Os determinantes sociais de saúde e o uso de agrotóxicos por produtores de hortaliças que atuam em feira do produtor rural em uma cidade na Amazônia brasileira

Abstract

The social determinants of health according to the WHO are related to the conditions in which a person lives and works. Social, economic, cultural, ethnic/racial, psychological and behavioral factors that influence the occurrence of health problems and risk factors for the population, such as housing, food, education, income and employment, can also be considered. In addition to the working conditions and environments, which are often involved in the use of pesticides, which can generate acute intoxication manifested by numerous symptoms. For this reason, this study aimed to characterize the environment and working conditions and the risks inherent in the labor activity, as well as describe the social determinants of health of family farm workers who work at the buritizal fair, evaluating the prevalence of self-reported symptoms and the reason for prevalence between use/non-use of pesticides with self-reported symptoms. A qualitative and quantitative descriptive and cross-sectional study was carried out with application of a form to workers (n=36) to verify social determinants of health, use of pesticides and the perception of symptoms related to pesticide poisoning. The variables use/non-use of pesticides and reported symptoms were submitted to Poisson regression with robust variance in order to identify the prevalence ratio, considering results with statistical significance of α ≤ 0.05 and p<0.05 and confidence interval of 95%. In addition, a visit was made to the farmers' production area in order to verify distortions to work safety that could be a risk factor for accidents or work-related illnesses. The average age of farmers is 47.72 years. 50% are male and another 50% female. 80.55% call themselves brown. 16.7% claim to be smokers, 52.8% drinkers and 52.8% claim to have no leisure activity. 41.7% are people who studied 4 years or less. Regarding income, 63.88% live on less than R$ 15.00 per capita per day. 44.40% claim to have a 6/6 month visit with a health professional, but 52.88% think that the health services offered are very bad. 91.7% say they do not have treated water by the Amapá supply company and 100% do not have sewage treatment available. Only 36.1% have regular garbage collection and 38.9% of the houses are in masonry. 63.9% claim to use some type of pesticide. 83.3% think that the use of these products can be harmful to health. 72.2% reported having a headache; 66.7% forgetfulness; 63.9% vertigo/dizziness; 61.1% cramps, 61.1% blurred vision; 55.6% burning eyes and 55.6% irritability. There were no statistically significant correlations between the use of pesticides and symptoms of acute intoxication considering the p value <0.05 and 95% confidence interval. Regarding working conditions and work environment, exposure of workers to physical risks (heat) without the use of PPE, chemicals (pesticides), ergonomic and work organization risks was identified. The results show that the use of pesticides is high and there is a high prevalence of symptoms among farmers; these were not statistically significant with the variable use/not of pesticides, but they may be linked to the work environment that has numerous risk factors for accidents and illness, in addition to the SDH that impact so that there is an imbalance in the health-disease process.