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Soares ACDO, Petarli GB, Cattafesta M, dos Santos Neto ET, Salaroli LB. Complex multimorbidity in hemodialysis patients: Study in a metropolitan region in Brazil. PLoS One 2024; 19:e0303068. [PMID: 38753673 PMCID: PMC11098310 DOI: 10.1371/journal.pone.0303068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
The objective of this article was to analyze the factors associated with complex multimorbidity (CMM) among hemodialysis patients in a metropolitan region in southeastern Brazil. To this end, a cross-sectional epidemiological survey was carried out with 1,024 individuals in the year 2019. CMM data were collected through the application of a questionnaire to hemodialysis patients. The binary logistic regression model was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) between independent variables and CMM. The prevalence of CMM was 81% and the results indicated that: living in cities with a low rate of general mortality (OR = 0.395, 95%CI = 0.179-0.870), being aged between 18 and 29 (OR = 0.402, 95%CI = 0.196-0.825), having an elementary education (OR = 0.536, 95%CI = 0.290-0.966) and assessing health as good/very good (OR = 0.446, 95%CI = 0.301-0.661) are factors that reduced the chances of having CMM, whereas a longer period of hemodialysis (OR = 1.779 and 95%CI = 1.057-2.997) increased the chances of CMM. The findings show that characteristics of the social and individual context are associated with CMM in hemodialysis patients, signaling the need for public health policies that include monitoring the complex multimorbidity condition among individuals undergoing hemodialysis treatment.
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Affiliation(s)
| | - Glenda Blaser Petarli
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Monica Cattafesta
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil
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Karthick Rajan D, Mohan K, Rajarajeswaran J, Divya D, Thanigaivel S, Zhang S. Toxic effects of organophosphate pesticide monocrotophos in aquatic organisms: A review of challenges, regulations and future perspectives. ENVIRONMENTAL RESEARCH 2024; 244:117947. [PMID: 38109962 DOI: 10.1016/j.envres.2023.117947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023]
Abstract
In recent times, usage of pesticide, herbicides and synthetic fertilizers in farming lands has made the environment worse. The pesticide residues and toxic byproducts from agricultural lands were found to contaminate the aquatic ecosystem. The misuse of synthetic pesticide not only affects the environment, but also affects the health status of aquatic organisms. The organophosphate pesticide pollutants are emerging contaminants, which threatens the terrestrial and aquatic ecosystem. Monocrotophos (MCP) is an organophosphate insecticide, utilized on crops including rice, maize, sugarcane, cotton, soybeans, groundnuts and vegetables. MCP is hydrophilic in nature and their solubilizing properties reduce the soil sorption which leads to groundwater contamination. The half-life period of MCP is 17-96 and the half-life period of technical grade MCP is 2500 days if held stable at 38 °C in a container. MCP causes mild to severe confusion, anxiety, hyper-salivation, convulsion and respiratory distress in mammals as well as aquatic animals. The MCP induced toxicity including survival rate, behavioural changes, reproductive toxicity and genotoxicity in different aquatic species have been discussed in this review. Furthermore, the ultimate aim of this review is to highlight the international regulations, future perspectives and challenges involved in using the MCP.
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Affiliation(s)
- Durairaj Karthick Rajan
- Department of Cell Biology, School of Life Sciences, Central South University, Changsha, Hunan, 410013, PR China.
| | - Kannan Mohan
- PG and Research Department of Zoology, Sri Vasavi College, Erode, Tamil Nadu, 638 316, India.
| | - Jayakumar Rajarajeswaran
- Department of Nanobiomaterials, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, 602105, Tamil Nadu, India
| | - Dharmaraj Divya
- Department of Animal Health and Management, Alagappa University, Karaikudi, Tamilnadu, 630003, India
| | - Sundaram Thanigaivel
- Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology, Kattankulathur Campus, 603 203, Tamilnadu, India
| | - Shubing Zhang
- Department of Cell Biology, School of Life Sciences, Central South University, Changsha, Hunan, 410013, PR China
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Aitken AV, Minassa VS, Batista TJ, Oliveira JKDS, Sant'Anna KDO, Felippe ISA, Paton JFR, Coitinho JB, Bissoli NS, Sampaio KN. Acute poisoning by chlorpyrifos differentially impacts survival and cardiorespiratory function in normotensive and hypertensive rats. Chem Biol Interact 2024; 387:110821. [PMID: 38042398 DOI: 10.1016/j.cbi.2023.110821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/04/2023]
Abstract
Hypertension is the most important and well-known risk factor for cardiovascular disease (CVD). Recently, acute organophosphate (OP) poisoning has also been pointed as a CVD risk factor. Despite this evidence, no studies have contrasted the acute toxicosis and cardiovascular (CV) effects of OP poisoning under conditions of normotension and hypertension. In this work, adult male normotensive Wistar and Spontaneously Hypertensive rats (SHR) were intraperitoneally injected with saline or chlorpyrifos (CPF), an OP compound, monitored for acute toxicosis signs and 24-h survival. After poisoning, blood pressure, heart rate and ventilation were recorded, the Bezold-Jarisch Reflex (BJR), the Chemoreflex (CR) were chemically activated, as well as the cardiac autonomic tone (AUT) was assessed. Erythrocyte and brainstem acetylcholinesterase and plasmatic butyrylcholinesterase (BuChE) activities were measured as well as lipid peroxidation, advanced oxidation protein products (AOPP), nitrite/nitrate levels, expression of catalase, TNFα and angiotensin-I converting enzyme (ACE-1) within the brainstem. CPF induced a much more pronounced acute toxicosis and 33 % lethality in SHR. CPF poisoning impaired ventilation in SHR, the BJR reflex responses in Wistar rats, and the chemoreflex tachypneic response in both strains. CPF inhibited activity of cholinesterases in both strains, increased AOPP and nitrite/nitrate levels and expression of TNFα and ACE-1 in the brainstem of Wistar rats. Interestingly, SHR presented a reduced intrinsic BuChE activity, an important bioscavenger. Our findings show that, CPF at sublethal doses in normotensive rats lead to lethality and much more pronounced acute toxicity signs in the SHR. We also showed that cardiorespiratory reflexes were differentially impacted after CPF poisoning in both strains and that the cardiorespiratory disfunction seems to be associated with interference in cholinergic transmission, oxidative stress and inflammation. These results points to an increased susceptibility to acute toxicosis in hypertension, which may impose a significant risk to vulnerable populations.
