UBIRATAN DE PAULA SANTOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Heart rate and ventilation in a group of burned sugar cane cutters (Brazil): Estimative of particulate matter (PM2,5) exposure load(2012) COZZA, Izabela; NAMBU, Danilo; FERNANDES, Frederico; BUSSACOS, Marcos; PACELI, Renato; PRADO, Gustavo; TERRA-FILHO, Mario; SANTOS, Ubiratan- Burnt Sugarcane Harvesting - Cardiovascular Effects on a Group of Healthy Workers, Brazil(2012) BARBOSA, Cristiane Maria Galvao; TERRA-FILHO, Mario; ALBUQUERQUE, Andre Luis Pereira de; GIORGI, Dante Di; GRUPI, Cesar; NEGRAO, Carlos Eduardo; RONDON, Maria Urbana Pinto Brandao; MARTINEZ, Daniel Godoy; MARCOURAKIS, Tania; SANTOS, Fabiana Almeida dos; BRAGA, Alfesio Luis Ferreira; ZANETTA, Dirce Maria Trevisan; SANTOS, Ubiratan de PaulaBackground: Brazil is the world's largest producer of sugarcane. Harvest is predominantly manual, exposing workers to health risks: intense physical exertion, heat, pollutants from sugarcane burning. Design: Panel study to evaluate the effects of burnt sugarcane harvesting on blood markers and on cardiovascular system. Methods: Twenty-eight healthy male workers, living in the countryside of Brazil were submitted to blood markers, blood pressure, heart rate variability, cardiopulmonary exercise testing, sympathetic nerve activity evaluation and forearm blood flow measures (venous occlusion plethysmography) during burnt sugarcane harvesting and four months later while they performed other activities in sugar cane culture. Results: Mean participant age was 31 +/- 6.3 years, and had worked for 9.8 +/- 8.4 years on sugarcane work. Work during the harvest period was associated with higher serum levels of Creatine Kinase - 136.5 U/L (IQR: 108.5-216.0) vs. 104.5 U/L (IQR: 77.5-170.5), (p = 0.001); plasma Malondialdehyde-7.5 +/- 1.4 mu M/dl vs. 6.9 +/- 1.0 mu M/dl, (p = 0.058); Glutathione Peroxidase - 55.1 +/- 11.8 Ug/Hb vs. 39.5 +/- 9.5 Ug/Hb, (p < 0.001); Glutathione Transferase- 3.4 +/- 1.3 Ug/Hb vs. 3.0 +/- 1.3 Ug/Hb, (p = 0.001); and 24-hour systolic blood pressure - 120.1 +/- 10.3 mmHg vs. 117.0 +/- 10.0 mmHg, (p = 0.034). In cardiopulmonary exercise testing, rest-to-peak diastolic blood pressure increased by 11.12 mmHg and 5.13 mmHg in the harvest and non-harvest period, respectively. A 10 miliseconds reduction in rMSSD and a 10 burst/min increase in sympathetic nerve activity were associated to 2.2 and 1.8 mmHg rises in systolic arterial pressure, respectively. Conclusion: Work in burnt sugarcane harvesting was associated with changes in blood markers and higher blood pressure, which may be related to autonomic imbalance.
- Tunnel excavation triggering pulmonary sarcoidosis(2012) KAWANO-DOURADO, L. B.; CARVALHO, C. R. R.; SANTOS, U. P.; CANZIAN, M.; COLETTA, E. N. A.; PEREIRA, C. A. C.; KAIRALLA, R. A.Context A definite cause of sarcoidosis has not been identified, however past research suggests that environmental factors may be triggers of the granulomatous response in genetically susceptible individuals. Case Presentation A 22-year-old male non-smoker, presented with progressive exertional dyspnea and cough of 3 months duration. One year before, when he started working in tunnel excavation, he had a normal chest radiograph. Chest imaging revealed bilateral nodules and masses of peribronchovascular distribution plus mediastinal lymphadenomegaly. Histologic lymph node analysis revealed non-caseating confluent granulomas. Sarcoidosis was diagnosed. The patient was treated with corticosteroids and advised to change jobs. Complete remission of the disease was achieved and persisted for at least one year without steroid treatment. Discussion Sarcoidosis is believed to have environmental triggers. The timing of the onset of sarcoidosis in this patient following intensive exposure to tunnel dust suggests an environmental contribution. The recognition that sarcoidosis may have occupational triggers have medical, employment, and legal implications. Am. J. Ind. Med. 55: 390-394, 2012. (C) 2011 Wiley Periodicals, Inc.
