective To investigate the prevalence of back pain and associated factors in children attending public schools from South Brazil. Methods A cross-sectional study, conducted between May-July 2014, where a random sample of 619 adolescents, aged 10-17 years of age, was evaluated. The prevalence of back pain was assessed using the Nordic Musculoskeletal Questionnaire, and the independent variables (demographic and biological information, the way of transporting school supplies, and pain during and after the walk) were obtained through a standardized questionnaire. The Poisson regression model was used to estimate unadjusted and adjusted prevalence of back pain in association with the factors investigated. Results The prevalence of back pain was 45.2 %, out of which 64.6 % reported pain in one region, 27.1 % in two and 8.3 % in the three regions investigated. After an individual assessment of regions, it was found that the highest prevalence of pain relates to the dorsal region (26.2 %). The most relevant associated factors include female gender (OR=1.43, 95 %CI 1.19-1.74; p<0.01), age between 14 and 17 (OR=1.22; 95 %CI = 1.03-1.45; p=0.02), and dark skin (OR=1.20, 95 %CI 1.01-1.43; p=0.04). Conclusion The results highlight the need for greater attention to adolescents complaining of back pain, in order to prevent the presence of this chronical disorder in adolescence and later in adulthood. Therefore, it is necessary to educate adolescents and their guardians for the stimulation and consequent adoption of healthy practices for musculoskeletal integrity.(AU)

RESUMEN Objetivo Investigar la prevalencia de dolor en la espalda y factores asociados, en escolares del sur de Brasil. Métodos Estudio transversal realizado entre mayo y julio de 2014, con una muestra aleatoria de 619 adolescentes, entre 10 y 17 años. La prevalencia del dolor de espalda se investigó mediante el cuestionario estandarizado Nordic Musculoskeletal Questionnaire, así como las variables independientes (demográficas, biológicas, forma de transporte de material escolar y el dolor durante y después de caminar). Se utilizó el modelo de regresión de Poisson para estimar las proporciones de prevalencia bruta y ajustada y factores asociados. Resultados La prevalencia de dolor en la espalda fue 45,2 %. De estos, el 64,6 % informó de dolor en una región, 27,1 % en dos y 8,3 % en tres regiones de la espalda. Cuando se evaluó por separado, hubo una mayor prevalencia en la región dorsal (26,2 %). Se asoció de forma significativa con el desenlace, el sexo femenino (OR=1,43, IC95 %: 1,19-1,74; p<0,01), las edades comprendidas entre los 14 y los 17 años (RP=1,22; IC95 %=1,03-1,45; p=0,02) y el color de la piel negro/marrón (RP=1,20; IC95 % =1,01-1,43; p=0,04). Conclusión Los resultados ponen de relieve la necesidad de una mayor atención a los adolescentes que se quejan de dolor de espalda con el fin de evitar la presencia de este tipo de trastorno crónico en la adolescencia y más tarde en la vida adulta. Por lo tanto, es necesaria la formación de los adolescentes y sus cuidadores para estimular la adopción de prácticas saludables para mantener la salud músculo-esquelética.(AU)

Musculoskeletal disorders and their influence on the quality of life of the dockworker: A cross-sectional study.

BACKGROUND: Dockworkers are subjected to intense physical labor which leads to frequent occurrence of musculoskeletal disorders. OBJECTIVE: This study aims to measure the prevalence of work-related musculoskeletal disorders (WMSD) of temporary dockworkers and its influence on their quality of life. METHODS: This was a cross-sectional study developed with temporary dockworkers in Brazil. Recruitment was done by inviting workers when they presented themselves for work at the trade union. The Nordic Musculoskeletal Questionnaire and the Short-Form Health Survey were used. The association between the outcome and the different investigated factors was analyzed through Poisson Regression with robust variance. The Mann-Whitney test was used to compare the data from the Short-Form Health Survey scale among the groups both with and without work-related musculoskeletal disorders. RESULTS: The sample was composed of 318 temporary dockworkers with a mean age of 48 years. WMSD prevalence was 37.4%. WMSD was associated with not practicing physical activity (PR = 2.03; p = 0.005), participation in housework (PR = 1.88; p = 0.029), taking care of preschool children (PR = 1.65; p <  0.000) and handling heavy objects (PR = 1.83; p = 0.007). The lumbar spine was the most frequently mentioned area of the body (22.5%) in the WMSD analysis. Workers without WMSD had higher (p <  0.00) quality of life scale scores in relation to functional capacity, physical and social aspects, pain and vitality. CONCLUSIONS: The results highlight the relevance of developing action plans regarding the needs of this specific population of workers, especially concerning the reduction of risk factors.

