Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 14 de 14
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Artigo em Português | PAHO-IRIS | ID: phr-51932

RESUMO

[RESUMO]. Objetivo. Verificar a existência de associação de indicadores de gestão de resíduos sólidos e socioeconômicos municipais com índices de incidência de dengue, Zika e Chikungunya nos municípios do estado brasileiro de Minas Gerais. Métodos. Este estudo de caráter exploratório, quantitativo e transversal abrangeu os 853 municípios do estado de Minas Gerais. Todos os dados utilizados foram secundários, coletados e agrupados por regionais de planejamento. Como variáveis independentes, foram consideradas a cobertura de coleta de resíduos sólidos urbanos, cobertura de coleta seletiva e massa de resíduos sólidos urbanos, além de um indicador da qualidade da destinação final de resídulos, índices de desenvolvimento humano municipal e de Gini, renda mensal per capita e porcentagem de vulneráveis à pobreza. Os fatores potencialmente associados aos desfechos – incidências municipais de dengue, Chikungunya e Zika – foram selecionados inicialmente através de análises univariadas. Posteriormente, os modelos de regressão linear para as incidências de dengue, Chikungunya ou Zika foram gerados considerando os preditores selecionados pela análise univariada. Resultados. Não foi observada associação entre gestão de resíduos sólidos e incidência de Chikungunya e Zika. Por sua vez, a incidência de dengue associou-se à gestão de resíduos sólidos e apresentou relação inversa significativa com o percentual de vulneráveis à pobreza. Houve também associação direta o índice de Gini, sugerindo que quanto maiores os registros de incidência de dengue de 2007 a 2016, maiores os valores de Gini dos municípios – ou seja, maior a desigualdade social. A cobertura da coleta seletiva apresentou relação inversa e significativa com os casos de dengue, sugerindo que quanto menor a cobertura da coleta de seletiva, maiores foram os casos registrados de dengue. Conclusões. A gestão de resíduos sólidos pode influenciar os casos de dengue e, por isso, deve ser considerada nas ações de saúde pública.


[ABSTRACT]. Objective. To investigate whether solid waste management and municipal socioeconomic indicators are associated with incidence rates of dengue, Zika, and Chikungunya in municipalities located in the state of Minas Gerais, Brazil. Methods. This exploratory, quantitative, cross-sectional study included all the 853 municipalities of Minas Gerais. Only secondary data were used, collected and grouped according to planning regions. Independent variables included regular urban solid waste collection, separated waste collection, and urban solid waste mass, in addition to a quality indicator of final waste disposal, municipal human development and Gini indices, monthly per capita income, and percentage of population vulnerable to poverty. The factors potentially associated with outcomes – municipal incidence of dengue, Chikungunya, and Zika – were initially selected by univariate analysis, followed by linear regression analysis for the incidence of dengue, Chikungunya, or Zika using the predictors selected through univariate analysis. Results. Solid waste management was not associated with incidence of Zika or Chikungunya. In turn, the incidence of dengue was associated with solid waste management and had a significant inverse association with percent population vulnerable to poverty. A direct association was also observed with Gini index, suggesting that the higher the incidence of dengue from 2007 to 2016, the higher the municipal Gini coefficient and thus social inequality. Selective waste collection was inversely and significantly correlated with dengue cases, suggesting that the lower the coverage by regular separated waste collection, the higher the number of dengue cases. Conclusions.Solid waste management may influence the occurrence of dengue cases, and therefore should be considered in the planning of public health actions.


