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WRA accounts for 15-20% of asthma in adults. The aim is to assess socioeconomic and quality of life (QoL) impact of WRA in a middle-income country. Methods: 201 patients from a referral hospital were evaluated, 101 asthma patients with no relation to work (NWRA) and 100 WRA cases. All subjects had occupational histories taken, socioeconomic status determined and responded to asthma control questionnaires (ACQ6 and ACT), Hospital Anxiety and Depression Scale (HADS) and Juniper Asthma Quality of Life Questionnaire (AQLQ). Results: The most prevalent occupations in the NWRA group was in the administrative services sector, while WRA patients worked mostly in cleaning services. NWRA group had more women (p=0.04), more asthma family history (p=0.04) and more rhinitis (p=0.036) while WRA group was older (p Indviduals with WRA had a decrease in wage and family income (p Conclusion: Individuals with WRA showed negative socioeconomic impact since diagnosis, and when compared to NWRA group they had worst asthma control, QoL and psychological outcomes.

This study investigated the relative contribution of asbestos-related pleural thickening (PT) to lung function indices and to respiratory symptoms. A group of 828 former asbestos cement workers enrolled in a cross-sectional and cohort study of respiratory morbidity and submitted to a detailed occupational history, respiratory symptoms questionnaire, spirometry, postero-anterior chest x-ray, and high-resolution computed chest tomography (HRCT). Asbestos exposure was assessed by years of exposure (a semi-quantitative method), cumulative exposure, and latency time from first exposure. Smoking was assessed in pack-years. PT and asbestosis were assessed according to HRCT criteria. Statistical analysis included descriptive analysis, univariate and multivariate analysis of variance for comparisons of factors related to PT, stepwise multiple regression analysis for continuous dependent variables, and logistic regression analysis for dichotomous dependent variables. Mean age was 51.4 (SD 10.5) years, mean years of exposure 12.4 (SD 8.8), mean cumulative exposure 79.9 (SD 68.5), and mean latency time 25.2 yr (SD 10.4). Of the 828, 238 (28.7%) were smokers, 288 (34.8%) former smokers, and 302 (36.2%) nonsmokers. PT was present in 246 (29.7%) and asbestosis in 74 (8.9%); 97 (11.9%) had shortness of breath of Grade III or more. PT subjects had lower height-adjusted forced vital capacity (FVC) and forced expiratory volume in I s (FEV1) and lower FEV1/FVC% (p < .00001 for all). Variables significantly related to PT were age (p < .000 1), years of exposure (p < .0000 1), cumulative exposure (p < .00001), latency time (p < .00001), pack-years (p < .0000 1), and asbestosis (p < .00 1). In a multiple stepwise regression model, after controlling for confounders, height adjusted FEV1 and FVC were in versely and significantly associated with PT, mainly when associated with asbestosis. A logistic regression model with shortness of brea th as the dependent va riable, con trolled for confounders, showed that PT was significa ntly associated with the symptom, even without asbestosis. In conclusion, PT is independently associated with lower va lues of FEV1 and FVC. PT is also independently associated with an increased risk of shortn ess of breath report. PT should be considered as a disease for clinical follow up and for compensa tion claims.

Background Occupational asthma (OA) is the leading occupational respiratory disease in the area of Sao Paulo Municipality. Understanding its characteristics can provide useful information for better interventions. Methods From a joint registry of OA from five outpatient public clinics for occupational respiratory diseases, data on occupation, with job titles corrected by an expert evaluation, agents, exposure and symptom duration, and spirometry were analyzed by gender. Data on employment for Sao Paulo Municipality were used to calculate expected ratios for men/women in broad economical sectors. Results Three hundred and ninety four OA cases were reported with a ratio of men/women of 1.5. Women had significantly shorter exposure duration (5.6 ± 5.2 vs. 8.9 ± 9.0 years, P = 0.0005), shorter symptoms duration (2.6 ± 3.7 vs. 3.2 ± 3.5 years, P = 0.1270), and higher prevalence of previous atopy (27.0 vs. 18.4%, P = 0.0485). The main occupations related to OA cases were cleaning activities, working in plastics manufacture and in chemical and pharmaceutical plants. Women reported significantly more exposures to cleaning products, biologic agents, and textile fibers, whereas men reported more exposures to isocyanates, metal dusts and fumes, oil mists, wood dusts and anhydrides. Women presented an increased risk of OA in the service sector (odds ratio (OR) = 1.77, confidence interval (CI) = 1.61–1.96). Conclusions Cleaning services was the main reported occupation and cleaning products the main reported agents. Women had significantly shorter exposure duration possibly due to difference in exposures, previous atopy, and behavior. There was an excess of cases of women in the service sector. Am. J. Ind. Med. 43:611–617, 2003. © 2003 Wiley-Liss, Inc.

