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Occupational risks associated with chronic kidney disease of non-traditional origin (CKDnt) in Brazil: it is time to dig deeper into a neglected problem nontraditional non traditional CKDnt (CKDnt Brazil
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Buralli, Rafael Junqueira

; Albuquerque, Polianna L M Moreira

; Santo, Cintia da Espiritu

; Calice-Silva, Viviane

; Nerbass, Fabiana Baggio

Brazilian Journal of Nephrology

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sep 2024, Volume 46 N. 3 elocation e20230123

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Nas últimas décadas, uma epidemia de doença renal crônica (DRC) tem sido associada a fatores ambientais e ocupacionais (estresse térmico decorrente de cargas de trabalho elevadas em altas temperaturas e exposição a produtos químicos, como agrotóxicos e metais), denominada DRC de origem não tradicional (DRCnt). Esta revisão descritiva tem como objetivo apresentar evidências recentes sobre estresse térmico, agrotóxicos e metais como possíveis causas de DRCnt e fornecer uma visão geral das estratégias brasileiras de regulamentação, fiscalização e vigilância sanitária relacionadas. Os trabalhadores brasileiros são comumente expostos a condições extremas de calor e outros fatores de risco de DRCnt, incluindo o aumento da exposição a agrotóxicos e metais. Além disso, há uma falta de regulamentação e fiscalização, políticas públicas e estratégias adequadas para proteger a saúde renal dos trabalhadores em relação aos principais fatores de risco. É provável que a DRCnt seja uma causa significativa de DRC no Brasil, uma vez que a etiologia da doença é desconhecida em muitos pacientes e diversas condições para seu desenvolvimento estão presentes no país. Estudos epidemiológicos devem ser realizados para explorar associações causais e estimar o impacto do calor, dos agrotóxicos e dos metais na DRCnt no Brasil. Além disso, as políticas públicas devem priorizar a redução da exposição dos trabalhadores e a promoção de sua saúde e segurança. décadas (DRC químicos metais, , metais) DRCnt. . (DRCnt) relacionadas disso Brasil país segurança (DRCnt

Abstract In the past decades, an epidemic of chronic kidney disease (CKD) has been associated with environmental and occupational factors (heat stress from high workloads in hot temperatures and exposure to chemicals, such as pesticides and metals), which has been termed CKD of non-traditional origin (CKDnt). This descriptive review aims to present recent evidence about heat stress, pesticides, and metals as possible causes of CKDnt and provide an overview of the related Brazilian regulation, enforcement, and health surveillance strategies. Brazilian workers are commonly exposed to extreme heat conditions and other CKDnt risk factors, including increasing exposure to pesticides and metals. Furthermore, there is a lack of adequate regulation (and enforcement), public policies, and strategies to protect the kidney health of workers, considering the main risk factors. CKDnt is likely to be a significant cause of CKD in Brazil, since CKD’s etiology is unknown in many patients and several conditions for its development are present in the country. Further epidemiological studies may be conducted to explore causal associations and estimate the impact of heat, pesticides, and metals on CKDnt in Brazil. Moreover, public policies should prioritize reducing workers´ exposure and promoting their health and safety. decades (CKD chemicals metals, , metals) nontraditional non traditional CKDnt. . (CKDnt) enforcement Furthermore enforcement) Brazil CKDs s country Moreover safety (CKDnt

https://doi.org/10.1590/2175-8239-jbn-2023-0123en

Prevalence of congenital malformations from 2015 up to 2019, in Rondônia (RO), Amazon, Brazil 201 2019 RO, RO , (RO) Amazon 20 (RO 2
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Franco, Tainara Ferrugem

; Marques, Rejane Corrêa

; Miranda, Amarildo

; Dórea, José Garrofe

; Cunha, Mônica Pereira Lima

; Buralli, Rafael Junqueira

; Guimarães, Jean Remy Davée

Revista Brasileira de Saúde Materno Infantil

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2023, Volume 23 elocation e20220389