[RESUMEN]. Objetivo. Investigar si el manejo de los residuos sólidos y los indicadores socioeconómicos municipales están asociados con las tasas de incidencia de dengue, zika y chikunguña en los municipios del estado de Minas Gerais, Brasil. Métodos. Estudio exploratorio, cuantitativo y transversal que incluyó los 853 municipios de Minas Gerais. Sólo se utilizaron datos secundarios, recopilados y agrupados según las regiones de planificación. Las variables independientes incluyeron la recolección urbana regular de residuos sólidos, la recolección separada de residuos y la masa de residuos sólidos urbanos, además de un indicador de calidad de la eliminación final de desechos, el desarrollo humano municipal y los índices de Gini, el ingreso mensual per cápita y el porcentaje de población vulnerable a la pobreza. Los factores potencialmente asociados con los resultados –incidencia municipal de dengue, zika y chikunguña– se seleccionaron inicialmente mediante un análisis univariado, seguido de un análisis de regresión lineal para la incidencia del dengue, zika o chikunguña utilizando los predictores seleccionados mediante el análisis univariado. Resultados. El manejo de residuos sólidos no se asoció con la incidencia de zika o chikungunya. A su vez, la incidencia del dengue se asoció con un manejo sólido y tuvo una asociación inversa significativa con el porcentaje de población vulnerable a la pobreza. También se observó una asociación directa con el índice de Gini, lo que sugiere que cuanto mayor sea la incidencia del dengue entre 2007 y 2016, mayor será el coeficiente de Gini municipal y, por lo tanto, la desigualdad social. La recolección selectiva de residuos se correlacionó de manera significativa e inversa con los casos de dengue, lo que sugiere que cuanto menor sea la cobertura de la recolección regular selectiva de residuos, mayor será el número de casos de dengue. Conclusiones. La gestión de los residuos sólidos puede influir en la aparición de casos de dengue y, por lo tanto, debe considerarse en la planificación de las medidas de salud pública.


Assuntos
Dengue , Zika virus , Vírus Chikungunya , Resíduos Sólidos , Brasil , Vírus Chikungunya , Resíduos Sólidos , Brasil , Zika virus , Vírus Chikungunya , Resíduos Sólidos
3.
Environ Monit Assess ; 191(5): 275, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30976940

RESUMO

An evaluation of the environmental risk assessment (ERA) proposed by European Medicines Agency (EMA) and its applicability in Brazil was performed on ten of Belo Horizonte's most pharmaceuticals by the Brazilian National Health Service (SUS). The predicted environmental concentrations (PECs) was proposed, with some refinements to a better representation of the city of study. All PECs obtained were compared only to measured environmental concentrations around the world, due to the lack available data in the city of study and in Brazil. During the performance of EMA's guideline, the risk quotient (RQ) of impact was established through the ratio of PECs and predicted no-effect concentrations (PNECs). The PECs obtained in more refined phases show the initial evaluation of EMA's guideline, possible subdimensions, and the potential risks. The RQ for all studied pharmaceuticals ranges from clonazepam (1.26) to losartan (5457.45). These results indicate potential risks to the aquatic life present in the streams that receive the wastewater treatment plant's effluent. This risk can be spread since the streams carry these contaminants to other water bodies that undergo to multiple cities of Brazil, and even after dilutions, it can still be potentially toxic to the biotic life. ERA shows that it can be a useful tool for a better understanding and modeling of pharmaceuticals fate in the environment, specifically in water bodies. In addition, the usage of this model shows to be a useful tool that determines which contaminant should follow a more thorough study since the detection and analysis of pharmaceuticals in environmental samples are costly and technically challenging.


Assuntos
Monitoramento Ambiental/métodos , Modelos Teóricos , Preparações Farmacêuticas/análise , Medição de Risco/métodos , Rios/química , Poluentes Químicos da Água/análise , Brasil , Cidades , Águas Residuárias/análise
4.
Rev Soc Bras Med Trop ; 52: e20180289, 2019 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-30698197

