Riesgo biológico en el personal de enfermería de la Unidad de Cuidados Intensivos del Hospital Alberto Sabogal Sologuren / Biological risk in the nursing staff of the Intensive Care Unit of the Alberto Sabogal Sologuren Hospital

Según la Organización Internacional del Trabajo (OIT) se estima que 2,34 millones de personas mueren cada año a causa de accidentes y enfermedades relacionados con el trabajo. Entre las áreas hospitalarias, la unidad de cuidados intensivos (UCI) es considerada como la más tensa, traumática y agresiva, que ha pesar de la pesada rutina de trabajo, los peligros a la que el personal de enfermería (enfermeros, técnicos y asistentes) está continuamente expuesto. No sólo el medio ambiente es insalubre, sino que dada la ocurrencia frecuente de situaciones de emergencia y la alta concentración de pacientes en estado crítico que se someten a cambios en su estado de salud. El personal de enfermería la UCI tienen un mayor riesgo relacionado con los peligros biológicos, ya que están expuestos a organismos infecciosos durante los procedimientos invasivos y no invasivos. En ese sentido, este trabajo busca indagar sobre percepción acerca de la exposición a los riesgos biológicos para las enfermeras que laboran en la UCI en el Hospital Alberto Sabogal Sologuren, Perú. Los resultados llevados con las trabajadoras de la salud de Unidad de Cuidados Intensivos en el Hospital Alberto Sabogal indicaron que en general, las enfermeras de ese centro asistencial hacen uso de buenas prácticas de riesgo, siendo el de mayor prevalecencia (71%) el relacionado con los principios de bioseguridad, y siendo el de menor cuidado (37%), el referente al lavado de las manos antes y después de tener contacto con los pacientes. Es preocupante, que un porcentaje bajo de enfermeras, entre un 5 y 22% respondieron algunas veces a las prácticas de riesgo, siendo un factor importante de contaminación o peligro con su salud(AU)

According to the International Labor Organization (ILO), an estimated 2.34 million people die each year from work-related accidents and diseases. Among the hospital areas, the intensive care unit (ICU) is considered the most tense, traumatic and aggressive, which has despite the heavy work routine, the dangers to which the nursing staff (nurses, technicians and assistants) They are continually exposed. Not only is the environment unhealthy, but given the frequent occurrence of emergency situations and the high concentration of critically ill patients undergoing changes in their health status. ICU nursing staff are at increased risk related to biohazards, as they are exposed to infectious organisms during invasive and non-invasive procedures. In this sense, this work seeks to investigate the perception of exposure to biological risks for nurses who work in the ICU at the Alberto Sabogal Sologuren Hospital, Peru. The results carried out with the health workers of the Intensive Care Unit at the Alberto Sabogal Hospital indicated that in general, the nurses of this care center make use of good risk practices, with the highest prevalence (71%) being related to the principles of biosafety, and being the least careful (37%), the reference to washing hands before and after having contact with patients. It is worrisome that a low percentage of nurses, between 5 and 22% sometimes responded to risk practices, being an important factor of contamination or danger to their health(AU)

Diagnóstico do tratamento de esgotos no Rio Grande do Sul e sua associação aos riscos com a saúde / Diagnosis of sewage treatment in Rio Grande do Sul and its association with health risks

O presente trabalho tem como objetivo estimar o volume de esgoto gerado no RS em Demanda Bioquímica de Oxigênio (DBO kg/dia), e o volume de esgoto (DBO kg/dia) que chega até as estações de tratamento de esgoto ETEs; diagnosticar a eficiência das estações de tratamento de esgotoem relação ao percentual de remoção de (DBO kg/dia); correlacionando com a presença de cianobactérias próximas aos pontos de captação de água superficial para consumo humano; analisar se há inativação ou remoção de protozoários no lançamento do efluente ao retornar ao manancial. Como resultado obteve-se o volume total de matéria orgânica lançada nos corpos hídricos por dia estimado no Rio Grande do Sul é 511.769,00 DBO kg/dia no RS. As Estações de Tratamento de Esgoto captam 390.285,45 DBO kg/dia apresentaram resultados de remoção de 145.500,50 DBO kg/dia e de 22.963,21 DBO kg/dia residual; O volume ocioso das ETEs fica em torno de 5.049,89 L/s. O processo de eliminar ou inativar grande quantidade de protozoários presentes no afluente se dá através de etapas terciárias avançadas nas ETEs. Não encontramos no RS no ano 2019 ETEs com esses tipos avançados de tratamento. Sugere-se então que haja um melhor aproveitamento destas estações de tratamento no que se refere à quantidade e qualidade de volume de esgoto tratado e que sejam ampliados estudos para viabilidade de projetos de execução de novas ETEs para os demais municípios que despejam seus esgotos in natura nos mananciais impactando-os.

This work aims to estimate the volume of sewage generated in RS in Biochemical Oxygen Demand (BOD kg/day), and the volume of sewage (BOD kg/day) that reaches the sewage treatment stations (STS)s; diagnose the efficiency of sewage treatment station in relation to the percentage of removal (BOD kg/day); correlating with the presence of cyanobacteria close to the surface water intake points for human consumption; analyze if there is inactivation or removal of protozoa in the discharge of the effluent when returning to the source. As a result, the total volume of organic matter released into water bodies per day estimated in Rio Grande do Sul is 511,769.00 BOD kg/day in RS. The Sewage Treatment Plants capture 390,285.45 BOD kg/day showed removal results of 145,500.50 BOD kg/day and 22,963.21 BOD kg/day residual; The idle volume of ETEs is around 5,049.89 L/s. The process of eliminating or inactivating a large amount of protozoa present in the tributary takes place through advanced tertiary stages in the STSs. We did not find in RS in the year 2019 STSs with these advanced types of treatment. It is therefore suggested that there is a better use of these treatment plants with regard to the quantity and quality of the volume of treated sewage and that studies for the feasibility of projects for the execution of new STSs be expanded to the other municipalities that dump their raw sewage in water sources impacting them.

