Carlos Machado de Freitas

Problemas ambientais, saúde coletiva e ciências sociais

Problemas ambientais e sua interface com a saude estao sempre presentes nos discursos e praticas sanitarias. Em meados do seculo 19, com os intensos impactos do processo de industrializacao e urbanizacao sobre as condicoes sanitarias e de saude, esses problemas sao vistos como resultados de processos politicos e sociais. Mas com o paradigma microbiano essa relacao foi reduzida aos problemas de saneamento e a controle de vetores. A dimensao social e politica passa a ocupar lugar marginal e periferico. Para os movimentos ambientalistas e a medicina social latino-americana a nocao de problemas ambientais e de problemas de saude e ampliada. Apesar dos avancos, a analise de dados sobre grupos de pesquisa, a producao de teses e dissertacoes e a publicacao de artigos cientificos revelam que o campo da saude coletiva ocupa um papel marginal na pesquisa sobre o tema problemas ambientais e a pesquisa e a producao das ciencias sociais respondem por uma parcela muito pequena. O quadro atual impoe a necessidade de se avancar quantitativa e qualitativamente na pesquisa e producao cientifica da saude coletiva sendo urgente no que se refere as ciencias sociais e, particularmente, nas ciencias sociais em saude.

A vigilância da qualidade da água para consumo humano: desafios e perspectivas para o Sistema Único de Saúde

The control of the drinking water quality became itself an action of public health from 70s, when the Norm 52 BSB 77, through of Ministry of Health, stated the norm of drinkability of water supply in all country. However, the achievement of a program of drinking water surveillance alone occurred from the creation of the National System of Environmental Health Surveillance in 1999. This paper approach the challenges put on itself by drinking water surveillance as proposals, not just by rationalizing of the Government, but incorporating the perspective of surveillance in health: the promotion and prevention of health as set of measures adopted by the Brazilian Health System (SUS) and that it point of following lines of direction: the generation of data, analysis and dissemination of the information; the decentralization; intersectoriality; and participation of the society. To carry through such objective, the paper is frameworked in order to describe from a historical perspective, the process of normatization and regulation of the drinking water quality in Brazil; approaching the main challenges and perspectives of the drinking water quality surveillance on sense to seek way for intersectorial and decentralized actions, opened to participatory management and the social control.

Acidentes químicos ampliados: um desafio para a saúde pública

Os acidentes envolvendo substâncias perigosas nas atividades de transporte, armazenamento e producao industrial de produtos quimicos constituem um serio risco a saude e ao meio ambiente. Objetiva-se discutir, no âmbito da saude publica, alguns dos desafios que esses tipos de acidentes colocam, principalmente para os paises de economia periferica. Atraves da combinacao de informacoes quantitativas e qualitativas, foram definidos e caracterizados esses tipos de acidentes e seus diversos riscos. Esses acidentes tem se apresentado com a maior gravidade nos paises de economia periferica, embora a maioria deles venha ocorrendo sem o adequado registro de informacoes basicas para a avaliacao e vigilância, como e demonstrado no caso do Rio de Janeiro (Brasil). Alem da tarefa de se avaliar as consequencias de eventos, por vezes extremamente complexos, coloca-se tambem, a de formular estrategias de controle e prevencao em realidades sociais que configuram um terreno fertil para a ocorrencia e agravamento dos mesmos.

Vulnerabilidade socioambiental, redução de riscos de desastres e construção da resiliência: lições do terremoto no Haiti e das chuvas fortes na Região Serrana, Brasil

Data on disasters around the world reveal greater seriousness in countries with lower social and economic development levels. In this context, disaster risk-reduction and resilience-building policies are priorities in the sustainable development agenda, featuring among the topics selected for the Rio+20 Summit. By means of a contribution of a conceptual nature and from examples of disasters in countries with different development levels, namely the Haiti earthquake and the torrential rains in the mountain range close to Rio de Janeiro in Brazil, the scope of this article is to demonstrate how socio-environmental vulnerability creates conditions for disasters, while at the same time limiting strategies for their prevention and mitigation. Lastly, some of the measures that disaster risk reduction and resilience-building demand in a socio-environmental vulnerability context are highlighted. These involve changes in the current patterns of social, economic and environmental development geared toward ecological sustainability and social justice as pillars of sustainable development.Data on disasters around the world reveal greater seriousness in countries with lower social and economic development levels. In this context, disaster risk-reduction and resilience-building policies are priorities in the sustainable development agenda, featuring among the topics selected for the Rio+20 Summit. By means of a contribution of a conceptual nature and from examples of disasters in countries with different development levels, namely the Haiti earthquake and the torrential rains in the mountain range close to Rio de Janeiro in Brazil, the scope of this article is to demonstrate how socio-environmental vulnerability creates conditions for disasters, while at the same time limiting strategies for their prevention and mitigation. Lastly, some of the measures that disaster risk reduction and resilience-building demand in a socio-environmental vulnerability context are highlighted. These involve changes in the current patterns of social, economic and environmental development geared toward ecological sustainability and social justice as pillars of sustainable development.