RESUMO

Hepatitis delta virus (HDV) has been associated with acute or chronic hepatitis in Latin America, but there is no prevalence study covering South American countries. This meta-analysis aimed to estimate anti-HDV prevalence through a systematic review of published articles in English, Portuguese and Spanish until December 2017. Searches were conducted in Health Virtual Library, Capes, Lilacs, PubMed, and SciELO, according to defined criteria regarding participant selection and geographical setting. Study quality was assessed using the GRADE guidelines. Pooled anti-HDV prevalence was calculated using the DerSimonian-Laird random-effects model with Freeman-Tukey double arcsine transformation. Out of the 405 identified articles, only 31 met the eligibility criteria for inclusion in the meta-analysis. In South America, pooled anti-HDV prevalence among hepatitis B virus carriers was 22.37% (95% confidence interval: 13.72-32.26), though it appeared less frequently in some countries and populations, according to the data collection date. The findings indicated significant successive reductions in anti-HDV prevalence over thirty years. However, there was a scarcity of HDV epidemiological studies outside the Amazon Basin, notably in the Southwest continent and absence of target population standardization. There was a high HDV prevalence in South American countries, despite differences in methodological characteristics and outcomes, highlighting a drastic decline in the last decades. Future studies should identify HDV prevalence estimates in other regions of the continent and identify risk factors.


Assuntos
Hepatite D/epidemiologia , Vírus Delta da Hepatite , Genótipo , Vírus Delta da Hepatite/genética , Vírus Delta da Hepatite/imunologia , Humanos , Filogenia , Prevalência , América do Sul/epidemiologia
5.
Waste Manag Res ; 37(3): 278-286, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30565515

RESUMO

Some healthcare waste presents hazardousness characteristics and requires specific procedures to ensure the safety management. Waste segregation is an important action to control the risks of each type of waste. Healthcare waste indicators also may improve the waste management system. The aim of this article was to evaluate the healthcare waste management in a Brazilian university hospital, as well as the waste indicators, quantifying and qualifying the waste generation. Weighing of wastes occurred by sampling occurred sampling of seven consecutive days or daily, between 2011 and 2017. General wastes represent more than 55.6% of the total generated, followed by infectious, sharps and chemicals wastes, respectively, 39.1%, 2.9% and 2.4%. The generation rate in 2017 was 4.09 kg bed-1 day-1, including all types of wastes. Non-dangerous wastes represented around 93.3%, including infectious wastes with low potential risks, while dangerous was represented by high infectious risk (1.4%), chemicals (2.4%) and sharps (2.9%). Healthcare waste indicators may favour the risk identification and improve the waste management system, in particular when involving hazardous wastes. Failures in healthcare waste segregation could represent, in addition to the health risks, unnecessary expenses.


Assuntos
Eliminação de Resíduos de Serviços de Saúde , Resíduos de Serviços de Saúde , Gerenciamento de Resíduos , Brasil , Resíduos Perigosos , Hospitais Públicos
6.
Qual Health Res ; 29(3): 371-381, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30196766

RESUMO

Frequent contact with hazardous materials makes waste collection a potentially unhealthy activity. This article assesses the perception of waste management workers regarding work-related accidents in domestic and health service contexts in Brazil. Six focus groups were performed between June 2014 and August 2015. The aims of this study were to apprehend different aspects of the participants' health, workers' experiences of work-related accidents and perception of risks. Cuts and puncture injuries were reported most frequently in the line of work and were often considered as irrelevant. Immunization against hepatitis B was not common among all workers, which increases the risk of infection for those individuals. Finally, it is considered urgent to consolidate an inclusive space in which workers can have discussions on their health.


Assuntos
Acidentes de Trabalho/psicologia , Acidentes de Trabalho/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Doenças Profissionais/psicologia , Gerenciamento de Resíduos/estatística & dados numéricos , Adulto , Brasil , Feminino , Grupos Focais , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Vacinas contra Hepatite B/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Saúde do Trabalhador , Equipamento de Proteção Individual/estatística & dados numéricos , Pesquisa Qualitativa , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/psicologia
7.
Doc Ophthalmol ; 138(1): 3-19, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30456454