Medidas declaradas por padres y cuidadores de lactantes y preescolares para prevenir la exposición a humo de tabaco ambiental / Measures stated by parents and caregivers of infants, toddlers, and preschoolers to prevent environmental tobacco smoke exposure

Introducción. La exposición a humo de tabaco ambiental constituye un problema de salud pública por sus potenciales riesgos en los niños. Objetivo. Determinar las acciones preventivas adoptadas por padres y/o cuidadores de lactantes y preescolares respecto de la exposición a humo de tabaco ambiental. Métodos. Estudio transversal analítico en padres y cuidadores de lactantes y preescolares escolarizados, residentes en la ciudad de Valdivia, Chile. Se aplicó un cuestionario sobre medidas preventivas del humo de tabaco ambiental. Se analizó con estadística descriptiva y de asociación usando el test exacto de Fisher y la regresión logística para calcular odds ratio (OR) y sus respectivos intervalos de confianza del 95% (IC95%) como estimación de riesgo de no adopción de medidas preventivas en el hogar. Resultados. Participaron 469 padres y cuidadores. La prevalencia de hogares con un miembro fumador fue 51,8%. La mayoría fumaba fuera del hogar (92,2%). La medida más adoptada fuera del hogar fue evitar lugares con gente fumando. En este ambiente, hubo diferencia significativa entre hombres y mujeres en no prevenir la exposición (7,6% vs. 2,2%; p= 0,040). Se constató mayor riesgo de no prevenir el consumo en el hogar (dentro o fuera) cuando hubo algún miembro fumador (OR 3,55; IC95%: 2,05-6,14). Y menor riesgo cuando hubo dos o más niños en el hogar (OR 0,46; IC95%: 0,26-0,83). Conclusiones. La mayoría de los padres y cuidadores piden que se fume fuera del hogar y evitan los lugares con gente fumando, aunque, en los hogares con miembros fumadores, la prevención es menor.

Introduction. The exposure to environmental tobacco smoke is a public health problem because of its potential risks for children. Objective. To determine the preventive actions taken by parents and/or caregivers of infants, toddlers, and preschoolers regarding environmental tobacco smoke exposure. Methods. Cross-sectional, analytical study in parents and caregivers of infants, toddlers, and preschoolers from Valdivia, Chile. A questionnaire on preventive measures regarding environmental tobacco smoke was administered. The questionnaire was analyzed with descriptive and association statistics using Fisher's exact test and logistic regression to calculate the odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) as an estimation of the risk for not taking preventive measures at home. Results. A total of 469 parents and caregivers participated. The prevalence of households with one member who smoked was 51.8%. Most of them smoked outside the house (92.2%). The most common measure taken outside the household was to avoid places where people smoked. In this setting, a significant difference was observed between men and women in relation to avoiding exposure (7.6% versus 2.2%; p= 0.040). A higher risk for not avoiding tobacco use inside or outside the housewas confirmed when a household member smoked (OR: 3.55; 95% CI: 2.05-6.14). Also, a lower risk was observed when there were two or more children in the household (OR: 0.46; 95% CI: 0.26-0.83). Conclusions. Most parents and caregivers ask others to smoke outside and avoid places where people smoke; however, the level of prevention is lower among households with smokers.

Occupational hazards of Brazilian solid waste workers: a systematic literature review / Riscos ocupacionais em trabalhadores da limpeza urbana no Brasil: uma revisão sistemática da literatura

Background: In Brazil, urban cleaning professionals play an important role within a context characterized by annual increase of the garbage production. However, the job exposes such workers to various occupational hazards, an issue little discussed in the literature. Objective: To identify occupational hazards to which Brazilian solid workers are exposed, as well as factors associated with their minimization. Methods: A systematic review of the literature was performed in databases Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), and PubMed. Gray literature was also searched through Google Scholar and included studies published along a ten-year period (2006-2016) in Portuguese, English, and Spanish. Results: Twelve studies were located; the results showed that waste workers were exposed to biological, accidental, chemical, ergonomic, physical, and psychosocial risks. The risks declined with adherence to use of personal protective equipment and guidance for workers, employers, and population. Conclusions: Given the few studies in this field, more evidence-based research is necessary to serve as grounds for the development and implementation of public health policies aiming at reducing occupational risks among the studied population.

Contexto: No Brasil, os profissionais de limpeza urbana desempenham um papel importante em um contexto em que a produção de lixo no país aumenta consideravelmente a cada ano. No entanto, esse trabalho expõe tais trabalhadores a vários riscos ocupacionais, sendo essa questão pouco discutida na literatura. Objetivo: Identificar os riscos ocupacionais aos quais esses trabalhadores estão expostos e fatores associados à sua minimização. Métodos: Realizou-se uma revisão sistemática da literatura utilizando as bases de dados Scientific Scielo, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e PubMed. A literatura cinza também foi consultada através do Google Scholar e incluiu estudos publicados em um recorte de dez anos (2006-2016) em português, inglês e espanhol. Resultados: Doze estudos foram identificados e seus resultados mostraram que os trabalhadores de resíduos estão expostos a riscos biológicos, de acidentes, químicos, ergonômicos, físicos e psicossociais. Os riscos diminuem com a aderência a Equipamentos de Proteção Individual e orientação aos trabalhadores, empregadores e população. Conclusão: Dada a escassez de estudos neste campo, há a necessidade de mais pesquisas baseadas em evidências que possam servir de subsídio para o desenvolvimento e implementação de políticas públicas de saúde visando a redução dos riscos ocupacionais no grupo estudado.

