Heart rate and energy expenditure during garbage collection in Rio de Janeiro, Brazil

Physiological workload is used to estimate the physical demand of tasks in the workforce, but limited information is available for the various work activities in developing countries. Eighty-three randomly selected male workers participated in the present study, aimed at assessing the physiological workload of garbage collection (GC) in Rio de Janeiro, Brazil. Heart rate (HR) was obtained on four consecutive workdays. Energy expenditure (EE) was extrapolated from heart rate data based on individual laboratory-established heart rate/oxygen consumption curve in 70 workers. Mean HR during GC was 104.0 +/- 11.7 bpm (+/- SD), representing 56.9 +/- 7.5% of maximum heart rate. EE was 1608.3 +/- 738.5 kcal for an average of 293.1 +/- 103.9 minutes of work per day. Based on all measurements, work in garbage collection in Rio de Janeiro can be considered excessively heavy. These data emphasize the need to develop appropriate classification of workload to be used in health-related research and in the development of maximum acceptable work time in association with the physiological workload, particularly in developing countries.     

Analisys of work-related accidents and incidents in an oil refinery in Rio de Janeiro

Accidents in the chemical industry can have serious consequences for workers, communities, and the environment and are thus highly relevant to public health. This article is the result of an occupational surveillance project involving several public institutions. We analyze 800 work-related accidents that resulted in injuries, environmental damage, or loss of production in 1997 in an oil refinery located in Rio de Janeiro, Brazil. The methodology was based on managerial and organizational approaches to accident investigation, with the European Union reporting system as the reference. The results highlight various limitations in the process of reporting and investigating accidents, as well as a certain hierarchy of accidents, with more attention given to accidents involving loss of production and less to those resulting in injuries, particularly among outsourced workers.     

Cat-transmitted sporotrichosis, Rio de Janeiro, Brazil

Sporotrichosis is an emerging zoonosis in Rio de Janeiro, Brazil. From 1998 to 2003, 497 humans and 1,056 cats with culture-proven sporotrichosis were studied. A total of 421 patients, 67.4% with a history of a scratch or bite, reported contact with cats that had sporotrichosis.     

Work-related accidents on oil drilling platforms in the Campos Basin, Rio de Janeiro, Brazil

The offshore oil industry is characterized by complex systems in relation to technology and organization of work. Working conditions are hazardous, resulting in accidents and even occasional full-scale catastrophes. This article is the result of a study on work-related accidents in the offshore platforms in the Campos Basin, Rio de Janeiro State. The primary objective was to provide technical back-up for both workers' representative organizations and public authorities. As a methodology, we attempt to go beyond the immediate causes of accidents and emphasize underlying causes related to organizational and managerial aspects. The sources were used in such a way as to permit classification in relation to the type of incident, technological system, operation, and immediate and underlying causes. The results show the aggravation of safety conditions and the immediate need for public authorities and the offshore oil industry in Brazil to change the methods used to investigate accidents in order to identify the main causes in the organizational and managerial structure of companies.     

HIV vaccine evaluation center in Rio de Janeiro, Brazil

We conducted an HIV seroincidence study among high-risk men who have sex with men in Rio de Janeiro to determine whether this population would be suitable for vaccine and non-vaccine HIV prevention studies. There were 34 HIV seroconversions during the follow-up period, for a seroincidence of 3.1 per 100 person-years. The incidence among the youngest members of our cohort was over 8%, an extraordinarily high transmission rate for a homosexual male population. We have used the sensitive/less sensitive ELISA assay to identify a high-risk heterosexual population for intervention studies in Brazil. The estimated seroincidence was 1.9 and 2.8 per 100 person-years among heterosexual females and males, respectively. We are presently conducting a study to investigate behavior changes among 202 participants of a post-sexual-exposure chemoprophylaxis (PEP) study. During a median follow-up of 24 months, there were 11 HIV seroconversions, 10 of which were among non-PEP users. Additionally, we are conducting a phase 2 HIV vaccine trial of the ALVAC-HIV vector vCP1452 alone and in combination with a subunit vaccine, MN rgp120, in healthy adult volunteers. The primary goal of this trial is to define the immunogenicity and confirm the safety of the most promising vector-based vaccine alone and in combination with a recombinant envelope protein vaccine with an established safety and immunogenicity profile. A phase 3 HIV vaccine trial is planned to begin in the next 18-24 months.     