Background This study was designed to assess the effect of asbestos exposure on longitudinal lung function decline. Methods A group of 502 former asbestos-cement workers with at least two spirometry tests 4 years apart. Repeated evaluations included respiratory symptoms questionnaire, spirometry and chest imaging. Asbestos exposure was ascertained as years of exposure, an index of cumulative exposure and latency time. The mixed effects model was used to evaluate the effect of exposure on the level and rate of change in forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC). Results Mean age at entry was 51 (SD 9.9) years, mean latency time 25.6 (SD 10.0) years, mean follow-up time 9.1 (SD 2.8) years and mean number of spirometry tests 3.5. The FEV 1 level was significantly related to pack-years of smoking at entry and during the follow-up, the index of cumulative asbestos exposure at entry, and the presence of asbestosis at follow-up. The FVC level was significantly related to pack-years of smoking during the follow-up, cumulative asbestos exposure at entry, asbestosis and pleural thickening at follow-up, and body mass index at entry. Asbestos exposure was not associated with increasing rates of FEV 1 and FVC decline. However, FEV 1 regression slopes with age, estimated by terciles of cumulative exposure, showed significant differences. Combined effects of smoking and exposure conferred further acceleration in lung function decline. Conclusions Occupational exposure in asbestos-cement industry was a risk factor for increased lung function decline. The effect seems to be mostly concentrated during the working period. Smoking and exposure had synergic effects.

Apresenta-se o resultado de um estudo de campo sobre a leishmaniose visceral autóctone da Ilha de São Luís. Com início em 2004 e término em 2006, a pesquisa visou conhecer aspectos epidemiológicos e clínicos determinantes da endemia. Foram analisados 299 casos autóctones, sendo 83,6% em menores de 9 anos e 54,1% do sexo masculino. O agravo ocorreu em todos os meses do ano com pico em junho. O coeficiente de incidência foi reduzido de 46,1 para 35,2 casos por 100.000 habitantes nos anos estudados. O diagnóstico teve confirmação laboratorial em 93,3% dos casos. O tratamento de escolha foi à base de N-metilglucamina com percentual de cura de 96,1%. A letalidade média foi de 3,7%. Em função da inexistência de ações mais sistemáticas de controle, propõe-se a criação de um programa a ser desenvolvido pelos municípios sob a coordenação da Secretaria de Estado da Saúde. The results from a field study on autochthonous visceral leishmaniasis on the island of São Luís are presented. This study started in 2004 and finished in 2006 and had the aim of ascertaining the determinant epidemiological and clinical characteristics of this endemic disease. Two hundred ninety nine autochthonous cases were analyzed, of which 83.6% were children younger than 9 years old and 54.1% were male. The disease occurred in all months of the year, with a peak in June. The coefficient of incidence decreased from 46.1 to 35.2 cases per 100,000 inhabitants over the years studied. The diagnosis was confirmed by laboratory tests in 93.3% of the cases. The treatment of choice was based on N-methylglucamine, with a cure rate of 96.1%. The mean lethality rate was 3.7%. Because of the absence of systematic control actions, the authors propose the creation of a specific program to be developed by the municipalities under the coordination of the State Department of Health.

Apresenta-se uma revisão bibliográfica das doenças asbesto-relacionadas. São discutidos e atualizados os critérios diagnósticos, as características radiológicas, tomográficas e funcionais das alterações benignas de pleura, da asbestose, do câncer de pulmão ocupacional e do mesotelioma maligno de pleura.This chapter presents a bibliographic review of asbestos-related diseases. The latest diagnostic, radiological, computed tomography and lung function aspects of benign pleural disease, asbestosis, occupational lung cancer and mesothelioma are discussed.

Apresenta-se uma revisão bibliográfica das doenças asbesto-relacionadas. São discutidos e atualizados os critérios diagnósticos, as características radiológicas, tomográficas e funcionais das alterações benignas de pleura, da asbestose, do câncer de pulmão ocupacional e do mesotelioma maligno de pleura. This chapter presents a bibliographic review of asbestos-related diseases. The latest diagnostic, radiological, computed tomography and lung function aspects of benign pleural disease, asbestosis, occupational lung cancer and mesothelioma are discussed.