La comunicación de riesgo en salud: aspectos teóricos y metodológicos para el control de emergencias públicas sanitarias / Risk communication in health: theoretical and methodological aspects for the control of sanitary public emergencies

En las últimas décadas las sociedades contemporáneas han estado expuestas de manera recurrente a situaciones de emergencia sanitaria, por lo que la comunicación se ha convertido en un importante componente del control de riesgo. En este artículo se fundamentan, desde los referentes teóricos de la comunicación de riesgo, las experiencias de algunos autores y organizaciones en la dirección ante emergencias sanitarias y en la estrategia de comunicación de riesgo como herramienta fundamental; además se enfatiza en la necesidad de la comunicación de riesgo como una práctica sistemática dirigida a enfrentar situaciones de emergencia pública sanitaria, donde el aumento de la percepción de riesgo en la población permitirá minimizar los efectos negativos de estos sucesos

In the last decades the contemporary societies have been exposed in a recurrent way to situations of sanitary emergency, reason why the communication has become an important component of risk control. In this work, the experiences of some authors and organizations in the management when facing sanitary emergencies and in the strategy of risk communication as fundamental tool are supported from the theoretical referent of risk communication; it is also emphasized in the necessity of risk communication as a systematic practice directed to face situations of sanitary public emergency, where the increase of risk perception in the population will allow to minimize the negative effects of these events

Riesgos ambientales y de seguridad en calderas a carbón de las pequeñas y medianas empresas «PYME¼, ubicadas en el municipio de Itagüí, Antioquia / Safety and environmental risks of coal fired boilers in small and medium-sized enterprises «SMEs¼, located in Itagüí town, Antioquia

RESUMEN Objetivo Caracterizar los riesgos ambientales y de seguridad presentes en calderas con combustible de carbón de las pequeñas y medianas empresas, ubicadas en el municipio de Itagüí. Método Estudio descriptivo transversal: Se seleccionó una muestra a conveniencia de ocho calderas y sus operadores. La caracterización de las calderas se realizó por medio de la aplicación de cuatro instrumentos para evaluar y valorar los riesgos de seguridad, el nivel de seguridad, los riesgos ambientales y los impactos ambientales. Resultados El resultado del riesgo de seguridad mostró que el 62 % de las calderas presentó un nivel de riesgo no aceptable. El resultado del nivel de seguridad presentó que el 62 % de las calderas obtuvieron una valoración deficiente. El resultado del riesgo ambiental indicó que el 100 % de las calderas presentó un nivel de riesgo alto de afectación al entorno ambiental y un nivel de riesgo medio de afectación a los operadores. Con respecto a la valoración del impacto ambiental se observó que el 100 % de las calderas en estudio presentaban afectación de significancia alta sobre el componente aire, y afectación de significancia media sobre los componentes agua y suelo. Conclusiones Debido al bajo nivel de seguridad y al alto nivel de riesgo ambiental encontrado en las calderas estudiadas, las PYME deben conocer los riesgos existentes con el fin de disminuir la prevalencia de afectación de la salud de los calderistas e impactos al medio ambiente. Así mismo, implementar medidas de gestión encaminadas a la prevención y control de los riesgos caracterizados.(AU)

ABSTRACT Objective To describe the environmental and safety risks present in coal fired boilers in small and medium-sized enterprises, located in Itagüí town. Method Cross sectional descriptive study: An appropriate sample of 8 boilers with its corresponding operators was selected. The description of the boilers was carried out through the implementation of four instruments to evaluate and assess security risks; Its level of safety, the environmental risks and the environmental impacts. Results The security risk outcome showed that 62 % of the boilers presented an unacceptable level of risk. The safety level outcome showed that 62 % of boilers obtained a poor rating. The environmental risk outcome indicated that 100 % of the boilers had a high level of environmental impact and a medium level of impact for operators. Regarding the environmental impact assessment, 100 % of the boilers under study showed a high level of impact on the air component and medium level of impact on water and soil components. Conclusions Due to the low level of safety and the high level of environmental risk found in the boilers under study; SMEs should be aware of the current risks in order to reduce the exposure of the operators to health danger and the environme tal impacts as well. Moreover, it is needed to implement management measures aimed to prevent and control the risks described.(AU)

Contaminação química, precarização, adoecimento e morte no trabalho: benzeno no Brasil / Chemical contamination, precariousness, illness and death at work: benzene in Brazil

Resumo A toxicidade do benzeno é conhecida e os tipos de doenças a ele ligadas vêm se ampliando. Foi recuperada a trajetória e as descobertas relacionadas às doenças combinadas com o deslocamento das atividades dos países centrais para os periféricos. Neste processo há correlações na prevenção da exposição ao benzeno. No Brasil foram analisadas as aplicações das regulações para identificar seu impacto, pois as informações sobre contaminação ambiental e doenças é bastante precária. Prevaleceram legislações formais sem registro de sua aplicação. Somente quando houve mobilização de trabalhadores e técnicos ocorreram avanços.

Abstract The toxicity of benzene is widely known, and types of illnesses linked to it have been increasing. This article traces the historical trajectory and the findings related to the diseases, combined with the displacement of industrial activities from central countries to peripheral ones. In this process, there are correlations in prevention of benzene exposure. In Brazil, the application of regulations was analyzed to identify their impact because information on environmental contamination and diseases is very precarious. Formal legislation prevailed without records of its application. Only when workers and technicians mobilized did advances occur.