Análise de riscos tecnológicos na perspectiva das ciências sociais

Technology, technological risks, and the scientific methods for analyzing these have emerged as part of the development of contemporary societies and are increasingly apart of our everyday lives. From a historical and critical perspective, this article shows that both technological risks as well as their analysis derive from social processes and cannot be reduced to physical, chemical, and biological dimensions alone. These characteristics of technological risks and risk analysis make it necessary to link the field into the social sciences (e.g., history, anthropology, sociology, political science, and others) not only so that risk analyses may become broader in scope and have greater impact on risk management but also so that they can afford a better understanding of our technological society and how to intervene in it. It is concluded that the social sciences must take part in risk analysis, albeit this process of incorporation will entail certain challenges.

Enchentes e saúde pública: uma questão na literatura científica recente das causas, consequências e respostas para prevenção e mitigação

Floods are among the most frequent natural disasters and they affect the lives of approximately 102 million people each year, mainly in developing countries and in major urban areas with a tendency to grow further over the coming decades. The scope of this paper is to provide input for a clearer understanding of these events through the results and experiences to be gleaned from the recent scientific literature. From the Pubmed database, 70 articles were analyzed that fulfilled the criteria to address at least one of the items selected for analysis, namely: 1) causes; 2) consequences; 3) responses and actions: submission of proposals and solutions for the prevention and/or mitigation of the risks and impacts of flooding. Tables for each of the items selected were organized in order to systematize and synthesize the results for causes (attributed to natural and human activities); environmental, infrastructure and services, and health consequences (injuries and diseases classified according to chapters of ICD-10); prevention and mitigation responses and actions. It was concluded that given the scenarios of increased frequency and severity of these events, the challenges facing public health for disaster risk reduction require integrated responses with broad policies for sustainable development.

O Princípio da Precaução no uso de indicadores de riscos químicos ambientais em saúde do trabalhador

Taking the Principle of Precaution as a reference, this article reviews critically the intensive use of isolated biological and environmental indicators to assess chemical exposition. Vigilance and monitoring occupational chemical risk relies mainly on analytical laboratory techniques. The need to develop interdisciplinary and participative approaches is felt by the authors, who propose the surpass of traditional monitoring health practices, and its trend to subordinate the complex to the simple. According to the Principle of Precaution, biological as well as environmental indicators of exposure can only achieve their true value when applied within a global view of the system under analysis. This demands a comprehensive change of perspective in our scientific and social practices of chemical risks control and prevention.

Ecosystem approaches and health in Latin America

Important environmental changes that have become increasingly pronounced in the last two centuries and that are seriously affecting human health require the development of integrated and participatory scientific approaches that can result in proposals for institutional and public policy changes. The purpose of this article is to offer some elements that can contribute to a line of reflection based on studies with ecosystem approaches in the Latin America context. The authors begin with a brief description of current scientific literature in public health that links ecosystems and human health in Latin America; next, they describe and compare the two prevailing trends that form the basis for the theoretical and methodological debates on ecosystem approaches; they also review the empirical research in Latin America or concerning Latin American countries in which an ecosystem approach has been adopted. The results point to limited scientific output on the interface between ecosystems and human health; aspects involving public participation and implementation of institutional changes and public policies are still in a rather incipient stage.

Occupational accidents in an oil refinery in Brazil

OBJECTIVE Work in oil refineries involves the risk of minor to major accidents. National data show the impact of accidents on this industry. A study was carried out to describe accident profile and evaluate the adequacy of accident reporting system. METHODS Data on all accidents reported in an oil refinery in the state of Rio de Janeiro for the year 1997 were organized and analyzed. The study population consisted of 153 injury cases, 83 hired and 69 contracted workers. The variables were: type of accident, operation mode and position of the worker injured. RESULTS Among hired workers, minor accidents predominated (54.2%) and they occurred during regular operation activities (62.9%). Among contracted workers, there also predominated minor accidents (75.5%) in a higher percentage, but they occurred mainly during maintenance activities (96.8%). CONCLUSIONS The study results showed that there is a predominance of accidents in lower hierarchy workers, and these accidents occur mainly during maintenance activities. There is a need to improve the companys accident reporting system and accident investigation procedures.

Indicadores de sustentabilidade ambiental e de saúde na Amazônia Legal, Brasil

One of the challenges for public health is to build systems of indicators that allow monitoring current conditions and trends in environmental and health sustainability. This article focuses on the Legal Amazonia macro-region, which has undergone profound socioeconomic, environmental, and health changes since the mid-20th century. The conceptual framework adopted here was the model entitled Driving Forces, Pressures, State, Exposure, Effects, and Action (DPSEEA) proposed by the World Health Organization and adopted for environmental health surveillance by the Brazilian Ministry of Health. The results show that numerous motor forces and pressures have contributed to the growth of the economy and the population, as well as to improvements in some traditional health indicators (a reduction in infant mortality and an increase in life expectancy), alongside major social and economic inequalities and heterogeneity in environmental health impacts. This same process has been accompanied by environmental changes that indicate an unsustainable development model for present and future generations, demanding comprehensive action by public health and environmental institutions.