Apresenta-se uma revisão bibliográfica das doenças asbesto-relacionadas. São discutidos e atualizados os critérios diagnósticos, as características radiológicas, tomográficas e funcionais das alterações benignas de pleura, da asbestose, do câncer de pulmão ocupacional e do mesotelioma maligno de pleura. This chapter presents a bibliographic review of asbestos-related diseases. The latest diagnostic, radiological, computed tomography and lung function aspects of benign pleural disease, asbestosis, occupational lung cancer and mesothelioma are discussed. Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Santa Casa de São Paulo Faculdade de Ciências Médicas Departamento de Medicina Social Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina UNIFESP, EPM SciELO

Occupational asthma (OA) is the leading occupational respiratory disease in the area of São Paulo Municipality. Understanding its characteristics can provide useful information for better interventions.From a joint registry of OA from five outpatient public clinics for occupational respiratory diseases, data on occupation, with job titles corrected by an expert evaluation, agents, exposure and symptom duration, and spirometry were analyzed by gender. Data on employment for São Paulo Municipality were used to calculate expected ratios for men/women in broad economical sectors.Three hundred and ninety four OA cases were reported with a ratio of men/women of 1.5. Women had significantly shorter exposure duration (5.6 +/- 5.2 vs. 8.9 +/- 9.0 years, P = 0.0005), shorter symptoms duration (2.6 +/- 3.7 vs. 3.2 +/- 3.5 years, P = 0.1270), and higher prevalence of previous atopy (27.0 vs. 18.4%, P = 0.0485). The main occupations related to OA cases were cleaning activities, working in plastics manufacture and in chemical and pharmaceutical plants. Women reported significantly more exposures to cleaning products, biologic agents, and textile fibers, whereas men reported more exposures to isocyanates, metal dusts and fumes, oil mists, wood dusts and anhydrides. Women presented an increased risk of OA in the service sector (odds ratio (OR) = 1.77, confidence interval (CI) = 1.61-1.96).Cleaning services was the main reported occupation and cleaning products the main reported agents. Women had significantly shorter exposure duration possibly due to difference in exposures, previous atopy, and behavior. There was an excess of cases of women in the service sector.

Background Production of asbestos-cement products in Brazil started in the 1940s, peaked in the 60- 70s and is still an active industry. This study was designed to assess the non-malignant effects of asbestos exposure in the asbestos-cement industry in Brazil. Methods A group of 828 former asbestos-cement workers enrolled in a cross-sectional and cohort study of respiratory morbidity, submitted to a detailed occupational history, respiratory symptoms questionnaire, spirometry, PA chest x-ray, and high resolution computed chest tomography (HRCT). Asbestos exposure was assessed by years of exposure, cumulative exposure (a semi-quantitative method), and latency time from first exposure. Asbestos is and pleural thickening were assessed according to HRCT criteria. Results Asbestosis was present in 74 (8.9%) and pleural thickening in 246 (29.7%). Using the HRCT as the best available evidence, it was shown that were more false negatives than false positives in the x-ray readings for parenchymal (21.6% false negatives, 4.2% false positives) and pleural (26.0% false negatives, 14.4% false positives) diseases due to asbestos. Latency time from first exposure was the best predictor for both asbestosis and pleural thickening. Subjects in the higher exposure groups presented lower levels of lung function. Obstructive defects were significantly related to smoking, shortness of breath, body mass index, and age, whereas restrictive defects were related to asbestosis, shortness of breath, and latency time. Chronic bronchitis increased with latency time in the three smoking groups and was significantly related to pleural thickening (OR 1.56 (1.00-2.42)). Shortness of breath was significantly associated with body mass index and pleural thickening (OR 1.30 (1.24-2.09)). Conclusions Pleural thickening and asbestosis showed a significant association with latency time and exposure. FVC and FEV 1 decreased across increasing profusion with an added effect of pleural thickening. There was a significant and independent effect of exposure on lower levels of FVC and FEV 1 . Obstructive defects were mainly related to smoking and restriction to asbestosis. Dust exposure and smoking were synergistic in increasing chronic bronchitis and shortness of breath report. Shortness of breath report was also related to pleural thickening and higher body mass index.