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivos: determinar e caracterizar a prevalência de malformações congênitas entre nascidos vivos em Rondônia, no período de 2015 a 2019. Métodos: estudo ecológico, com dados públicos disponíveis no Sistema de Informações sobre Nascidos Vivos coletados em janeiro de 2021. Foi calculada a prevalência das malformações e as possíveis associações. A força de associação entre as variáveis foi medida pela razão de odds. Aquelas variáveis consideradas estatisticamente significante ao nível de 5% foram selecionadas para o cálculo de razão de odds ajustada, usando modelo de regressão logística. A linguagem de programação R foi usada para todas as análises e interação com o banco de dados. O Intervalo de Confiança considerado foi de 95%. Resultados: foram analisados 1.110 registros. A prevalência geral de malformação congênita foi de 8,36, sendo maior entre mães com idade acima de 35 anos, baixa escolaridade, solteiras, com partos prematuros; crianças com baixo peso ao nascer e baixos escores de Apgar. Conclusão: a prevalência de malformação congênita no estado foi próxima da nacional, mas houve discrepâncias entre as regiões de saúde que merecem uma investigação futura. Objetivos Rondônia 201 2019 Métodos ecológico 2021 associações 5 ajustada logística 95 95% Resultados 1110 1 110 1.11 registros 836 8 36 8,36 3 anos escolaridade solteiras prematuros Apgar Conclusão nacional futura 20 202 9 111 11 1.1 83 8,3 2 1. 8,

Abstract Objectives: to determine and characterize the prevalence of congenital malformations among live births in Rondônia, from 2015 to 2019. Methods: an ecological study was conducted using publicly available data at Sistema de Informações sobre Nascidos Vivos collected in January 2021. The prevalence of congenital malformation and possible associations were calculated. The strength of the association between variables was measured using the odds ratio. Variables that were statistically significant at the 5% level were selected for adjusted odds ratio calculation using logistic regression models. The R programming language was used for all analyses and interactions with the database. A 95% confidence interval was considered. Results: a total of 1,110 records were analyzed. The overall prevalence of congenital malformation was 8.36, with higher rates observed among mothers over 35 years, those with low educational levels, unmarried status, and preterm birth. Infants with low birth weight and low Apgar scores also had higher prevalence rates of congenital malformations. Conclusion: the prevalence of congenital malformations in the state was similar to the national average, but regional disparities were observed and warrant further investigation. Objectives Rondônia 201 2019 Methods 2021 calculated 5 models database 95 considered Results 1110 1 110 1,11 analyzed 836 8 36 8.36 3 years levels status Conclusion average investigation 20 202 9 111 11 1,1 83 8.3 2 1, 8.

https://doi.org/10.1590/1806-9304202300000389-en

COVID-19 and isolation: Risks and implications in the scenario of new variants
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Dias, Viviane Maria de Carvalho Hessel

; Oliveira, Alexandre Ferreira

; Marinho, Ana Karolina Barreto Berselli

; Santos Ferreira, Carlos Eduardo dos

; Domingues, Carlos Eduardo Ferreira

; Fortaleza, Carlos Magno Castelo Branco

; Vidal, Claudia Fernanda de Lacerda

; Carrilho, Claudia Maria Dantas de Maio

; Pinheiro, Debora Otero Britto Passos

; de Assis, Denise Brandão

; Medeiros, Eduardo Alexandrino

; Morejón, Karen Mirna Loro

; Weissmann, Leonardo

; Michelin, Lessandra

; Carneiro, Marcelo

; Nogueira, Maria Dolores Santos da Purificação

; de Oliveira, Priscila Rosalba Domingos

; Buralli, Rafael Junqueira

; Stucchi, Raquel Silveira Bello

; Lins, Rodrigo Schrage

; Costa, Silvia Figueiredo

; Chebabo, Alberto

Brazilian Journal of Infectious Diseases

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2022, Volume 26 N. 5 elocation 102703

