Vigilância da qualidade da água para consumo humano: potencialidades e limitações com relação à fluoretação segundo os trabalhadores

Belotti, Lorrayne; Brandão, Soraya da Rocha; Pacheco, Karina Tonini dos Santos; Frazão, Paulo; Esposti, Carolina Dutra Degli

doi:10.1590/0103-11042019s304

Cited by 7 publications

(8 citation statements)

References 17 publications

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“…After the year 2000, a normative device began to require municipal health authorities to implement an appropriate sampling plan to guide surveillance actions [ 62 ]. An information system was developed by the Brazilian Ministry of Health for supporting the National Program of Surveillance on Environmental Health Related to the Quality of Water for Human Consumption.…”

Section: Discussionmentioning

confidence: 99%

The Use of Fluorides in Public Health: 65 Years of History and Challenges from Brazil

Frazão

2022

IJERPH

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Untreated dental caries is the most common disease globally and fluoride use at the population level is crucial for its control. To investigate the economic and political conditions under which the trajectory of population-based fluoride use has occurred is key for a more comprehensive view on its current and future challenges. The objective was to give a brief history and summarize the information on the use of fluorides at the population level in Brazil from 1952 to 2017 and to point to current and future challenges. A critical overview was undertaken based on country-level analyses comprising political and economic conditions. The analytical approach adopted a set of premises applicable to the study of capitalist democracies. Fluoride methods of systemic and topic use began to be employed in Brazilian public health programs in the 1950s and in a combined way from 1974. Differences in political and economic contexts were highlighted for four periods: the first interventions from 1952 to 1974, when the fluoridated water law was approved; the expansion after 1974 until 1988, when a new constitution was enacted; the following time until 2010; and the final period. From the 1980s to 2008, water fluoridation coverage increased progressively, consolidating as a major strategy of systemic use in spite of inequalities among territories. Activities aimed to promote access to topical fluoride use increased and maintained stability until 2014, when they dropped sharply. Regulation of fluoride dentifrice’s quality remained insufficient. It was hypothesized that the strengthening of conservative liberalism and the increase in fiscal austerity observed in recent years might produce serious constraints on public investment and limit access to fluorides. To reduce inequities and promote benefits for all, including the most vulnerable groups, policies based on egalitarian and social justice theoretical perspectives are needed more than ever.

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Section: Discussionmentioning

confidence: 99%

The Use of Fluorides in Public Health: 65 Years of History and Challenges from Brazil

Frazão

2022

IJERPH

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“…A baixa qualidade da informação em muitos municípios pode estar relacionada às dificuldades relativas à disponibilidade de recursos estruturais necessários para assegurar a alimentação adequada do sistema, tais como, computadores apropriados e acesso à internet no ambiente de trabalho 26 . Além disso, os desafios da sua estruturação, como a referência no registro dos dados e na transparência na divulgação de informações sobre o abastecimento de água no Brasil, também incluem a conscientização dos sujeitos envolvidos sobre a necessidade de inserção de dados no sistema e sua importância para o gerenciamento dos riscos à saúde associados ao abastecimento de água no país 8 .…”

Section: Discussionunclassified

Cobertura dos dados de fluoreto em sistemas de abastecimento de água usando o software R

et al. 2022

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OBJETIVO Apresentar um protocolo para a crítica dos dados sobre monitoramento do fluoreto na água com recursos de programação do software R, ilustrando sua aplicação para descrever a cobertura dos dados e a qualidade da fluoretação em 2015. MÉTODOS Foi utilizado big data proveniente do Sistema de Informação de Vigilância da Qualidade da Água para Consumo Humano que incluía todos os municípios brasileiros. Os procedimentos de crítica dos dados foram realizados com auxílio do software R. Aplicaram-se filtros para remover municípios com menos de quatro meses de registro (1), e registros com valores nulos (2) e aberrantes (3). Os municípios foram classificados quanto à presença de informações válidas e à qualidade da fluoretação segundo macrorregião, unidades da federação e porte populacional, apresentando-se o script em cada passo. RESULTADOS Foram analisados aproximadamente 134 mil registros. Dos municípios brasileiros, 39% possuíam dados sobre o parâmetro fluoreto e apenas 33,3% apresentaram quatro meses ou mais de frequência de informação. Após a aplicação dos filtros, 1.810 (32,5%) municípios apresentaram informação válida para o parâmetro fluoreto, com substancial variação entre as macrorregiões Sul (83,6%) e Norte (0,7%). Destes, 726 (40,1%) exibiram muito boa qualidade da fluoretação, determinada por 80% ou mais de registros dentro do intervalo concentração ótima para prevenção da cárie dentária, com valor mais alto (54,3%) nos municípios com 50 mil habitantes ou mais e mais baixo (34,2%) naqueles com menos de 10 mil habitantes. CONCLUSÕES Persistem importantes diferenças entre e dentro das macrorregiões brasileiras no que se refere tanto à disponibilidade da informação sobre o parâmetro quanto à qualidade da fluoretação da água nos sistemas de abastecimento público no Brasil. O protocolo para crítica e manuseio dos dados com recursos de programação do software R se mostrou bastante útil para produção de informação voltada a tomada de decisão ancorada em método padronizado.

