A vigilância em saúde ambiental como resposta ao desastre do rompimento da barragem de rejeitos em Brumadinho

Abstract

RESUMO A saúde ambiental se constitui o campo da saúde pública responsável pelas políticas públicas relacionadas com a interação entre a saúde humana e os fatores do meio ambiente. A gestão de risco de desastres envolve um processo de antecipação, planejamento e preparação para resposta, com atuação de diferentes áreas de governo, como o setor saúde. Este relato de experiência teve o objetivo de descrever as ações desenvolvidas pela vigilância em saúde ambiental da Secretaria de Estado de Saúde de Minas Gerais em resposta ao rompimento da barragem B1 em Brumadinho. Entre as ações desenvolvidas, destacam-se o monitoramento da qualidade da água para consumo humano nos municípios atingidos, a participação em reuniões em espaços de decisão e deliberação e a produção de documentos técnicos. As experiências vivenciadas pela equipe, durante as ações de resposta ao desastre, motivaram reflexões sobre a necessidade de fortalecer o desenvolvimento das ações de forma intra e intersetorial e a importância de qualificação dos dados registrados nos sistemas de informação e de conhecimento das informações locais de cada território, a fim de subsidiar a atuação do setor saúde de modo oportuno em situações de desastre.

Worldwide Surveillance Actions and Initiatives of Drinking Water Quality: A Scoping Review

“…The study design was described in some publications (24; 48.90%): descriptive (8; 16.32%) [30][31][32][33][34][35][36][37], cross-sectional or ecological (4; 8.16%) [38][39][40][41], documentary (3; 6.12%) [42][43][44], retrospective cohort [45,46], epidemiological [47,48], case study [49], action research [50], experience report [51], and quantitative-qualitative evaluative and mixedmethods research [52]. Other publications were reports regarding surveillance actions (14; 28.57%) [53][54][55][56][57][58][59][60][61][62][63][64][65][66].…”

“…The responsible for health surveillance actions were professionals linked to public health departments (40; 81.63%) from municipal, state, or federal spheres [31][32][33][34][35][36][37][38][39][40]42,43,[46][47][48][49][50][51][53][54][55][56][57][58][59][60][61][62][63]65,[67][68][69][70][71][72][73][74][75][76], agencies responsible for water protection [45,77], department of environment and conservation [41], department of public health engineering [78], national water laboratory [30], or in-field sanitary inspectors of the water test laboratory [52]. Sometimes, the surveillance involved other sectors besides health (e.g., environmental, civil protection, and responsible for the supply)…”

“…This finding is a problem for public health since 55 of the identified contaminants were not listed in the current Brazilian water quality parameters for routine sampling [85]. Surveillance actions of drinking water quality in emergency situations were related to natural or anthropogenic disasters, such as tsunamis [49], dam failure accidents [51], and environmental disasters in the paper industry [31]. The actions involved the identification of priorities related to drinking water quality [49], including periodic monitoring and collective and individual supply solutions to gather water from underground sources in the affected municipalities [51]; detection of vulnerable points in the network [31] to improve the microbiological and chemical safety of water; and analysis of household wells to classify the risk in water consumption [9].…”

“…Surveillance actions of drinking water quality in emergency situations were related to natural or anthropogenic disasters, such as tsunamis [49], dam failure accidents [51], and environmental disasters in the paper industry [31]. The actions involved the identification of priorities related to drinking water quality [49], including periodic monitoring and collective and individual supply solutions to gather water from underground sources in the affected municipalities [51]; detection of vulnerable points in the network [31] to improve the microbiological and chemical safety of water; and analysis of household wells to classify the risk in water consumption [9]. The need to create intersectoral technical working groups [31] or operating committees for integrating essential areas to attend to emergencies [51] was also highlighted, besides the installation of chlorinated water tanks, distribution of domestic water treatment reagents to residences in the affected areas [65], and improvements in water management related to source protection, disinfection practices, and attention to contamination [49].…”

“…The surveillance actions of water quality highlighted in this class addressed the identification of chemical contaminants in households (i.e., lead [71,73], arsenic [67,72,73], iron [71,73,78], nitrate [69,73,78], fluoride [47,78], aluminum, manganese, strontium, and nitrogen [73]), revealed locations that did not fully comply with regulations of chemical contamination [49], and identified volatile organic compounds within the allowed level [69]. Identifying these contaminants has been part of testing programs at residences of people from risk groups (e.g., women with children [71], low-income families with pregnant women, and young children [73]) and assessments of supply sources and sources needing treatment after a disaster [51].…”