Intake of oral photoprotectors by postmen in Porto Alegre

Introduction: Postmen are daily exposed to high levels of solar radiation, and lack of protection can result in many health damages. The present study aimed to identify cutaneous phototypes and evaluate the intake of oral photoprotectors by postmen. Methods: Cross-sectional study, carried out from August 2011 to December 2012 in the city of Porto Alegre, state of Rio Grande do Sul, Brazil. Socioeconomic and behavioral data regarding daily solar exposure were collected through a questionnaire. To evaluate the intake of beta-carotene, lycopene and omega-3, two 24-hour dietary recalls were applied. Cutaneous phototypes were assessed by Fitzpatrick's classification. Results: A total of 181 postmen were analyzed, whose mean age was 40.2±11.4 years old, and 140 (77.3%) were male. The cutaneous phototypes II, III and IV were the most prevalent (n=138), totaling 76.3% of the sample. The median for the oral photoprotectors intake was 1.16 mg (0.46-2.29) of beta-carotene, 3.60 mg (1.01-6.31) of lycopene and 0.95 g (0.61-1.45) of n-3 fatty acids, all values significantly lower than the minimal doses to obtain photoprotective effect (p<0.001). The individuals in the group of phototypes V and VI showed lower adherence to the use of sunscreen and lower intake of beta-carotene, comparing to the other groups. Conclusions: The intake of oral photoprotectors is low in this population. Future studies may evaluate the real effect of oral photoprotectors, so that preventive measures using this approach can be included in photoprotection education actions for outdoor workers (AU)

Sistema de apoio à avaliação de impactos da poluição sonora sobre a saúde pública / Sistema de apoyo a la evaluación del impacto del ruido sobre la salud pública / A system for evaluating the impact of noise pollution on the population's health

Resumo: O objetivo do trabalho foi desenvolver um sistema de apoio à avaliação da poluição sonora, aplicado na zona central de Rio Claro, São Paulo, Brasil. Para isso, dados foram obtidos por meio de medições sonoras e entrevistas com a população, gerando como indicadores o nível sonoro equivalente (Leq ), o índice de ruído de tráfego (LTNI ) e um diagnóstico participativo (Dp ), integrados por intermédio de um sistema de inferência fuzzy (SIF). Como resultado, o sistema proposto permitiu classificar os pontos avaliados quanto ao grau de impacto da poluição sonora sobre a saúde da população (IPS ) na área de estudo, que pode ser considerado significativo em 31,4% dos pontos e muito significativo em 62,9%. A possibilidade de adequar o SIF de acordo com as condições de estudo viabiliza a sua generalização e, desta forma, apoia a avaliação e respectiva gestão do ruído ambiental em outras regiões.

Resumen: El objetivo del trabajo fue desarrollar un sistema de apoyo a la evaluación de la contaminación acústica, aplicado en la zona central de Río Claro, São Paulo, Brasil. Con este fin, se obtuvieron datos mediante mediciones sonoras y entrevistas a la población, generando como indicadores el nivel sonoro equivalente (Leq ), el índice de ruido de tráfico (LTNI ) y un diagnóstico participativo (Dp ), integrados a través de un sistema de inferencia fuzzy (SIF). Como resultado, el sistema propuesto permitió clasificar los puntos evaluados, en cuanto al grado de impacto de la contaminación sonora sobre la salud de la población (IPS ) en el área de estudio, que puede ser considerado significativo en un 31,4% de los puntos y muy significativo en un 62,9%. La posibilidad de adecuar el SIF, de acuerdo a las condiciones de estudio, viabiliza su generalización y, de esta forma, puede apoyar la evaluación y consiguiente gestión del ruido ambiental en otras regiones.

Abstract: The aim of this study was to develop a support system for the evaluation of noise pollution, applied to the central urban area of Rio Claro, São Paulo State, Brazil. Data were obtained from noise measurements and interviews with the population, generating the following indicators: equivalent sound level (Leq ), traffic noise index (LTNI ), and a participatory diagnosis (Dp ), integrated through a fuzzy inference system (FIS). The proposed system allowed classifying the measurement points according to the degree of impact of noise pollution on the population's health (IPS ) in the study area. Impact was considered significant in 31.4% of the measurement points and very significant in 62.9%. The FIS can be adjusted to local conditions, allowing generalization and thus also supporting noise pollution evaluation and respective environmental noise management in other geographic areas.

Hacia un plan nacional para el control de los efectos del mercurio en la salud en Colombia / Toward a national plan to control health effects of mercury in Colombia

Introducción. La problemática del uso del mercurio es global y afecta tanto a los humanos como al ambiente. Los efectos del mercurio en la salud son diversos, por eso es necesario abordar el problema desde una perspectiva amplia, identificando las poblaciones en riesgo de exposición, sus efectos en la salud, los procesos productivos involucrados y las acciones para disminuir la exposición y mitigar el impacto. Objetivo. Diseñar un marco conceptual y operativo para desarrollar estrategias de prevención, control y mitigación de los efectos del mercurio sobre la salud y el ambiente en Colombia. Materiales y métodos. Se hizo un estudio en dos fases: una revisión de la literatura científica siguiendo la metodología Cochrane, y foros con expertos nacionales e internacionales orientados a la planificación integral para identificar las acciones prioritarias y construir la agenda de investigación nacional . Resultados. Los resultados de la revisión se estructuraron en cuatro componentes: efectos del mercurio en la salud, marco legal en Colombia, inventario de emisiones en el país, y planes y programas existentes en el sector de la salud. Se presentaron recomendaciones para diseñar un plan de intervenciones considerando cinco líneas de acción: gestión tecnológica para la prevención de la exposición, fortalecimiento institucional para la prevención y el control de la exposición, fortalecimiento de estrategias de diagnóstico y atención, educación en salud sobre los riesgos del mercurio y generación de conocimiento . Conclusiones. Se visibilizaron vacíos de información, así como debilidades técnicas, administrativas y necesidad de recursos en Colombia, y se propusieron acciones prioritarias para disminuir el impacto económico, social y en salud de la exposición al mercurio.