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Affiliation(s)
- Andrew Vieira Aitken
- Postgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil; Department of Anatomy, Physiology, and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, 36849, USA
| | - Vítor Sampaio Minassa
- Postgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil; Postgraduate Program in Physiological Sciences, Department of Physiology, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Thatiany Jardim Batista
- Postgraduate Program in Physiological Sciences, Department of Physiology, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Janne Ketly da Silva Oliveira
- Postgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Karoline de Oliveira Sant'Anna
- Postgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Igor Simões Assunção Felippe
- The Centre for Heart Research - Manaaki Mānawa, Department of Physiology, Faculty of Health & Medical Sciences, University of Auckland, Grafton Campus, Auckland, 1023, New Zealand
| | - Julian Francis Richmond Paton
- The Centre for Heart Research - Manaaki Mānawa, Department of Physiology, Faculty of Health & Medical Sciences, University of Auckland, Grafton Campus, Auckland, 1023, New Zealand
| | - Juliana Barbosa Coitinho
- Postgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil; Postgraduate Program in Biochemistry, Department of Physiology, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Nazaré Souza Bissoli
- Postgraduate Program in Physiological Sciences, Department of Physiology, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Karla Nívea Sampaio
- Postgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
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Rodrigues APDS, Batista SRR, Santos ASEA, Canheta ABDS, Nunes BP, de Oliveira Rezende AT, de Oliveira C, Silveira EA. Multimorbidity and complex multimorbidity in Brazilians with severe obesity. Sci Rep 2023; 13:16629. [PMID: 37789121 PMCID: PMC10547747 DOI: 10.1038/s41598-023-43545-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/25/2023] [Indexed: 10/05/2023] Open
Abstract
To investigate the prevalence of multimorbidity and complex multimorbidity and their association with sociodemographic and health variables in individuals with severe obesity. This is a baseline data analysis of 150 individuals with severe obesity (body mass index ≥ 35.0 kg/m2) aged 18-65 years. The outcomes were multimorbidity and complex multimorbidity. Sociodemographic, lifestyle, anthropometric and self-perceived health data were collected. Poisson multiple regression was conducted to identify multimorbidity risk factors. The frequency of two or more morbidities was 90.7%, three or more morbidities was 76.7%, and complex multimorbidity was 72.0%. Living with four or more household residents was associated with ≥ 3 morbidities and complex multimorbidity. Fair and very poor self-perceived health was associated with ≥ 2 morbidities, ≥ 3 morbidities and complex multimorbidity. A higher BMI range (45.0-65.0 kg/m2) was associated with ≥ 2 morbidities and ≥ 3 morbidities. Anxiety (82.7%), varicose veins of lower limbs (58.7%), hypertension (56.0%) were the most frequent morbidities, as well as the pairs and triads including them. The prevalence of multimorbidity and complex multimorbidity in individuals with severe obesity was higher and the risk for multimorbidity and complex multimorbidity increased in individuals living in households of four or more residents, with fair or poor/very poor self-perceived health and with a higher BMI.
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Affiliation(s)
| | - Sandro Rogério Rodrigues Batista
- Department of Internal Medicine, School of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
- Primary Healthcare Office, Federal District State Health Department, Brasília, Distrito Federal, Brazil
| | | | | | | | | | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK.
| | - Erika Aparecida Silveira
- Department of Internal Medicine, School of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
- Department of Epidemiology & Public Health, University College London, London, UK
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Cancino J, Soto K, Tapia J, Muñoz-Quezada MT, Lucero B, Contreras C, Moreno J. Occupational exposure to pesticides and symptoms of depression in agricultural workers. A systematic review. ENVIRONMENTAL RESEARCH 2023; 231:116190. [PMID: 37217130 DOI: 10.1016/j.envres.2023.116190] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND The use of pesticides can result in harm to both the environment and human health. There is a growing concern in the field of occupational health about the impact on the mental health of agricultural workers. OBJECTIVES The objective of this review was to systematize scientific evidence from the last ten years on the impact of occupational exposure to pesticides on the development of depression symptoms in agricultural workers. METHODS We conducted a comprehensive search in the PubMed and Scopus databases from 2011 to September 2022. Our search included studies in English, Spanish, and Portuguese that examined the association between occupational exposure to pesticides and symptoms of depression in agricultural workers, following the guidelines recommended by the PRISMA statement and the PECO strategy (Population, Exposure, Comparison, and Outcomes). RESULTS Among the 27 articles reviewed, 78% of them indicated a link between exposure to pesticides and the incidence of depression symptoms. The pesticides most frequently reported in the studies were organophosphates (17 studies), herbicides (12 studies), and pyrethroids (11 studies). The majority of the studies were rated as having intermediate to intermediate-high quality, with the use of standardized measures to assess both exposure and effect. CONCLUSION The updated evidence presented in our review indicates a clear association between pesticide exposure and the development of depressive symptoms. However, more high-quality longitudinal studies are necessary to control for sociocultural variables and utilize pesticide-specific biomarkers and biomarkers of depression. Given the increased use of these chemicals and the health risks associated with depression, it is crucial to implement more stringent measures to monitor the mental health of agricultural workers regularly exposed to pesticides and to enhance surveillance of companies that apply these chemicals.
