Sugarcane cutting work, risks, and health effects: a literature review / O trabalho no corte de cana-de-açúcar, riscos e efeitos na saúde: revisão da literatura

ABSTRACT OBJECTIVE Describe the main work risks for sugarcane cutters and their effects on workers' health. METHODS Critical review of articles, with bibliographic research carried out in the PubMed, SciELO Medline, and Lilacs databases. The following keywords were used: sugarcane workers, sugarcane cutters, sugarcane harvesting, cortadores de cana-de-açú car , and colheita de cana -de-açúcar . The inclusion criteria were articles published between January 1997 and June 2017, which evaluated working conditions and health effects on sugarcane cutters. Those that did not deal with the work impact of cutting burned and unburnt sugarcane in the cutter's health were excluded. The final group of manuscripts was selected by the lead author of this study and reviewed by a co-author. Disagreements were resolved by consensus using the predefined inclusion and exclusion criteria and, where necessary, the final decision was made by consulting a third co-author. RESULTS From the 89 articles found, 52 met the selection criteria and were evaluated. Studies have shown that cutters work under conditions of physical and mental overload, thermal overload, exposure to pollutants, and are subject to accidents. The main effects observed were respiratory, cardiovascular, renal, musculoskeletal, heat stress, dehydration, genotoxic, and those due to accidents. CONCLUSIONS Work on the manual cutting of sugarcane, especially of burned sugarcane, exposes workers to various risks, with different health impacts. Risk reduction for exposure to pollution and thermal and physical overload is required as a measure to preserve the health of the worker.

RESUMO OBJETIVO Descrever os principais riscos do trabalho de cortadores de cana-de-açúcar e seus efeitos na saúde dos trabalhadores. MÉTODOS Revisão critica de artigos, com pesquisa bibliográfica realizada nas bases de dados PubMed, SciELO Medline, e Lilacs. Foram empregadas as palavras-chave: sugarcane workers, sugarcane cutters, s ugarcane harvesting , cortadores de cana-de-açúcar e colheita de cana-de-açúcar. Os critérios de inclusão foram artigos publicados entre janeiro de 1997 a junho de 2017, que avaliaram as condições de trabalho e os efeitos na saúde em trabalhadores cortadores de cana-de-açúcar. Foram excluídos aqueles que não tratassem do impacto do trabalho no corte da cana-de-açúcar queimada e não queimada na saúde do cortador. O grupo final de manuscritos foi selecionado pelo autor principal deste estudo e revisado por um coautor. As discordâncias foram resolvidas por consenso usando os critérios de inclusão e exclusão predefinidos e, quando necessário, a decisão final foi realizada consultando um terceiro coautor. RESULTADOS De 89 artigos encontrados, 52 atenderam aos critérios de seleção e foram avaliados. Os estudos mostraram que os cortadores trabalham em condições de sobrecarga física e mental, sobrecarga térmica, exposição a poluentes e sujeitos a acidentes. Os principais efeitos observados foram respiratórios, cardiovasculares, renais, osteomusculares, estresse por calor, desidratação, genotóxicos e decorrente de acidentes. CONCLUSÕES O trabalho no corte manual da cana-de-açúcar, principalmente da cana-de-açúcar queimada, expõem os trabalhadores a diversos riscos, com variados impactos à saúde. A redução de riscos com exposição à poluição e sobrecarga térmica e física se impõe como medida para preservação da saúde do trabalhador.

