The occurrence of antimicrobial residues and antimicrobial resistance genes in urban drinking water and sewage in Southern Brazil.

Antimicrobial resistance (AMR) is currently discussed as an important issue worldwide, and the presence of antimicrobial residues (ARs) and antimicrobial resistance genes (ARGs) in the environment, especially in the water sources, is a challenge for public health. This study was conducted to evaluate the occurrence and diversity of AR and ARG in water sources from an urban center, in Southern Brazil. A total of thirty-two water samples from drinking water treatment plants (24) and sewage systems (8) were collected during two annual samplings, winter and summer. The PCR was performed by 18 ARGs, and the detection of 47 ARs was performed by LC-MS/MS. All sewage samples presented carbapenemases, ESBL, and mcr-1 genes as well as quinolones and sulfamethoxazole residues. In drinking water, we just detected blaTEM and tetB genes and doxycycline residues in samples before treatment. This study provides data about AR and ARG in drinking water and sewage systems showing that these sources are important reservoirs of both. The limited effectiveness of wastewater treatment processes to remove mainly AR demonstrates the need to implement better protocols of disinfection, in order to limit the spread of AMR in the environment.

Identification of pesticides in water samples by solid-phase extraction and liquid chromatography-electrospray ionization mass spectrometry.

The Contaminants of Emerging Concern (CECs), including pesticides, have been a trending topic and Brazil is the country with the highest usage of pesticides worldwide. This study aimed to measure the presence of pesticide residues in the water from different sources in the city of Porto Alegre. We analyzed 55 samples from drinking water treatment plants, public water sites, and sewage treatment plants from winter 2018 to summer 2020 by solid-phase extraction and high-performance liquid chromatography-electrospray ionization mass spectrometry. Among 184 pesticides evaluated, 107 matched validation criteria (linearity, trueness, accuracy, repeatability, reproducibility) and 15 of them were detected in different water samples, including seven insecticides, five antifungals, and three herbicides, with a wide range of toxicity levels and noticeable seasonal differences. For the worst-case scenario evaluation, 20 out of 22 (90.9%) samples exceeded the Risk Quotient of 1. The sum of pesticide concentrations exceeded 100 ng L-1 in 66.7% of samples in February 19 and in 75% of samples in February 20 and the total pesticide concentration has reached the worrisome mark of 1615 and 954.96 ng L-1 respectively. Therefore, our results make evident the need to promote public policies to achieve better water quality monitoring. PRACTITIONER POINTS: Among 184 pesticides evaluated, 107 matched validation criteria (linearity, trueness, accuracy, repeatability, reproducibility). A total of 55 different water samples were analyzed, and 15 pesticides were detected and five quantified. For the worst-case scenario evaluation, 20 out of 21 samples exceeded the Risk Quotient of 1 on Feb/20. The pesticide concentrations sum exceeded 100 ng L-1 in 66.7% of samples on February 19 and in 75% of samples on February 20. It is mandatory to improve water monitoring to guide the development of public policies concerning its quality.

Access and use of secondary dental care of a large city of Rio Grande do Sul, Brazil

Introduction: The Brazilian Dental Specialty Centers (CEOs) were created due to a limitation of Brazilian public dental care. In 2004, the specialized services corresponded to no more than 3.5% of total dental clinical procedures. These services are a reference for oral health teams in primary care in order to perform additional procedures at this level of attention. Despite the expansion of specialized procedures, the resolution of these services is subject to discussion between managers and researchers. Objective: To evaluate the access and use of the secondary dental care of a large city. Material and methods: The descriptive retrospective longitudinal study was conducted using CEO primary data from November 2012 to July 2013. These data were obtained from the Technical Department of Oral Health and the coordination of services were analyzed and then compared to the guidelines of Ordinance no. #1.464/MS. Results: The performance of services was low, ranging from 47.2 to 60.6% of the overall fulfillment of goals, in average. By analyzing per subgroup, endodontics was the subgroup with lower fulfillment (33.2%) and periodontics was that with the most fulfillment (88.3%). Absenteeism on the first appointments, the average per service ranged between 29.4 and 44.2%, and periodontics was the most affected subgroup (51%). The percentage of finished treatment ranged from 52.9 to 66.4%, and stomatology was the subgroup with less number of finished treatments (19.2%). Conclusion: The study revealed low utilization of the evaluated services associated with high absenteeism. Further studies and management initiatives are necessary to find ways to optimize secondary dental care integration to primary care services.

Modelo de atenção e saúde dos trabalhadores: perfil, ações e percepções dos dentistas da rede básica de Florianópolis, SC na atenção a saúde dos trabalhadores / Tecnoassistencial model and workers health care: profile, practices and perceptions according to the dentists at the public health services in Florianópolis ­ Santa Catarina

Introdução e Objetivo: Este artigo analisa a atenção à saúde do trabalhador disponibilizada pela rede pública de assistência à saúde bucal do Município de Florianópolis, SC. A referência teórica circula pela história das políticas de saúde brasileiras, pela recentemente reconhecida especialização Odontologia do Trabalho, pela reestruturação produtiva e pela moderna divisão do trabalho. Material e métodos: A partir desta revisão, foi estruturado um questionário aplicado aos dentistas da rede de saúde do Município. Foram enviados 63 questionários de forma individualizada obtendo-se 36,5% de participação dos dentistas da rede. Resultados e Conclusão: As respostas obtidas estabeleceram o perfil e registraram percepções dos profissionais, permitindo analisar também as práticas desenvolvidas pelos serviços. Os resultados apontam para práticas e concepções ainda em desacordo com as proposições estabelecidas pela legislação em vigor no País no que se refere à atenção à saúde da população trabalhadora.

Introduction and Objective: This article proposes the discussion of the public health services, specifically, the dental care for workers available in Florianópolis, Santa Catarina. The theoretical background went trough the history of the Brazilian health policies, the recently recognized specialization called 'Labour Dentistry', the third industrial revolution, the modern work organization and the concept of 'Worker's Health'. Material and Methods: Based on this review, a questionnaire was built and applied to the dentists who work at the city of Florianópolis, in the state of Santa Catarina. 63 questionnaires were sent and a 36,5% rate of response was achieved. Results and Conclusion: The data set the professionals profile and their perceptions on the issue, allowing also the analysis of the practices developed by the services. The results point to practices and perceptions still in disagreement to the propositions established by the Brazilian legislation which refer to workers health assistance.

Saúde do trabalhador e a atenção odontológica: entre um novo modelo de atenção e a superespecialização / Worker's Health and Dentistry Attention: between a new care model and over-specialization

Suplantar práticas e conceitos incoerentes com as propostas construídas no campo da saúde nas últimas décadas no País é um embate a ser travado pelos serviços de saúde que prestam assistência aos trabalhadores. Este trabalho discute a atuação profissional do cirurgião-dentista e contextualiza o reconhecimento e a regulamentação da nova especialidade da Odontologia do Trabalho, a partir de uma revisão da história das políticas públicas em saúde e da evolução dos conceitos de atenção à saúde do trabalhador. A própria discussão em torno da regulamentação da especialidade da Odontologia do Trabalho reverbera toda uma histórica incompatibilidade entre a racionalidade liberal e a criação de um novo modelo de atenção à saúde do trabalhador. Uma intervenção atenta às conquistas históricas registradas no arcabouço jurídico-institucional que compreenda as especificidades da re-estruturação produtiva no perfil epidemiológico do trabalhador deve fazer parte da construção desta especialidade e das práticas nesta linha de cuidado.