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Affiliation(s)
- Javier Cancino
- School of Psychology, Faculty of Health Sciences, Universidad Católica del Maule, Chile; The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Karly Soto
- School of Psychology, Faculty of Health Sciences, Universidad Católica del Maule, Chile; The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Joaquín Tapia
- School of Psychology, Faculty of Health Sciences, Universidad Católica del Maule, Chile; The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - María Teresa Muñoz-Quezada
- The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile.
| | - Boris Lucero
- The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Caterina Contreras
- The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Jaime Moreno
- Faculty of Medicine, Universidad Católica del Maule, Talca, Chile
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Cremonini ACP, Ferreira JRS, Martins CA, do Prado CB, Petarli GB, Cattafesta M, Salaroli LB. Metabolic Syndrome and Associated Factors in Farmers in Southeastern Brazil: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6328. [PMID: 37510560 PMCID: PMC10379224 DOI: 10.3390/ijerph20146328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
(1) Background: Metabolic syndrome is a strong predictor of cardiovascular disease thus the objective of the study was to verify the prevalence of metabolic syndrome in farmers, as well as to verify the association with sociodemographic, work and lifestyle factors. (2) Methods: Cross-sectional, observational study, conducted with 790 individuals. For the diagnosis of metabolic syndrome, the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) criteria were used. Pearson's chi-square test and binary logistic regression were used to verify factors associated with metabolic syndrome (3) Results: The prevalence of MS according to the IDF criteria was 16.3% overall, with 9.7% of women (95% CI: 6.66-16.16) and 6.6% of men (95% CI: 5.17-11.97). According to the NCEP/ATP III criterion, it was 12.3% overall, with 7.5% corresponding to women (95% CI: 6.62-13.13) and 4.8% to men (95% CI: 3.5-8.70). With regard to the conditions that make up metabolic syndrome, it was found that high density lipoprotein, high blood pressure and high waist circumference were the most prevalent. (4) Conclusions: The prevalence of metabolic syndrome is considerable in the population when compared to other regions, both rural and urban, in Brazil.
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Affiliation(s)
| | - Júlia Rabelo Santos Ferreira
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Cleodice Alves Martins
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
- Graduate Program Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Camila Bruneli do Prado
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Glenda Blaser Petarli
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Monica Cattafesta
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
- Graduate Program Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043900, Brazil
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Martins CA, do Prado CB, Ferreira JRS, Zandonade E, de Paula Alves Bezerra OM, Salaroli LB. Self-rated health status and associated factors in rural workers. BMC Public Health 2023; 23:680. [PMID: 37046261 PMCID: PMC10091575 DOI: 10.1186/s12889-023-15548-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Self-rated health status can be considered a good predictor of morbidity and mortality and has been used due to its easy assessment and applicability. The instrument is efficient for understanding sociodemographic, environmental and clinical conditions that may be related to the self-rated health status. Thus, this study aims to analyze the self-assessment of health status in rural workers and its association with socioeconomic characteristics, lifestyle, clinical condition and work characteristics. METHODS This is a cross-sectional study carried out with 787 male and female rural reporting agriculture as their main source of income in the municipality of Santa Maria de Jetibá. A simple and direct question was used "In general, compared to people your age, how do you rate your own state of health?" to see how rural workers rate their current health status. The independent variables analyzed were socioeconomic, clinical, health and work conditions. The magnitude of the associations was evaluated by means of hierarchical logistic regression. RESULTS It was found that 42.1% of rural workers self-rated their health status as regular or poor. Belonging to socioeconomic classes C (OR = 1.937; 95% CI = 1.009-3.720) or D/E (OR = 2.280; 95% CI = 1.178-4.415), being overweight (or having excess weight) (OR = 1.477; 95% CI = 1.086-2.008), multimorbidity (OR = 1.715; 95% CI = 1.201-2.447) and complex multimorbidity (OR = 1.738; 95% CI = 1.097-2.751) were risk factors for worse self-rated health. CONCLUSION It was concluded that chronic diseases, socioeconomic status and overweight are risk factors for negative self-rated health. The identification of these determinants through self-rated status can support the planning of actions aimed at improving the health of the rural population. TRIAL REGISTRATION This study was approved by the Research Ethics Committee of the Health Sciences Center of the Federal University of Espírito Santo (Protocol No. 2091172; CAAE No. 52839116.3.0000.5060). All research participants gave their informed consent.
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Affiliation(s)
- Cleodice Alves Martins
- Graduate Program Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Maruípe, Vitória, ES, 29040-090, Brazil
| | - Camila Bruneli do Prado
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Maruípe, Vitória, ES, 29040-090, Brazil
| | - Júlia Rabelo Santos Ferreira
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Maruípe, Vitória, ES, 29040-090, Brazil
| | - Eliana Zandonade
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Maruípe, Vitória, ES, 29040-090, Brazil
| | - Olívia Maria de Paula Alves Bezerra
- Department of Family Medicine, Mental and Collective Health, Medical School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Maruípe, Vitória, ES, 29040-090, Brazil.
- Graduate Program Collective Health, Health Sciences Center, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Maruípe, Vitória, ES, 29040-090, Brazil.
