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Genetic polymorphisms may be involved with mercury levels and signs and symptoms of intoxication from this exposure. Therefore, the aims were to describe the frequency of the GSTP1 polymorphism and to evaluate its effects on mercury levels and neurological signs in three Munduruku indigenous villages in the Brazilian Amazon. One-hundred-and-seven indigenous (over 12 years old) were included and genotyped (rs1695) using a TaqMan validated assay. Then, associations were evaluated by binary logistic regression, using odds ratios (OR) and 95% confidence intervals (CI). Mean age was 27.4 ± 13.9 years old, 52.3% were male, mean hair mercury concentration was 8.5 ± 4.3, exceeding the reference limit (≥6.0 µg/g), and were different among the three villages: 13.5 ± 4.6 µg/g in Sawré Aboy, 7.4 ± 2.3 µg/g in Poxo Muybu and 6.9 ± 3.5 µg/g in Sawré Muybu. The minor allele frequency of GSTP1 G was significantly different among the villages: 57% Sawré Muybu, 21% Poxo Muybu and 15% Sawré Aboy. Finally, after adjustment, GSTP1 GG and GA genotypes were associated with lower levels of Hg (OR = 0.13; CI95% = 0.03-0.49) and abnormal somatosensory signs (OR = 3.7; 95%IC = 1.5-9.3), respectively. In conclusion, monitoring this population is imperative to identify individuals at higher risk of developing signs of chronic mercury exposure based on the genetic profile.

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Resumo Objetivos: analisar os impactos positivos e negativos da cadeia produtiva do etanol em municípios do polo agroindustrial do estado de Mato Grosso como subsídio à formulação de uma proposta de vigilância integrada e participativa em Saúde e Meio Ambiente. Métodos: estudo de caso no campo da Vigilância em Saúde Ambiental desenvolvido no perímetro de abrangência de uma usina de etanol. Utilizou-se o método de Diagnóstico Rápido e Participativo com uso de dados secundários, análise documental e entrevistas. Resultados: a análise de conteúdo propiciou quatro temáticas: impactos positivos e negativos da cadeia produtiva do etanol na área de influência direta e indireta do empreendimento; riscos socioambientais em território inserido no polo agroindustrial do etanol; condições e relações de trabalho dos (ex-)trabalhadores inseridos na cadeia do agronegócio; vigilância em Saúde e Meio Ambiente para um empreendimento de médio porte em polo agroindustrial de etanol no Cerrado. Conclusão: os impactos usualmente percebidos como positivos não promoveram melhorias sociais e econômicas permanentes para os trabalhadores e a população local. Verificou-se que a vigilância ao meio ambiente e à saúde dos trabalhadores inexiste, mas a vigilância participativa contribui para o empoderamento dos atores sociais nas discussões dos direitos dos trabalhadores e para a percepção socioambiental local.

Abstract Objective: to analyze the negative and positive impacts of the ethanol production chain in municipalities from the agro-industrial complex of the State of Mato Grosso, Brazil, as a subsidy to elaborate a proposal for integrated and participative surveillance on Health and Environment. Methods: case study based on Environmental Health Surveillance developed in the impact area of an ethanol plant. We used Rapid and Participatory Diagnosis with secondary data, document analysis and interviews. Results: content analysis provided four themes: positive and negative impacts of the ethanol production chain in the direct and indirect enterprise influence area; socio-environmental risks in the territories within the ethanol agro-industrial complex; working conditions and labor relations of (former) workers within the agribusiness chain; Health and Environmental surveillance for medium-sized enterprises in ethanol agro-industrial complexes in the Cerrado region. Conclusion: impacts usually perceived as positive had no permanent social and economic improvements for workers and the local population. Although environmental and occupational health surveillance is non-existent, participatory surveillance contributes to empowering social actors in discussions on labor rights and local social-environmental awareness.

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Genetic polymorphisms involved in mercury toxicokinetics and toxicodynamics may be associated with severe mercury toxicity. This study aimed to investigate the impact of an ALAD polymorphism on chronic mercury exposure and the health situation of indigenous children from the Brazilian Amazon. One-hundred-and-three indigenous children (under 15 years old) were included and genotyped (rs1800435) using a TaqMan validated assay. The mean age was 6.6 ± 4.5 years old, 60% were female, 49% presented with anemia, and the mean hair mercury concentration was 7.0 ± 4.5 (1.4-23.9) µg/g, with 49% exceeding the reference limit (≥6.0 µg/g). Only two children were heterozygous ALAD, while the others were all wild type. Minor allele frequency (ALAD G) and heterozygous genotype (ALAD CG) were 1% and 2%, respectively. The two children (12 and 14 years old) with the ALAD polymorphism had mercury levels above the average as well as had neurological symptoms related to chronic mercury exposure, such as visual field alterations, memory deficit, distal neuropathy, and toe amyotrophy. Both children also reported frequent consumption of fish in the diet, at least three times a week. In conclusion, our data confirm that an ALAD polymorphism can contribute to mercury half-life time, harmful effects, and neuropsychological disorders in indigenous children with chronic mercury exposure to gold mining activity.

