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NESTE TRABALHO faz-se uma revisão do perfil epidemiológico das populações amazônicas em relação com a dinâmica socioambiental da região. Propõe-se um modelo conceitual de análise que inclui três grandes categorias de paisagens na Amazônia: naturais, antropizadas e construídas. A cada uma destas macropaisagens identifica-se um conjunto bem definido de agravos à saúde. Utilizando-se um conceito próprio de paisagem de doença, modificado da epidemiologia paisagística clássica, é feita uma análise comparativa da dinâmica epidemiológica da malária em seis tipos de paisagens, definidas com base em formas de usos da terra.

O artigo apresenta um levantamento efetuado no ano de 1997 em 40 propriedades rurais de Cachoeiras de Macacu (RJ) acerca da percepção de risco e das práticas de uso dos agrotóxicos. A pesquisa de campo foi feita com agricultores (40 questionários) e com autoridades (entrevistas abertas). A análise dos resultados demonstrou que 22,5% dos agricultores reportaram já terem sido intoxicados por agrotóxico, sendo o inseticida Decis 25 CE e o herbicida Gramoxone (ambos extremamente tóxicos) os mais utilizados na região. Verificou-se que 85% dos agricultores não utilizavam Equipamentos de Proteção Individual (EPI), que 27,5% jogavam embalagens de agrotóxicos no rio ou no mato, que 60% de entrevistados nunca foram treinados para manusear agrotóxicos e que 85% disseram não precisar de receituário agronômico para comprá-los. Quanto à percepção do risco do uso de agrotóxicos, foram identificadas três categorias: 70% percebem, mas continuam usando; 27% não percebem o risco; 3% percebem e não utilizam mais. Discutem-se as razões para estas práticas de risco, comparando-se com achados de outros autores.

The Amazonian environment is changing rapidly, due to deforestation, in the short term, and, climatic change is projected to alter its forest cover, in the next few decades. These modifications to the, environment have been altering the dynamics of infectious diseases which have natural foci in the, Amazonian biome, especially in its forest. Current land use practices which are changing the, epidemiological profile of the parasitic diseases in the region are road building; logging; mining; expansion of agriculture and cattle ranching and the building of large dams. Malaria and the cutaneous, leishmaniasis are the diseases best known for their rapid changes in response to environmental, modifications. Others such as soil-transmitted helminthiases, filarial infections and toxoplasmosis, which have part of their developmental cycles in the biophysical environment, are also expected to, change rapidly. An interdisciplinary approach and an integrated, international surveillance are needed, to manage the environmentally-driven changes in the Amazonian parasitic diseases in the near future.

This study was conducted in a meteorological tower located in the Caxiuanã Forest (municipality of Melgaço, Pará, Brazil)

Vulnerability, understood as the propensity to be adversely affected, has attained importance in the context of climate change by helping to understand what makes populations and territories predisposed to its impacts. Conditions of vulnerability may vary depending on the characteristics of each territory studied—social, environmental, infrastructural, public policies, among others. Thus, the present study aimed to evaluate what makes the municipalities of the state of Amazonas, Brazil, vulnerable to climate change in the context of the largest tropical forest in the world, and which regions of the State are the most susceptible. A Municipal Vulnerability Index was developed, which was used to associate current socio-environmental characteristics of municipalities with climate change scenarios in order to identify those that may be most affected by climate change. The results showed that poor adaptive capacity and poverty had the most influence on current vulnerability of the municipalities of Amazonas with the most vulnerable areas being the southern, northern, and eastern regions of the state. When current vulnerability was related to future climate change projections, the most vulnerable areas were the northern, northeastern, extreme southern, and southwestern regions. From a socio-environmental and climatic point of view, these regions should be a priority for public policy efforts to reduce their vulnerability and prepare them to cope with the adverse aspects of climate change.

A national quantitative assessment of the current vulnerability of the Brazilian population to the health impacts of climate change was undertaken with the support of the Brazilian Ministry of Science and Technology. A conceptual framework of vulnerability in the health sector, according to a modified general 'exposure-response' model, was adopted (Confalonieri 2003). For the quantification of vulnerability, a new methodology was used to develop a synthetic (composite) general vulnerability index from averages of specific indices of vulnerability in 3 areas: socio-economic, epidemiological and climatological. We found that the greatest influence on the general vulnerability index (of the most vulnerable states) was from the socio-economic vulnerability index. The approach used also demonstrated that the northeast is the most vulnerable Brazilian region to the health impacts of a changing climate.KEY WORDS: Vulnerability · Health · Climate change · Assessment · Brazil · Methods Resale or republication not permitted without written consent of the publisherContribution to CR Special 20 'Integrating analysis of regional climate change and response options'

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