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Stumpf FMDM, de Oliveira ASD, Faerstein E, Curioni CC. Cross-sectional associations between body mass index, waist circumference, and multimorbidity: Pró-Saúde study. PeerJ 2023; 11:e14744. [PMID: 36778147 PMCID: PMC9910183 DOI: 10.7717/peerj.14744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/23/2022] [Indexed: 02/08/2023] Open
Abstract
Background This study aimed (1) To investigate the association between the Body Mass Index (BMI) and waist circumference (WC) with multimorbidity (MM), and (2) To identify patterns of MM and investigate the relationship between BMI and WC with specific combinations of MM (patterns of MM). Methods A cross-sectional study was conducted with 2,698 participants of the fourth phase of the Brazilian Longitudinal Study of Adult Health (Pró-Saúde Study). MM was defined by the presence of two or more morbidities. MM patterns were identified by exploratory factor analysis based on tetrachoric correlations. Logistic regression models were used to assess associations (odds ratios (OR) with the respective confidence intervals (CI)). Results Of the total number of participants, 39.5% were overweight and 30.0% were obese; 89.0% (n = 1,468) of women and 77.0% (n = 952) of men were abdominally obese. Indeed, 60.7% (n = 1,635) was identified with MM. For the category four or more morbidities, OR values of 5.98 (95% CI 4.84-7.13) and 7.48 (95% CI 6.14-8.18) were found for each point of increase in BMI, and 6.74 (95% CI 5.48-7.99) and 8.48 (95% CI 7.64-9.29) for each additional centimeter in the WC, for female and male, respectively. Five patterns of MM were identified: respiratory, osteoarticular, cardiometabolic, gastric, and thyroid diseases (56.4% of the total variance). Positive associations were found between BMI and patterns of cardiometabolic, osteoarticular, thyroid and gastric diseases (higher OR of 1.09 [95% CI 1.04-1.14]) and less pronounced between WC and patterns of cardiometabolic and osteoarticular (higher OR of 1.04 [95% CI 1.03-1.04]). Conclusions The results showed that an increase of both BMI and WC was associated with a higher number of morbidities and with patterns of cardiometabolic and osteoarticular diseases.
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Affiliation(s)
| | | | - Eduardo Faerstein
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cintia Chaves Curioni
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Moftakhar L, Rezaeianzadeh R, Ghoddusi Johari M, Hosseini SV, Rezaianzadeh A. Epidemiology and predictors of multimorbidity in Kharameh cohort study: A population-based cross-sectional study in southern Iran. Health Sci Rep 2022; 6:e988. [PMID: 36514331 PMCID: PMC9731168 DOI: 10.1002/hsr2.988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
Background and Aim Multimorbidity is one of the problems and concerns of public health. The aim of this study was to estimate the prevalence and identify the risk factors associated with multimorbidity based on the data of the Kherameh cohort study. Methods This cross-sectional study was performed on 10,663 individuals aged 40-70 years in the south of Iran in 2015 to 2017. Demographic and behavioral characteristics were investigated. Multimorbidity was defined as the coexistence of two or more of two chronic diseases in a person. In this study, the prevalence of multimorbidity was calculated. Logistic regression was used to identify the predictors of multimorbidity. Results The prevalence of multimorbidity was 24.4%. The age-standardized prevalence rate was 18.01% in males and 29.6% in females. The most common underlying diseases were gastroesophageal reflux disease with hypertension (33.5%). Multiple logistic regression results showed that the age of 45-55 years (adjusted odds ratio [ORadj]] = 1.22, 95% confidence interval [CI], 1.07-1.38), age of over 55 years (ORadj = 1.21, 95% CI, 1.06-1.37), obesity (ORadj = 3.65, 95% CI, 2.55-5.24), and overweight (ORadj = 2.92, 95% CI, 2.05-4.14) were the risk factors of multimorbidity. Also, subjects with high socioeconomic status (ORadj = 1.27, 95% CI, 1.1-1.45) and very high level of socioeconomic status (ORadj = 1.53, 95% CI, 1.31-1.79) had a higher chance of having multimorbidity. The high level of education, alcohol consumption, having job, and high physical activity had a protective role against it. Conclusion The prevalence of multimorbidity was relatively high in the study area. According to the results of our study, age, obesity, and overweight had an important effect on multimorbidity. Therefore, determining interventional strategies for weight loss and control and treatment of chronic diseases, especially in the elderly, is very useful.
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Affiliation(s)
- Leila Moftakhar
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Ramin Rezaeianzadeh
- Experimental Medicine Program, Department of Medicine, Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | | | - Abbas Rezaianzadeh
- Colorectal Research CenterShiraz University of Medical ScienceShirazIran
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10
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do Prado CB, Martins CA, Cremonini ACP, Ferreira JRS, Cattafesta M, Almeida-de-Souza J, Zandonade E, Bezerra OMDPA, Salaroli LB. Cut Points of the Conicity Index and Associated Factors in Brazilian Rural Workers. Nutrients 2022; 14:nu14214487. [PMID: 36364746 PMCID: PMC9654182 DOI: 10.3390/nu14214487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Metabolic syndrome is associated with cardiovascular complications. Therefore, this study aims to establish cut points for the conicity index based on the components of metabolic syndrome and to associate it with characteristic sociodemographic, food consumption and occupational factors in Brazilian rural workers; (2) Methods: A cross-sectional study carried out with farmers. The receiver operating characteristic curve was calculated and the cut-off points for the conicity index were identified by the area under the curve, sensitivity and specificity. The variables included in the binary logistic regression analysis were selected by considering p < 0.20 in the bivariate test; (3) Results: The cut points were similar in females according to both criteria, resulting in a single cut-off of 1.269. In males, the cut points showed differences, resulting in 1.272 according to the NCEP-ATP III and 1.252 according to the IDF. We have shown that younger people, those who work more than 40 h a week and the lowest contribution of culinary ingredients are associated with increased odds of abdominal obesity, while the consumption of the products they sell or produce decreases these chances; (4) Conclusions: The conicity index showed high discriminatory power for the identification of abdominal obesity in rural workers. Therefore, there is a need to improve eating habits and promote healthier eating environments for individuals, respecting traditional food culture, mainly to contain the advance of MS in rural areas.