A prospective study was performed to identify knowledge concerning visceral leishmaniasis (VL) in endemic areas of Maranhao, amongst the rural population of the Codo township and in a peripheral urban area (an old settlement, Maracana, on the outskirts of the city of Sao Luis, and Vila Nova/Bom Viver, Paco do Lumiar township). A total of 283 persons were interviewed, including 53 from Maracana, 103 from Vila Nova/Bom Viver, and 127 from Codo. The sites presented favorable conditions for the development and maintenance of VL. Some 93.8% of those interviewed had heard of kala-azar. In Maracana, 50.9% referred to sandflies as responsible for the transmission of VL, while 87.2% knew that dogs are the main link in the epidemiological cycle of the disease. Some 77.8% of those interviewed did not know how to control the disease. As regards manifestations of the disease, they largely associated it with fever, anemia, weight loss, and an enlarged abdomen. Only five individuals knew that Glucantime® is used to treat VL. We conclude that knowledge is poor with regard to all aspects of VL in both the rural and peripheral urban area.

Submitted by Ruth Quaresma de Freitas (ruth_quaresma@hotmail.com) on 2019-03-07T17:44:53Z No. of bitstreams: 1 MAISA SALES COSTA - DISSERTAÇÃO PPGECA 1991..pdf: 25901471 bytes, checksum: d5824f483a74639ac378353b06149aab (MD5) Made available in DSpace on 2019-03-07T17:44:53Z (GMT). No. of bitstreams: 1 MAISA SALES COSTA - DISSERTAÇÃO PPGECA 1991..pdf: 25901471 bytes, checksum: d5824f483a74639ac378353b06149aab (MD5) Previous issue date: 1991-02-01 O objetivo deste trabalho e de examinar e analisar os aspectos críticos relacionados com cruzamentos semaforizados em área urbana baseado no Highway Capacity Manual de 1985 - Special Report 2 09 da TRB. Apresenta uma revisão bibliográfica de estudos analíticos de cruzamentos, focalizando as principais teorias que inspiraram e determinaram o aparecimento do Manual de Capacidade (HCM-85), e os principais avanços surgidos no assunto após a publicação do Manual, com afinalidade de aperfeiçoamento da análise recomendada pelo HCM-85 e de levantamento de questões ainda duvidosas relacionadas com os aspectos críticos. A metodologia do HCM-85 é completamente descrita em seus mínimos detalhes, sendo identificados os seus principais aspectos, apresentando todo o seu processo de análise tanto operacional quanto de planejamento. Isto efeito tendo por objetivo guiar possíveis usuários do Manual, tendo em vista que ainda e usado largamente no Brasil o método tradicional de Webster. Uma análise operacional e de planejamento de Recife - PE, através de um estudo de caso na região metropolitana de Recife - PE, a título de demonstração e teste da metodologia nos seus aspectos mais relevantes, e de verificação da sensibilidade das: principais mudanças sugeridas pelo HCM-85. Propõe, também, um software para o desenvolvimento da análise apresentada pelo Manual, com o objetivo de possibilitar ao analista criar diversos cenários em busca de uma solução mais eficiente para a situação em estudo. Os diversos fatores que influenciam no estudo de cruzamentos semaforizados são analisados, procurando-se determinar aqueles, que realmente são relevantes, de modo a tornar disponíveis ao usuário do HGM-85 considerações feitas por outros pesquisadores, após a publicação do Manual. Isto efeito levando - se em consideração sugestões feitas por diversos estudos que surgiram de pois da publicação do HCM-85. The objective of this work is to examine and analyze the critical aspects related to traffic intersections in urban areas based on the TRB 1985 Highway Capacity Manual. It presents a bibliographic review of cross-analytical studies, focusing on the main theories that inspired and determined the appearance of the Capacity Manual (HCM-85), and the main advances that emerged after the publication of the Manual, in order to improve the recommended analysis by the HCM-85 and to raise still dubious issues related to the critical aspects. The methodology of the HCM-85 is fully described in its minimum details, identifying its main aspects, presenting all its analysis process both operational and planning. This effect has the purpose of guiding possible Users of the Manual, considering that the traditional method of Webster is still widely used in Brazil. An operational and planning analysis of Recife - PE, through a case study in the metropolitan area of ​​Recife - PE, to demonstrate and test the methodology in its most relevant aspects, and to verify the sensitivity of the main changes suggested by the HCM-85. It also proposes software for the development of the analysis presented by the Manual, in order to allow the analyst to create several scenarios in search of a more efficient solution for the situation under study. The various factors that influence the study of signal-crosses are analyzed in order to determine those that are really relevant, so as to make available to the HGM-85 user the considerations made by other researchers after the publication of the Manual. This effect takes into consideration suggestions made by several studies that have arisen since the publication of HCM - 85.