RESUMO

PURPOSE: To assess the in vivo release profile and the retinal toxicity of a poly (lactic-co-glycolic acid) (PLGA) sustained-release sirolimus (SRL) intravitreal implant in normal rabbit eyes. METHODS: PLGA intravitreal implants containing or not SRL were prepared, and the viability of ARPE-19 and hES-RPE human retinal cell lines was examined after 24 and 72 h of exposure to implants. New Zealand rabbits were randomly divided into two groups that received intravitreal implants containing or not SRL. At each time point (1-8 weeks), four animals from the SRL group were euthanized, the vitreous was collected, and drug concentration was calculated. Clinical evaluation of the eyes was performed weekly for 8 weeks after administration. Electroretinography (ERG) was recorded in other eight animals, four for each group, at baseline and at 24 h, 1, 4, 6, and 8 weeks after the injection. ERG was carried out using scotopic and photopic protocols. The safety of the implants was assessed using statistical analysis of the ERG parameters (a and b waves, a and b implicit time, B/A ratio, oscillatory potential, and Naka-Rushton analysis) comparing the functional integrity of the retina between the PLGA and SRL-PLGA groups. After the last electrophysiological assessment, the rabbits were euthanized and retinal histopathology was realized. RESULTS: After 24 and 72 h of incubation with PLGA or SRL-PLGA implants, ARPE-19 and hES-RPE cells showed viability over 70%. The maximum concentration of SRL (199.8 ng/mL) released from the device occurred within 4 weeks. No toxic effects of the implants or increase in the intraocular pressure was observed through clinical evaluation of the eye. ERG responses showed no significant difference between the eyes that received PLGA or SRL-PLGA implants at baseline and throughout the 8 weeks of follow-up. No remarkable difference in retinal histopathology was detected in rabbit eyes treated with PLGA or SRL-PLGA implants. CONCLUSIONS: Intravitreal PLGA or SRL-PLGA implants caused no significant reduction in cell viability and showed no evident toxic effect on the function or structure of the retina of the animals. SRL was released from PLGA implant after application in the vitreous of rabbits during 8 weeks.


Assuntos
Imunossupressores/farmacocinética , Imunossupressores/toxicidade , Epitélio Pigmentado da Retina/efeitos dos fármacos , Sirolimo/farmacocinética , Sirolimo/toxicidade , Corpo Vítreo/metabolismo , Implantes Absorvíveis , Animais , Disponibilidade Biológica , Linhagem Celular , Sobrevivência Celular , Sistemas de Liberação de Medicamentos , Implantes de Medicamento , Eletrorretinografia , Células-Tronco Embrionárias/efeitos dos fármacos , Humanos , Injeções Intravítreas , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Coelhos , Retina/efeitos dos fármacos
8.
Rev. Soc. Bras. Med. Trop ; 52: e20180289, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-985161

RESUMO

Abstract Hepatitis delta virus (HDV) has been associated with acute or chronic hepatitis in Latin America, but there is no prevalence study covering South American countries. This meta-analysis aimed to estimate anti-HDV prevalence through a systematic review of published articles in English, Portuguese and Spanish until December 2017. Searches were conducted in Health Virtual Library, Capes, Lilacs, PubMed, and SciELO, according to defined criteria regarding participant selection and geographical setting. Study quality was assessed using the GRADE guidelines. Pooled anti-HDV prevalence was calculated using the DerSimonian-Laird random-effects model with Freeman-Tukey double arcsine transformation. Out of the 405 identified articles, only 31 met the eligibility criteria for inclusion in the meta-analysis. In South America, pooled anti-HDV prevalence among hepatitis B virus carriers was 22.37% (95% confidence interval: 13.72-32.26), though it appeared less frequently in some countries and populations, according to the data collection date. The findings indicated significant successive reductions in anti-HDV prevalence over thirty years. However, there was a scarcity of HDV epidemiological studies outside the Amazon Basin, notably in the Southwest continent and absence of target population standardization. There was a high HDV prevalence in South American countries, despite differences in methodological characteristics and outcomes, highlighting a drastic decline in the last decades. Future studies should identify HDV prevalence estimates in other regions of the continent and identify risk factors.

