University of Brasília, Faculty of Ceilandia, Brasília, Brazil.
School of Health Sciences and State Secretariat of Health of the Federal District, Brasília, Brazil.
BMC Public Health. 2019 May 16;19(1):581. doi: 10.1186/s12889-019-6879-x.
The inadequate management of solid waste impacts populations' health and quality of life, and disproportionately affects developing countries. This study aims to describe a protocol for epidemiological diagnosis, the purpose being to estimate the prevalence of chronic and communicable and non communicable diseases in waste pickers, and the occupational and environmental risk factors to which these are exposed.
This is a cross-sectional study, based on survey design in an area of extreme social vulnerability - the largest garbage dump in Latin America. Using a multidimensional research protocol, divided in three stages: 1- The identification of the subjects, and the scheduling of tests; 2- Situational diagnosis through interviews, anthropometric evaluation, measuring blood pressure, collecting hair and nail samples to detect exposure to heavy metals and undertaking laboratory tests; 3- The return of the waste pickers to receive the test results, followed by referral to the health team and to report occupational accidents.
One thousand twenty-five waste pickers undertook tests and interviews. The majority were women (67.0%), with 36-45 years old (45.7%), and 96.0% had children. In total, 27.3% of the participants did not attend to any school and 47.7% were educated only up to primary level. The majority of waste pickers (68.70%) reported accidents and most of them (89.69%) were related to sharp objects. The mean time working in this open dump was 15 years. According the anthropometric measure, 32.6% were overweight and 21.1% were obese. The most common reported diseases were: osteomuscular disorders (78.7%); arboviruses (28.6%); episodic diarrhea (24.9%); hypertension (24.2%); bronchitis (14.3%); intestinal worms (12.6%) and diabetes (10.1%). According to the blood tests, the values outside the reference limits were: Uric acid (23.89%); creatinine (54.06%); GGT range (16.04%); SGOT - Serum Glutamic Oxaloacetic Transaminase (5.29%); SGPT - serum Glutamic-Pyruvic Transaminase (35.52%).
This study is the first to evaluate multiple risks and diseases in the majority of waste pickers working in the largest garbage dump of a continent. These findings highlight the importance to address urgently the environmental, social and health impacts related to the management of solid waste in developmental countries to protect these workers and their families.
固体废物管理不善会影响人口健康和生活质量，并对发展中国家造成不成比例的影响。本研究旨在描述一种流行病学诊断方案，目的是估计拾荒者中慢性和传染性及非传染性疾病的患病率，以及他们所接触的职业和环境风险因素。
这是一项基于横断面研究设计的研究，在社会极度脆弱的地区进行 - 拉丁美洲最大的垃圾场。采用多维研究方案，分为三个阶段：1. 确定研究对象并安排检查；2. 通过访谈、人体测量评估、测量血压、收集头发和指甲样本以检测重金属暴露情况以及进行实验室检查进行情况诊断；3. 让拾荒者返回以获取测试结果，然后将其转介给医疗团队，并报告职业事故。
共有 1025 名拾荒者接受了测试和访谈。大多数是女性（67.0%），年龄在 36-45 岁（45.7%），96.0%有子女。总的来说，27.3%的参与者没有上过学，47.7%只接受过小学教育。大多数拾荒者（68.70%）报告了事故，其中大多数（89.69%）与尖锐物体有关。他们在这个露天垃圾场工作的平均时间为 15 年。根据人体测量，32.6%超重，21.1%肥胖。报告的最常见疾病是：肌肉骨骼疾病（78.7%）；虫媒病毒（28.6%）；间歇性腹泻（24.9%）；高血压（24.2%）；支气管炎（14.3%）；肠道蠕虫（12.6%）和糖尿病（10.1%）。根据血液检查结果，超出参考范围的值为：尿酸（23.89%）；肌酐（54.06%）；GGT 范围（16.04%）；血清谷氨酸草酰乙酸转氨酶（5.29%）；血清谷氨酸丙酮酸转氨酶（35.52%）。
这是第一项评估在大陆最大垃圾场工作的大多数拾荒者的多种风险和疾病的研究。这些发现强调了迫切需要解决发展中国家固体废物管理方面的环境、社会和健康影响，以保护这些工人及其家人。