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“…Even so, the analysis of the fluoride parameter was reduced, presenting an increase of only 3.8% in the years surveyed. The lack of analysis of the fluoride parameter in a municipality in the state of ES was also reported by Belotti et al (2019) through an interview with water surveillance system workers. Roncalli et al (2019), assessing municipalities with more than 50 thousand inhabitants in Brazil, observed a significant improvement in the registration of data on external control of water in the surveillance information system; however, the percentage of data referring to the analysis of the fluoride parameter was still deficient.…”

Section: Quality Of Fluoridationmentioning

confidence: 95%

“…Even with the better control of information in Sisagua found in this research, workers responsible for the Vigiagua Program in some municipalities that make up the Metropolitan health region also reported difficulties faced in the daily life of the sector, such as work overload, lack of initial training related to the activities of the water surveillance program, deficiency and structural limitation of the sector itself, lack of inputs in the laboratory responsible for the analyses and delay in the reports. The lack of disclosure of the results obtained through the external control process was also pointed out, showing an important noncompliance with the legislation (Belotti et al, 2019).…”

Section: Quality Of Fluoridationmentioning

confidence: 99%

“…According to the Inventory of the National Water Quality Surveillance Program for Human Consumption, some municipalities in the state of Acre, without data recorded in the surveillance system, reported the following difficulties: not having health surveillance actions, unavailability of internet and computers for registration of data generated by Vigiagua and lack of knowledge of the water surveillance program (Brasil, 2018). The reduced number of collaborators in the health surveillance team can interfere in the accomplishment of the activities of collecting and feeding the database, given the possible overload of functions that apply in carrying out all the actions inherent to the responsible sector, the low valuation of the professional and high turnover in teams, contributing to possible failures during the planning and analysis processes of the information generated (Campos et al, 2015;Belotti et al 2019).…”

Section: Quality Of Fluoridationmentioning

confidence: 99%

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Surveillance of public water supply fluoridation and municipal indicators: an analysis in the state of Espirito Santo, Brazil

Mendonça¹,

Martinelli²,

Esposti³

et al. 2021

Rev. ambiente água

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This study investigated the demographic, socioeconomic, and municipal health indicators related to the quality of water fluoridation. An ecological study was carried out in Espirito Santo state (ES), based on data from the Drinking Water Quality Surveillance Information, from 2014 to 2017. The non-parametric Mann-Whitney and Spearman tests were applied to compare municipal indicators with the availability of information and the quality of fluoridation, respectively. Fluoridation quality was calculated to define the percentage of fluoride concentration values in each municipality within the range of the optimal level corresponding to the maximum benefit for preventing dental caries and minimum risk for the occurrence of dental fluorosis. The proportion of 80% or more samples were defined as a compliance criterion. In 2014, 62.8% of the municipalities had information available, and 16.7% performed analyses of fluoride concentration. The percentage of available data increased about 30%, in 2017, with 3.8% referring to fluoride. The quality of fluoridation remained high (> 80%) in ES in almost every year, except in 2014. The municipalities with the largest population, the highest GDP per capita, and the lowest coverage of the oral health team exhibited a greater availability of information about fluoride (p <0.05). The child mortality rate showed a strong negative correlation with the quality of fluoridation. The findings reinforce the importance of directing public policies that ensure the correct practices for monitoring and maintaining the quality of fluoridation.

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Vigilância da qualidade da água para consumo humano: potencialidades e limitações com relação à fluoretação segundo os trabalhadores

Cited by 7 publications

References 17 publications

The Use of Fluorides in Public Health: 65 Years of History and Challenges from Brazil

The Use of Fluorides in Public Health: 65 Years of History and Challenges from Brazil

Cobertura dos dados de fluoreto em sistemas de abastecimento de água usando o software R

Surveillance of public water supply fluoridation and municipal indicators: an analysis in the state of Espirito Santo, Brazil

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