Abstract: En | Text: En | PDF: En

Abstract With the emergence of new variants of SARS-CoV-2, questions about transmissibility, vaccine efficacy, and impact on mortality are important to support decision-making in public health measures. Modifications related to transmissibility combined with the fact that much of the population has already been partially exposed to infection and/or vaccination, have stimulated recommendations to reduce the isolation period for COVID-19. However, these new guidelines have raised questions about their effectiveness in reducing contamination and minimizing impact in work environments. Therefore, a collaborative task force was developed to review the subject in a non-systematic manner, answering questions about SARS-CoV-2 variants, COVID-19 vaccines, isolation/quarantine periods, testing to end the isolation period, and the use of masks as mitigation procedures. Overall, COVID-19 vaccines are effective in preventing severe illness and death but are less effective in preventing infection in the case of the Omicron variant. Any strategy that is adopted to reduce the isolation period should take into consideration the epidemiological situation of the geographical region, individual clinical characteristics, and mask for source control. The use of tests for isolation withdrawal should be evaluated with caution, due to results depending on various conditions and may not be reliable.

https://doi.org/10.1016/j.bjid.2022.102703

Agricultura urbana no município de São Paulo: considerações sobre produção e comercialização
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Biazoti, André Ruoppolo

; Leão, Vitória Oliveira P. de Souza

; Buralli, Rafael Junqueira

; Mauad, ThaIs

Estudos Avançados

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apr 2021, Volume 35 N. 101 Pages 189 - 208

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A Agricultura Urbana (AU) tem sido apontada, mais recentemente, como elemento importante nos discursos e nas práticas que visam à segurança alimentar urbana. O presente artigo procurou discutir a produção agrícola do Município de São Paulo (MSP) e seu escoamento, considerando a diversidade de perfis que a AU pode assumir. Para tal, foi avaliada a produção agrícola em bases de dados oficiais. No que se refere à comercialização, foram coletadas informações em sete entrevistas semiestruturadas com agricultores do MSP entre 2018 e 2020. Os principais resultados encontrados indicam que houve um crescimento das práticas agropecuárias no município, acessando uma ampla variedade de canais de comercialização. A abertura de novos mercados, o desenvolvimento de políticas públicas e o reconhecimento público foram essenciais para o crescimento da agricultura no MSP.

ABSTRACT Urban agriculture (UA) has recently been pointed out as an important element in the discussion and practices of urban food security. This article seeks to discuss agricultural production and distribution in the city of São Paulo , considering the diversity of profiles that UA can assume. To this end, official databases were used to compute agricultural production. With regard to commercialization, information was collected from seven semi-structured interviews with farmers of the city of São Paulo between 2018 and 2020. The main findings indicate that there was an increase in agricultural practices in the city, encompassing a wide variety of commercialization channels. The opening of new markets, the development of public policies and public recognition were essential for the growth of agriculture in the city of São Paulo.

https://doi.org/10.1590/s0103-4014.2021.35101.012 854 downloads

Conhecimentos, atitudes e práticas de agricultores familiares brasileiros sobre a exposição aos agrotóxicos
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Buralli, Rafael Junqueira

; Ribeiro, Helena

; Leão, Renata Spolti

; Marques, Rejane Corrêa

; Silva, Daniele Santos

; Guimarães, Jean Remy Davée

Saúde e Sociedade

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2021, Volume 30 N. 4 elocation e210103

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O artigo discute conhecimentos, atitudes e práticas (CAP) de agricultores familiares brasileiros a respeito dos impactos na saúde e no ambiente gerados pelo uso de agrotóxicos. Trata-se de um estudo transversal misto, realizado em 2014 em São José de Ubá, RJ. A pesquisa é composta por uma etapa qualitativa, baseada em observações em campo e entrevistas com 25 participantes sobre CAP, no que se refere ao uso de agrotóxicos. A etapa quantitativa abrange avaliação sociodemográfica e de exposição aos agrotóxicos de 78 agricultores. Apesar de reconhecerem parcialmente os perigos dos agrotóxicos, os agricultores enfrentam os riscos da exposição e comumente adotam práticas laborais inadequadas. Fatores como a carência de apoio técnico e treinamento laboral, baixa escolaridade, dificuldade de compreensão das orientações de bulas e rótulos dos agrotóxicos, valor elevado e desconforto causado pelo equipamento de proteção individual (EPI), além da crença da dependência do uso de agrotóxicos, explicam parcialmente as atitudes não seguras. É preciso promover práticas agrícolas mais sustentáveis, fortalecer o apoio técnico e treinamento laboral, melhorar a comunicação e o gerenciamento dos riscos e reduzir as desigualdades de gênero entre os agricultores brasileiros, como a forma mais eficaz e imediata de prevenir os agravos relacionados ao trabalho com agrotóxicos.