Contribution of environmental pollutants to male infertily: A working model of germ cell apoptosis induced by plasticizers

Bisphenol A [2,2-bis(4-hydroxyphenyl)propane] (BPA), 4-nonylphenol (NP) and di(2-ethylhexyl)phthalate (DEHP), and its metabolite mono-2-ethylhexyl phthalate (MEHP) are chemicals found in plastics, which act as endocrine disruptors (EDs) in animals, including human. EDs act like hormones in the endocrine system, and disrupt the physiologic function of endogenous hormones. Most people are exposed to different endocrine disruptors and concern has been raised about their true effect on reproductive organs. In the testis, they seem to preferentially attack developing testis during puberty rather than adult organs. However, the lack of information about the molecular mechanism, and the apparently controversial effect observed in different models has hampered the understanding of their effects on mammalian spermatogenesis. In this review, we critically discuss the available information regarding the effect of BPA, NP and DEHP/ MEHP upon mammalian spermatogenesis, a major target of EDs. Germ cell sloughing, disruption of the blood-testis-barrier and germ cell apoptosis are the most common effects reported in the available literature. We propose a model at the molecular level to explain the effects at the cellular level, mainly focused on germ cell apoptosis.

El ambiente laboral como fuente de exposición a humo de tabaco ambiental: Estudio en trabajadores de bares y restaurantes de Santiago, Chile / The work environment as a source of exposure to secondhand smoke: a study in workers of bars and restaurants of Santiago, Chile

Background: Secondhand smoke (SHS) is an established cause of morbidity and mortality among non-smokers. The workplace is an important source of exposure, especially among workers of restaurants, bars and nightclubs. Aim: To estimate the daily occupational exposure to SHS among non-smoking workers of bars and restaurants of Santiago, Chile. Material and Methods: Environmental vapor-phase nico-tine was measured for 95 non-smoking workers of bars and restaurants of Santiago, using passive personal samplers during a daily work shift and outside the workplace. Results: The median occupational exposure to air nicotine was 9.18 µg/m³ (P25-P75 3.15-25.67 µg/m³). Higher concentrations were found among workers of places with no smoking restrictions (22.72 µg/m³; P25-P75 5.73-34.85 µg/m³), bar workers (20.75 µg/m³, P25-P75 5.03-44.67 µg/m³), waiters (20.57 µg/m³, PP25-P75 5.66-42.73 µg/m3) and bartenders (10.37 µg/m³, P25-P75 9.75-25.67 µg/m³). The median concentration of nicotine outside the workplace was 1.79 µg/m³ (P25-P75 1.02-3.00 µg/m³). Occupational exposure was 4.77 times higher compared to the non-work exposure. Conclusions: Workers of bars and restaurants are exposed to high levels of SHS at the workplace. Moreover, occupational exposure among these non-smoking workers is, in most cases, the main source of daily exposure to this pollutant.

Avaliação do processamento auditivo central em adolescentes expostos ao mercúrio metálico / Evaluation of central auditory processing in adolescents exposed to metallic mercury

TEMA: processamento auditivo central e exposição ao mercúrio metálico. OBJETIVO: comparar o desempenho nos testes comportamentais de processamento auditivo central entre adolescentes expostos e não expostos ao mercúrio metálico. MÉTODO: foram avaliados 52 adolescentes de ambos os sexos que apresentavam limiares auditivos dentro dos padrões de normalidade. O grupo de estudo (GE) incluiu 21 adolescentes que referiram trabalhar na queima dos amálgamas de ouro-mercúrio, re-queimar ouro em lojas que comercializam este metal ou residir próximos às áreas de garimpos e às lojas que comercializam ouro. O grupo de comparação (GC) foi composto por 31 adolescentes que não apresentaram história de exposição ao mercúrio. Os procedimentos incluíram um questionário sobre a história clínica, laboral e da exposição ao mercúrio, audiometria tonal liminar e bateria de testes para avaliação do processamento auditivo central. RESULTADOS: As diferenças de desempenho na avaliação do processamento auditivo central entre o GE e o GC foram estatisticamente significantes para o teste de memória seqüencial para sons não verbais (p = 0,001), para os testes de padrão de freqüência (p = 0,000) e de duração (p = 0,000) e para o SSW em Português (p = 0,006). CONCLUSÃO: os adolescentes expostos ao mercúrio metálico apresentaram desempenho significativamente inferior aos não expostos para a maioria dos testes comportamentais do processamento auditivo central e a principal alteração encontrada nessa população foi no processamento de sons breves e sucessivos.