Prevalence of musculoskeletal pain and its association with inadequate school furniture / Prevalência de dor musculoesquelética e sua associação com a inadequação do mobiliário escolar

ABSTRACT BACKGROUND AND OBJECTIVES: Inadequate school furniture is a factor contributing to musculoskeletal pain onset in students. This study aimed at estimating the adequacy of school desks and chairs with regard to students’ anthropometric characteristics and its possible association with musculoskeletal pain in different parts of the body. METHODS: A survey was carried out with 625 students and the furniture of 69 classrooms. The simplified Nordic Questionnaire for Analysis of Osteomuscular Symptoms was used for the analysis of musculoskeletal symptoms, and parameters recommended by standard NBR 14006 (Brazilian Association of Technical Standards) were used to analyze furniture. RESULTS: This study has shown that 87.2% of chairs and 45.6% of desks were totally inadequate. There has been significant association between inadequate desks and neck/cervical (12.6%; p=0.05) and dorsal (15.1%; p=0.00) musculoskeletal pain. Similar result was found with regard to inadequate chairs (neck/cervical: 17.5%; p=0.02; dorsal: 23.8%; p=0.00). CONCLUSION: The high levels of inadequate school chairs and desks demand a review of these items of furniture which are used by students for long periods of time every day. It is recommended that public authorities be informed of this situation and request that school furniture be urgently brought into line with prevailing legislation. Our results stress the need for futher care to be taken with regard to school students’ health. .

RESUMO JUSTIFICATIVA E OBJETIVOS: A inadequação do mobiliário escolar é um fator que contribui para o surgimento de dor musculoesquelética em estudantes. O objetivo deste estudo foi estimar a adequação das mesas e cadeiras escolares em comparação com características antropométricas dos alunos e sua possível associação com dor musculoesquelética em diferentes regiões do corpo. MÉTODOS: Foi realizado um levantamento de 625 alunos do ensino e mobiliário em 69 salas de aula. Utilizou-se o Questionário Nórdico de Sintomas Osteomusculares simplificado para análise de sintomas musculoesqueléticos, e para análise do mobiliário escolar utilizou-se os parâmetros recomendados pela norma NBR 14006 (Associação Brasileira de Normas Técnicas). RESULTADOS: Esta análise mostrou que 87,2% das cadeiras e 45,6% de mesas eram totalmente inadequadas. Foi encontrada associação significativa entre mesas inadequadas e dor musculoesquelética no pescoço/região cervical (12,6%; p=0,05) e na região dorsal (15,1%; p=0,00). Resultado semelhante foi encontrado em relação à inadequação das cadeiras (pescoço/região cervical: 17,5%; p=0,02; região dorsal: 23,8%; p=0,00). CONCLUSÃO: Os altos níveis de mesas e cadeiras escolares inadequadas exigem uma revisão desses itens de mobiliário que são usados por alunos por longos períodos todos os dias. Recomenda- se que as autoridades públicas sejam informadas da situação e solicitem que o mobiliário escolar seja urgentemente adequado à legislação vigente. Os resultados encontrados neste estudo sublinham a necessidade de mais cuidado a ser tomado em relação à saúde dos alunos da escola. .

Developmental effects of parental exposure to soil contaminated with urban metals.

Soil is a highly complex material, and because of rapid population growth, intense industrial activity and petrochemical development, it has suffered from contamination with substances of various origins. These environmental contaminants may have detrimental effects on human health, particularly during development. Due to the ability to transmit contaminants to the fetus, evaluating the effects of exposure of pregnant women on the psychomotor development of their offspring is of particular interest. Therefore, this study aimed to investigate the effects of exposure of female rats to an urban soil influenced by the dispersion of air contaminants during periods of pre-pregnancy, pregnancy and lactation on offspring development. Using physiological, behavioral and hematological parameters, deleterious effects on offspring were assessed. In behavioral parameters, parental exposure during pregnancy and lactation resulted in no significant differences in the evaluated parameters when compared to the control group. In contrast, pups from the pre-pregnancy group displayed decreased locomotor and exploratory activity in addition to increased levels of anxiety. Furthermore, offspring of rats exposed to contaminated urban soil during pre-pregnancy demonstrated significant changes in weight gain and development length and a reduction in the number of platelets compared to controls. Significantly, pups born to mothers exposed to contaminated urban soil during the pregnancy displayed changes in birth weight, weight gain during the growth, development length, incisor eruption and opening of the ears in addition to a reduction in their physical performance and a change in the number of lymphocytes. These results clearly show the negative influence of parental exposure to contaminated urban soil on the general development of the rats during the periods studied. These data indicate that developing organisms are highly sensitive to external factors. Further, they demonstrate the utility of these various biomarkers for identifying and displaying toxic effects of exposure to contaminated soils.