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Affiliation(s)
- Camila Bruneli do Prado
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Cleodice Alves Martins
- Graduate Program Nutrition and Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | | | - Júlia Rabelo Santos Ferreira
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Monica Cattafesta
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Juliana Almeida-de-Souza
- Centro de Investigação de Montanha (CIMO), Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-25 Bragança, Portugal
| | - Eliana Zandonade
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Olívia Maria de Paula Alves Bezerra
- Departament of Family Medicine, Mental and Collective Health, Medical School, Federal University of Ouro Preto, Ouro Preto 35400-000, MG, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program Collective Health and Graduate Program Nutrition and Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil;
- Correspondence: ; Tel.: +55-27-992714227
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Sugiyama Y, Mutai R, Aoki T, Matsushima M. Multimorbidity and complex multimorbidity, their prevalence, and associated factors on a remote island in Japan: a cross-sectional study. BMC PRIMARY CARE 2022; 23:258. [PMID: 36192706 PMCID: PMC9531464 DOI: 10.1186/s12875-022-01860-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/14/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evidence is still limited on the prevalence of multimorbidity and complex multimorbidity in Japan, as well as their associated factors. Additionally, no studies regarding multimorbidity and complex multimorbidity in Japan have used patient data obtained directly from medical records. The primary objective was to clarify the prevalence of multimorbidity and complex multimorbidity using patient data obtained directly from medical records. The secondary objective was to elucidate factors associated with multimorbidity and complex multimorbidity. METHODS We conducted a cross-sectional study at Tarama Clinic on Tarama Island, a remote island in Okinawa, Japan. Among patients who visited Tarama Clinic from April 1 to June 30, 2018, those who were ≥ 20 years of age, lived on Tarama Island, and had capacity to give consent were eligible for study inclusion. We collected the following data using medical records, medical expense receipts, and self-administered questionnaires: multimorbidity and complex multimorbidity, participants' characteristics, and potentially associated factors. Multimorbidity was defined as having ≥ 2 among 17 chronic health conditions, in accordance with previous studies conducted in Japan, and having ≥ 2 among 16 chapters of the International Classification of Primary Care, 2nd edition (ICPC-2). Complex multimorbidity was defined as having ≥ 3 among 16 chapters of the ICPC-2. RESULTS We included 355 study participants. Descriptive analysis showed multimorbidity prevalence measured using the 17 chronic health conditions in this area was 30.0% (age ≥ 20 years) and 57.5% (age ≥ 65 years). Multimorbidity prevalence measured using the ICPC-2 was 32.9% (age ≥ 20 years) and 60.3% (age ≥ 65 years). We also found a 20.9% (age ≥ 20 years) and 45.1% (age ≥ 65 years) prevalence of complex multimorbidity, respectively. Poisson regression with robust error variance showed that age ≥ 60 years was associated with multimorbidity. Age ≥ 60 years (adjusted prevalence ratio [aPR] 1.887 and 1.831 for ages 60-79 and ≥ 80 years, respectively) and being unemployed (aPR 1.251) were associated with complex multimorbidity. However, having hazardous drinking or more was inversely associated with complex multimorbidity (aPR 0.745). CONCLUSIONS The population-based prevalence of multimorbidity and its upward trend with increasing age on a remote island in Japan was consistent with previous reports in the country. Multimorbidity was associated with age 60 years or older, and complex multimorbidity was associated with age 60 years or older, being unemployed, and not having hazardous drinking or more. Our study findings indicated a possible association between the coexistence of diseases and social determinants of health (SDH) in Japan. To improve care for patients with multimorbidity and complex multimorbidity, more research that takes SDH into account is warranted, and evidence-based policymaking is essential for Japan. The present study can provide a foundation for accumulating such evidence.
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Affiliation(s)
- Yoshifumi Sugiyama
- grid.411898.d0000 0001 0661 2073Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-8461 Japan ,Tarama Clinic, Okinawa Miyako Hospital, 162-3, Shiokawa, Tarama, Miyako-gun, Okinawa, 906-0601 Japan ,grid.411898.d0000 0001 0661 2073Division of Community Health and Primary Care, Center for Medical Education, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-8461 Japan
| | - Rieko Mutai
- grid.411898.d0000 0001 0661 2073Department of Adult Nursing, The Jikei University School of Nursing, 8-3-1, Kokuryocho, Chofu, Tokyo 182-8570 Japan
| | - Takuya Aoki
- grid.411898.d0000 0001 0661 2073Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-8461 Japan
| | - Masato Matsushima
- grid.411898.d0000 0001 0661 2073Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-8461 Japan
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Carvalho KP, Corassa RB, Petarli GB, Cattafesta M, Zandonade E, Salaroli LB. Exogenous pesticide poisoning in the state of Espírito Santo, Brazil, 2007-2016: spatial distribution and temporal trend in the incidence rate and case fatality ratio of notified cases. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2021424. [PMID: 35830062 PMCID: PMC9887970 DOI: 10.1590/s2237-96222022000200008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 04/04/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To describe the spatial distribution of pesticide poisoning cases and analyze the temporal trend in the incidence rate and case fatality ratio of this event in the state of Espírito Santo, Brazil. METHODS This was a time series study of confirmed cases of pesticide poisoning registered on the Notifiable Health Conditions Information System (SINAN) between 2007 and 2016. Incidence rates were presented in thematic maps. Scatter plots were used to show the incidence and case fatality ratio of cases. RESULTS There was an increasing incidence rate of poisoning in the period regarding the total number of cases, by sex and age group - except for those aged 70 years and over. There was a decreasing case fatality ratio until 2012, with a subsequent increase. Eight municipalities presented the highest notification rates (30 to 46 new cases/100,000 inhabitants). CONCLUSION There was an increase in the incidence of notifications in the period. There was a decrease in case fatality ratio until 2012, subsequently followed by an increase.