BACKGROUND: central auditory processing and exposure to metallic mercury. AIM: to evaluate the performance on tests of central auditory processing in adolescents exposed to metallic mercury. METHOD: participants were 52 adolescents, of both genders, who presented hearing thresholds within normal limits. The study group (SG) was composed by 21 adolescents who worked on the burning of gold-mercury amalgams, on the re-burning of gold in stores that sell this metal or who lived next to gold mines or gold shops. The control group (CG) was composed by 31 adolescents who had no history of exposure to mercury. Investigation procedures included the application of a clinical, occupational and mercury exposure history questionnaire, basic audiometric assessment as well as central auditory processing tests. RESULTS: Statistical significant differences in the auditory processing tests of non-verbal sound sequence memory test (p = 0,001), frequency pattern test (p = 0,000), duration pattern test (p = 0,000) and SSW test in Portuguese (p = 0,006) were observed between SG and CG. CONCLUSION:adolescents exposed to metallic mercury presented a lower performance on most of the auditory processing tests when compared to those who had no history of exposure to mercury. The main deficit found in the study was related to difficulty in distinguishing successive brief sounds.

Cytogenetic evaluation of traffic policemen occupationally exposed to vehicular exhaust.

Background & objectives: Automobile exhaust consists of many toxic components and is considered to be a major health concern in urban areas. Traffic policemen are occupationally exposed to vehicular exhaust during the traffic control. Hence, the present study was aimed to evaluate genotoxic effects of vehicular exhaust in traffic policemen in Hyderabad, south India. Methods: Analysis of chromosomal aberrations was carried out in 136 traffic policemen, including 78 non smokers and 58 smokers who were exposed to vehicular exhaust for a period of 1-28 yr. For comparison, 115 healthy males including 69 non smokers and 46 smokers of the same age group and socio-economic status (who were not exposed to any chemical or radiation at their workplace) were studied. Results: A significant increase (P<0.05) was observed in the mean frequency of chromosomal aberrations in non smoker and smoker traffic policemen (6.48 and 8.96 respectively) when compared to their respective control groups (3.35 and 4.30). According to the age a significant increase in the frequency of chromosomal aberrations was observed both in control and exposed groups (P<0.05). As the duration of exposure increased in traffic policemen, there was a corresponding increase in the frequency of chromosomal aberrations. Interpretation & conclusions: Cytogenetic damage was more pronounced in smokers when compared to non smokers. Age and duration of exposure also appear to play a vital role in causing cytogenetic damage. Thus the present study suggests that the induction of cytogenetic damage might be due to the cumulative effect of smoking, age and duration of exposure to vehicular exhaust.

Prevalência de sintomas respiratórios e fatores associados: estudo de base populacional em adultos de Lages, Santa Catarina, Brasil / Prevalence of respiratory symptoms and associated factors: a population-based study in adults from Lages, Santa Catarina State, Brazil

Realizou-se estudo transversal de base populacional em Lages, Santa Catarina, Brasil, para estimar a prevalência de sintomas de bronquite crônica, falta de ar e chiado no peito e os fatores associados em adultos de 20-59 anos de idade (n = 2.051). Processo de amostragem através de conglomerados e análise de regressão de Poisson foram realizados. As prevalências de bronquite crônica, falta de ar e chiado no peito foram de 5 por cento, 35,7 por cento e 20,2 por cento, respectivamente. Análises ajustadas mostraram presença de bronquite crônica associada à baixa escolaridade, fumar dez ou mais pacotes de cigarros ao ano e internação por problemas de pulmão na infância. Falta de ar associou-se ao sexo feminino, baixa escolaridade e renda familiar, pardos e amarelos, história de internação por problemas de pulmão na infância, ser fumante e trabalhar com poeira ou pó. Presença de chiado no peito associou-se ao sexo feminino, baixa escolaridade e renda familiar, pardos e pretos, história de internação por problemas de pulmão na infância, ser fumante e trabalhar com poeira ou pó. Particularidades do clima e das atividades laborais devem ser consideradas no planejamento das ações em saúde.

