RESUMEN

Supervised by three or four medical doctors and one nurse in rotating shifts, the medical clinic in Costa Rica's Moín Container Terminal is open 24/7 for visits from port workers. In our study, we aimed to identify the sociodemographic and clinical characteristics of a consecutive series of patients who attended the medical clinic for outpatient services during an 8-month period. Our descriptive study involved collecting patient records from the medical clinic during the first 8 months of 2021 (i.e., 1 January-31 August 2021), during which 3050 visits from 1301 port workers were registered. Terminal tractor drivers, crane operators, and stevedores were the most frequent job categories among the patients. Doping (i.e., ICD-10 Z03.6) was observed in 64% of the visits. The top ICD-10 codes among all other patients not observed to have engaged in doping (n = 469) were diseases of the musculoskeletal system (7.2%) and abnormal clinical and laboratory symptoms (6.2%). Problems with the musculoskeletal system were primarily back pain (36.0%), muscle contracture (30.1%), and secondary headache (25.2%). Two-thirds of the visits were due to screening for alcohol and drugs or doping; however, inconsistency in the coding system complicates the analysis of data, and a dropdown menu in the registration is therefore needed to prevent errors. Relative risk calculations are impossible due to a lack of data about the at-risk population but should be pursued under different circumstances in future studies. In the support chain of goods, the medical clinic in the port plays a key role in saving time in shipping, which means that the injured or sick employees in most cases can continue working. For the shipping industry, quick un- and offloading is very important to stay competitive in the market for transport.

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RESUMEN

Bolivia does not have a surveillance program for pesticide residues in food. The few published studies have suggested that pesticide contamination in food may present a public health problem. Data are lacking for all foods except tomatoes and breast milk. In this study 10 potato, 10 onion, and 10 lettuce samples from La Paz were sampled on August 15, 2015 at a local market and screened for 283 pesticides. Residues of cypermethrin, chlorpyrifos, difenoconazol, or/and λ-cyhalothrin were detected in 50% of the lettuce samples, whereas no pesticides were found in potatoes and onions. In 20% of the lettuce samples, the measurements were above the maximum residue limits, and 2 or 3 pesticides were identified simultaneously. Washing almost halved the pesticide levels, but still 20% of the samples showed measurements above the limits. No samples contained concentrations of pesticides which alone or together would lead to exposures that exceeded the acceptable daily intake or the acute reference dose. To protect consumers from pesticide poisonings and chronic effects, the development of measures for prevention, control, and monitoring of food contamination by pesticides in Bolivia is suggested.

RESUMEN

AIMS: The mismanagement of empty containers of pesticides, posing a risk to the environment and the health of people, has motivated the promotion of international policies and guidelines to mitigate such problems. Despite these guidelines, attention to this problem is inadequate in Bolivia. The objective was to study the knowledge and practical management of the containers and to implement a responsible management plan for empty pesticide containers. METHODS: This study implemented the project from 2014 to 2016 in 2 municipalities of the Department of Santa Cruz. Integral and participatory processes of information, education, and training were used. A questionnaire study among pesticide users was used to investigate knowledge and management of the empty pesticide containers. RESULTS: The authorities and the population responded to the program by taking a critical and active approach to the problem, improving their responsible practices, and 5500 kg of empty containers were collected. The cross-sectional study showed that 93% of the empty containers were disposed of in vulnerable places; 62% of the population did not know what triple washing is; 60% felt discomfort, headache, and/or dizziness while using pesticides; and 31% of the empty containers had pesticide residue inside them. CONCLUSIONS: The study illustrates a complex situation, mainly caused by lack of knowledge and clear guidelines. We recommend documentation of the social, economic, and productive characteristics of the region before any municipal program action is undertaken. The key element to sustainable change is an informed and coordinated participation of all actors.