Assessment of Primary Health Care for rural workers exposed to pesticides
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFLA |
Texto Completo: | http://repositorio.ufla.br/jspui/handle/1/43234 |
Resumo: | OBJECTIVE To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute “degree of affiliation” had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered. |
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Assessment of Primary Health Care for rural workers exposed to pesticidesAvaliação da atenção primária à saúde de trabalhadores rurais expostos a praguicidasRural workersOccupational healthAgrochemicalsPoisoningPersonal protection equipmentWorking conditionsPrimary health careRural health servicesTrabalhadores ruraisSaúde do trabalhadorAgroquímicosEnvenenamentoEquipamento de proteção individualCondições de trabalhoAtenção primária à saúdeServiços de saúde ruralOBJECTIVE To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute “degree of affiliation” had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.OBJETIVO Avaliar os atributos da atenção primária à saúde (APS) na assistência à saúde de trabalhadores rurais; analisar condições sociodemográficas, histórico de intoxicação e internações por agrotóxicos e uso de equipamentos de proteção individual; e verificar a exposição aos praguicidas pela determinação de bioindicadores. MÉTODOS Estudo transversal, descritivo-analítico, com amostra de 1.027 trabalhadores rurais residentes em municípios pertencentes a uma superintendência regional de saúde do sul de Minas Gerais, cuja APS é regida pelo modelo da Estratégia Saúde da Família. Utilizou-se o Instrumento de Avaliação da Atenção Primária (PCATool Brasil) versão adulto e um questionário estruturado para coleta de dados socioeconômicos, histórico de intoxicação e internação por agrotóxicos e uso de equipamentos de proteção individual. Foram coletadas amostras sanguíneas para dosagem de biomarcadores de exposição a praguicidas e de sinais de sequelas renais e hepáticas. RESULTADOS A baixa escolaridade foi prevalente, bem como o contato intenso dos trabalhadores com praguicidas. O uso frequente de equipamentos de proteção individual foi maior entre os homens, assim como o histórico de intoxicação e de internações por agrotóxicos. Detectaram-se índices de 20% de intoxicação, 15% de hepatopatia e 2% de nefropatia. Os sinais de hepatotoxicidade foram mais frequentes em homens. As diferenças entre sexos foram todas estatisticamente significantes. Com relação à APS, apenas o atributo “grau de afiliação” apresentou escore elevado. Nenhum dos casos de intoxicação detectados no estudo tinha diagnóstico prévio. CONCLUSÕES A despeito de uma alta cobertura da Estratégia Saúde da Família, o risco ocupacional e suas consequências não têm sido detectados pelos serviços de saúde, que se apresentam como não orientados à atenção primária, carecendo mesmo de seus atributos essenciais. Percebe-se a necessidade de adequação imediata e efetiva das políticas públicas no que concerne à saúde do trabalhador rural, com adequada capacitação das equipes e revisão da carteira de serviços da APS ofertados.Faculdade de Saúde Pública da Universidade de São Paulo2020-09-29T16:43:13Z2020-09-29T16:43:13Z2020info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfSILVÉRIO, A. C. P. et al. Assessment of Primary Health Care for rural workers exposed to pesticides. Revista de Saúde Pública, São Paulo, v. 54, 2020.http://repositorio.ufla.br/jspui/handle/1/43234Revista de Saúde Públicareponame:Repositório Institucional da UFLAinstname:Universidade Federal de Lavras (UFLA)instacron:UFLAAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessSilvério, Alessandra Cristina PupinMartins, IsaritaNogueira, Denismar AlvesMello, Marco Antônio SantosLoyola, Edilaine Assunção Caetano deGraciano, Miriam Monteiro de Castroeng2020-09-29T19:50:24Zoai:localhost:1/43234Repositório InstitucionalPUBhttp://repositorio.ufla.br/oai/requestnivaldo@ufla.br || repositorio.biblioteca@ufla.bropendoar:2020-09-29T19:50:24Repositório Institucional da UFLA - Universidade Federal de Lavras (UFLA)false |