Introduction: The problem of mercury effects on humans and the environment is global, and it has different impacts on health. It is necessary, therefore, to address this issue from a broad overview to identify populations at risk of exposure, health effects, the production processes involved and the actions aimed at reducing exposure and mitigating the impact. Objective: To design a conceptual and operational framework to develop strategies for prevention, control and mitigation of mercury effects on health and on the environment in Colombia. Materials and methods: We conducted a two-phase study: a literature review following the Cochrane methodology and forums with national and international experts using a comprehensive planning methodology to identify priority actions and establish a national research agenda. Results: The results of the review were structured into four components: mercury effects on health, legal framework in Colombia, emission inventory for the country and health plans and programs. We made recommendations for the design of an intervention plan considering five lines of action: technologies for exposure management, institutional strengthening for exposure prevention and control, strategies for strengthening diagnosis and care, health education on mercury risks, and knowledge generation. Conclusion: We detected information gaps, technical weaknesses, and the need of administrative and other resources in this field in Colombia. We proposed priority actions to reduce the economic, social and health impact from exposure to mercury.

Exposición a plaguicidas y prácticas de uso y protección en embarazadas de zona rurales en control de atención primaria en la región de Valparaíso, Chile / Exposure to pesticides and use and protection practices in pregnant women from rural areas in primary care control in the Valparaíso region, Chile

ANTECEDENTES: Los trabajadores agrícolas y habitantes rurales están expuestos a productos plaguicidas. Aun cuando las políticas sanitarias se preocupan de normarlos, diversos estudios demuestran exposición en trabajadores y residentes cercanos a las zonas productivas. Entre ellos se encuentran mujeres gestantes, consideradas población particularmente vulnerable frente a plaguicidas. OBJETIVO: Identificar el contacto con plaguicidas, así como conductas asociadas a su uso, en mujeres gestantes de dos comunas agrícolas de la V Región en control prenatal en Centros de Salud Familiar. MÉTODO: Estudio observacional transversal, realizado en una muestra de ochenta gestantes que ingresaron a control entre mayo 2013 y abril 2014. El instrumento de recolección de datos fue una encuesta, aplicada por el equipo de salud al ingreso. RESULTADOS: Las gestantes, en su gran mayoría, alguna vez han tenido contacto con plaguicidas, y cerca de la mitad lo tuvo en el mismo año en que se aplicó la encuesta. La exposición a plaguicidas se da tanto en los espacios productivos, como residenciales. Se observó que las medidas preventivas asociadas al contacto con agrotóxicos son insuficientes. A la vez, destaca la exposición a fumigaciones aéreas, frente a las cuales la posibilidad de prevención es aún menor. CONCLUSIÓN: En comunas rurales puede existir un contacto permanente de la población femenina gestante con plaguicidas, lo cual sucede sin las medidas de protección adecuadas, incrementando el riesgo de exposición a estas sustancias. Es pertinente entonces, desarrollar una labor educativa activa para mejorar las prácticas de uso de plaguicidas.

BACKGROUND: Agriculture workers and rural dwellers are exposed to pesticide products. Sanitation policies attempt to regulate their use, but studies demonstrate that a significant percentage of workers and residents who are close to the productive zones are exposed to these chemicals. Pregnant women are particularly vulnerable to pesticides. AIM: To identify the risk of exposure to pesticides and practices of pesticide handling in women under pregnancy control programs in Family Health Care Centers in two rural districts of the 5th Region. METHOD: Cross-sectional study, conducted during May 2013 and April 2014 on eighty women, who entered pregnancy control programs in either rural district. The health professionals of the Centers collected the data in a survey. RESULTS: Most of the pregnant women declared having been in contact with pesticides at some point. Almost half of them had this contact in the same year of their interview, that is previous or during their pregnancy. The exposure to pesticides takes place in productive locations as well as residential areas. The preventive measures associated to the contact with pesticides are not sufficient. Rural populations are also exposed to aerial fumigations, which further limits preventive measures. CONCLUSION: Pregnant women living in a rural district may be permanently exposed to pesticides. Exposure to agrochemicals is not associated to safe prevention practices which increase the risk of exposure. Educational programs may aid to enhance safe pesticide use.

Hazards for Women and Children in Rural Settings / Peligros para las mujeres y niños en el ámbito rural

Objectives a) To identify possible risk factors associated with rural accidents in women, b) to describe women's knowledge about zoonosis, c) to describe women's risk perception about farming, d) to describe mother´s risk perception about children's activities in rural settings, e) to estimate the initial age of exposure to the rural setting and its dangers, and f) to identify possible risk factors associated with rural accidents in children. Materials and Methods: Cross-sectional design. Women with children that live in the countryside were surveyed (n=24). Structured questionnaire. Statistical analyses: χ2, Student's t-test, Pearson's correlation coefficient and logistic regression. Results Many women had suffered an accident in the countryside (65.6 %). Farm worker usually did not use personal protective equipment (PPE). Hearing protection, gloves, and safety goggles were rarely used. Working women showed a high risk perception for urban driving, the handling of agrochemicals, and driving on main roads (85.7 %, 70 % and 66.7 %). There was no significant association between risk perception and PPE use. Most mothers (87.5 %) thought that was good for children to learn how to perform farm chores starting at a young age. Children started to drive a tractors at 9 years of age; 12.23 years on average. More than 7 % of the children (7.14 %) have suffered an accident on the farm. The most frequent accidents were being trapped in machinery (60 %). No association was found between the independent variables and the dependent variable; farm-related accidents in children (p>0.2). Conclusions Risk communication is necessary to inform people involved and to reduce exposure.

