Mariana Tavares Guimarães

Pregnancy outcomes in contaminated areas, SP, Brazil

OBJECTIVE Estimate and compare prevalence of events related to pregnancy (pregnancy, low birth weight, premature delivery, spontaneous abortion, stillbirth, congenital malformation, and multiple births) in populations exposed and non-exposed to environmental contaminants in Santos and São Vicente Estuary. METHODS This study was part of a large project financed by CNPq, which aimed to estimate health effects associated with environmental area, contaminants exposure among individuals of the Baixada Santista region. This cross-sectional study evaluated two neighborhoods of São Vicente near a contaminated area, and one neighborhood of Bertioga, the control area. A structured and previously tested questionnaire was applied at 236 households in São Vicente and 251 households in Bertioga in order to obtain the data. The chi-square test or Fishers exact test were used to evaluate associations between area and qualitative variables; Students t test or two proportion comparison test were used to evaluate differences between variables; and a significance level of 5% adopted. RESULTS There was significant association between living in Bertioga (p = 0.01) and number of pregnancies in the past five years. In São Vicente, 64 (28.3%) childbearing age women became pregnant whereas in Bertioga there where 109 (38.8%). There were no statistical significant associations between living in any area and others pregnancy outcomes evaluated. CONCLUSION Although no significant association was found, prevalence of low birth weight, preterm delivery and spontaneous abortion and prevalent odds ratio were higher in contaminated area. This studys evidence of a reduced number of pregnancies in contaminated area strengthens the need for additional more in-depth studies in Santos and São Vicente Estuary.

Determination of Environmental Exposure to DDT by Human Hair Analysis in Santos and São Vicente Estuary, São Paulo, Brazil

In 2009, human hair samples were collected in Brazilian sites historically contaminated with organochlorine to assess the level of contamination with DDT and its metabolites in local human populations (Santos and Sao Vicente Estuary - Sao Paulo State). 122 hair samples from members of four contaminated community were collected (Piloes and Agua Fria, Cubatao Center, Continental Sao Vicente and Guaruja), along with one non-contaminated sample (Bertioga). DDT and its metabolites were detected in approximately 70.0% of the hair samples from all areas, and its concentrations ranged from 50.3 ng.g -1 to 141.8 ng.g -1 in Cubatao Center and Piloes and Agua Fria, respectively. The highest p,p’-DDT concentration was detected in Piloes and Agua Fria (134 ng.g -1 ) and, Cubatao Center (43.9 ng.g -1 ) exhibited the lowest concentration. There was not a clear association between the occurrence of evaluated diseases and DDT detection in hair. None of the locally produced groceries appeared to be risk factors for the presence of DDT in hair. However, DDT concentrations found in this study showed an increase of DDT available for human exposure. These results strengthen the evidence of current exposure routes between DDT and the population of the estuarine region; therefore, this issue deserves further investigation. DOI: http://dx.doi.org/10.17807/orbital.v10i4.1089

Air pollution and low birth weight in an industrialized city in Southeastern Brazil, 2003-2006

Introduction: Birth weight is an important indicator of several conditions that manifest earlier (as fetal and neonatal mortality and morbidity, inhibited growth and cognitive development) and later in life such as chronic diseases. Air pollution has been associated with adverse pregnancy outcomes. Objective: Retrospective cohort study investigated the association between low birth weight (LBW) and maternal exposure to air pollutants in Volta Redonda city, Rio de Janeiro, Brazil, from 2003 to 2006. Methods: Birth data was obtained from Brazilian Information System. Exposure information (O3, PM10, temperature and humidity) was provided by Governmental Air Quality Monitoring System. Linear and Logistic models, adjusted for sex, type of pregnancy, prenatal care, place of birth, maternal age, parity, education, congenital anomalies and weather variables were employed. Results: Low birth weight (LBW) represented 9.1% of all newborns (13,660). For an interquartile range increase in PM10 it was found OR2 ndTrimester = 1.06 (95%CI 1.02 - 1.10), OR3 rdTrimester = 1.06 (95%CI 1.02 - 1.10) and, in O3 it was found OR2 ndTrimester = 1.03 (95%CI 1.01 - 1.04), OR3 rdTrimester = 1.03 (95%CI 1.02 - 1.04). The dose-response relationship and a reduction in birth weight of 31.11 g (95%CI -56.64 - -5.58) was observed in the third trimester of pregnancy due to an interquartile increase of O3. Conclusion: This study suggests that exposures to PM10 and O3, even being below the Brazilian air quality standards, contribute to risks of low birth weight.

0280 Factors associated with the severity of work injuries in the formal sector in piracicaba, são paulo state, brazil

Introduction Work injuries represent a relevant public health issue. Evaluation of associated factors is an important tool for occupational health surveillance. We aimed to identify factors associated with the severity of work injuries in Piracicaba from 2004–2013. Methods This is a cross-sectional study and is part of ”Work Accident: from socio-technical analysis towards the social construction of changes” supported by the São Paulo Research Foundation. Work injuries data were retrieved from the Work Accident Surveillance System (SIVAT) for formal workers with at least 18 years old for the period 2004–2013. Using a multiple logistic regression model, odds ratios (OR) and their 95% confidence intervals (CI95%) were calculated considering the severity of the injury (severe or fatal versus moderate and light) and selected variables (injury type, sex, age group). All analyses were done using STATA 13.1. Results In the period 2004–2013, 78 198 work injuries occurred with formal workers in Piracicaba, being 1522 (1.92%) severe or fatal accident. In severe or fatal accident, the frequency was higher among workers from manufacturing industry (750;49%), followed by services (389;26%). Increased risk for severe and fatal injuries was found for men (OR=1.16 CI95%:1.01–1.33), route accident (OR=2.0;CI95%:1.77–2.26), and an upward trend in risk with increasing age (trend test:p<0.001). Conclusion Action plans to prevent workplace injuries and deaths should be designed considering that men at older ages working in manufacturing industry and in the service sectors are at increased risk. SIVAT represents an important tool to assess worker’s health in the Piracicaba region and guide occupational health surveillance.

0281 Evaluating the completeness of compulsory work-related diseases/injuries notifications recorded by three cities in southeast brazil

Introduction The Brazilian Notifiable Diseases Information System (SINAN) includes eleven work-related diseases and injuries (in nine forms), which communication is mandatory. As a way to evaluate the quality of this database, this study aimed to rate the completeness of information reported by three cities of the São Paulo State from 2007–2016. Methods Descriptive study as part of ‘Work Accident: from Socio-technical analysis towards the social construction of changes’ supported by the Sao Paulo Research Foundation. Data from the work-related diseases and injuries forms were retrieved from SINAN for Araraquara, Campinas and Piracicaba for the period 2007-2016(16 094 files). Completeness was assessed by the percentage of filled variables by form and city, and it were categorised as: excellent (<5% unfilled), good (≥5,<10% unfilled), regular (≥10,<20% unfilled), poor (≥20,<50% unfilled), and very poor (≥50% unfilled). Analyses were done using STATA 13.1. Results 669 variables were analysed, one of them is a compulsory field (occupation) and its completeness was very high (≥97%) for all cities. Araraquara had 71.63% variables with excellent completeness, but the occupational dermatosis file had 34.29% variables classified as very poor. Piracicaba showed 56.24% variables classified as excellent, and the occupational dermatosis and cancer files had 41.46% and 55.07% filled very poorly, respectively. Campinas had 40.80% variables filled as excellent, and more than 30% of variables were classified as poor or very poor in all files. Conclusion There are differences in the completeness among the cities. Routine quality data assessments are crucial to ensure information quality used by health surveillance agents.