Postgraduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
Center for Health Sciences, Federal University of Espírito Santo, Vitória, Brazil.
PLoS One. 2019 Nov 19;14(11):e0225416. doi: 10.1371/journal.pone.0225416. eCollection 2019.
To estimate the prevalence of multimorbidity and complex multimorbidity in rural workers and their association with sociodemographic characteristics, occupational contact with pesticides, lifestyle and clinical condition.
This is a cross-sectional epidemiological study with 806 farmers from the main agricultural municipality of the state of Espírito Santo/Brazil, conducted from December 2016 to April 2017. Multimorbidity was defined as the presence of two or more chronic diseases in the same individual, while complex multimorbidity was classified as the occurrence of three or more chronic conditions affecting three or more body systems. Socio-demographic data, occupational contact with pesticides, lifestyle data and clinical condition data were collected through a structured questionnaire. Binary logistic regression was conducted to identify risk factors for multimorbidity.
The prevalence of multimorbidity among farmers was 41.5% (n = 328), and complex multimorbidity was 16.7% (n = 132). More than 77% of farmers had at least one chronic illness. Hypertension, dyslipidemia and depression were the most prevalent morbidities. Being 40 years or older (OR 3.33, 95% CI 2.06-5.39), previous medical diagnosis of pesticide poisoning (OR 1.89, 95% CI 1.03-3.44), high waist circumference (OR 2.82, CI 95% 1.98-4.02) and worse health self-assessment (OR 2.10, 95% CI 1.52-2.91) significantly increased the chances of multimorbidity. The same associations were found for the diagnosis of complex multimorbidity.
We identified a high prevalence of multimorbidity and complex multimorbidity among the evaluated farmers. These results were associated with increased age, abdominal fat, pesticide poisoning, and poor or fair health self-assessment. Public policies are necessary to prevent, control and treat this condition in this population.
评估农村工人的多种疾病和复杂多种疾病的患病率及其与社会人口统计学特征、职业性接触杀虫剂、生活方式和临床状况的关系。
这是一项横断面流行病学研究，对象为巴西圣埃斯皮里图州主要农业市的 806 名农民，研究于 2016 年 12 月至 2017 年 4 月进行。多种疾病定义为同一人存在两种或两种以上的慢性疾病，而复杂多种疾病则定义为三种或三种以上影响三个或三个以上身体系统的慢性疾病的发生。通过结构化问卷收集社会人口统计学数据、职业性接触杀虫剂、生活方式数据和临床状况数据。采用二元逻辑回归分析确定多种疾病的危险因素。
农民多种疾病的患病率为 41.5%（n=328），复杂多种疾病的患病率为 16.7%（n=132）。超过 77%的农民至少有一种慢性疾病。高血压、血脂异常和抑郁症是最常见的疾病。40 岁或以上（OR 3.33，95%CI 2.06-5.39）、以前有农药中毒的医学诊断（OR 1.89，95%CI 1.03-3.44）、高腰围（OR 2.82，95%CI 1.98-4.02）和较差的健康自评（OR 2.10，95%CI 1.52-2.91）显著增加了多种疾病的患病风险。复杂多种疾病的诊断也存在同样的关联。
我们发现，在所评估的农民中，多种疾病和复杂多种疾病的患病率较高。这些结果与年龄增长、腹部脂肪堆积、农药中毒和健康自评较差有关。需要制定公共政策来预防、控制和治疗这一人群的这种疾病。