Objetivos a) identificar posibles factores de riesgo asociados a accidentes rurales en mujeres, b) describir el conocimiento sobre zoonosis de las mujeres, c) describir la percepción de riesgos de las mujeres acerca de las actividades realizadas en el campo, d) describir la percepción de riesgos de las madres sobre las actividades de los niños en el campo, e) estimar la edad de exposición inicial de los niños al ambiente rural y sus peligros y f) identificar potenciales factores de riesgo asociados a accidentes rurales en niños. Materiales y Métodos Diseño transversal. Fueron encuestadas las mujeres con hijos que vivían en el campo (n= 24). Cuestionario estructurado. Análisis estadístico: χ2, T Student, coeficiente de correlación de Pearson y Regresión Logística. Resultados Muchas de las mujeres sufrieron un accidente en el campo (65,6 %). Las trabajadoras rurales generalmente no usaban elementos de protección personal (EPP). Protección auditiva, guantes y antiparras eran escasamente utilizados. Las trabajadoras demostraron tener una percepción del riesgo alta sobre el manejo de vehículos en zonas urbanas, manipulación de agroquímicos y manejo de vehículos en rutas (85,7 %, 70 % y 66,7 %). No se encontró asociación significativa entre percepción de riesgos y uso de EPP. Muchas madres (87,5 %) pensaban que era bueno para los niños que aprendieran a realizar tareas del campo desde muy pequeños. Los niños comenzaban a manejar un tractor desde los 9 años, 12,23 años en promedio. Más del 7% de los niños (7,14 %) sufrieron un accidente en el campo. Los más frecuentes fueron atrapamiento por maquinaria (60 %). No se encontró asociación significativa entre las variables independientes y la variable dependiente accidente en un niño (p>0,2). Conclusiones Es necesaria la comunicación de los riesgos para informar a los involucrados y reducir la exposición.

Determinants of exposure to second-hand smoke at home and outside the home among students aged 11-17 years: Results from the Mumbai Student Tobacco Survey 2010.

Background: While no level of exposure to Second-hand smoke (SHS) is free of risk, 37% of students from South-East Asia region were exposed to SHS. Aims: To estimate the prevalence of exposure to SHS and identify predictors of exposure to SHS at home and outside the home among 1,511 school students aged 11-17 years. Setting: The City of Mumbai. Study Design: This study used a two-stage cluster sampling design. Materials and Methods: Mumbai Student Tobacco Survey (MSTS) was a cross-sectional study, using anonymous self-administered structured questionnaire among students. The probability of schools being selected was proportional to the enrolment into grades 8 to 10. The study aimed to sample around 60 students from selected classes in each chosen school. Statistical Analysis: Proportions, 95% confidence interval and adjusted odds ratios (AOR) were used. Results: About 79.9% students were aware about the current smoking ban at public places and 88.1% were knowledgeable about the deleterious influence of SHS on them. Overall, 16.5% of students were exposed to SHS at home, and 39.9% outside of the home. Students from families where at least one parent used tobacco were at the greatest risk of SHS exposure at home in addition to outside the home exposure. Those students who were not aware about the smoking ban in public places were at a significantly higher risk of SHS exposure outside the home. Conclusion: Self-reported tobacco use status, age, parents' tobacco use, close friends' smoking, and the route they take to school were significant determinants of exposure to SHS at home and outside the home.

Diseño y aplicación de un Programa de Comunicación de Riesgos para la salud ambiental infantil en un sitio contaminado con plomo y arsénico / Designing and application of a Risk Communication Program for children environmental health on a lead and arsenic contaminated location

Una industria metalúrgica en la ciudad de San Luis Potosí, México ha contaminado el sitio con plomo (Pb) y arsénico (As) principalmente. Desde 1989 se han reportado por nuestro grupo altas concentraciones de Pb en sangre (PbS) y As en orina (AsO) en los niños del lugar. En el presente estudio se generó un Programa de Comunicación Riesgos (PCR) para informar a los niños sobre los riesgos ambientales del sitio donde viven y que cambiaran conductas para disminuir la exposición al Pb y al As. Se trabajó con 170 niños (5 a 7 años) de la zona. Se aplicó el PCR y se realizó la evaluación mediante análisis de dibujos, cuestionarios y monitoreo biológico. En los dibujos de los niños se encontraron elementos tóxicos tales como el Pb, la tierra contaminada, entre otros. En los cuestionarios aplicados a los niños y a los padres de familia se pudo apreciar un cambio en los conocimientos y en algunas conductas respecto a los contaminantes, sus efectos y su exposición. No se encontró una disminución en los niveles de PbS ni de AsO. Esto quizás porque la principal ruta de exposición no es únicamente el suelo, como se había contemplado anteriormente.

A metallurgical industry in San Luis Potosí city, México, has contaminated the zone by lead (Pb) and arsenic (As). Since 1989 were reported by our group high concentrations of Pb in blood (PbB) and As in urine (AsU) in the local children. In present work, a Risk Communication Program (RCP) was generated to inform the children about the environmental risks of the site where they live, and to change conducts to diminish the exposure to Pb and As. We worked with 170 children (5 to 7 years) of the zone. The RCP was applied and the evaluation was realized by means of analysis of drawings, questionnaires and biological monitoring. In drawings of the children appeared toxic elements such as Pb, contaminated soil, cigarettes, among others. In the questionnaires applied to the children and family parents it was possible to estimate a change in the knowledge and in some conducts with regard to the pollutants, their effects and their exposure. There was not a decrease in the levels of PbB and in the levels of AsU. These were due probably because the principal route of exposure is not only the soil that had been contemplated previously.

Evaluación de riesgo para la salud pública: nuevo instrumento de gestión ambiental para Chile / Evaluation of public health risk: A new instrument for environmental management in Chile

One of the main challenges in environmental management is to prevent the public health impact of projects that can cause pollution. To tackle this problem, the new Chilean bill on environmental management has defined the need to determine the potential health risks of a given Project. This paper gives a summary of the method used for risk evaluation and its evolution. Its incorporation in the Environmental Impact Evaluation System is proposed, to guarantee an effective prevention of the potential risks on health of new projects.

