Many human cancers develop as a result of exposure to risk factors related to the environment and ways of life. The aim of this study was to estimate attributable fractions of 25 types of cancers resulting from exposure to modifiable risk factors in Brazil. The prevalence of exposure to selected risk factors among adults was obtained from population-based surveys conducted from 2000 to 2008. Risk estimates were based on data drawn from meta-analyses or large, high quality studies. Population-attributable fractions (PAF) for a combination of risk factors, as well as the number of preventable deaths and cancer cases, were calculated for 2020. The known preventable risk factors studied will account for 34% of cancer cases among men and 35% among women in 2020, and for 46% and 39% deaths, respectively. The highest attributable fractions were estimated for tobacco smoking, infections, low consumption of fruits and vegetables, excess weight, reproductive factors, and physical inactivity. This is the first study to systematically estimate the fraction of cancer attributable to potentially modifiable risk factors in Brazil. Strategies for primary prevention of tobacco smoking and control of infection and the promotion of a healthy diet and physical activity should be the main priorities in policies for cancer prevention in the country.

Benzene is a ubiquitous environmental pollutant and an important industrial chemical present in both gasoline and motor vehicle emissions. Occupational human exposure to benzene occurs in the petrochemical and petroleum refining industries as well as in gas-station workers, where it can lead to benzene poisoning (BP), but the mechanisms of BP are not completely understood. In Brazil, a significant number of gas-station service workers are employed. The aim of the present study was to evaluate alterations related to BP and metabolic polymorphisms in gas-station service workers exposed to benzene in the city of Rio de Janeiro, Brazil. Occupational exposure was based on clinical findings related to BP, and metabolic polymorphisms in 114 Brazilian gas-station attendants. These workers were divided into No Clinical Findings (NCF) and Clinical Findings (CF) groups. Neutrophil and Mean Corpuscular Volume (MCV) showed a significant difference between the two study groups, and neutrophil has the greatest impact on the alterations suggestive of BP. The clinical findings revealed higher frequencies of symptoms in the CF group, although not all members presented statistical significance. The frequencies of alleles related to risk were higher in the CF group for GSTM1, GSTT1, CYP2E1 7632T > A, but lower for NQO1 and CYP2E1 1053C > T genotypes. Moreover, an association was found between GSTM1 null and alterations related to BP, but we did not observe any effects of other polymorphisms. Variations in benzene metabolizing genes may modify benzene toxicity and should be taken into consideration during risk assessment evaluations.

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BackgroundChronic exposure of BTX (benzene, toluene, xylene) may lead to progressive degeneration of bone marrow, aplastic anemia and/or leukemia. In Brazil there is no self-service fuel in gas stations and attendants fill the fuel themselves. Due to this they are chronically exposed to high concentration of BTX. Occupational exposure to benzene has been associated with increased chromosomal aberrations in peripheral blood lymphocytes. Fluorescence in situ hybridization (FISH) using whole chromosome painting (wcp) probes allows the rapid detection of chromosomal aberration. In the present study three-color wcp probes for chromosomes 1, 2 and 4 were used for monitoring 60 gas station attendants.ResultsBlood tests were done and interviews were conducted for each worker. For searching for possible associations between the clinical characteristics and the frequency of chromosomal aberrations the workers were divided into two groups (≤ 10 chromosomal abnormalities per 1,000 metaphases and > 10 chromosomal abnormalities per 1,000 metaphases).The studied workers had a low median age (36 year), albeit long period of BTX exposure (median was 16 years). Low prevalence of smoking and moderate consumption of alcoholic beverages were found in this population. The cytogenetic analysis showed 16.6% (10/60) of workers with a high frequency of chromosomal abnormalities (>10 chromosomal abnormalities per 1,000 metaphases). Translocations were the most frequently observed chromosome aberration. The statistical analysis revealed highly significant differences in skin color (p = 0.002) and a weak significant differences in gender (p = 0.052) distribution between the two groups.Conclusion16.6% of the studied population showed elevated frequencies of chromosomal abnormalities, which is highly likely to be correlated with their exposure to BTX during their work. Therefore, further studies are needed for better characterize the work associated damage of the genome in gas station workers. It is necessary to better understand the risks that these workers are exposed, so that we can be effective in preventing diseases and maintaining the health of these workers and possibly the offspring.