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This study evaluates the nutritional status of children and women of an indigenous Yanomamigroup, and seeks to clarify associated factors. It was a cross-sectional study, carried out in 17 villages, in 2014. For evaluation of nutritional status we used 2006 growth standards to assign height-for-age (stunting)Z-scores (Z), weight-for-age Z (underweight) and weight-for-height Z (wasting and overweight), using the software WHO-Anthro and WHO-AnthroPlus. Short stature (SS) was defined as values lower 145cm for mothers over the age of 18. The Poisson regression was made in R software. Among children under 60 months the prevalences were: stunting 83.8%; underweight 50%; wasting 5.4%; and overweight 2.7%. In 59.5% of the children there was severe stunting, and 68.1% of the mothers were SS. Prevalence ratio (PR) for severe stunting was higher in age group 36-59 months, in comparison with age group 0.1-23 (PR = 1.3; CI 95%: 1.1-2.3), as did also children of mothers with SS, when compared to the children of mothers without SS (PR = 2.1; CI 95%; 1.2-3.6). The alarming rates of stunting and severe stunting reveal the seriousness of the nutritional situation children. The association of severe stunting in infants and in mothers reflects the intergenerational nature of the problem.

O objetivo do estudo foi avaliar o estado nutricional de crianças e mulheres indígenas Yanomami e elucidar fatores associados. Estudo transversal, realizado em 17 aldeias, em 2014. Para a avaliação do estado nutricional utilizou-se as curvas de crescimento de 2006 e os escores-Z (ESZ) de estatura/idade (E/I), peso/idade (P/I), peso/estatura (P/E), os quais foram gerados nos programas WHO-Anthro e WHO-AnthroPlus. Estatura inferior a 145cm foi o descritor de baixa estatura materna nas > 18 anos. A regressão de Poisson e as análises estatísticas foram efetuadas no software R, versão 3.1.2. Nos < 5 anos a prevalência de baixa E/I foi 83,8%, de baixo P/I 50%, de baixo P/E 5,4% e de sobrepeso 2,7%. Em 59,5% das crianças observou-se muito baixa E/I e em 68,1% das mães baixa estatura. As crianças de 36-59 meses apresentaram maior risco de baixa estatura severa, em comparação com as de 0,1-23 (RP = 1,3; IC 95%: 1,1-2,3), assim como os filhos de mães com estatura < 145cm, em relação aos filhos de mães com estatura > 144cm (RP = 2,1; IC 95%;1,2-3,6). As alarmantes prevalências de baixa estatura severa revelam a grave situação nutricional das crianças. Já a associação de baixa estatura severa nas crianças e baixa estatura materna reflete o caráter intergeracional do problema.

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Resumo O objetivo do estudo foi avaliar o estado nutricional de crianças e mulheres indígenas Yanomami e elucidar fatores associados. Estudo transversal, realizado em 17 aldeias, em 2014. Para a avaliação do estado nutricional utilizou-se as curvas de crescimento de 2006 e os escores-Z (ESZ) de estatura/idade (E/I), peso/idade (P/I), peso/estatura (P/E), os quais foram gerados nos programas WHO-Anthro e WHO-AnthroPlus. Estatura inferior a 145cm foi o descritor de baixa estatura materna nas > 18 anos. A regressão de Poisson e as análises estatísticas foram efetuadas no software R, versão 3.1.2. Nos < 5 anos a prevalência de baixa E/I foi 83,8%, de baixo P/I 50%, de baixo P/E 5,4% e de sobrepeso 2,7%. Em 59,5% das crianças observou-se muito baixa E/I e em 68,1% das mães baixa estatura. As crianças de 36-59 meses apresentaram maior risco de baixa estatura severa, em comparação com as de 0,1-23 (RP = 1,3; IC 95%: 1,1-2,3), assim como os filhos de mães com estatura < 145cm, em relação aos filhos de mães com estatura > 144cm (RP = 2,1; IC 95%;1,2-3,6). As alarmantes prevalências de baixa estatura severa revelam a grave situação nutricional das crianças. Já a associação de baixa estatura severa nas crianças e baixa estatura materna reflete o caráter intergeracional do problema.

Abstract This study evaluates the nutritional status of children and women of an indigenous Yanomamigroup, and seeks to clarify associated factors. It was a cross-sectional study, carried out in 17 villages, in 2014. For evaluation of nutritional status we used 2006 growth standards to assign height-for-age (stunting)Z-scores (Z), weight-for-age Z (underweight) and weight-for-height Z (wasting and overweight), using the software WHO-Anthro and WHO-AnthroPlus. Short stature (SS) was defined as values lower 145cm for mothers over the age of 18. The Poisson regression was made in R software. Among children under 60 months the prevalences were: stunting 83.8%; underweight 50%; wasting 5.4%; and overweight 2.7%. In 59.5% of the children there was severe stunting, and 68.1% of the mothers were SS. Prevalence ratio (PR) for severe stunting was higher in age group 36-59 months, in comparison with age group 0.1-23 (PR = 1.3; CI 95%: 1.1-2.3), as did also children of mothers with SS, when compared to the children of mothers without SS (PR = 2.1; CI 95%; 1.2-3.6). The alarming rates of stunting and severe stunting reveal the seriousness of the nutritional situation children. The association of severe stunting in infants and in mothers reflects the intergenerational nature of the problem.

