OBJECTIVE To estimate worldwide prevalence of chronic low back pain according to age and sex.METHODS We consulted Medline (PubMed), LILACS and EMBASE electronic databases. The search strategy used the following descriptors and combinations: back pain, prevalence, musculoskeletal diseases, chronic musculoskeletal pain, rheumatic, low back pain, musculoskeletal disorders and chronic low back pain. We selected cross-sectional population-based or cohort studies that assessed chronic low back pain as an outcome. We also assessed the quality of the selected studies as well as the chronic low back pain prevalence according to age and sex.RESULTS The review included 28 studies. Based on our qualitative evaluation, around one third of the studies had low scores, mainly due to high non-response rates. Chronic low back pain prevalence was 4.2% in individuals aged between 24 and 39 years old and 19.6% in those aged between 20 and 59. Of nine studies with individuals aged 18 and above, six reported chronic low back pain between 3.9% and 10.2% and three, prevalence between 13.1% and 20.3%. In the Brazilian older population, chronic low back pain prevalence was 25.4%.CONCLUSIONS Chronic low back pain prevalence increases linearly from the third decade of life on, until the 60 years of age, being more prevalent in women. Methodological approaches aiming to reduce high heterogeneity in case definitions of chronic low back pain are essential to consistency and comparative analysis between studies. A standard chronic low back pain definition should include the precise description of the anatomical area, pain duration and limitation level.

ObjectiveTo describe epidemiological aspects of suicide mortality in a 10-year time series.

Brazil is one of the world leaders in pesticide consumption and exposed workers are numerous and diversified. Acute poisonings are just the most visible aspect of pesticide impact on human health. An assessment of many official information systems that notify pesticide poisoning concluded that none of them performed appropriately the role of a surveillance system. Only acute and severe cases are notified. One of the main gaps concerns exposure information: the only official source (the Agronomic Prescriptions) has many limitations and is not available for research. A review of published articles in Brazil shows a quantitative and qualitative increase of studies in this area with many different approaches. The impact of such a high chemical burden and the huge numbers of workers exposed are two important reasons for the development of an epidemiological research on pesticide poisoning, an issue that has still a vast field to cover in Brazil.

ObjectiveDespite the intensive use of pesticides in agriculture there are few studies assessing the risk of respiratory conditions from this exposure. The study aimed at quantifying the prevalence of respiratory symptoms among farmers and evaluating its relationship with occupational use of pesticides and the prevalence of respiratory symptoms. Methods A cross-sectional study was conducted among 1,379 farmers from two municipalities of Southern Brazil in 1996. Frequency and type of chemical exposure and pesticide poisoning were recorded for both sexes. All subjects aged 15 years or older with at least 15 weekly hours of agricultural activity were interviewed. An adapted questionnaire developed by the American Thoracic Society was used for the assessment of respiratory symptoms. Multivariate logistic regression analysis was carried out. Results More than half (55%) of interviewees were male. The prevalence of asthma symptoms was 12% and chronic respiratory disease symptoms was 22%. Higher odds ratios for both asthma (OR=1.51; 95% CI: 1.07-2.14) and chronic respiratory disease (OR=1.34; 95% CI 1.00-1.81) symptoms were found in women. Logistic regression analysis identified associations between many forms of exposure to pesticides and increased respiratory symptoms. Occurrence of pesticide poisoning was associated with higher prevalence of asthma symptoms (OR=1.54; 95% CI: 1.04-2.58) and chronic respiratory disease symptoms (OR=1.57; 95% CI: 1.08-2.28). ConclusionsIn spite of causality limitations, the study results provide evidence that farming exposure to pesticides is associated with higher prevalence of respiratory symptoms, especially when the exposure is above two days per month. Resumo Objetivo

The study reinforces the evidence of the association between pesticide poisoning and mental health disorders. It also points to increased risk of MPD from low socioeconomic status, dermal pesticide exposure as well as from exposure to organophosphates. Furthermore, the study reveals intense nicotine exposure as a risk for tobacco farmers' mental health.

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.

Realizou-se um estudo transversal entre trabalhadores rurais na região serrana do Rio Grande do Sul. O objetivo foi estudar o perfil sócio-demográfico da população, conhecer as características do trabalho rural e descrever a prevalência de algumas patologias na população referida. A amostra foi de 1.479 trabalhadores, em 495 estabelecimentos agrícolas. Nesta amostra, a idade média foi de 41 anos, 56% eram do sexo masculino, com escolaridade média de cinco anos, sendo 87% da família proprietária. Os estabelecimentos tinham área média de 37 ha, 50% tinham pelo menos um tipo de máquina agrícola e a principal produção era a fruticultura. Cerca 75% dos trabalhadores lidavam com agrotóxicos de vários tipos e 12% referiram intoxicação por estes produtos em algum momento da vida. A prevalência de transtornos psiquiátricos menores foi de 36%, a freqüência anual de acidentes de trabalho foi 10%. Os dados revelam a diversidade de atividades e de riscos ocupacionais. As altas prevalências dos problemas de saúde avaliados alertam para a necessidade de se priorizar ações de proteção para a saúde do trabalhador rural.

BackgroundDespite being the second largest tobacco producer in the world, Brazil does not have prevalence studies about green tobacco sickness (GTS).MethodsA cross‐sectional study was carried out on a sample of Brazilian tobacco workers. The sample was described according to socio‐demographic, behavioral, and occupational variables. Gender‐stratified multivariate analyses examined variables associated with GTS.ResultsGTS prevalence among men in the previous month was 6.6%, while among women it was 11.9%. Among men, age, being a non‐smoker, hanging tobacco sticks in the barn, harvesting wet leaves, and exposure to physical exertion were risk factors for GTS. Among women, tying hands of tobacco, transporting bales, harvesting wet leaves, having had contact with pesticides, and exposure to physical exertion were positively associated with GTS.ConclusionResearch is required to improve methods for GTS screening, as well as the ability to distinguish GTS from pesticide poisoning. Health professionals should be trained to diagnose and treat GTS. Am. J. Ind. Med. 57:726–735, 2014. © 2014 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.