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Affiliation(s)
- Karla Patrício Carvalho
- Programa de Pós-Graduação em Saúde Coletiva, Universidade
Federal do Espírito Santo, Vitória, ES, Brazil
| | - Rafael Belo Corassa
- Programa de Pós-Graduação em Saúde Coletiva, Universidade
Federal do Espírito Santo, Vitória, ES, Brazil
| | - Glenda Blaser Petarli
- Programa de Pós-Graduação em Saúde Coletiva, Universidade
Federal do Espírito Santo, Vitória, ES, Brazil
| | - Monica Cattafesta
- Programa de Pós-Graduação em Saúde Coletiva, Universidade
Federal do Espírito Santo, Vitória, ES, Brazil
| | - Eliana Zandonade
- Programa de Pós-Graduação em Saúde Coletiva, Universidade
Federal do Espírito Santo, Vitória, ES, Brazil
| | - Luciane Bresciani Salaroli
- Programa de Pós-Graduação em Saúde Coletiva, Universidade
Federal do Espírito Santo, Vitória, ES, Brazil
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Cattafesta M, Petarli GB, Zandonade E, Bezerra OMDPA, de Abreu SMR, Salaroli LB. Prevalence and determinants of obesity and abdominal obesity among rural workers in Southeastern Brazil. PLoS One 2022; 17:e0270233. [PMID: 35797372 PMCID: PMC9262245 DOI: 10.1371/journal.pone.0270233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
The objectives of this study were to assess the nutritional status of rural workers from a municipality in Southeastern Brazil and estimate the association of sociodemographic, labor, lifestyle, and dietary pattern factors with obesity and abdominal obesity of men and women of this rural area. This is a cross-sectional, epidemiological study of 740 farmers (51.5%, n = 381 males; 48.5%, n = 359 females). The sociodemographic, labor, lifestyle and dietary patterns determinants were assessed. Food intake data were obtained by applying three 24-hour recalls and dietary patterns were determined by Principal Component Analysis with Varimax orthogonal rotation. Poisson regression with robust variance stratified by sex was applied. The general prevalence of overweight status was 31.5% (95% CI 28.2-34.8%), 19.7% of obesity (95% CI 16.8-22.6%) and 31.5% of abdominal obesity (95% CI 28.2-34.8%), with higher rates in women (P < 0.001). Men of higher socioeconomic class had a 2.3 times higher prevalence of obesity (95% CI 1.08-4.90). In addition, the shorter travel time to purchase food increased the prevalence of abdominal obesity in males. For women, the older the age group, the greater the general and central obesity. A lower adherence to traditional dietary patterns (approximately PR [prevalence ratio] 1.6 for general obesity and PR 1.3 for abdominal obesity) and a greater number of places to buy food were associated with higher rates of obesity in women. Finally, women farmers with a higher workload had a 20% lower prevalence of central obesity (PR 0.80; 95% CI 0.65-0.97). Such findings demonstrate that obesity must be an issue in the health care of remote and rural populations. There is a need to promote healthier environments that respect traditional food culture through multiple approaches that consider the heterogeneity of rural areas and the differences between sexes.
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Affiliation(s)
- Monica Cattafesta
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória/ES, Brazil
| | - Glenda Blaser Petarli
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória/ES, Brazil
| | - Eliana Zandonade
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória/ES, Brazil
| | | | - Sandra Marlene Ribeiro de Abreu
- Research Center in Physical Activity, Health and Leisure (CIAFEL) of Faculty of Sports-University of Porto (FADEUP), Laboratory for Integrative and Translational Research in Population Health (ITR), and Faculty of Sports, Research Center on Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
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Exposure Routes and Health Risks Associated with Pesticide Application. TOXICS 2022; 10:toxics10060335. [PMID: 35736943 PMCID: PMC9231402 DOI: 10.3390/toxics10060335] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023]
Abstract
Pesticides play an important role in agricultural development. However, pesticide application can result in both acute and chronic human toxicities, and the adverse effects of pesticides on the environment and human health remain a serious problem. There is therefore a need to discuss the application methods for pesticides, the routes of pesticide exposure, and the health risks posed by pesticide application. The health problems related to pesticide application and exposure in developing countries are of particular concern. The purpose of this paper is to provide scientific information for policymakers in order to allow the development of proper pesticide application technics and methods to minimize pesticide exposure and the adverse health effects on both applicators and communities. Studies indicate that there are four main pesticide application methods, including hydraulic spraying, backpack spraying, basal trunk spraying, and aerial spraying. Pesticide application methods are mainly selected by considering the habits of target pests, the characteristics of target sites, and the properties of pesticides. Humans are directly exposed to pesticides in occupational, agricultural, and household activities and are indirectly exposed to pesticides via environmental media, including air, water, soil, and food. Human exposure to pesticides occurs mainly through dermal, oral, and respiratory routes. People who are directly and/or indirectly exposed to pesticides may contract acute toxicity effects and chronic diseases. Although no segment of the general population is completely protected against exposure to pesticides and their potentially serious health effects, a disproportionate burden is shouldered by people in developing countries. Both deterministic and probabilistic human health risk assessments have their advantages and disadvantages and both types of methods should be comprehensively implemented in research on exposure and human health risk assessment. Equipment for appropriate pesticide application is important for application efficiency to minimize the loss of spray solution as well as reduce pesticide residuals in the environment and adverse human health effects due to over-spraying and residues. Policymakers should implement various useful measures, such as integrated pest management (IPM) laws that prohibit the use of pesticides with high risks and the development of a national implementation plan (NIP) to reduce the adverse effects of pesticides on the environment and on human health.