[Opportunities for physical therapy contributions to primary health care in the South of Brazil]. / Situações com potencialidade para atuação da fisioterapia na atenção básica no Sul do Brasil.

OBJECTIVE: To identify opportunities for physical therapy contributions in an area covered by the Family Health Strategy in the South of Brazil. METHODS: In this cross-sectional study, 629 households were visited and information on 2 316 people was collected using a semi-structured instrument investigating the occurrence of health problems that could benefit from physical therapy (diabetes, hypertension, musculoskeletal diseases, neurological disorders, respiratory diseases in adults and children). When health problems were identified, we investigated whether the families or patients had received guidance to improve quality of life, and which professionals had provided advice. Finally, we investigated whether respondents were familiar with physical therapy and if they had required this type of care in their lifetime or in the past 12 months. RESULTS: The following health problems were reported by 629 participating families: diabetes (11.9%), hypertension (46.9%), musculoskeletal disorders (36.7%), neurological diseases (3.4%), respiratory diseases in adults (18.9%) and children (15.7%) and developmental delay (3.8%). Specific guidance was provided to 57.3% of people with diabetes, 64.1% of people with hypertension, 39.8% of people with musculoskeletal disorders, 45.5% of neurological patients, 26.9% of adults and 60.6% of children with respiratory diseases and 62.5% of children with developmental delay. Regarding knowledge about the profession, 92.4% of respondents were familiar with physical therapy. Of these, 41% reported having had the need for physical therapy, mostly (54.4%) for trauma/orthopedic disorders. CONCLUSIONS: The present results warrant the inclusion of physical therapists as part of the Family Health Strategy team in Brazil.

Fatores associados à dor musculoesquelética em escolares da rede pública municipal no extremo sul do Brasil / Factors associated with musculo-skeletal pain in municipal public school students in the far South of Brazil

Identificar os fatores associados à dor musculoesquelética (DME) em escolares da rede municipal de ensino na cidade de Rio Grande, extremo sul do Brasil, entre junho e dezembro de 2010. Métodos: trata-se de um estudo seccional conduzido em uma amostra aleatória de 625 escolares entre seis e 18 anos de idade. A DME foi pesquisada utilizando o Questionário Nórdico de Sintomas Osteomusculares (QNSO) e informações demográficas, biológicas, forma de transporte do material escolar e de estilo de vida obtidas via questionário padronizado. As razões de prevalência bruta e ajustada da associação da DME com os fatores investigados foi estimada em um modelo de regressão de Poisson. Resultados: a prevalência de DME foi de 37,6 por cento. Idade entre 11 e 18 anos (RP=1,70; IC95 por cento=1,36- 2,11; p<0,001), sexo feminino (RP=1,47; IC95 por cento=1,19-1,81; p<0,001) e histórico familiar de distúrbio na coluna (RP=0,78; IC95 por cento=0,64-0,96; p=0,020) estiveram associados ao desfecho. Não praticar esportes de competição foi um fator de proteção (RP=0,65; IC95 por cento=0,51-0,81; p<0,001). Conclusão: estes resultados confirmam a influência negativa de diferentes fatores presentes no ambiente escolar sobre a saúde dos estudantes. Considera-se como medida importante a implantação de programas de promoção da saúde nas escolas, que estimulem entre os estudantes a adoção de práticas saudáveis que minimizem os efeitos deletérios da DME...