Repercussão de uma intervenção educativa com agentes comunitários de saúde nas condições ambientais de domicílios de crianças asmáticas / Impact that an educational intervention carried out by community health agents has on environmental conditions in the households of children with asthma

OBJETIVO: Verificar o impacto de uma intervenção educativa problematizadora sobre o controle ambiental para aeroalérgenos, conduzida por agentes comunitários de saúde, nos domicílios de crianças com asma. MÉTODOS: Estudo prospectivo de intervenção. Foram visitados 95 domicílios com crianças (faixa etária de 2-10 anos) com episódios recorrentes de dispneia e sibilância no município de Iguatu (CE). A intervenção educativa envolveu grupos focais com agentes comunitários de saúde com a problematização sobre medidas educativas a serem implementadas. Após a intervenção, 84 domicílios foram revisitados e reavaliados. RESULTADOS: Após a intervenção, houve uma redução significativa na limpeza do piso com vassoura (p = 0,02), no uso de fogão a carvão (p = 0,001) e no número de bichos de pelúcia no domicílio (p = 0,05). Houve uma melhoria significativa no controle ambiental para aeroalérgenos nos quartos das crianças após a intervenção (p = 0,003). CONCLUSÕES: A intervenção educativa mostrou ser uma importante ferramenta junto à população estudada, minimizando os aspectos negativos das condições ambientais dos domicílios das crianças asmáticas.

OBJECTIVE: To determine the impact that an educational intervention employing problem-solving strategies for the environmental control of aeroallergens has on environmental conditions in the households of children with asthma. The intervention was carried out by community health agents. METHODS: This was a prospective intervention study. The community health agents visited 95 households in which there were children (2-10 years of age) who had recurrent episodes of wheezing and dyspnea. All of the households investigated were in the city of Iguatu, Brazil. The educational interventions involved focus groups and community health agents. The focus groups were asked to brainstorm the educational measures to be implemented, in order to devise problem-solving strategies. After the intervention, 84 households were revisited and reevaluated. RESULTS: After the intervention, there was a significant decrease in the use of brooms for cleaning the floor (p = 0.02), in the use of coal-burning stoves (p = 0.001), and in the number of stuffed toys (p = 0.05). There was also a significant post-intervention improvement in the environmental control of aeroallergens in the bedrooms of the children (p = 0.003). Conclusions: The educational intervention applied in this study proved to be an important tool for the target population, improving environmental conditions in the households of children with asthma.

Pediatria ambiental: um tema emergente / Environmental pediatrics: an emerging issue

OBJETIVO: Revisar os artigos mais relevantes sobre a pediatria ambiental, seus efeitos potenciais para a saúde e, especialmente, seus avanços na prevenção. FONTES DOS DADOS: Foi realizada uma pesquisa utilizando as bases de dados MEDLINE/PubMed e SciELO. Foram revisados artigos de 1990 a 2010, além de capítulos de livros relacionados à pediatria ambiental. SÍNTESE DOS DADOS: Há uma variedade significativa de fatores que tornam as crianças altamente vulneráveis à exposição a riscos ambientais, associados principalmente ao consumo comparativamente maior de água, comida e ar por parte da criança, em relação ao seu peso corporal. De acordo com a Organização Mundial de Saúde, mais de 3 milhões de crianças menores de 5 anos morrem devido a doenças relacionadas ao meio ambiente. Aproximadamente 30-40 por cento das doenças pediátricas estão relacionadas a fatores ambientais. As crianças estão constantemente expostas a vários riscos ambientais para a saúde, dentre os quais se destacam: água contaminada, falta de condições adequadas de saneamento, poluição do ar, vetores de doenças, perigos químicos, injúrias e acidentes. CONCLUSÕES: Atualmente, os pediatras são desafiados a tratar das necessidades de saúde ligadas à pediatria ambiental. A história pediátrica deve ser mais abrangente, acrescentando-se questões pontuais que ajudem a identificar potenciais riscos ambientais. A conscientização e o entendimento sobre os efeitos nocivos das várias condições ambientais e o conhecimento sobre as medidas de prevenção relacionadas resultarão em intervenções oportunas e adequadas que melhorarão a saúde e o desenvolvimento das nossas crianças.

OBJECTIVE: To review the most relevant articles regarding environmental pediatrics, its potential effects on health, and especially its advances in prevention. SOURCES: A literature search was conducted using MEDLINE/PubMed and SciELO databases. Articles from 1990 to 2010 were reviewed, in addition to book chapters related to environmental pediatrics. SUMMARY OF THE FINDINGS: There is a significant variety of factors that make children highly vulnerable to environmental hazard exposure, which are mainly associated with children’s comparatively greater consumption of water, food, and air in relation to body weight. According to the World Health Organization, every year more than 3 million children under the age of 5 die because of environment-related conditions. Approximately 30 to 40 percent of pediatric diseases are related to environmental factors. Children are constantly exposed to various environmental health hazards, among which the following stand out: contaminated water, lack of adequate sanitation facilities, air pollution, disease vectors, chemical hazards, injuries, and accidents. CONCLUSIONS: Nowadays, pediatricians are challenged to address environmental pediatrics health care needs. The pediatric health history needs to be more comprehensive by adding pointed questions to help identify potential environmental risks. Awareness and understanding of the noxious effects of various environmental conditions and knowledge of the related prevention measures will result in timely and adequate interventions that will improve our children’s health and development.

effects of internal wall covering materials on hazards of indoor radon concentrations in houses of Iran