A cross-sectional population-based study was conducted in Lages, Santa Catarina State, Brazil, in order to estimate the prevalence of symptoms of chronic bronchitis, breathlessness, and wheezing and associated factors in a sample of adults 20 to 59 years of age (n = 2,051). The study employed a cluster sample design and Poisson regression analyses. Prevalence rates for chronic bronchitis, breathlessness, and wheezing were 5 percent, 35.7 percent, and 20.2 percent, respectively. The adjusted analysis showed chronic bronchitis associated with low schooling, smoking, and hospital admissions due to respiratory illness during childhood. Breathlessness was associated with female gender, low schooling and family income, non-white race, hospital admissions due to respiratory illness during childhood, smoking, and occupational exposure to dust. Wheezing was associated with female gender, low schooling and family income, non-white race, hospital admissions due to respiratory illness during childhood, smoking, and occupational exposure to dust. Public health planners should consider climatic factors and work activities when developing activities to prevent respiratory diseases.

Anthracotic airways disease: report of 102 cases

Numerous causes can lead to chronic inflammatory lesions of the lower respiratory airways including those recognized as chronic obstructive pulmonary disease [COPD], of which tobacco smoke has been established. Air pollution and smokes from indoor and outdoor origins are among the possible causes. However, further investigations are required on this issue. Amongst those who underwent diagnostic bronchoscopy in the pulmonary endoscopy unit, Tehran University of Medical Sciences from April 1975 to March 2000, 102 patients revealed generalized chronic changes of the airways with significant anthracotic deposits. Their clinical manifestations, demographic data, radiological, biopsy and bronchial washing findings were evaluated and compared with a similar number of contemporary cases without anthracotic lesions but with a variety of established pathologies. Clinically, the patients with anthracotic airway lesions were already respiratory cripples. Females [n=60] had been exposed to long-term indoor smoke inhalation while baking home-made bread. Males [n=42] had a variety of occupations that entailed heavy smokes. Those without bronchial anthracosis had no similar histories. Long-term smoke inhalation can cause chronic anthracotic bronchopathies leading to respiratory invalidism. The problem seems to be extensive and has not confined to Iran. Further worldwide studies are required to address different aspects, including prevention of these ailments

Exposição ocupacional e ocorrência de pneumoconioses na região de Campinas (SP) Brasil, 1978-2003 / Occupational exposure and occurrence of pneumoconioses in Campinas, Brazil, 1978-2003

OBJETIVO: Desenvolver e consolidar uma ampla base de dados acerca da ocorrência das pneumoconioses numa região industrializada do Brasil, com especial referência às atividades mais freqüentemente relacionadas a essas doenças. MÉTODOS: Numa avaliação retrospectiva observacional, coletaram-se dados referentes à casuística ambulatorial das pneumoconioses no Hospital das Clínicas da Universidade Estadual de Campinas, entre o período de 1978 e 2003. Incluíram-se os indivíduos com diagnóstico de pneumoconiose, com base no histórico ocupacional e no radiograma do tórax, segundo recomendações da Organização Internacional do Trabalho, de 1980 e 2000, com anormalidades compatíveis com comprometimento intersticial do parênquima pulmonar. RESULTADOS: Foram identificados 1.147 casos de pneumoconiose (1.075 homens e 72 mulheres), sendo 1.061 casos (92,5 por cento) de silicose, 51 (4,45 por cento) de pneumoconiose por poeira mista, 15 (1,31 por cento) de asbestose, 13 (1,13 por cento) de pneumoconiose por rocha fosfática e 7 (0,61 por cento) de outras pneumoconioses (por carvão, grafite e metais duros). As alterações radiológicas com profusão 1/0, 1/1 e 1/2 e as pequenas opacidades regulares p, q e r foram as mais freqüentes, tendo sido identificados 192 casos (16,74 por cento) com grandes opacidades. Observou-se redução pronunciada da ocorrência dos casos a partir da década de 1990; adicionalmente, o tempo de exposição foi caracteristicamente mais breve do que o observado em série norte-americana. CONCLUSÕES: Os dados do presente estudo estabelecem uma ampla base de dados para a investigação da ocorrência de pneumoconioses numa região industrializada brasileira, tornando factível a realização de estudos de seguimento e a elaboração de políticas de saúde relacionadas aos agravos respiratórios ocupacionais.