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Hardman R, Begg S, Spelten E. Multimorbidity and its effect on perceived burden, capacity and the ability to self-manage in a low-income rural primary care population: A qualitative study. PLoS One 2021; 16:e0255802. [PMID: 34370758 PMCID: PMC8351969 DOI: 10.1371/journal.pone.0255802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 07/25/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Multimorbidity is increasing in prevalence, especially in low-income settings. Despite this, chronic conditions are often managed in isolation, potentially leading to burden-capacity imbalance and reduced treatment adherence. We aimed to explore, in a low-income population with common comorbidities, how the specific demands of multimorbidity affect burden and capacity as defined by the Cumulative Complexity Model. MATERIALS AND METHODS Qualitative interviews with thirteen rural community health centre patients in Victoria, Australia. Participants were aged between 47-72 years and reported 3-10 chronic conditions. We asked about perceived capacity and burden in managing health. The Theory of Patient Capacity was used to analyse capacity and Normalisation Process Theory to analyse burden. All data specifically associated with the experience of multimorbidity was extracted from each burden and capacity domain. RESULTS The capacity domains of biography, resource mobilisation and work realisation were important in relation to multimorbidity. Conditions causing functional impairment (e.g. chronic pain, depression) interacted with physical, psychological and financial capacity, leading to biographical disruption and an inability to realise treatment and life work. Despite this, few people had a treatment plan for these conditions. Participants reported that multimorbidity affected all burden domains. Coherence and appraisal were especially challenging due to condition interactions, with clinicians providing little guidance. DISCUSSION The capacity and burden deficits highlighted by participants were not associated with any specific diagnosis, but were due to condition interactions, coupled with the lack of health provider support to navigate interactions. Physical, psychological and financial capacities were inseparable, but rarely addressed or understood holistically. Understanding and managing condition and treatment interactions was a key burden task for patients but was often difficult, isolating and overwhelming. This suggests that clinicians should become more aware of linkages between conditions, and include generic, synergistic or cross-disciplinary approaches, to build capacity, reduce burden and encourage integrated chronic condition management.
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Affiliation(s)
- Ruth Hardman
- School of Rural Health, La Trobe University, Bendigo, Victoria, Australia
- Sunraysia Community Health Services, Mildura, Victoria, Australia
| | - Stephen Begg
- School of Rural Health, La Trobe University, Bendigo, Victoria, Australia
| | - Evelien Spelten
- School of Rural Health, La Trobe University, Bendigo, Victoria, Australia
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Huaquía-Díaz AM, Chalán-Dávila TS, Carrillo-Larco RM, Bernabe-Ortiz A. Multimorbidity in Latin America and the Caribbean: a systematic review and meta-analysis. BMJ Open 2021; 11:e050409. [PMID: 34301665 PMCID: PMC8311299 DOI: 10.1136/bmjopen-2021-050409] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To estimate the pooled prevalence of multimorbidity (≥2 non-communicable diseases in the same individual) among adults of the general population of Latin American and the Caribbean (LAC). DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, Embase, Global Health, Scopus and LILACS up to 1 July 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES The outcome was the prevalence of multimorbidity. Reports were selected whether they enrolled adult individuals (age ≥18 years) from the general population. DATA EXTRACTION AND SYNTHESIS Reviewers extracted relevant data and assessed risk of bias independently. A random-effects meta-analysis was conducted to report pooled prevalence estimates of multimorbidity; pooled estimates by pre-specified subgroups (eg, national studies) were also pursued. RESULTS From 5830 results, we selected 28 reports, mostly from Brazil and 16 were based on a nationally representative sample. From the 28 selected reports, 26 were further included in the meta-analysis revealing a pooled multimorbidity prevalence of 43% (95% CI: 35% to 51%; I2: 99.9%). When only reports with a nationally representative sample were combined, the pooled prevalence was 37% (95% CI: 27% to 47%; I2: 99.9%). When the ascertainment of multimorbidity was based on self-reports alone, the pooled prevalence was 40% (95% CI: 31% to 48%; I2: 99.9%); this raised to 52% (95% CI: 33% to 70%; I2: 99.9%) for reports including self-reported and objective diagnosis. CONCLUSIONS Our results complement and advance those from global efforts by incorporating much more reports from LAC. We revealed a larger presence of multimorbidity in LAC than previously reported. PROSPERO REGISTRATION NUMBER CRD42020196177.
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Affiliation(s)
| | | | - Rodrigo M Carrillo-Larco
- Department of Epidemiology and Bisotatistics, School of Public Health, Imperial College London, London, UK
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- Universidad Científica del Sur, Lima, Peru
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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Garrido MA, Mark L, Parra M, Nowak D, Radon K. Executive Function among Chilean Shellfish Divers: A Cross-Sectional Study Considering Working and Health Conditions in Artisanal Fishing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115923. [PMID: 34073026 PMCID: PMC8199200 DOI: 10.3390/ijerph18115923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 01/04/2023]
Abstract
Knowledge about professional diving-related risk factors for reduced executive function is limited. We therefore evaluated the association between decompression illness and executive functioning among artisanal divers in southern Chile. The cross-sectional study included 104 male divers and 58 male non-diving fishermen from two fishing communities. Divers self-reported frequency and severity of symptoms of decompression illness. Executive function was evaluated by perseverative responses and perseverative errors in the Wisconsin Card Sorting Test. Age, alcohol consumption, and symptoms of depression were a-priori defined as potential confounders and included in linear regression models. Comparing divers and non-divers, no differences in the executive function were found. Among divers, 75% reported a history of at least mild decompression sickness. Higher frequency and severity of symptoms of decompression illness were associated with reduced executive function. Therefore, intervention strategies for artisanal divers should focus on prevention of decompression illness.