Abstract This paper discusses the knowledge, attitudes, and practices (KAP) of the Brazilian family farmers regarding the impact of pesticides on health and the environment. This mixed cross-sectional study was conducted in 2014 in São José de Ubá, Rio de Janeiro. It encompasses two stages: a qualitative one, based on field observations and interviews with 25 participants on KAP about the use of pesticides; and a quantitative one, assessing sociodemographic data and exposure to pesticides among 78 farmers. Despite partially recognizing the danger of pesticides, farmers face the risks of exposure and usually adopt inappropriate work practices. Lack of technical support and occupational training, low schooling, difficulty in understanding the instructions on pesticides labels and package inserts, high price and discomfort caused by the use of Personal Protective Equipment (PPE), and the belief in the need for using pesticides, partially explain the unsafe attitudes. Effective and immediate prevention of pesticides-related injuries and diseases requires promoting more sustainable agricultural practices, strengthening technical support and occupational training, improving communication and pesticides risk management, and reducing gender inequalities among the Brazilian farmers.

https://doi.org/10.1590/s0104-12902021210103 213 downloads

Conhecimentos, atitudes e práticas de agricultores familiares brasileiros sobre a exposição aos agrotóxicos
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Buralli, Rafael Junqueira

; Ribeiro, Helena

; Leão, Renata Spolti

; Marques, Rejane Corrêa

; Silva, Daniele Santos

; Guimarães, Jean Remy Davée

Saúde e Sociedade

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2021, Volume 30 N. 4 elocation e210103

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/s0104-12902021210103

Occupational exposure to pesticides and health symptoms among family farmers in Brazil
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Buralli, Rafael Junqueira

; Ribeiro, Helena

; Iglesias, Verónica

; Muñoz-Quezada, María Teresa

; Leão, Renata Spolti

; Marques, Rejane Correa

; Almeida, Milena Maria Cordeiro de

; Guimarães, Jean Remy Davée

Revista de Saúde Pública

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2020, Volume 54 elocation 133

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE: To explore the association of occupational pesticide exposure with acute and mental health symptoms. METHODS: Cross-sectional survey carried out with 78 Brazilian family farmers, who were pesticide applicators and helpers conveniently selected. Symptoms and exposure data were collected by interviews, and mental health outcomes by the Self-Reporting Questionnaire. Blood samples were analyzed to assess cholinesterase levels. Exposure indicators and symptoms were compared between applicators and helpers, and Poisson regression was performed to estimate prevalence ratios. RESULTS: Farmers reported exposure to multiple pesticides from early ages; they worked without safety training, technical support, and full protective equipment, and they had a high prevalence of acute and mental health symptoms (e.g., headache, mucosal irritation, tachycardia, and depressive signs). Applicators had more cholinesterase changes than helpers, but less symptoms. Helpers used less personal protection and had significantly higher prevalence ratio of headache, dyspnea, wheezing, cough, poor digestion, tiredness, and feeling worthless, after adjustment. CONCLUSIONS: Acute and mental health symptoms were observed, both among farmers and helpers. Thus, surveillance actions must be reinforced in Brazil, technical support and safety training improved, focused on applicators and helpers, who are occupationally and environmentally exposed to pesticides. Agricultural practices of these groups with less pesticide use should receive incentive.