OBJETIVO: Conhecer a freqüência da desnutrição como causa de morte na população idosa. MÉTODOS: Foram selecionados indivíduos com 60 anos ou mais de ambos os sexos, dos municípios da região Sudeste, entre 1980 e 1997. As fontes de dados foram o registro de óbitos do Sistema de Informação Sobre Mortalidade (1980-1998) e a população estimada pelo Centro de Desenvolvimento e Planejamento Regional (Cedeplar). Para classificação dos óbitos, empregou-se a CID-9 (260 a 263.9), para os anos de 1980 até 1995, e a CID-10 (E40 a E46), para os anos mais recentes. RESULTADOS: No Brasil, entre 1980 e 1997, ocorreram 36.955 óbitos por desnutrição em idosos. A região Sudeste concentrou o maior número -- 23.968 (64,9%) -- dentre as demais regiões brasileiras. No Estado de São Paulo, ocorreram 11.067 óbitos por desnutrição em idosos, e, no Rio de Janeiro, 7.763, obtendo, esses dois estados em conjunto, os maiores valores da região. É maior a proporção de óbitos e maiores os coeficientes de mortalidade em indivíduos de 70 anos ou mais do que em indivíduos da faixa etária de 60 a 69 anos, independentemente do sexo. CONCLUSÃO: Os resultados preliminares do estudo levantam algumas questões: o papel da desnutrição como causa associada; a tendência de aumento dos óbitos por desnutrição na velhice; o comportamento diferenciado entre estados da mesma região. Análises estatísticas do tipo séries-temporais possivelmente conseguiriam explicar melhor os fenômenos apontados. Será preciso aprofundar o estudo do papel da desnutrição na população com 60 anos ou mais para estabelecer estratégias de intervenção adequadas.

Self-rated health and physical disabilities due to heath problems RESUMO OBJETIVO: Avaliar a autopercepção de saúde e a presença de limitações físicas devido a problemas de saúde. MÉTODOS: RESULTADOS:Os resultados mostraram que as piores condições de saúde são referidas por mulheres, indivíduos com 50 anos ou mais e com menor grau de escolaridade. Os percentuais relacionados à percepção de saúde regular ou ruim foram maiores nas cidades das regiões Norte e Nordeste quando comparados aos das cidades das regiões Sul e Sudeste. CONCLUSÕES:As piores condições de saúde das regiões Norte/Nordeste comparadas as das regiões Sul/Sudeste revelam um conjunto de fatores relacionados às desigualdades sociais, entre os quais o menor grau de escolaridade.

In Brazil, gas station workers are occupationally exposed to the benzene present in gasoline. Brazilian law indicates the use of trans,trans-muconic acid(t,t-MA) as a biomarker of benzene exposure. The aim of this study was to evaluate the level of exposure to benzene in gas station workers, through the quantification of t,t-MA present in urine. A total number of 269 gas station workers divided into 179 filling station attendants exposed by inhalation and dermal route and 90 convenience store workers exposed only by inhalation were included. A control group was formed by 100 office workers, without occupational exposure to benzene. The urinary levels of t,t-MA were evaluated by HPLC with a UV detector. Gas station workers showed higher mean values of t,t-MA (0.204 mg/g creatinine; 95% CI 0.170–0.237) than office workers (0.126 mg/g creatinine; 95% CI 0.0817–0.1693). T,t-MA levels were higher in convenience store workers exposed to gasoline only by inhalation (0.221 mg/g creatinine; 95% CI 0.160–0.282), than in those exposed to gasoline by inhalation and dermal route—filling station attendants (0.195 mg/g creatinine; 95% CI 0.155–0.235). Gas station workers with a higher level of t,t-MA had epistaxis. T,t-MA values were higher in the Downtown (0.15 mg/g creatinine) region’s workers than in the more affluent South Zone region’s workers (0.07 mg/g creatinine). Smoking habits influenced the urinary t,t-MA values, while the frequency of consumption of industrialized and frozen foods showed no influence.

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