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Affiliation(s)
- Marie Astrid Garrido
- Center for International Health@Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig-Maximilians-University, 80539 Munich, Germany; (L.M.); (M.P.); (K.R.)
- Correspondence: ; Tel.: +56-9-78783908
| | - Lorenz Mark
- Center for International Health@Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig-Maximilians-University, 80539 Munich, Germany; (L.M.); (M.P.); (K.R.)
| | - Manuel Parra
- Center for International Health@Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig-Maximilians-University, 80539 Munich, Germany; (L.M.); (M.P.); (K.R.)
- Faculty of Medicine, University of Atacama, Atacama 1532297, Chile
| | - Dennis Nowak
- Institute for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig-Maximilians-University, 80539 Munich, Germany;
| | - Katja Radon
- Center for International Health@Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig-Maximilians-University, 80539 Munich, Germany; (L.M.); (M.P.); (K.R.)
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Cattafesta M, Petarli GB, Zandonade E, Bezerra OMDPA, de Abreu SMR, Salaroli LB. Energy contribution of NOVA food groups and the nutritional profile of the Brazilian rural workers' diets. PLoS One 2020; 15:e0240756. [PMID: 33112887 PMCID: PMC7592810 DOI: 10.1371/journal.pone.0240756] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022] Open
Abstract
We estimated the caloric contribution of minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods in Brazilian farmers' diets and their association with the nutritional profile of the diet. It is an epidemiological study of cross-sectional, analytical and quantitative design with 740 farmers adults of Southeastern Brazil. Food intake data were obtained by applying three 24-hour recalls and were classified according to the degree and purpose of processing. The largest caloric contribution came from the group of minimally processed foods (64.7%), followed by ultra-processed foods (17.7%), processed culinary ingredients (12.4%), and processed foods (5.2%). Individuals in the fourth quartile of caloric contribution from minimally processed foods showed lower energy consumption (β -0.16, P<0.001) and greater consumption of all 15 micronutrients analyzed. In contrast to what was identified for this food group, the higher caloric contribution from ultra-processed foods was associated with a greater caloric content of the diet (β 0.17, P<0.001) and lower consumption of all 23 analyzed nutrients. Therefore, the caloric contribution from the consumption of ultra-processed foods in the rural area is still lower than the national average. However, measures aimed at delaying isocaloric exchanges for the group of ultra-processed foods must be carried out, maintaining the local food culture, since this group had worse nutritional levels. In addition, incentives to the greater consumption of minimally processed foods should be carried out, due to their nutritional quality.
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Affiliation(s)
- Monica Cattafesta
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Glenda Blaser Petarli
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Eliana Zandonade
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil
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Dutheil F, Baker JS, Mermillod M, De Cesare M, Vidal A, Moustafa F, Pereira B, Navel V. Shift work, and particularly permanent night shifts, promote dyslipidaemia: A systematic review and meta-analysis. Atherosclerosis 2020; 313:156-169. [PMID: 33069952 DOI: 10.1016/j.atherosclerosis.2020.08.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/15/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Shift work is common worldwide and linked to deleterious cardiovascular effects that might be underlined by dyslipidemia. The aim of this systematic review and meta-analysis is to determine the impact of shiftwork on dyslipidemia. METHODS Searching in PubMed, Cochrane Library, Science Direct and Embase databases without language restriction on 15 February 2020, included studies that describe blood lipids levels or a risk measure in shift workers compared with fixed-day workers (controls). Differences by study-level characteristics were estimated using stratified meta-analysis by type of shift work, and meta-regression to examine relations between dyslipidemia and demographic, lifestyle and work characteristics. Estimates were pooled using random-effect meta-analysis. RESULTS We included a total of 66 articles, representing 197,063 workers. Shift work globally increased the levels of triglycerides (overall SMD = 0.09; 95CI 0.05 to 0.13; p < 0.001), and globally decreased the levels of c-HDL (-0.08; 95CI -0.12 to -0.03; p = 0.001). Permanent night shift workers were an at-risk type of shift for dyslipidemia with significantly higher blood levels of total cholesterol (0.22; 95CI 0.01 to 0.42; p = 0.043) and triglycerides (0.18; 0.03 to 0.33; p = 0.017), and significantly lower blood levels of c-HDL (-0.16; 95CI -0.32 to 0.00; p = 0.05). Permanent night shift workers were more at-risk for total cholesterol than rotating 3 × 8 shift workers (Coefficient 0.22; 95CI 0.01 to 0.42; p = 0.038) and rotating 2 × 12 shift workers (0.24; 0.02 to 0.46; p = 0.037), and more at-risk for triglycerides than rotating day shift workers (0.21; 95CI 0.03 to 0.38; p = 0.023). Results were non-significant for c-LDL, nor depending on type of shifts. CONCLUSIONS Shift work, and particularly permanent night shift, is associated with dyslipidaemia via elevated total cholesterol and triglycerides, and reduced HDL-cholesterol. Our current study provides a practical and valuable strengthening of the evidence-base required for preventive health initiatives and workplace reform.
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Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000, Clermont-Ferrand, France.
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, Grenoble, France; Institut Universitaire de France, Paris, France
| | - Mélanie De Cesare
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, F-63000, Clermont-Ferrand, France
| | - Alexia Vidal
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, F-63000, Clermont-Ferrand, France
| | - Fares Moustafa
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Emergency Unit, F-63000, Clermont-Ferrand, France
| | - Bruno Pereira
- University Hospital of Clermont-Ferrand (CHU), Clinical Research and Innovation Direction, Clermont-Ferrand, France
| | - Valentin Navel
- Université Clermont Auvergne, CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France
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