https://doi.org/10.11606/s1518-8787.2020054002263 279 downloads

Occupational exposure to pesticides and health symptoms among family farmers in Brazil
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Buralli, Rafael Junqueira

; Ribeiro, Helena

; Iglesias, Verónica

; Muñoz-Quezada, María Teresa

; Leão, Renata Spolti

; Marques, Rejane Correa

; Almeida, Milena Maria Cordeiro de

; Guimarães, Jean Remy Davée

Revista de Saúde Pública

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2020, Volume 54 elocation 133

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2020054002263

MOVING TOWARDS THE SUSTAINABLE DEVELOPMENT GOALS: THE UNLEASH INNOVATION LAB EXPERIENCE
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BURALLI, RAFAEL JUNQUEIRA

; CANELAS, TIAGO

; CARVALHO, LAURA MARTINS DE

; DUIM, ETIENNE

; ITAGYBA, RENATA FORTES

; FONSECA, MARÍLIA

; OLIVER, SOFIA LIZARRALDE

; CLEMENTE, NÚRIA SANCHEZ

Ambiente & Sociedade

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2018, Volume 21 elocation e00010

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Em resposta a problemas cada vez mais complexos e interconectados, entre os quais figuram diversos desafios de saúde pública, as Nações Unidas lançaram a Agenda 2030 de Desenvolvimento Sustentável que pretende servir como guia para lidar com essas questões. Visando abordar a complexidade destes desafios, foi proposta a iniciativa UNLEASH, um evento que reúne 1.000 jovens talentos de todo o mundo anualmente até 2030 para encontrar soluções inovadoras aos 17 Objetivos do Desenvolvimento Sustentável (ODS) propostos na Agenda 2030. A Faculdade de Saúde Pública da Universidade de São Paulo foi a única instituição de ensino latino-americana selecionada para enviar estudantes na primeira edição do evento, realizado na Dinamarca em 2017. O presente artigo tem como objetivo abordar os sete ODS (saúde, comida, água, energia, sustentabilidade urbana, consumo sustentável e educação) que foram trabalhados neste primeiro encontro, refletir sobre os mesmos e relatar a experiência dos pós-graduandos no evento global e inovador da UNLEASH.

Abstract In response to innumerable global challenges in a world ever more complex and interconnected, including a number of public health challenges, the United Nations launched the 2030 Agenda for Sustainable Development; a guideline intended to deal with these issues. Foreseeing their huge complexity, the UNLEASH initiative was created with a vision to gather, on a yearly basis until 2030, 1.000 young talents from all over the world to co-create disruptive solutions for the 17 Sustainable Development Goals (SDGs). The School of Public Health of the University of São Paulo was selected as the only educational institution partner in South America and was invited to select and send students to the launching event in Denmark in August 2017. The aim of this study is to address and reflect on the seven SDGs (health, food, water, energy, urban sustainability, sustainable consumption and production and education) that were explored in this first event and relate the students’ experiences of this global innovation lab.

Resumen Como respuesta a los innumerables desafíos globales en un mundo cada vez más complejo e interconectado, las Naciones Unidas lanzó la Agenda 2030 para el Desarrollo Sostenible; como un guía para tratar con estos problemas. Previendo las grandes complejidades de estos, la iniciativa UNLEASH, fue creada con la visión de reunir anualmente 1000 jóvenes talentos de todo el mundo hasta 2030 para encontrar soluciones disruptivas para los 17 Objetivos de Desarrollo Sostenible (ODS). La Facultad de Salud Pública de la Universidad de São Paulo ha sido elegida como la única institución colaboradora en América del Sur, y fue invitada a seleccionar y enviar estudiantes para el primer evento en agosto del 2017 en Dinamarca. El objetivo de este estudio es abordar y reflexionar sobre los siete ODS (salud, alimentación, agua, energía, sostenibilidad urbana, producción y consumo responsables, y educación) que fueron explorados en este primer evento, y relatar las experiencias de los estudiantes sobre este laboratorio de innovación global.

https://doi.org/10.1590/1809-4422asoc17ex0001vu18l1td 5201 downloads

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