Radon gas emanating from underground can concentrate indoor and reach levels, which represent a risk to people's health. According to WHO [World Health Organization] and ERA [Environmental Protection Agency], radon is the second leading cause of lung cancer in the world. Due to the direct correlation of lung cancer and radon exposure, it is ideal to evaluate the hazards of radon accumulation in the Iran dwellings with different materials by direct measurement of the radon concentrations using accurate, simple and fast method. The aim of this study was to measure variation of radon concentrations with different covering materials on internal building surfaces including walls, which are used in Iran dwellings. A special chamber with changeable walls of different covering materials [gypsum, wallpaper, oil dye, plastic dye, wood board, and Belka] was made. Radioactive lantern mantles were used for elevating the radon [220]Rn] levels in the chamber artificially. Ventilation in the chamber had been such way that accumulation of radon could be possible. Active measurement by Prassi portable radon gas surveyor was performed for staging purposes. The average radon concentration for wood and plastic dye was 869.0 +/- 66.7 and 936.8_60.6 [bq/m[3]], respectively, while that for wallpaper and gypsum was 449.2 +/- 101.7, 590.9 +/- 49.0 [bq/m[3]], significantly lower than other covers. The average radon concentration for oil dye and Belka cover was 668.3 +/- 42.3, 697.2 +/- 136.7 [bq/m[3]], respectively. Individuals living in a house with internal wall covering materials of gypsum and wallpaper receive an average annual dose smaller than one living in a house with internal wall covering materials of wood board and plastic dye. Using wallpaper and gypsum as an internal cover for the dwellings suggested

Efecto ambiental de agroquímicos y maquinaria agrícola en cultivos transgénicos y convencionales de algodón / Environmental effects of agrochemicals and agricultural machinery in transgenic and conventional crops cotton

La producción de alimentos se basa en el uso de diferentes tecnologías agrícolas, que pueden derivar en conflictos entre medioambiente y agricultura. Es significativo estudiar el impacto ambiental de las nuevas tecnologías aplicadas a la agricultura, la más importante de las cuales es la transgénesis. Este trabajo se realizó en la zona algodonera del municipio del Espinal, departamento del Tolima, para la cosecha de algodón del primer semestre de 2009, usando las metodologías de Brookes y Barfoot (2006) y Kovach y colaboradores (1992). Se estudió el efecto ambiental de la aplicación de agroquímicos y el uso de maquinaria agrícola en cultivos de algodón transgénico y convencional. Se recogió información mediante encuestas en veinte fincas productoras de algodón. El análisis de las encuestas se realizó de forma descriptiva, determinando diferencias de tipo cuantitativo y cualitativo para los predios que utilizan la tecnología convencional o la tecnología transgénicas (doble gen, Bt/RR), para luego realizar una correlación con el “Enviromental Index Quotient” (EIQ). No se encontraron diferencias entre el EIQ de campo de las dos tecnologías, aunque la tecnología transgénica tiene ventajas ambientales en el control de algunas plagas de lepidópteros. En relación con el uso de maquinaria agrícola, se encontró que la tecnología convencional genera menor liberación de CO2, gas de efecto invernadero. La metodología de Brookes y Barfoot puede adaptarse para estudios comparativos de tecnologías agrícolas en países tropicales.

Food production is based on the use of various agricultural technologies, which can lead to conflicts between environment and agriculture. It is important to study the environmental impact of new technologies applied to agriculture, the most important of which is transgenesis. This work was carried out in the cotton belt of the town of Espinal, Tolima Department for the cotton crop in the first half of 2009, through methodologies Brookes & Barfoot (2006) and Kovach et al (1992). We studied the environmental impact of pesticide application and use of agricultural machinery for cultivation of transgenic and conventional cotton. Information was collected through surveys of 20 farms producing cotton. The analysis of the survey was conducted descriptively, by determining differences in quantitative and qualitative for the sites that use conventional technology, and transgenic (Bt gene and double RR / RR), and then make a correlation with the Environmental Index Quotient (EIQ). No differences were found between the fields EIQ the two technologies, although transgenic technology has environmental advantages in the control of some lepidopteran pests. In connection with the use of agricultural machinery, was found to conventional technology generates less release of CO2, greenhouse gas. The Brookes and Barfoot methodology could be adapted in comparative studies of agricultural technologies in tropical countries.

La prevención de las patologías del asbesto: perspectivas operativas de la cooperación italiana con los países de América Latina / Preventing asbestos-related diseases: operative action for Italian cooperation with Latin-American countries

El propósito del presente estudio es el de valorar la tesis de que el impacto a la salud de la exposición a fibras de asbesto presentes en los lugares de trabajo y en el ambiente requiere contramedidas basadas en la evidencia científica y la cooperación internacional. La evidencia científica adquirida a nivel internacional sobre el asbesto, la experiencia pluridecenal madurada en Italia sobre este tema, así como la conciencia de que la adaptación de medidas para combatir los efectos en la salud causados por la exposición a asbesto debe ser verificada considerando la especificidad de los diversos contextos nacionales y locales en América Latina, constituyen la base para la identificación de las cuatro principales directrices de intervención (Promoción del acceso a la documentación sobre el asbesto - Realización de intervenciones para reducir la exposición al asbesto - Vigilancia sanitaria de los sujetos expuestos - Detección del mesotelioma) - que pueden ser desarrolladas en el ámbito de la cooperación técnico-científica entre Italia y los países de América Latina. La integración de las capacidades de los investigadores colombianos e italianos podrá permitir conseguir estos resultados, contribuyendo al proceso de eliminación del asbesto ya en curso en América Latina.

The present paper was aimed at promoting countermeasures based on scientific evidence and international cooperation for evaluating the impact on health caused by exposure to asbestos fibres in the workplace and the environment. Scientific evidence regarding asbestos made available by the international scientific community, decades of experience gained in Italy on this issue and being aware that adopting measures to combat the health effects caused by asbestos exposure should be verified considering the specificity of various national and local contexts in Latin-America form the basis for identifying four main areas for intervention which may be developed in the field of technical and scientific cooperation between Italy and Latin-America countries: promoting access to information about asbestos, interventions for reducing exposure to asbestos, health surveillance of exposed subjects and mesothelioma detection. Integrating Colombian and Italian researchers' abilities may lead to such results being achieved, thereby contributing to banning asbestos, which is already underway in Latin-America.