Factors associated with psychological distress among military police in Rio de Janeiro, Brazil

This study investigates factors associated with psychological distress among military police (n = 1,120) in Rio de Janeiro, Brazil. The article describes their social, economic, and demographic characteristics, quality of life, mental health, and work conditions. Measurement of psychological distress used the Self-Reported Questionnaire. Analysis of associations used logistic regression, considering factors associated with psychological distress. The results indicate an association between psychological distress and factors such as ability to react to difficult situations, dissatisfaction with life, health problems (especially digestive, nervous, and musculoskeletal symptoms), and adverse work conditions such as excessive workload, constant stress, and victimization. The article concludes by highlighting the need for health promotion interventions for the military police, focusing especially on their mental health.     

Occupational exposures to bloodborne pathogens among healthcare workers in Rio de Janeiro, Brazil

Healthcare workers (HCWs) frequently face the risk of occupational infection from bloodborne pathogens following exposure to blood and body fluids. This study describes the results of a surveillance system of occupational exposure to bloodborne pathogens among HCWs in Rio de Janeiro, Brazil, during an eight-year period. A total of 15 035 exposures reported from 537 health units were reviewed. Six circumstances comprised nearly 70% of the reported exposures: recapping needles (14%), performing surgical procedures or handling surgical equipment (14%), handling trash (13%), during disposal into sharps containers (13%), performing percutaneous venepuncture (10%) and during blood drawing (5%). Easily preventable exposures, such as incidents related to recapping needles, handling trash, and sharps left in an inappropriate place, represented 30% of the exposures reported. Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) was initiated for 46% of exposed HCWs. Although Brazilian guidelines indicate that PEP is usually not recommended for exposures with insignificant or very low risk of HIV infection, PEP was prescribed to a large proportion of exposed HCWs under these circumstances. The prevention of occupational exposure to bloodborne pathogens among HCWs and their safety must be considered as a public health issue. Although infection-preventative measures such as antiretroviral drugs and rapid tests are available, this study shows that there are still a high number of easily preventable exposures. The implementation of more effective prevention strategies is urgently required in this country.     

Knowledge of AIDS and HIV transmission among drug users in Rio de Janeiro, Brazil

Background  

Proper knowledge of HIV transmission is not enough for people to adopt protective behaviors, but deficits in this information may increase HIV/AIDS vulnerability.     

Middle-class teenage sexuality and pregnancy in Rio de Janeiro, Brazil

The subject of this paper is teenage pregnancy among middle-class youth, a topic not sufficiently studied in Brazil. The paper is based on a qualitative, socio-anthropological study of 14 middle-class families in Rio de Janeiro, Brazil, whose children have remained single, living with their parents after the child's birth. A total of 25 in-depth interviews were conducted with 6 young men and 7 young women, ages 18 to 24, and their parents (11 mothers, one father), to examine the event in retrospect and its impact on these young people and their families. Three aspects are analyzed: difficulties young people face in internalizing contraception as a norm; late discovery of pregnancy; and how the decision to either have an abortion or give birth is made by young people and their parents. This research allows seeing teenage pregnancy as an event that hinges on the process of constructing a young person's autonomy, in which sexuality plays a prominent role. Concluding, the phenomenon should be analyzed in a specific historical and cultural context, with changes over the decades in the rules underlying the process of individualization among young people.     

