Occupational cancer burden in developing countries and the problem of informal workers.

Most workplaces in developing countries are "informal", i.e. they are not regularly surveyed/inspected and laws for workers' protection are not implemented. Research on occupational risks in informal workplaces and the related cancer burden is needed. The results of studies addressing exposures among informal workers are difficult to generalize because of the specificities of social contexts, and study populations are small. The estimation of the burden of cancers attributable to occupational exposures is also made difficult by the fact that occupational cancers are usually clinically indistinguishable from those unrelated to occupation.

Recovering records on cancer of the larynx from anonymous health information databases.

OBJECTIVE: To develop a linkage algorithm to match anonymous death records of cancer of the larynx (ICD-10 C32X), retrieved from the Mortality Information System (SIM) and the Hospital Information System of the Brazilian Unified National Health System (SIH-SUS) in Brazil. METHODOLOGY: Death records containing ICD-10 C32X codes were retrieved from SIM and SIH-SUS, limited to individuals aged 30 years and over, between 2002 and 2012, in the state of São Paulo. The databases were linked using a unique key identifier developed with sociodemographic data shared by both systems. Linkage performance was ascertained by applying the same procedure to similar non-anonymous databases. True pairs were those having the same identification variables. RESULTS: A total of 14,311 eligible death records were found. Most records, 10,674 (74.6%), were exclusive to SIM. Only 1,853 (12.9%) deaths were registered in both systems, representing true pairs. A total of 1,784 (12.5%) cases of laryngeal cancer in the SIH-SUS database were tracked in SIM with different causes of death. The linkage failed to match 167 (9.4%) records due to inconsistencies in the key identifier. CONCLUSION: The authors found that linking anonymous data from mortality and hospital records is a feasible measure to track missing records and may improve cancer statistics.

Child and adolescent labor, socioeconomic status, and reduced adult height.

This population-based cross-sectional study of 3262 individuals aged 18 to 65 years from Aracaju, Brazil investigates the effects of child/adolescent labor (CAL) experience on adult height, considering gender, socioeconomic status (SES), and skin color. We hypothesized that the younger children are at their first job, the greater the negative effects will be on their later growth as adults. Child/adolescent laborers reported having paid jobs before 14 years of age. Among males in the low and medium SES strata, CAL experience was negatively associated with adult height independent of skin color; among females, this inverse association was observed for those in the low and high SES strata. Among males in the low and medium SES strata, there was a linear inverse relation between age at first job and adult height. CAL could reduce height in adulthood, suggesting a need for programs that reduce the impact of CAL on future physical development.

Occupation and maternal mortality in Brazil.

OBJECTIVE: To estimate maternal mortality ratio according to occupation in Brazil. METHODS: This is a mortality study conducted with national data from the Mortality Information System (SIM) and the Live Birth Information System (SINASC) in 2015. Maternal mortality ratios were estimated according to the occupation recorded in death certificates, using the Brazilian Classification of Occupation (CBO), version 2002. RESULTS: A total of 1,738 maternal deaths records were found, corresponding to a maternal mortality ratio of 57.6/100,000 live births. It varied among occupational groups, with higher estimates among service and agricultural workers, particularly for domestic workers (123.2/100,000 live births), followed by general agricultural workers (88.3/100,000 live births). Manicurists and nursing technicians also presented high maternal mortality ratio. Maternal occupation was not reported in 17.0% of SIM registers and in 13.2% of SINASC data. Inconsistent records of occupation were found."Housewife" prevailed in SIM (35.5%) and SINASC (39.1%). CONCLUSIONS: Maternal mortality ratio differs by occupation, suggesting a work contribution, which requires further research focusing occupational risk factors. Socioeconomic factors are closely related to occupation, and their combination with work exposures and the poor access to health services need to be also addressed.

Occupational exposure to organophosphate pesticides and hematologic neoplasms: a systematic review. / Exposição ocupacional a agrotóxicos organofosforados e neoplasias hematológicas: uma revisão sistemática.

OBJECTIVE: To update findings of observational analytical studies on the association between occupational exposure to organophosphates and hematologic malignancies. METHODOLOGY: Systematic literature review, including cohort and case-control studies, without limitation of publication time, in Portuguese and English. The articles were traced from June 2017 to July 2019 in PubMed, MEDLINE, LILACS, Web of Science, and Scopus databases. The qualitative bias risk assessment was performed using the Newcastle-Ottawa Scale and the Downs and Black Checklist. Results were presented according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). RESULTS: Seventeen studies evaluated as good/high methodological quality were eligible. Exposure to diazinon (1 cohort), phonophos (1 cohort), dichlorvos, crotoxiphos and famphur (1 case control) was associated with leukemia, while exposure to organophosphate was associated to lymphomas (6 case control); the risk of non-Hodgkin's lymphoma was higher in those exposed to diazinon (1 control case) and malathion (3 control case) than non-exposed ones. Multiple myeloma occurred more commonly in organophosphate exposed than in non-exposed individuals (1 case-control). CONCLUSION: Occupational exposure to organophosphates increases the risk of hematologic malignancies, especially among individuals with longer exposure periods. Worker monitoring and exposure control measures are recommended.

[Factors associated with quality of work accident records in Brazil's Mortality Information System]. / Fatores associados à qualidade de registros de acidentes de trabalho no Sistema de Informações sobre Mortalidade no Brasil.

This study aimed to identify factors associated with the quality of fatal work accident records in the Brazilian Mortality Information System in individuals 18 to 65 years of age from 1998 to 2013. The quality of the record of possible causal relationship between accidents and the work , a field that appears on death certificates and is exclusive to accidents among external causes, was analyzed with two variables: (1) record "ignored" (R-IGN, yes/no); (2) missing or inconsistent records (R-AUS, yes/no). A total of 665,531 deaths were located, of which 67.7% of the records showed poor quality. Factors associated with record "ignored" were: male sex; white skin color; schooling less than university; non-blue-collar workers or non-farmers; death certificate issued by the Forensic Medical Office (IML); Southeast and Northeast regions of the country; and death in hospital. Missing or inconsistent records were associated with: age greater than 34 years; non-white skin color; no schooling; all regions of Brazil except the Southeast; death in hospital or at home; police report as the source of information; and death certificate issued by the IML. The factors independently associated with poor quality of completion of the field included individual dimensions, source issuing the death certificate, place of death, and geographic variables. The findings reveal the need to improve the quality of death records in hospitals, the IML, and police reports, besides training and supervising teams throughout Brazil.

Este estudo teve como objetivo identificar fatores associados à qualidade do registro de acidentes de trabalho fatais no Sistema de Informações sobre Mortalidade (SIM), ocorridos com pessoas de 18 a 65 anos, entre 1998 e 2013, no Brasil. A qualidade do registro da possível relação causal de acidentes com o trabalho , campo existente em declarações de óbitos, exclusivo para acidentes dentre as causas externas, foi analisada com duas variáveis: (1) registro "ignorado" (R-IGN, sim/não); (2) registros ausentes ou inconsistentes (R-AUS, sim/não). Foram encontrados 665.531 óbitos dentre os quais 67,7% dos registros de eram de má qualidade. Fatores associados a registro "ignorado" foram: sexo masculino; cor da pele branca; escolaridade menor que a superior; não operários ou não agricultores; atestante Instituto Médico Legal (IML); regiões Sudeste e Nordeste; e óbito em hospital. Registros ausentes ou inconsistentes se associaram: à idade acima de 34 anos; à cor da pele não branca; a sem escolaridade; a todas as regiões, exceto à Sudeste; a óbito em hospital ou no domicílio; a boletim de ocorrência como fonte; e a atestante IML. Esses fatores, independentemente associados à má qualidade de preenchimento do campo , compreendiam dimensões individuais, da fonte de emissão, do local do óbito e geográficas. Isso revela a necessidade de melhoria da qualidade de declarações de óbito em hospitais, IML e boletins de ocorrência, treinando e supervisionando equipes em todo o Brasil.

El objetivo de este estudio fue identificar factores asociados a la calidad del registro de accidentes de trabajo fatales en el Sistema de Información sobre Mortalidad (SIM), ocurridos con personas de 18 a 65 años, entre 1998 y 2013, en Brasil. La calidad del registro de la posible relación causal de accidentes con el trabajo , campo existente en las declaraciones de fallecimiento, exclusivo para accidentes entre las causas externas, se analizó con dos variables: (1) registro "ignorado" (R-IGN, sí/no); (2) registros ausentes o inconsistentes (R-AUS, sí/no). Se encontraron 665.531 óbitos entre los cuales un 67,7% de los registros de eran de mala calidad. Los factores asociados al registro "ignorado" fueron: sexo masculino; color de piel blanco; escolaridad menor que la superior; no obreros o no agricultores; con atestado del Instituto Médico Legal (IML); región sudeste y nordeste; y fallecimiento en hospital. Los registros ausentes o inconsistentes se asociaron a: edad por encima de 34 años; color de piel no blanca; sin escolaridad; todas las regiones, excepto la sudeste; fallecimiento en hospital o en el domicilio; boletín de ocurrencia como fuente; y con atestado IML. Estos factores independientemente asociados a la mala calidad en la cumplimentación del campo incluían dimensiones individuales, de la fuente de emisión, del lugar del fallecimiento y geográficas. Esto revela la necesidad de mejora en la calidad de las declaraciones de óbito en hospitales, IML y boletines de ocurrencia, entrenando y supervisando equipos en todo Brasil.

The recording of fatal work-related injuries in information systems in Brazil. / Registro de dados sobre acidentes de trabalho fatais em sistemas de informação no Brasil.

This study aims to identify information systems having fatal work-related (ATF) data in Brazil, describing their characteristics, flows and barriers to information quality. Using a documental research approach, we found: the Mortality Information System (SIM), the Hospital Admission Register from the Unified Health System (SIH-SUS), the Notifiable Diseases Information System (SINAN) and the Violence and Injuries Surveillance Program (VIVA) from the Health Ministry; the Work-related Injuries Reporting System (SISCAT) of the Ministry of Social Insurance; and the Annual Report of Social Information (RAIS), Ministry of Labour and Employment. A lack of key common variables limits the construction of a single database composed by all ATF recorded cases. From several barriers identified, the most relevant for data quality was the lack of work-relatedness recognition and recording, a task performed by the health team.

O objetivo deste estudo é identificar sistemas de informação que dispõem de dados sobre acidentes de trabalho fatais (ATF) no Brasil, descrever suas características, fluxos e barreiras para a qualidade da informação. Empregando-se o método da pesquisa documental, foram encontrados: o Sistema de Informações sobre Mortalidade (SIM), o Sistema de Informações Hospitalares do SUS (SIH/SUS), o Sistema de Informação de Agravos de Notificação (Sinan) e o Sistema do Programa Vigilância de Violência e Acidentes (VIVA) do Ministério da Saúde; o Sistema de Informação de Comunicação de Acidentes do Trabalho (Siscat) da Previdência Social; e do Ministério do Trabalho e Emprego, a Relação Anual de Informações Sociais (RAIS). A falta de variáveis chave comuns limita a construção de uma base de dados única com todos os casos de ATF registrados. Dentre os vários filtros e barreiras identificados destaca-se o não reconhecimento da relação do acidente com o trabalho pelos profissionais registrantes.

[Work-related diseases and health-related compensation claims, Northeastern Brazil, 2000]. / Doenças do trabalho e benefícios previdenciários relacionados à saúde, Bahia, 2000.

OBJECTIVE: To estimate the contribution of work-related diseases to sick leaves due to general and occupational health problems. METHODS: Sociodemographic, occupational and health data from 29,658 records of temporary disability benefits, granted on account of health problems by the Instituto Nacional do Seguro Social (National Institute of Social Security) in the state of Bahia (Northeastern Brazil), were analyzed. All constant ICD-10 clinical diagnoses were taken into consideration, except for those referring to external causes and factors that influence contact with health services. The link between diagnosis and occupation was based on the ICD-10 code and whether the type of compensation was due to a "work-related accident/disease" or not. RESULTS: From all the benefits, 3.1% were granted due to work-related diseases: 70% were musculoskeletal system and connective tissue diseases, while 14.5% were related to the nervous system. In general, benefits granted at more than two times the expected frequency were as follows: tenosynovitis in the manufacturing sector (Proportion Ratio-PR=2.70), carpal tunnel syndrome in the financial intermediation sector (PR=2.43), and lumbar disc degeneration in the transportation, postal service and telecommunications sectors (PR=2.17). However, no causal connection could be established for these diseases, in these activity sectors, in a significant percentage of benefits. CONCLUSIONS: Results suggest the existence of possible occupational risk factors for diseases in these fields of activity, as well as the underreporting of the link between diseases and work, thus disguising the responsibility of companies and the perspective of prevention through work reorganization.

Qualidade dos registros de ocupação das doenças associadas ao asbesto no sistema de informação sobre mortalidade, Brasil / Quality of occupation records of asbestos-related diseases in the mortality information system, Brazil

Resumo Introdução: Registros de ocupações de trabalhadores em sistemas de informação significam muito mais que um dado sociodemográfico. Na Medicina do Trabalho e na Epidemiologia em Saúde do Trabalhador, são especialmente relevantes por indicarem possíveis fatores de risco ocupacionais. Objetivo: Estimar indicadores de qualidade do registro da ocupação das doenças associadas ao asbesto no Sistema de Informação sobre Mortalidade (SIM), Brasil. Método: Estudo transversal conduzido com registros de óbito de maiores de 16 anos de idade, registrados no SIM, entre 2000-2016, com diagnósticos de doenças tipicamente associadas ao asbesto (DAA): mesotelioma, asbestose e placas pleurais. O registro da "ocupação" foi analisado para a completude e consistência. Resultados: Foram identificados 3.764 registros de óbito, para os quais observou-se 60,3% (n=2.268) de incompletude/inconsistência do registro da ocupação. Dados inválidos da ocupação representaram 40,1% (n=1.508), concentrando-se em registros de aposentados e donas de casa, não reconhecidos como ocupações. A má qualidade do registro de ocupação entre os óbitos por DAA foi superior a 50,0% em todas as regiões do país. Conclusões: A qualidade do registro da ocupação no SIM foi ruim tanto para as DAA quanto outros diagnósticos, especialmente no que se refere a completude e consistência dos dados, em relação à Classificação Brasileira de Ocupações.

Abstract Background: Records from occupations of workers in information systems mean much more than just sociodemographic data. In Occupational Medicine and Occupational Health Epidemiology, they are especially relevant as they indicate possible occupational risk factors. Objective: To estimate quality indicators of the record of occupation of asbestos-related diseases in the Mortality Information System (SIM), Brazil. Method: Cross-sectional study, conducted with death records of people over 16 years of age, registered in SIM, from 2000 to 2016, with diagnoses of asbestos-related diseases (ARD): mesothelioma, asbestosis, and pleural plaques. The "occupation" field was analyzed for completeness and consistency. Results: From a total of 3,764 death records, for which 60.3% (n=2,268) of missed/inconsistent occupation records were observed. Invalid occupation data accounted for 40.1% (n=1,508), mainly filled with "retired" or "housewives", not recognized as formal job titles. The poor occupancy record quality among ARD records was over 50.0% in all regions of the country. Conclusions: The quality of the occupation records in SIM was poor for both ARD and other diagnoses, especially regarding the completeness and consistency of the data, in relation to the Brazilian Classification of Occupations.

[The Brazilian Workers' Food Program and its impact on weight gain and overweight]. / Programas de alimentação para o trabalhador e seu impacto sobre ganho de peso e sobrepeso.

OBJECTIVE: To evaluate the impact of worker food programs on weight gain and overweight. METHODS: This is a retrospective cohort study carried out in the state of Bahia, northeastern Brazil, between 1995 and 2000. All 10,368 workers from manufacturing and construction industries enrolled in the Brazilian Industry Social Service workers' health program were included in the study. Workers data were obtained from electronic medical records corresponding to pre-employment, periodic and dismissal clinical exams. Company data were obtained through phone interviews with key informants from human resources departments. Statistical analysis was based on incidence rate ratio and 95% confidence intervals calculated using the exact binomial test. RESULTS: Workers covered by the Brazilian Workers' Food Program (Programa de Alimantação do Trabalhador) (incidence rate ratio,,IRR=1.71; 95% CI 1.45-2.00) or other food programs (IRR=2.00; 95% CI 1.70;2.35) have increased incidence rate of weight gain compared to non-covered workers. Overweight was also associated to being covered by the Programa (IRR=1.91; 95% CI 1.26;2.91) or other food programs (IRR=2.13; 95% CI 1.41;3.23). CONCLUSIONS: Food programs contributed to weight gain and overweight. Program strategies need to be reviewed taking into consideration not only the daily amount of calories but also promotion of adequate nutritional balance and physical activity as well as other healthy life habits.

Quality of the record of data on fatal workplace injuries in Brazil.

OBJECTIVE: To evaluate the quality of the data on fatal workplace injuries in Brazil, in the Mortality Information System (SIM) and the Information System of Notifiable Diseases (SINAN-AT), analyzing the spatial and temporal distribution between 2007 and 2012. METHODS: We identified fields related to fatal workplace injuries, which were examined for completeness and the use of the "ignored" option. From the SIM, we extracted the records of deaths from external causes, which require the completing of the field about their relation with work. From the SINAN, we analyzed the field, which allows us to identify fatal cases among s severe workplace injuries. RESULTS: In the SIM, from 469,121 records, the field was left unfilled or filled as ignored in 84.2% of them; the Brazilian region with the highest proportion was the Northeast (79.1%), from which the state of Alagoas (94.4%) had the highest amount. There was a 5.5% decreasing trend between 2007 (86.6%) and 2012 (81.8%). Among the 251,681 records found in the SINAN-AT, 28.3% had unfilled or ignored responses for , varying from 39.7% in 2007 to 23.2% in 2012, a 41.6% decrease. CONCLUSIONS: The quality of the records on the fields of interest needed to identify fatal workplace injuries is poor in the SIM, but gradually improving. Recording quality was better for SINAN-AT, which has also been strongly getting better lately.

[Mesothelioma mortality in Argentina, 1980-2013]. / Mortalidad por mesotelioma en Argentina, 1980-2013.

Mesothelioma mortality and its socio-demographic and temporal patterns in Argentina from 1980 to 2013 were estimated using data from death certificates obtained from the Vital Statistics System of Argentina's National Ministry of Health. There were 3,259 mesothelioma deaths corresponding to an age-adjusted mortality of 3.1/1,000,000 in 1980 and 5.7/1,000,000 in 2013, an average increase of 84.1% in 34 years. This raising trend became clearer after 1997. Males had higher mortality estimates compared with women in every year of the series; these findings suggest past exposure to asbestos. It is plausible that the asbestos exposure was mostly occupational, which is more common among men. Actions related to reinforcing the asbestos ban already in place and strengthening health surveillance directed at workplaces, previously exposed workers, and the population in general are recommended.

Fatores ocupacionais associados a neoplasias hematológicas em um polo fruticultor: estudo de caso-controle / Occupational factors associated with hematological neoplasms in a fruit production pole: a case-control study

Resumo Objetivos: identificar fatores de risco ocupacionais para neoplasias hematológicas, leucemia, linfomas e mieloma múltiplo. Métodos: estudo caso-controle conduzido com casos de neoplasias hematológicas e controles recrutados do mesmo serviço, com outros diagnósticos, pareados por frequência, sexo e idade. Entrevistas individuais foram realizadas por pesquisadores treinados, utilizando um questionário estruturado. Informações sobre a história ocupacional, uso e características de exposições a substâncias químicas, em geral, e a agrotóxicos foram registradas. Foram estimadas odds ratios (OR), por meio de modelos de regressão logística não-condicional multivariável para análise exploratória. Resultados: foram incluídos 61 casos e 146 controles. Trabalho na agropecuária (OR: 2,18; intervalo de confiança de 95% (IC95%): 1,10;4,30), exposição ocupacional a agrotóxicos (OR: 2,37; IC95%: 1,18;4,77), e tempo total de exposição ocupacional a agrotóxicos na vida laboral em horas - curto (OR: 3,52; IC95%: 1,25;9,87) e longo (OR: 3,95; IC95%: 1,54;10,14) - foram fatores de risco para neoplasias hematológicas, em comparação aos não expostos. Essas medidas foram ajustadas por consumo de álcool e tabagismo, prática de atividade física, renda, escolaridade e história de exposição ocupacional a produtos químicos. Conclusão: a exposição ocupacional a agrotóxicos se associa a neoplasias hematológicas, independentemente de características do estilo de vida e nível socioeconômico.

Abstract Objectives: to identify the occupational risk factors for hematological neoplasms, specifically leukemia, lymphomas, and multiple myeloma. Methods: this is a case-control study. Cases were individuals with hematological neoplasms and controls were individuals with other diagnoses; frequency-matched by sex and age. Individual interviews were conducted by trained researchers using a structured questionnaire. We collected information on participants' occupational history and chemicals use and exposure, in general, and pesticides, in particular. Odds ratios (OR) were used as association measurements, estimated by multivariate non-conditional logistic regression models for exploratory analysis. Results: 61 cases and 146 controls were included. We found that agricultural work (OR: 2.18; 95% confidence interval (95%CI): 1.10;4.30), occupational exposure to pesticides (OR: 2.37; 95%CI: 1.18;4.77), and total occupational exposure to pesticides throughout their working life (in hours) - both short (OR: 3.52; 95%CI: 1.25;9.87) and long (OR: 3.95; 95%CI: 1.54;10.14) - constituted risk factors for hematological neoplasms, when compared to those unexposed. We adjusted these measures for alcohol consumption and smoking, physical activity, income, education, and history of occupational exposure to chemicals. Conclusion: occupational exposure to pesticides is associated with hematological neoplasms regardless of lifestyle and socioeconomic status.

[Workers' health in Brazil: graduate research]. / Saúde do trabalhador no Brasil: pesquisa na pós-graduação.

OBJECTIVE: To study trends of dissertation and thesis production in workers' health in Brazil. METHODS: Observation units were dissertations and theses developed by Brazilian researchers in national and foreign graduate programs. Theses and dissertations were identified in previously compiled works, LILACS and Capes database. Search keywords were workers' health, ergonomics, occupational hygiene, toxicology, and occupational health. RESULTS: There were identified 1,025 documents. Of them, seven were published before 1970, 31 were published in 1970s, 121 in 1980s, 533 in 1990s, and 333 between 2000 and 2004. An exponential growth of studies during the study period was observed with a corresponding factor approximately equal to 4 in each decade. The majority of studies addresses major public health issues like musculoskeletal diseases, mental health, and occupational risks for health workers. It was noticeable the small number of studies on unemployment, occupational cancer, and primary sector and construction industry workers, known as a risk group for fatal work-related injuries. CONCLUSIONS: The growth of public and collective health graduate programs was a major factor for increasing research on workers' health in Brazil in recent years. Despite increasing academic studies in this area of knowledge there are some persisting gaps persist that need to be narrowed in the near future.

[Occupational accidents: social insurance costs and work days lost]. / Acidentes de trabalho: custos previdenciários e dias de trabalho perdidos.

OBJECTIVE: To estimate the proportion of occupational accident benefits granted within the total for health-related social security benefits, viewing the costs according to benefit type and the impact on productivity according to work days lost. METHODS: Records of benefit decisions from the National Benefits System of the National Social Security Institute for the State of Bahia in 2000 were utilized. Occupational accidents were defined in accordance with the clinical diagnoses of External Causes, Injuries and Poisoning (SS-00 to T99) of the International Classification of Diseases, 10th Revision, and with the benefit type, which distinguishes between occupational and non-occupational health problems. RESULTS: A total of 31,096 benefits granted due to illnesses or health problems were studied. Of these, 2,857 (7.3%) were caused by work accidents. Greater proportions were found among workers in the manufacturing, construction, electricity and gas industries, accounting for 18% of the total benefits. The costs of occupational accident benefits were estimated to be R$8.5 million, with around half a million work days lost during the year studied. CONCLUSIONS: Despite the fact that these data are under-reported and are restricted to workers who were able to receive health-related benefits, the findings reveal that avoidable health problems have a major impact on productivity and on the budget of the National Social Security Institute, thereby reinforcing the need for their prevention.

[Occupational exposure to benzene in Brazil: estimates based on an occupational exposure matrix]. / Exposição ocupacional ao benzeno no Brasil: estimativas baseadas em uma matriz de exposição ocupacional.

This study estimates the number of exposed workers and the prevalence of occupational benzene exposure in Brazil. Due to the lack of available local measurements for the study, data were used from an occupational exposure matrix, the Finnish National Job-Exposure Matrix (FINJEM), which covers proportions of individuals exposed to benzene, calculated as environmental measures. In Brazil, the 2010 Demographic Census identified 86,353,839 workers in the workforce and employed. Applying the FINJEM parameters, an estimated 7,376,761 (8.5%) belonged to potentially exposed occupational groups, while 770,212 were considered exposed to benzene, corresponding to an occupational group-weighted prevalence of 0.9%, higher in men (1.1%) than in women (0.6%). Exposed individuals were concentrated in the category of Machine and Motor Operators and Mechanics (62%). The number of exposed and prevalence of occupational exposure to benzene are high, even when compared to Finnish parameters, suggesting the need for monitoring and control of this carcinogen in Brazil.

[Mortality from work-related accidents among agricultural workers in Brazil, 2000-2010]. / Mortalidade por acidentes de trabalho entre trabalhadores da agropecuária no Brasil, 2000-2010.

This study estimated annual mortality from work-related injuries in agriculture in Brazil, 2000-2010. The Mortality Information System (SIM) was used to identify cases. Missing data for occupation and work-related injuries were retrieved through other available individual records and incorporated into total cases. Population data were obtained from the official censuses. A total of 8,923 deaths from work-related injuries were identified, of which 44.8% were located by data retrieval. In the year 2000, estimated crude mortality from work-related injuries was 6.4/100,000 workers, increasing to 8.1/100,000 in 2003 and declining to 7.3/100,000 in 2010. The leading circumstances of deaths in men involved "riding animals or using animal-drawn vehicles", whereas pesticide poisoning was the leading cause in women. Overall mortality from work-related injuries in agriculture was low when compared to that of other countries, suggesting residual under-recording despite data retrieval and thus calling for quality improvement in records. Gender-sensitive preventive measures are necessary.

Gathering Occupational Health Data from Informal Workers: The Brazilian Experience.

This study describes how occupational health data have been gathered by the Brazilian Unified Health System (SUS) to provide morbidity and mortality estimates for formal and informal workers. In 2007, data on work-related diseases and injuries was incorporated into the compulsory notification system (SINAN) and analyzed by the SUS occupational health service network, which covers all Brazilian states. However, this work has not been fully implemented, resulting in the large-scale undercounting and underreporting of cases, particularly in relation to informal workers. This is suggestive of barriers that prevent access to services and good quality health care. The inclusion of work-related diseases and injuries in SINANs appears to be a feasible strategy for the collection of useful data for the surveillance of the entire universe of workers, particularly in countries where informal workers prevail within the labor force. Attention needs to be paid to the disparities in access and quality that affect low-paid, informal workers.

Periodontal health and oral mucosal lesions as related to occupational exposure to acid mists.

OBJECTIVES: The association between exposure to acid mists and periodontal changes and oral mucosal lesions was measured using data from an Oral Health Promotion Program in a large metal plant. The role of sociodemographic factors, lifestyle, and oral health behavior in relation to these outcomes was also examined. METHODS: This is a cross-sectional study of 665 active male workers who volunteered to participate in the oral health program. A job exposure matrix was constructed with industrial hygienist scores and job titles to estimate years of exposure to acid mists. Oral health outcomes were identified during standardized dental examinations. Unconditional logistic regression models were utilized in the analysis. RESULTS: Duration of exposure to acid mists exposure was positively associated with oral mucosal lesions among workers without lip sealing. Only age, low salaries and oral hygiene-related variables were associated with periodontal changes, and estimates varied according to lip sealing. CONCLUSIONS: Results suggest that long-term occupational exposure to acid mists is associated with oral mucosal lesions, and that absence of lip sealing may increase the intensity of exposure.

[Reliability of reported data from adolescent and their mothers in a health survey]. / Concordância de informações de adolescentes e suas mães em inquérito de saúde.

OBJECTIVE: To estimate the reliability of data obtained from questionnaires applied to adolescents and their mothers in a health survey. METHODS: Data from population-based survey conducted with a one-stage random cluster area sampling of residents in the urban area of Salvador, Brazil, were assessed. The study sample comprised 82 pairs of adolescent workers aged 10 to 14 years and their mothers. After interviewing the adolescents, in a second visit, their mothers were invited to answer a similar questionnaire applied by a blinded interviewer. Respiratory and depressive symptoms, sleep pattern changes and distress in the neighborhood and at school were the variables analyzed. Reliability was measured using proportion of agreements and kappa index of agreement statistics. RESULTS: Overall agreement and kappa index were low. Mothers have provided more positive answers than adolescents, resulting in a negative bias. Reliability was higher among boys for all answers when compared to girls, except for sleep patterns changes. For depressive symptoms, mother's education level was negatively associated with agreement for both genders. CONCLUSIONS: Information from adolescents differs from that obtained from mothers. It is worth noticing that poor agreement does not impair validity, which needs to be examined in further studies.