To identify the factors associated with musculo-skeletal pain (MSP) in schoolchildren in municipal public schools in the city of Rio Grande, in the far south of Brazil, between June and December 2010. Methods: a sectional study was carried out with a random sample of 625 schoolchildren aged between six and eighteen years of age. MSP was investigated using the Nordic Osteomuscular Symptoms Questionnaire (NOSQ) and information relating to demographic and biological factors, the means of transport of school materials and lifestyle, obtained using a standardized questionnaire. The raw and adjusted prevalence rations for association between MSP and the factors under study were estimated using a Poisson regression model. Results: the prevalence of MSP was 37.6 percent. Being aged between 11 and 18 years (PR=1.70; CI95 percent=1.36-2.11; p<0.001), being female (PR=1.47; CI95 percent=1.19-1.81; p<0.001) and a family history of back pain (PR=0.78; CI95 percent=0.64-0.96; p=0.020) were associated with the outcome. Not practicing competitive sports was a protective factor (PR=0.65; CI95 percent=0.51-0.81; p<0.001). Conclusions: these results confirm the negative influence of various factors present in the school environment on the health of students. It is considered an important measure to introduce health promotion programs in schools to encourage students to adopt healthy practices that minimize the deleterious effects of MSP...

Situações com potencialidade para atuação da fisioterapia na atenção básica no Sul do Brasil / Opportunities for physical therapy contributions to primary health care in the South of Brazil

OBJETIVO: Identificar situações com potencialidade para atuação da fisioterapia em uma área de abrangência da Estratégia Saúde da Família no Sul do Brasil. MÉTODOS: Neste estudo transversal, foram visitados 629 domicílios e coletadas informações sobre 2 316 pessoas através de um instrumento semiestruturado que investigou a existência de agravos à saúde com potencialidade para atuação da fisioterapia (diabetes, hipertensão arterial, doenças osteomusculares, doenças neurológicas, doenças respiratórias em adultos e crianças). Na presença desses agravos, investigamos se as famílias ou pacientes haviam recebido orientação para melhora da qualidade de vida e qual profissional havia fornecido essas informações. Finalmente, investigamos se os entrevistados conheciam o atendimento fisioterapêutico e a demanda por esse tipo de atendimento ao longo da vida e nos últimos 12 meses. RESULTADOS: Nas 629 famílias investigadas, foram referidos os seguintes agravos: diabetes (11,9%), hipertensão (46,9%), doenças osteomusculares (36,7%), doenças neurológicas (3,4%), doenças respiratórias em adultos (18,9%) e crianças (15,7%) e atraso do desenvolvimento neuropsicomotor (DNPM) (3,8%). O recebimento de orientações específicas foi referido por 57,3% dos diabéticos, 64,1% dos hipertensos, 39,8% dos portadores de doenças osteomusculares, 45,5% dos doentes neurológicos, 26,9% dos adultos e 60,6% das crianças com doenças respiratórias e 62,5% das crianças com atraso do DNPM. Em relação ao conhecimento sobre a profissão, 92,4% já tinham ouvido falar em fisioterapia. Desses, 41,0% relataram ter necessitado fisioterapia alguma vez na vida, sendo a maioria (54,4%) para patologias traumato-ortopédicas. CONCLUSÕES: Os resultados respaldam a necessidade de inserção do fisioterapeuta na equipe da Estratégia Saúde da Família.

OBJECTIVE: To identify opportunities for physical therapy contributions in an area covered by the Family Health Strategy in the South of Brazil. METHODS: In this cross-sectional study, 629 households were visited and information on 2 316 people was collected using a semi-structured instrument investigating the occurrence of health problems that could benefit from physical therapy (diabetes, hypertension, musculoskeletal diseases, neurological disorders, respiratory diseases in adults and children). When health problems were identified, we investigated whether the families or patients had received guidance to improve quality of life, and which professionals had provided advice. Finally, we investigated whether respondents were familiar with physical therapy and if they had required this type of care in their lifetime or in the past 12 months. RESULTS: The following health problems were reported by 629 participating families: diabetes (11.9%), hypertension (46.9%), musculoskeletal disorders (36.7%), neurological diseases (3.4%), respiratory diseases in adults (18.9%) and children (15.7%) and developmental delay (3.8%). Specific guidance was provided to 57.3% of people with diabetes, 64.1% of people with hypertension, 39.8% of people with musculoskeletal disorders, 45.5% of neurological patients, 26.9% of adults and 60.6% of children with respiratory diseases and 62.5% of children with developmental delay. Regarding knowledge about the profession, 92.4% of respondents were familiar with physical therapy. Of these, 41% reported having had the need for physical therapy, mostly (54.4%) for trauma/orthopedic disorders. CONCLUSIONS: The present results warrant the inclusion of physical therapists as part of the Family Health Strategy team in Brazil.