dc.title.none.fl_str_mv |
Assessment of Primary Health Care for rural workers exposed to pesticides Avaliação da atenção primária à saúde de trabalhadores rurais expostos a praguicidas |
title |
Assessment of Primary Health Care for rural workers exposed to pesticides |
spellingShingle |
Assessment of Primary Health Care for rural workers exposed to pesticides Silvério, Alessandra Cristina Pupin Rural workers Occupational health Agrochemicals Poisoning Personal protection equipment Working conditions Primary health care Rural health services Trabalhadores rurais Saúde do trabalhador Agroquímicos Envenenamento Equipamento de proteção individual Condições de trabalho Atenção primária à saúde Serviços de saúde rural |
title_short |
Assessment of Primary Health Care for rural workers exposed to pesticides |
title_full |
Assessment of Primary Health Care for rural workers exposed to pesticides |
title_fullStr |
Assessment of Primary Health Care for rural workers exposed to pesticides |
title_full_unstemmed |
Assessment of Primary Health Care for rural workers exposed to pesticides |
title_sort |
Assessment of Primary Health Care for rural workers exposed to pesticides |
author |
Silvério, Alessandra Cristina Pupin |
author_facet |
Silvério, Alessandra Cristina Pupin Martins, Isarita Nogueira, Denismar Alves Mello, Marco Antônio Santos Loyola, Edilaine Assunção Caetano de Graciano, Miriam Monteiro de Castro |
author_role |
author |
author2 |
Martins, Isarita Nogueira, Denismar Alves Mello, Marco Antônio Santos Loyola, Edilaine Assunção Caetano de Graciano, Miriam Monteiro de Castro |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Silvério, Alessandra Cristina Pupin Martins, Isarita Nogueira, Denismar Alves Mello, Marco Antônio Santos Loyola, Edilaine Assunção Caetano de Graciano, Miriam Monteiro de Castro |
dc.subject.por.fl_str_mv |
Rural workers Occupational health Agrochemicals Poisoning Personal protection equipment Working conditions Primary health care Rural health services Trabalhadores rurais Saúde do trabalhador Agroquímicos Envenenamento Equipamento de proteção individual Condições de trabalho Atenção primária à saúde Serviços de saúde rural |
topic |
Rural workers Occupational health Agrochemicals Poisoning Personal protection equipment Working conditions Primary health care Rural health services Trabalhadores rurais Saúde do trabalhador Agroquímicos Envenenamento Equipamento de proteção individual Condições de trabalho Atenção primária à saúde Serviços de saúde rural |
description |
OBJECTIVE To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute “degree of affiliation” had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-29T16:43:13Z 2020-09-29T16:43:13Z 2020 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
SILVÉRIO, A. C. P. et al. Assessment of Primary Health Care for rural workers exposed to pesticides. Revista de Saúde Pública, São Paulo, v. 54, 2020. http://repositorio.ufla.br/jspui/handle/1/43234 |
identifier_str_mv |
SILVÉRIO, A. C. P. et al. Assessment of Primary Health Care for rural workers exposed to pesticides. Revista de Saúde Pública, São Paulo, v. 54, 2020. |
url |
http://repositorio.ufla.br/jspui/handle/1/43234 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
dc.source.none.fl_str_mv |
Revista de Saúde Pública reponame:Repositório Institucional da UFLA instname:Universidade Federal de Lavras (UFLA) instacron:UFLA |
instname_str |
Universidade Federal de Lavras (UFLA) |
instacron_str |
UFLA |
institution |
UFLA |
reponame_str |
Repositório Institucional da UFLA |
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Repositório Institucional da UFLA |
repository.name.fl_str_mv |
Repositório Institucional da UFLA - Universidade Federal de Lavras (UFLA) |
repository.mail.fl_str_mv |
nivaldo@ufla.br || repositorio.biblioteca@ufla.br |
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1815439292102606848 |