10.
Waste Manag Res ; 36(10): 934-941, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29966511

RESUMO

Healthcare waste (HCW) management represents a big challenge for managers around the world. Segregation is a fundamental action to allow the risk management inherent to each type of wastes. HCW indicators may favour the understanding of the waste management system status. The aim of this paper is to evaluate the HCW indicators applied in a Brazilian public institution, seeking to improve the management system and suggesting methods of applying this tool as an alternative of continuous improvement to the management process. Wastes were weighed every trimester for seven consecutive days, between of 2012 to 2017. The data represent daily, monthly and quarterly averages of the waste generated. Group B (chemical) and Group E (sharps) indicators had statistical non-significant data, suggesting very distant results from the stipulated goal. The generation rate was 355.3-500.7 kg.day-1 including all types of waste. Considering the approximate values of the non-infected wastes, which may be discarded in a landfill, the percentage represents about 75% of all HCW generated. The other 25% need to be treated at cost of $US0.76kg-1. An effectively dangerous portion of the infectious waste would be approximately 6%. Failures in segregation could represent, in addition to the health risks, unnecessary expenses of the generating establishments. HCW indicators have good potential to provide adequate risk management in health service environments.


Assuntos
Eliminação de Resíduos de Serviços de Saúde , Gerenciamento de Resíduos , Brasil
11.
Eng. sanit. ambient ; 22(6): 1037-1041, nov.-dez. 2017. tab
Artigo em Português | LILACS-Express | ID: biblio-891600

RESUMO

RESUMO A destinação dos resíduos de serviços de saúde (RSS) representa uma discussão ampla e polêmica, e o momento de revisão da resolução da diretoria colegiada n.º 306/2004, da Agência Nacional de Vigilância Sanitária (ANVISA), é oportuno para ampliar esse debate. Nesse contexto, este artigo buscou, por meio da revisão de publicações científicas, subsidiar escolhas que favoreçam a sustentabilidade ambiental e a proteção da saúde humana na destinação dos RSS. Foram realizadas pesquisa bibliográfica, em âmbitos nacional e internacional, e a revisão de instrumentos legais que regulam a destinação dos RSS no Brasil. As resoluções da ANVISA (n.º 306/2004) e do Conselho Nacional do Meio Ambiente (n.º 358/2005) mostram que a disposição final dos RSS do subgrupo A4 pode ser feita em local licenciado para receber RSS, sem tratamento prévio. Diversas publicações científicas apontam para a falta de evidências quanto à existência de riscos aumentados para o ambiente e à saúde humana dos RSS se comparados aos resíduos sólidos domiciliares e explicam que ambos poderiam ter destinação final com base nos mesmos requisitos. A segregação dos RSS de acordo com os riscos reais de cada grupo e no momento da geração, assim como o acondicionamento como barreira de proteção, é o procedimento mais seguro de gerenciamento de risco contra contaminações e acidentes, sobrepondo-se aos requisitos para a destinação final. A exigência de tratar previamente os resíduos do subgrupo A4 antes de serem aterrados, conforme defendem alguns, poderia resultar em desnecessária elevação dos custos do processo sem evidência de redução dos riscos envolvidos.


ABSTRACT The disposal of healthcare waste (HCW) is a controversial and wide discussion, and the review of the Collegiate Directorate Resolution no. 306/2004, from the National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA), a Brazilian regulation, is appropriate to increase this debate. In this context, through the review of scientific publications, this paper supports choices that promote environmental sustainability and the protection of human health during the HCW disposal process. A bibliographical research including national and international levels and a review of legal instruments about HCW management in Brazil were done. The rules of ANVISA (no. 306/2004) and National Environment Council (no. 358/2005) point out that the final disposal of HCW, specially the subgroup A4, could be done in certified place to disposal HCW, without prior treatment. Several scientific papers mention the lack of evidences about increased risks of some kinds of HCW when compared to domestic waste, and these wastes may have final disposal based on the same criteria. Segregation of the HCW according to the real risks of each group at the moment of the generation of waste, as well as the packaging as a protective barrier, configures a safer risk management procedures against contamination and accidents. The requirement to treat the A4 subgroup before landfill disposal, as argue by some researchers, could represent an increase of unnecessary economical costs without evidences of risk reduction.