OBJECTIVE: To develop and consolidate a comprehensive database on the occurrence of pneumoconioses in an industrialized region of Brazil, with a special focus on the activities most frequently related to these diseases. METHODS: A retrospective, observational study was conducted in order to gather data on cases of pneumoconioses treated at the outpatient clinic of the State University at Campinas Hospital das Clínicas between 1978 and 2003. Individuals diagnosed with pneumoconiosis, based on their occupational history and on chest X-ray findings of abnormalities consistent with interstitial lung disease involving the parenchyma, in accordance with the 1980 and 2000 recommendations of the International Labour Organization, were included in the study. RESULTS: A total of 1147 cases of pneumoconiosis were identified (1075 in males and 72 in females): 1061 cases of silicosis (92.5 percent); 51 cases of mixed-dust pneumoconiosis (4.45 percent); 15 cases of asbestosis (1.31 percent); 13 cases of phosphate rock-related pneumoconiosis (1.13 percent); and 7 cases of other types of pneumoconiosis (0.6 percent), including those related to exposure to coal, graphite and hard metals. The most common chest X-ray findings were 1/0, 1/1 or 1/2 profusion and small regular opacities (p, q or r), although 192 patients (16.74 percent) presented large opacities. There has been a substantial decline in the occurrence of the disease since the 1990s, and the duration of exposure was typically shorter than that observed in a study conducted in the United States. CONCLUSIONS: Our findings have been compiled into a comprehensive database for the investigation of pneumoconiosis in an industrialized area of Brazil. These data make it possible to conduct follow-up studies and develop health policies related to occupational respiratory disorders.

Volatile Organic Compounds Contribute to Airway Hyperresponsiveness

BACKGROUND: Volatile organic compounds (VOCs) in concentrations found in both the work and home environments may influence lung function. We investigated the prevalence of airway responsiveness in workers exposed to VOCs. METHODS: We used allergic skin tests, nonspecific airway hyperresponsiveness testing and questionnaires to study twenty exposed workers and twenty-seven control subjects. Atopy was defined as a reactor who showed >3+ response to one or more allergens on the skin prick tests. Airway hyperresponsiveness (BRindex) was defined as log [% fall of FEV1/ log (last concentration of methacholine) +10]. RESULTS: The VOC exposed workers, in comparison with the control subjects, tended to have a higher BRindex (1.19+/-0.07 vs. 1.15+/-0.08, respectively). Workers exposed to VOCs with atopy or smoker, as compared with the workers exposed to VOCs with non-atopy and who were non-smokers and the control subjects with non-atopy and who were non-smokers, had a significantly higher BRindex (1.20+/-0.05 vs. 1.14+/-0.06 vs. 1.10+/-0.03, respectively p<0.05). The BRindex was not correlated with atopy, the smoking status or the duration of VOC exposure. CONCLUSIONS: These findings suggest that VOCs may act as a contributing factor of airway hyperresponsiveness in workers exposed to VOCs.

Structural alteration of spermatozoa in the persons employed in lead acid battery factory.

Lead is one of the industrially heavy metals that caused adverse effects on male reproductive system among battery factory workers, but information on the possible impact of lead on the structural integrity of sperm cell is limited. Thus present study was undertaken to assess the structural details of human spermatozoa of lead acid battery factory workers. Blood and semen samples were collected from total 80 workers (7-15 years exposure) and 40 non-occupationally exposed control subjects. The lead exposed battery factory workers showed lowering (P < 0.001) of sperm count, density, motility and semen volume along with an increase incidence of sperm abnormality and prolong liquefaction time. Structural alteration of sperm cell was prevalent among the exposed population as evidenced by significantly (P < 0.001) low sperm viability, low hypoosmotic swelling test (HOST) percentage, high lipid peroxidation of sperm membrane with concomitant alterations of seminal plasma total and dehydro ascorbate level. Sharp depressions, membrane folding and granularity at sperm head surfaces were observed by scanning electron microscopy (SEM). Both blood lead and semen lead was significantly (P < 0.001) higher among the factory workers. Thus it appears plausible that lead may reduce the antioxidant level in seminal plasma and enhance the lipid peroxidative changes in sperm membrane leading to concomitant structural damage of sperm cell surface in the workers employed in lead acid battery factories.

Occupational genotoxicity risk evaluation through the comet assay and the micronucleus test

The micronucleus (MN) test and the alkaline single cell gel or comet assay were applied to exfoliated cells of the buccal mucous in order to evaluate the genotoxic risk associated with occupational exposure of 10 storage battery renovation workers, and 10 car painters, with age matched controls, in Pelotas, RS, in southern Brazil. In the MN test, 2000 exfoliated buccal cells were analyzed for each individual, while 100 cells were examined in the comet assay. In the comet test, both comet tail length and a damage index were calculated. Highly significant effects of occupational exposure were found with both the MN test and the comet assay (P<0.001). The comet assay was found to be rapid, of simple visualization, and it is a sensitive technique for measuring and analyzing DNA damage in human cells

Male reproductive toxic effects of carbendazim: hitherto unreported targets in testis.

Carbendazim (MBC), a widely used fungicide, is toxic to male reproductive mechanisms. Various cellular targets in the testis for MBC action are being understood only recently and still more targets have been conceived. The present study was aimed at finding such newer targets. Male rats were administered through oral route a single dose of carbendazim (400 mg/kg) and the testis was studied adopting routine histological technique. It has been observed that pachytene spermatocytes could also be targets for MBC action in the testis. The study also reports selective loss of step 14 spermatids, asynchrony of the stages in the spermatogenic cycle and development of Sertoli cell fibrosis of the seminiferous tubules of carbendazim-treated rats. From the different kinds of responses seen in the seminiferous tubules in the same testis to MBC, particularly in the Sertoli cell, MBC action in the testis appears dependent on the stage in the spermatogenic cycle at first exposure.

Abnormal pattern of lung functions in rubber factory workers.

The influence of suspended particulate matter, benzo(e) pyrene, benzo(e) pyrene and benzo(a) anthracene concentration on pulmonary lung functions ie, residual volume, total lung capacity, residual volume/total lung capacity, forced residual capacity were studied in 667 rubber factory workers during 1990-91. The respirable fraction of the particulate size (< 0.5 micron) showed high mean concentration of suspended particulate matter, benzo(a) pyrene, benzo(e) pyrene and benzo(a) anthracene in the compounding section (group III), when compared with vulcanising (group II) and packing loading (group I) units. While comparing the lung functions amongst these groups, the higher results of residual volume, residual volume/total lung capacity ratio, forced respiratory capacity and lower values of total lung capacity were observed in group III workers as compared with other two groups. And also these results seem to be correlated with the high pollutant concentrations to which group III workers were exposed, and reflect a clear combination of obstructive and restrictive pattern of lung functions in them.

Exposiçäo ao formaldeído em anatomia: um risco de saúde ocupacional? / Exposure to folmaldehyde in anatomy: an occupational health hazard?

Sao discutidos os efeitos prejudiciais do formaldeído, baseados em resultados de pesquisas científicas que sao principalmente publicados em revistas nao usualmente lidas por anatomistas. O objetivo do presente artigo é fazer uma súmula dos reais perigos dessa substância para a saúde. Suas propriedades e origem sao sucintamente mencionadas, seus efeitos tóxicos sao descritos e sao feitas recomendaçoes para minimizar as conseqüências do seu uso. Esses dados certamente ajudarao os anatomistas a discutirem com mais precisao o potencial de risco do formaldeído, para a saúde.