Gestational nightblindness among women attending a public maternity hospital in Rio de Janeiro, Brazil

This study evaluated the prevalence of gestational nightblindness among postpartum women seen at the University Maternal Hospital of the Federal University in Rio de Janeiro, Brazil and the association of this symptom with a biochemical indicator (serum retinol levels) and sociodemographic, anthropometric and antenatal care variables. In total, 262 postpartum women, who did not receive vitamin A supplementation during pregnancy, were interviewed. Gestational nightblindness was diagnosed through the standardized interview as proposed by WHO. Serum retinol levels were evaluated by spectrophotometry. Gestational nightblindness relating to low levels of serum retinol (<1.05 micromol/L, p = 0.000) was diagnosed in 17.9% of subjects interviewed. Less than five antenatal care appointments (odds ratio [OR] = 2.179; confidence interval [CI] 95% = 1.078 - 4.402) and a history of one or more miscarriage(s) (OR = 2.306; CI 95% = 1.185 - 4.491) were predictors for gestational nightblindness. These findings justify the need for nutritional counselling, aimed at improving the vitamin A nutritional status, especially among pregnant women with a history of previous miscarriages and poor antenatal care.     

Food consumption by pregnant adolescents in Rio de Janeiro, Brazil

The increase in teenage pregnancy has been viewed with concern by public health experts. Food consumption to help maintain high nutrient demands has been identified as one of the most relevant components. This study aims to present the habitual consumption of food and energy-specific nutrients by pregnant adolescents. A total of 1,180 adolescent mothers were interviewed in maternity hospitals in the City of Rio de Janeiro, and a simplified questionnaire on semi-quantitative frequency of food consumption was applied. Lower consumption of fruit juice, vegetables, and fruits was observed among adolescent mothers over 15. Adolescent mothers classified in the lowest quartile of consumption lack the minimum recommended consumption of energy and nutrients. An inverse association was found between the number of household members and energy and nutrient consumption. Adolescent mothers who received dietary information and changed their eating habits during pregnancy showed better results concerning the consumption of energy and nutrients. Prenatal care was a key factor for improving the results of pregnancy, emphasizing the importance of providing dietary information.     

Neonatal screening for hemoglobinopathies in Rio de Janeiro, Brazil]

OBJECTIVE: To describe the main results obtained in the first 15 months of neonatal screening for sickle cell disease in the state of Rio de Janeiro, Brazil, from August 2000 to November 2001. METHODS: Starting in August 2000, blood samples began to be collected for sickle cell disease screening from all newborns receiving care in primary health care clinics in the state of Rio de Janeiro. The samples were submitted to high-resolution liquid chromatography. If the resulting chromatogram was compatible with sickle cell disease, the child and the parents were referred for diagnostic confirmation and treatment. RESULTS: Between August 2000 and November 2001, 99 260 newborns were screened. There was one case of homozygous Hb C. On average, one of every 27 newborns who were screened presented sickle cell trait (Hb AS). Sickle cell disease was observed in 83 cases, or one new case in each 1 196 births. The 83 consisted of: 62 Hb S, 18 Hb SC, and 3 Hb SD. One child did not appear for diagnostic confirmation. The 82 children who were followed up by the program presented 15 intercurrent illnesses (upper respiratory infections, fever, splenic sequestration crises, hand-foot syndrome, and vascular occlusion), resulting in seven hospital admissions. Blood transfusions were necessary with 15 children, but none developed alloimmunization. All the other babies were doing well with the use of prophylactic penicillin. CONCLUSIONS: Our data show the importance of early diagnosis for sickle cell disease, so as to prevent the frequent infectious complications faced by these patients.     