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The scope of this study is to perform spatial analysis of integrated environmental and health indicators related to the factors affecting mortality due to diarrhea in children under 1 year of age in Brazilian regions in 2010. Seven environmental indicators, compiled from the IBGE System for Automatic Recovery of the Population Census 2010 database, were formulated. The data with respect to deaths due to diarrhea in children under 1 year of age and live births were obtained from the databases of the Mortality Information Systems and the Live Births Information System of the IT Department of the Unified Health System. The microregions located in the North and Northeast regions revealed 5 and 4 times the rate of mortality in 2009, respectively, due to diarrhea in children under 1 year of age than the Southern Region. Children under 1 year of age living in the microregions located in the North and Northeast are more exposed to risk of death from diarrhea, since the worst figures for the environmental indicators related to poverty and sanitation are concentrated in these locations. In this sense, social, economic, environmental, cultural and health public policies should be based on the principle of equity to address the different local needs of each region.

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O objetivo deste estudo é realizar a análise espacial de indicadores integrados de ambiente e saúde relativos aos fatores condicionantes da mortalidade por diarreia em menores de 1 ano nas regiões brasileiras no ano de 2010. Foram formulados 7 indicadores socioambientais, construídos a partir do banco de dados do Sistema IBGE de Recuperação Automática do Censo Demográfico de 2010. Os dados de óbitos por diarreia em crianças menores de 1 ano e de nascidos vivos foram obtidos das bases de dados dos Sistemas de Informação de Mortalidade e do Sistema de Informação de Nascidos Vivos do Departamento de Informática do Sistema Único de Saúde. As microrregiões situadas nas regiões Norte e Nordeste, apresentaram, em 2009, respectivamente, 5 e 4 vezes mais taxa de mortalidade por diarreia em menores de 1 ano, que a região Sul. As crianças menores de 1 ano residentes nas microrregiões localizadas nas regiões Norte e Nordeste estão mais expostas ao risco de óbito pela diarreia, uma vez que nestes locais concentram-se os piores valores para os indicadores socioambientais relacionados à pobreza e ao saneamento básico. Neste sentido, políticas públicas sociais, econômicas, ambientais, culturais e de saúde devem embasar-se no princípio de equidade para atender as diferentes necessidades locais de cada região.

The scope of this study is to perform spatial analysis of integrated environmental and health indicators related to the factors affecting mortality due to diarrhea in children under 1 year of age in Brazilian regions in 2010. Seven environmental indicators, compiled from the IBGE System for Automatic Recovery of the Population Census 2010 database, were formulated. The data with respect to deaths due to diarrhea in children under 1 year of age and live births were obtained from the databases of the Mortality Information Systems and the Live Births Information System of the IT Department of the Unified Health System. The microregions located in the North and Northeast regions revealed 5 and 4 times the rate of mortality in 2009, respectively, due to diarrhea in children under 1 year of age than the Southern Region. Children under 1 year of age living in the microregions located in the North and Northeast are more exposed to risk of death from diarrhea, since the worst figures for the environmental indicators related to poverty and sanitation are concentrated in these locations. In this sense, social, economic, environmental, cultural and health public policies should be based on the principle of equity to address the different local needs of each region.

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OBJECTIVE: To analyze the climatic seasonality of primary care visits for respiratory disease (RD) in children less than 15 years old. METHODS: This was a descriptive, epidemiological study based on data from the municipal records of primary care events from basic healthcare centers for the period 2004-2005, for the municipality of Tangará da Serra (MT), Brazil. Population estimates were obtained from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IGBE), and data on temperature and relative humidity of the air, from the National Meteorology Institute (Instituto Nacional de Meteorologia, INMET). Mean rates of primary care visits for RD were calculated according to sex, age group and anatomic location of complaint. The ratio of dry season to rainy season visits was calculated according to anatomic location of the RD. Data were analyzed using Epi-Info 3.2, testing differences between proportions using the chi-square test to a significance level of 5%. RESULTS: Male children had an almost 50% greater (37.3/25.0) rate of primary care visits for diseases of the lower respiratory tract than did females. The rates of primary care visits due to RD in children under 15 years of age varied as age increased, varying from 457.7 per thousand of children less than 1 year of age to 133.5 per thousand in the 10 to 14 years-of-age group. During the dry season there were an average of 21% (4,148/5,231) fewer visits for RD (p = 0.000). Peaks in numbers of visits were observed during the months of March and August, being more accentuated in March, which is the wet season in the region. CONCLUSION: Primary care visits for RD, especially those due to upper airway diseases, are related to the rainy season in this municipality.

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