[Smoking prevalence and associated factors among tobacco farmers in southern Brazil]

Stressors and Coping Strategies in Rural Farmers: A Qualitative Study

OBJECTIVE

Farmers in rural areas face unique lifestyle stressors which may cause physical and behavioral health issues. Because of external stressors, and often an internal drive to succeed, farmers in rural areas have high rates of prescription drug use, excessive alcohol use, depression, and suicide. These methods of coping may increase prevalence of distress and mental illness in farmers leading to poor health outcomes. Social norms within rural farming populations are influenced by culture, family, friends, and community beliefs which make it difficult to conduct research about substance use and mental health. The purpose of this study is to identify stressors in rural farmers and positive and negative coping strategies for stress in the farming population.

METHODS

In-depth interviews (35 minutes-1 hour) were conducted with full-time rural farmers (n = 15) in ten counties throughout Georgia. Using qualitative analysis, inductive coding was used to identify themes and patterns among transcribed interview recordings.

RESULTS

Stressors reported by farmers included: financial, work-life balance, physical health and disconnect from non-farming populations. Farmers described feeling misperceived by those outside of their community and feeling a distinct lack of control due to external factors. All the farmers identified alcohol use as a primary coping strategy to deal with stressors.

CONCLUSIONS

This study identifies distinct stressors associated with a farming lifestyle and socio-cultural factors that are barriers to care for mental health and substance use in rural farmers. This study can provide information to health practitioners that may lead to a better understanding of the factors influencing farmer's health outcomes.

Increased DNA damage is not associated to polymorphisms in OGGI DNA repair gene, CYP2E1 detoxification gene, and biochemical and hematological findings in soybeans farmers from Central Brazil

Our study evaluated 163 individuals, being 74 soybean farmers, occupationally exposed to pesticides, and 89 individuals from Goias municipalities, Central Brazil, with similar conditions to the exposed group, comprising the control group. Of the 74 soybean farmers, 43 exposed directly to pesticides and 31 exposed indirectly. The exposed group consisted of individuals aged 19 to 63 years, 21 women and 53 men, and the control group had ages ranging from 18 to 64 years, being 36 women and 53 men. 18.9% of the exposed group were poisoned by pesticides, and the most common symptoms were headache and gastrointestinal problems. The genotype frequencies of the rs2031920 (T>C) polymorphism in the CYP2E1 gene present significant differences between the exposed and control groups (p = 0.02), showing that 24.3% of the exposed group were heterozygotes against 6.7% in the control group. For the OGG1 gene, two SNPs, rs1052133 (G>C) and rs293795 (T>C), were evaluated and the genotype frequencies were not statistically different between the exposed and control groups. The DNA damage was distinct (p < 0.05) in the three analyzed comet parameters (tail length, Olive tail moment, %DNA) between groups. However, there was no influence of age and alcohol consumption between the groups associated with the polymorphisms in the CYP2E1 and OGG1 genes and DNA damage. We also did not find altered hematological and biochemical parameters in the exposed group. Thus, this pioneering study at Goias State carried out an overview of the health of soybean farmers. We evaluated classic laboratory exams, associated with exposure markers (comet assay) and susceptibility markers (genetic polymorphisms), emphasizing the need to expand the Brazilian health assessment protocol. We found, in soybean farmers, increased DNA damage and a higher number of heterozygotes in CYP2E1 gene, compared with the control group, despite the lack of association with age, educational level, smoking, drinking habits, and genetic polymorphisms.

Geographic distribution and time trends of esophageal cancer in Brazil from 2005 to 2015

The purpose of the present study was to investigate the geographical distribution and time trends of the incidence and lethality of esophageal cancer (EC) in Brazil. The present study conducted an ecological study of EC using records from January 2005 to December 2015 in the Health Informatics Department of the Brazilian Ministry of Health (DATASUS) registry. In addition to demographical data on the population, EC incidence and lethality rates were estimated from hospitalizations and in-hospital mortalities and were adjusted by total available hospital beds. The adjusted EC rates per 100,000 increased from 9.1 in 2005 to 12.1 in 2015. The prevalence among males increased from 69 to 78%, while the female rates remained stable over the same period. Although EC was the most common in South and Southeast Brazil, the rates increased proportionately more in the other regions of the country, especially among males. Geographical analysis revealed higher rates of EC in more urbanized areas, with a coast-to-inland gradient. While rates increased in people older than 50 years, they decreased among people below this age. However, the lethality rates remained stable and high during the study period, overlapping with hospital admission rates. The recent increasing trend in the EC incidence, with shifts from the south towards the north and from more urbanized towards rural areas, suggests that environmental factors are crucial in EC pathogenesis. The concentration of EC in South Brazil may reflect the presence of major environmental factors in association with a possible genetic predisposition. The unchanging high mortality associated with EC in the rapidly aging population suggests that EC will continue to impose a significant social and economic burden in the future.