OBJECTIVE:To describe the occupational exposure to acute poisoning by pesticides, especially organophosphates, and its incidence. METHODS:A descriptive study was carried out on 290 family fruit farmers in the municipality of Bento Gonçalves, Southern Brazil, conducted in two stages in 2006. Two hundred and forty-one of these workers completed the two stages, which corresponded to periods of low use and intense use of pesticides. Data on the property, occupational exposure to pesticides, sociodemographic data and frequency of health problems were gathered using a standardized questionnaire. Poisoning was characterized by reports of episodes, symptoms relating to pesticides and plasma cholinesterase examinations. Cases were classifi ed according to the matrix proposed by the World Health Organization (WHO). RESULTS:On average, each property used 12 different types of pesticides, consisting mainly of glyphosate and organophosphates. Most of the workers used tractors for pesticide application (87%), set aside the containers for selective garbage collection (86%) and used protective equipment during activities involving pesticides (≥ 94%). Among these family farmers, 4% reported occurrences of poisoning by pesticides over the 12 months preceding the investigation, and 19% at some time during their lives. According to the criterion proposed by WHO, 11% were classifi ed as probable cases of acute poisoning. Among the workers who had used organophosphates over the tenday period preceding the examination, 2.9% presented two or more symptoms relating to pesticides and a 20% reduction in cholinesterase. CONCLUSIONS:The poisoning occurrences according to the workers' perceptions were within what was expected, but the estimate based on the WHO classifi cation picked up a larger proportion of the cases. A fall in the harvest reduced the use of insecticides and may explain the low occurrence of abnormalities in the laboratory results. The criteria for defi ning pesticide poisoning, as well as the offi cial monitoring parameters, should be reevaluated in order to increase the workers' protection.
Hantavirus cardiopulmonary syndrome (HCPS) is an emerging rodent-borne disease in the Americas. The most common initial symptoms of HCPS are similar to those of COVID-19 and other respiratory infections that evolve rapidly to respiratory failure, resulting from pulmonary edema and shock in about 40% of cases. We describe a fatal case of HCPS in a 24-year-old man who was hospitalized with fever, hemoconcentration, thrombocytopenia, leukocytosis, dry cough and a bilateral diffuse alveolar pulmonary infiltrate during the emergence of the COVID-19 pandemic in Brazil. HCPS needs to be ruled out in patients with clinical manifestations compatible with respiratory infections such as influenza and COVID-19.
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