The evaluation of the physiological workload in the Brazilian legislation should be revised! The case of garbage collectors in Rio de Janeiro

The physiological workload (PW) involved in garbage collection was assessed in a probabilistic sample of 70 Rio de Janeiro city garbage collectors to determine the adequacy of Brazilian labor legislation regarding classification of work. PW was measured as energy expenditure (EE) and heart rate (HR) during total work time (TT) and actual time (AT) in garbage collection on 4 consecutive days. Median EE values were 288.4 and 319.1 kcal.h-1 during TT and AT, respectively, indicating moderately intense work according to Brazilian legislation. However, PW was considered heavy when work classifications based on individual response to work were used: 1) ratio of EE and resting metabolic rate was above 5.0, indicating heavy workload according to the WHO; 2) mean percentage of maximal EE was higher (36.2 and 41.1% for TT and AT, respectively) than the limit for garbage collection (30%) suggested as maximal for Dutch workers; and 3) percentage of maximal HR reserve was also higher than 30% (32.2 and 37.5% for TT and AT, respectively). These results indicate the need for a revision of the workload classification in the Brazilian legislation to take individual workers' characteristics into account.     

Income inequality and homicide rates in Rio de Janeiro, Brazil.

OBJECTIVES: This study determined the effect of income inequality on homicide rates in the state of Rio de Janeiro, Brazil. METHODS: We conducted an ecological study at 2 geographical levels, municipalities in the state of Rio de Janeiro and administrative regions in the municipality of Rio de Janeiro. The association between homicide and income inequality was tested by multiple regression procedures, with adjustment for other socioeconomic indicators. RESULTS: For the municipalities of Rio de Janeiro State, no association between homicide and income concentration was found an outcome that can be explained by the municipalities' different degrees of urbanization. However, for the administrative regions in the city of Rio de Janeiro, the 2 income inequality indicators were strongly correlated with the outcome variable (P < .01). Higher homicide rates were found precisely in the sector of the city that has the greatest concentration of slum residents and the highest degree of income inequality. CONCLUSIONS: The findings suggest that social policies specifically aimed at low-income urban youth, particularly programs to reduce the harmful effects of relative deprivation, may have an important impact on the homicide rate.     

Cancer mortality among agricultural workers from Serrana Region, state of Rio de Janeiro, Brazil

One of the proposed hypotheses to explain the higher incidence of specific-site cancers among agricultural workers is their higher exposure to pesticides. The role of pesticide exposure in morbidity and mortality profiles in Brazil is not well known. Therefore, in order to contribute to increase knowledge on this subject, an ecological analysis aiming to investigate cancer mortality among agricultural workers in an important agricultural area of the Rio de Janeiro State, Brazil, was performed. All causes of death for male workers 30-69 years old provided by the National Mortality Information System between 1979 and 1998 were evaluated. To estimate cancer mortality risks of selected sites, mortality odds ratio (MOR) was employed, and three reference populations were used. Higher mortality of esophagus, stomach, and larynx cancer in agricultural workers 50-69 years old was observed in the period from 1979 to 1988 and of esophagus and stomach cancer from 1989 to 1998. Agricultural workers 30-49 years old showed higher, but not statistically significant, mortality by stomach, esophagus, liver, testis, and prostate cancer, and soft-tissue sarcoma in the period of 1979-1988, and by testis and penis cancer, leukemia, and soft-tissue sarcoma in the period of 1989-1998. Despite the limitations of ecological approaches concerning causality ascertainment, we believe that this study raises questions of the possible role of pesticide exposure on the cancer mortality profile among Brazilian agricultural workers.     

Garbage, work, and health: a case study of garbage pickers at the metropolitan landfill in Rio de Janeiro, Brazil

This article presents the results of a study on the lives, work, and health conditions of garbage pickers in the largest metropolitan landfill in Rio de Janeiro, Brazil. Using a semi-structured questionnaire with open-ended and closed questions, the study interviewed these individuals and developed a discussion of their daily lives, work, and health conditions. According to a quantitative-qualitative analysis, the garbage pickers identified garbage as a source of survival and defined health simply as the ability to work. They thus tended to neglect the relationship between work and health. However, the risks and reported morbidity highlighted the hazardous nature of this activity, aggravated by their living and housing conditions. Finally, the article emphasizes the importance of establishing public policies that integrate different dimensions of the problem, such as social inclusion, environmental preservation, public health, and the dignity of these workers.