Assessment of Primary Health Care for rural workers exposed to pesticides

Detalhes bibliográficos
Autor(a) principal: Silvério, Alessandra Cristina Pupin
Data de Publicação: 2020
Outros Autores: Martins, Isarita, Nogueira, Denismar Alves, Mello, Marco Antônio Santos, Loyola, Edilaine Assunção Caetano de, Graciano, Miriam Monteiro de Castro
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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spelling 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
collection 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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