12.
Rev. Soc. Bras. Med. Trop ; 50(6): 756-763, Nov.-Dec. 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-897033

RESUMO

Abstract This meta-analysis, which is based on a previously published systematic review, aims to contribute to the scientific discussion on hepatitis B virus (HBV) infection in workers who are exposed to domestic and healthcare wastes. Publications were sought which had been made available on the data used by December 2013 and updated to December 2016. The quality of the included studies was assessed according to the guidelines of Loney et al. for the critical appraisal of studies on the prevalence or incidence of a health problem. To verify the presence of heterogeneity between the papers, we used the Chi-squared test based on a Q statistic. A funnel plot was used to test for publication bias. All included studies had across-sectional study design. The association between exposure to waste and positive serology for the HBV surface antigen (HBsAg) showed a significant association [odds ratio (OR) 1.89, 95% confidence interval (CI) 1.27-2.86; p = 0.0019]. The prevalence rates of HBsAg and anti-HBc seropositivity was 0.04 (95% CI 0.03-0.05) and 0.21 (95% CI 0.14-0.28), respectively (p <0.0001). We found no evidence of publication bias. The results of this meta-analysis indicate a statistically significant association between exposure to solid waste, whether healthcare or domestic, and positive HBV infection markers. Therefore, the working conditions of waste collectors should be analyzed more closely. Immunization against HBV is recommended as the chief preventive measure for all solid waste workers.

13.
Rev Soc Bras Med Trop ; 50(6): 756-763, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29340451

RESUMO

This meta-analysis, which is based on a previously published systematic review, aims to contribute to the scientific discussion on hepatitis B virus (HBV) infection in workers who are exposed to domestic and healthcare wastes. Publications were sought which had been made available on the data used by December 2013 and updated to December 2016. The quality of the included studies was assessed according to the guidelines of Loney et al. for the critical appraisal of studies on the prevalence or incidence of a health problem. To verify the presence of heterogeneity between the papers, we used the Chi-squared test based on a Q statistic. A funnel plot was used to test for publication bias. All included studies had across-sectional study design. The association between exposure to waste and positive serology for the HBV surface antigen (HBsAg) showed a significant association [odds ratio (OR) 1.89, 95% confidence interval (CI) 1.27-2.86; p = 0.0019]. The prevalence rates of HBsAg and anti-HBc seropositivity was 0.04 (95% CI 0.03-0.05) and 0.21 (95% CI 0.14-0.28), respectively (p <0.0001). We found no evidence of publication bias. The results of this meta-analysis indicate a statistically significant association between exposure to solid waste, whether healthcare or domestic, and positive HBV infection markers. Therefore, the working conditions of waste collectors should be analyzed more closely. Immunization against HBV is recommended as the chief preventive measure for all solid waste workers.


Assuntos
Hepatite B/transmissão , Eliminação de Resíduos de Serviços de Saúde , Doenças Profissionais/etiologia , Exposição Ocupacional/estatística & dados numéricos , Gerenciamento de Resíduos , Humanos , Fatores de Risco
14.
Cad Saude Publica ; 31 Suppl 1: 295-300, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26648384

RESUMO

Human contact with solid waste poses biological, chemical, and physical health risks for workers involved in waste collection, transportation, and storage. The potential risk to human health resulting from contact with health services waste or household waste still sparks considerable controversy. The aim of this study was to identify the context of scientific discussions on risk/infection from the hepatitis B and C viruses in workers that collect solid waste from health services or households. The search covered publications up to 2013 in Brazilian and international databases, and 11 articles were selected through a literature review. Of these, six conclude that there is an increased risk of infection in workers that collect household waste when compared to those unexposed to waste, three point to greater risk for workers that collect health services waste as compared to those that collect ordinary waste, and the other two found no difference between exposed and unexposed individuals.


Assuntos
Hepatite B/transmissão , Hepatite C/transmissão , Doenças Profissionais/epidemiologia , Exposição Ocupacional , Resíduos Sólidos/efeitos adversos , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , Doenças Profissionais/etiologia , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA