Search

Theaim of this cross-sectional study was to compare workplace conditions and metal exposures in 431 waste pickers who worked nearby at the Estrutural Dump in Brasilia utilizing hair (n = 310) and nail (n = 355) as matrices of exposure. Waste pickers were grouped according to their workplace (open waste dump: G1 and sorting plants: G2). Hair and nail samples were collected and analyzed using ICP-MS. The work duration in the facilities was significantly different between the groups with averages of 16.46 (8.48) yrs and 9.26 (6.28) yrs for hair donors in G1 and G2, and 15.92 (7.72) yrs and 8.55 (5.77) yrs for toenail donors in G1 and G2, respectively. The arithmetic means (µg/g) of cadmium, copper, lead, and manganese in hair were significantly higher in G2 (0.076 ± 0.133; 19.61 ± 18.16; 2.27 ± .56 and 3.87 ± 5.59, respectively) compared to G1 (0.069 ± 0.235; 15.72 ± 15.18; 1.72 ± 4.04 and 3.65 ± 5.5, respectively). Concentrations of arsenic, barium, cadmium, copper, cobalt, lead, manganese, and molybdenum in nail were significantly higher in G2 (0.57 ± 0.39; 22.74 ± 42.06; 0.1 ± 0.08; 22.7 ± 51.60; 0.48 ± 0.45; 4.69 ± 9.43; 19.07 ± 20.75; 1.80 ± 1.76, respectively) compared to G1 (0.40 ± 0.28; 15.32 ± 22.31; 0.08 ± 0.11; 11.91 ± 16.25; 0.37 ± 0.37; 3.94 ± 15.04; 13.01 ± 19.08; 1.16 ± 1.80, respective. Our findings suggest that the studied population was exposed to toxic metals and indicates the need for chemical exposure prevention policies to monitor chemical risk exposures in waste pickers. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El artículo enfoca en la organización brasileña "Comité Nacional para los Refugiados (CONARE). La comisión, integrada por representantes de varios ministerios federales, fue creada en 1997 para abordar las condiciones de los refugiados y regular el marco legal del asilo en Brasil. Se describe cómo abordan los temas de integración social, el reasentamiento y la vida familiar de los refugiados.

The article reports on the Brazilian National Committee for Refugees (CONARE), an inter-ministerial and inter-institutional body which works to determine refugee eligibility, promote refugee-related public policies, design and evaluate resettlement activities and regulate the legal framework for asylum in Brazil. As reported, CONARE has clarified and expanded the 1997 Refugee Act, the first legislation in South America to consider 'severe and generalised violations of human rights' as legitimate grounds for refugee status and became an example for other countries in the region. It is further reported that CONARE gives priority to the protection of refugees without legal and physical protection and women at risk.

• Despite dumpsite closures in Brazil, waste continues to be collected by waste pickers. • Workers are exposed to adverse health effects, including waterborne diseases. • Waterborne diseases included diarrhea, intestinal worms, hepatitis A, and leptospirosis. • Women are at greater risk than men. • Closing dumpsites has not reduced occupational hazards to water pickers. Brazil was home to the second largest open-air dump in the world, Estrutural, which officially closed in January of 2018; however, many dumpsites throughout the country continue to operate informally. Prior to government-recognized closure, there were about 1200 waste pickers working at the dump. These workers were subject to a myriad of occupational and environmental risks; one primary hazard involved exposure to contaminated water, which significantly affects health and quality of life. As part of the official closure plan for Estrutural, a study was conducted to determine the occurrence of waterborne diseases and rates of intestinal worms among the workers. A convergent parallel mixed methods approach, using a cross-sectional study and semi-structured interviews, sought to uncover answers to these objectives. There were 1025 waste pickers used in this study. Data confirmed waste pickers experienced continuous bouts of waterborne disease cases through episodic diarrhea (24.9%), intestinal worms (12.6%), hepatitis A (1.7%) and leptospirosis (0.7%). People who lived in unregulated areas (favelas) had increased risk of diarrhea (OR = 1.72) and those who did not use filtered water were at increased risk of intestinal worms (OR = 1.87) and diarrhea (OR = 1.5). Qualitative and quantitative data confirmed that many workers suffered from waterborne diseases, and that women were at greater risk than men. These findings highlight unsanitary and poor occupational health conditions for waste pickers at dumpsites, which likely continue despite official dumpsite closures. Moreover, this data provide evidence of supplemental occupational hazards to assess at dumpsites worldwide, especially for women. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the evidence of validity, reliability and responsiveness of the Brazilian version of the Safety Attitudes Questionnaire for Emergency Care Units., Method: Methodological study carried out in September 2020 with 46 health professionals from an Emergency Care Unit in the metropolitan region of the State of Espírito Santo. Reliability was verified through the analysis of internal consistency, stability and reproducibility. The validity and responsiveness of the instrument were tested., Results: Cronbach's alpha=0.85, showing excellent internal consistency. All domains are positively and significantly correlated with each other. In the stability assessment, the domains Job Satisfaction, Management Perception and Working Conditions showed strong correlations., Conclusion: It is concluded that the instrument presents satisfactory values in the evaluation of psychometric properties, showing evidence of validity, reliability and responsiveness. Thus, it is validated to be reproduced in other Emergency Care Units in Brazil.

The World Health Organization Call to Eliminate Cervical Cancer resonates in cities like Manaus, Brazil, where the burden is among the world's highest. Manaus has offered free cytology-based screening since 1990 and HPV immunization since 2013, but the public system is constrained by many challenges and performance is not well-defined. We obtained cervical cancer prevention activities within Manaus public health records for 2019 to evaluate immunization and screening coverage, screening by region and neighborhood, and the annual Pink October screening campaign. We estimated that among girls and boys age 14-18, 85.9% and 64.9% had 1+ doses of HPV vaccine, higher than rates for age 9-13 (73.4% and 43.3%, respectively). Of the 90,209 cytology tests performed, 24.9% were outside the target age and the remaining 72,230 corresponded to 40.1% of the target population (one-third of women age 25-64). The East zone had highest screening coverage (49.1%), highest high-grade cytology rate (2.5%) and lowest estimated cancers (38.1/100,000) compared with the South zone (32.9%, 1.8% and 48.5/100,000, respectively). Largest neighborhoods had fewer per capita screening locations, resulting in lower coverage. During October, some clinics successfully achieved higher screening volumes and high-grade cytology rates (up to 15.4%). Although we found evidence of some follow-up within 10 months post-screening for 51/70 women (72.9%) with high-grade or worse cytology, only 18 had complete work-up confirmed. Manaus has successfully initiated HPV vaccination, forecasting substantial cervical cancer reductions by 2050. With concerted efforts during campaigns, some clinics improved screening coverage and reached high-risk women. Screening campaigns in community locations in high-risk neighborhoods using self-collected HPV testing can achieve widespread coverage. Simplifying triage and treatment with fewer visits closer to communities would greatly improve follow-up and program effectiveness. Achieving WHO Cervical Cancer Elimination goals in high-burden cities will require major reforms for screening and simpler follow-up and treatment., Competing Interests: The authors have declared that no competing interests exist.

Objectives: to measure the frequency and compliance of breast cancer screening, according to the risk for this disease., Methods: a cross-sectional study with 950 female users of 38 public Primary Health Care services in São Paulo, between October and December 2013. According to UHS criteria, participants were grouped into high risk and standard risk, and frequency, association (p≤0.05), and screening compliance were measured., Results: 6.7% had high risk and 93.3% standard risk, respectively; in these groups, the frequency and compliance of clinical breast examination were 40.3% and 37.1%, and 43.5% and 43.0% (frequency p=0.631, compliance p=0.290). Mammograms were 67.7% and 35.5% for participants at high risk, and 57.4% and 25.4% for those at standard risk (frequency p=0.090, compliance p=0.000)., Conclusions: in the groups, attendance and conformity of the clinical breast exam were similar; for mammography, it was higher in those at high risk, with assertiveness lower than the 70% set in UHS.

The World Health Organization global call to eliminate cervical cancer encourages countries to consider introducing or improving cervical cancer screening programs. Brazil's Unified Health System (SUS) is among the world's largest public health systems offering free cytology testing, follow-up colposcopy, and treatment. Yet, health care networks across the country have unequal infrastructure, human resources, equipment, and supplies resulting in uneven program performance and large disparities in cervical cancer incidence and mortality. An effective screening program needs multiple strategies feasible for each community's reality, facilitating coverage and follow-up adherence. Prioritizing those at highest risk with tests that better stratify risk will limit inefficiencies, improving program impact across different resource settings. Highly sensitive human papillomavirus (HPV)-DNA testing performs better than cytology and, with self-collection closer to homes and workplaces, improves access, even in remote regions. Molecular triage strategies like HPV genotyping can identify from the same self-collected sample, those at highest risk requiring follow-up. If proven acceptable, affordable, cost-effective, and efficient in the Brazilian context, these strategies would increase coverage while removing the need for speculum exams for routine screening and reducing follow-up visits. SUS could implement a nationwide organized program that accommodates heterogenous settings across Brazil, informing a variety of screening programs worldwide., (©2021 American Association for Cancer Research.)

Worldwide, waste pickers are exposed to adverse health effects resulting from hazards at work. This study aimed to identify possible gender disparities among waste pickers. A quantitative cross-sectional epidemiological study, using semi-structured data was conducted in Estrutural 's dumpsite, Brasília, Brazil. It included 1,025 waste pickers, with 67% being female. Most of them lived without partners (73.7%), have 3 to 4 children (47.8%), and have a lower monthly income (62.6%

This article aims to analyze the completeness of the dengue fever notifications registered in a small municipality in Brazil, from 2007 to 2015. It involved a descriptive study with a quantitative approach, composed of the totality of records available in the National System of Notifiable Diseases. The absolute number and percentage of non-fulfillment of the key, mandatory and essential variables of the dengue notification forms were analyzed, and a score proposed by Romero e Cunha was used to assess the degree of non-completeness. The non-parametric linear correlation coefficient of Spearman (rs) was calculated, being preceded by the verification of the distribution of the data through the Kolmogorov Smirnov test. The proportion of information ignored was high for most of the variables and for some trends of non-completeness over the years were decreasing and statistically significant. The quality of the data was mostly classified as regular and very poor, making it imperative to establish strategies in the process of qualification of health teams that work in primary care, to raise awareness of the importance of quality in the registration of compulsory notifications.

There are approximately 15 million people engaged in waste collection or recycling activities in the world. Some of these dump sites are informal and people work in environments that are labor-intensive, unregulated, unregistered, low-paid, unrecorded, and environmentally hazardous. A systematic review was conducted to assess consequential health conditions and occupational risks that affect waste collectors in Brazil. The search was limited to Brazil because although the government closed dump sites, open-air dumping-the worst type of waste disposal-still occurs in about half of the country; moreover, Brazil is the only country to systematically collect data on the occupation, with an estimated 229,568 recyclable collectors of all types country-wide, which offers relevant and pertinent data on the topic. The results of the search indicated that nearly every region has individuals that work as recyclable collectors. As expected, the sites are full of occupational hazards to the workers that can include: long working hours; exposures to physical, chemical, mechanical, biological, ergonomic and social agents; and frequent work accidents. Exposure to these risks can result both in physical and psychological illnesses. In view of these findings, public policies could be strengthened by supporting and providing incentives to municipalities, schools, universities, health professionals, and all others who will contribute to the closure of open-air waste or poor waste disposal systems. Moreover, an improved awareness should be provided to the general population about environmental education and correct disposal of garbage. The goal of healthy waste disposal conditions ultimately decreases environmental and public health effects, while improving the working conditions, quality of life, and health outcomes for recyclable collectors., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: To report the etiology of liver cirrhosis cases diagnosed at the University Hospital in Vitoria, Espirito Santo, Brazil., Methods: The medical charts of patients with liver cirrhosis who presented to the University Hospital in Vitoria were reviewed. Chronic alcoholism and the presence of hepatitis B or C infections (HBV and HCV, respectively) were pursued in all cases., Results: The sample consisted of 1,516 cases (male:female ratio 3.5:1, aged 53.2 ± 12.6 years). The following main etiological factors were observed: chronic alcoholism alone (39.7%), chronic alcoholism in association with HBV or HCV (16.1 %), HCV alone (14.5%) and in association with alcoholism (8.6%) (total, 23.1 %), and HBV alone (13.1%) and in association with alcoholism (7.5%, total 20.6%). The remaining etiologies included cryptogenic cases (9.8%) and other causes (6.0%). The mean patient age was lower and the male-to-female ratio was higher in the cirrhosis cases that were associated with alcoholism or HBV compared with other causes. Intravenous drug abuse and a history of surgery or blood transfusion were significantly associated with HCV infection. Hepatocellular carcinoma was present at the time of diagnosis in 15.4% of cases. Chronic alcoholism associated with HCV infection was significantly associated (p<0.001) with reduced age (at the time of cirrhosis diagnosis) and increased prevalence of hepatocellular carcinoma (p = 0.052)., Conclusion: Alcoholism, HCV and HBV are the main factors associated with liver cirrhosis in the state of Espirito Santo. Chronic alcoholism associated with HCV infection reduced the age of patients at the time of liver cirrhosis diagnosis.

Background: Significantly higher prevalence of Strongyloides stercoralis has been reported in chronic alcoholic patients. The aim of this investigation was to report the prevalence of Strongyloides larvae in stools of chronic alcoholic patients with known daily ethanol intake., Methods: From January 2001 through December 2003 the results of fecal examinations and the daily ethanol intake were retrieved from the records of 263 chronic alcoholic and from 590 non-alcoholic male patients that sought health care at the outpatients unit of the University Hospital C A Moraes. Alcoholic patients were separated into four groups, with 150g intervals between the groups according to the daily ethanol intake., Results: (a) The frequency of Strongyloides was significantly higher in alcoholic patients than in control group (overall prevalence in alcoholic 20.5% versus 4.4% in control group; p = 0.001). Even in the group with a daily intake of ethanol equal to or less than 150g the prevalence was higher than in control group, although non significant (9.5%, versus 4.4% in control group; p = 0,071); (b) the prevalence of Strongyloides in alcoholic patients rises with the increase of ethanol intake (Pearson's Correlation Coefficient = 0.956; p = 0.022), even in patients without liver cirrhosis (Pearson's Correlation Coefficient = 0.927; p = 0.037)., Conclusion: These results confirm and reinforce the hypothesis that chronic alcoholism is associated with Strongyloides infection, which is in direct relationship with the severity of alcoholism, independently of the presence of liver cirrhosis.