conferenceObject Prospective analysis among medical school of University of Sao Paulo: GHPSS (2008/2011)(2012) PACELI, Renato; MARTINS, Stella; PRADO, Gustavo; MORAIS, Anna; LOMBARDI, Elisa; FERNANDES, Frederico; TERRA-FILHO, Mario; SANTOS, Ubiratan- Health Risks and Economic Costs of Absenteeism Due to Air Pollution in Sao Paulo, Brazil(2012) RODRIGUES-SILVA, Fernando; SANTOS, Ubiratan de Paula; SALDIVA, Paulo Hilario Nascimento; AMATO-LOURENCO, Luis Fernando; MIRAGLIA, Simone Georges El KhouriThis study aims to estimate the health risks and economic losses due to the effects of air pollution, with a focus on traffic controllers, and to estimate the associated costs through the use of work loss days (WLD) as an indicator of morbidity in Sao Paulo from 2000 to 2007. The association between traffic controllers' absenteeism and air pollution was determined by generalized linear models (GLM). The increase in relative risk for WLD was 2.08 (95% CI: 2.04-2.12) per 10 mu g/m(3) PM10, which in monetary terms represented 9,430 USD/year, equivalent to 133 absences per 1,308 traffic controllers annually that are attributable to air pollution (accumulated total cost was USD 75,439, which was 19% of the company's operational expenses during the period). These results were extrapolated for the economically active population, and we found that air pollution resulted in 129,832 absences/year and a cost of USD 6,472,686 (77% related to lost wages) per 3,555,237 workers. The estimated values are relevant for planning environmental policies, and are sufficient to promote corrective and preventive actions to avoid this externality.
- Smoking: What Has Been Addressed in Brazilian Journals(2012) PRADO, Gustavo Faibischew; LOMBARDI, Elisa Maria Siqueira; MORAIS, Anna Miethke; MARTINS, Stella Regina; SANTOS, Ubiratan de PaulaThe topic of tobacco smoking, in its several aspects, has been receiving increasing attention among researchers over the past few years, which has been reflected in more data and more solid scientific literature on the subject in national journals. This article aims to review the studies that focused on smoking published between January 2010 and June 2012, in Arquivos Brasileiros de Cardiologia (Brazilian Archives of Cardiology), Brazilian Journal of Medical and Biological Research, Clinics (Sao Paulo), Jornal Brasileiro de Pneumologia (Brazilian Journal of Pulmonology), Revista da Associacao Medica Brasileira (Journal of the Brazilian Medical Association) and Revista Brasileira de Cirurgia Cardiovascular (Brazilian Journal of Cardiovascular Surgery). During the aforementioned period 58 articles were published, 52 of which were original ones, addressing several aspects of smoking, such as effects on health, epidemiology, cessation and experimental studies.
- Burnt sugarcane harvesting: Particulate matter exposure and the effects on lung function, oxidative stress, and urinary 1-hydroxypyrene(2012) PRADO, Gustavo Faibischew; ZANETTA, Dirce Maria Trevisan; ARBEX, Marcos Abdo; BRAGA, Alfesio Luis; PEREIRA, Luiz Alberto Amador; MARCHI, Mary Rosa Rodrigues de; LOUREIRO, Ana Paula de Melo; MARCOURAKIS, Tania; SUGAUARA, Lucy Elaine; GATTAS, Gilka Jorge Figaro; GONCALVES, Fernanda Toledo; SALGE, Joao Marcos; TERRA-FILHO, Mario; SANTOS, Ubiratan de PaulaNon-mechanised sugarcane harvesting preceded by burning exposes workers and the people of neighbouring towns to high concentrations of pollutants. This study was aimed to evaluate the respiratory symptoms, lung function and oxidative stress markers in sugarcane workers and the residents of Mendonca, an agricultural town in Brazil, during the non-harvesting and harvesting periods and to assess the population and individual exposures to fine particulate matter (PM2.5). Sugarcane workers and healthy volunteers were evaluated with two respiratory symptom questionnaires, spirometry, urinary 1-hydroxypyrene levels, and the measurement of antioxidant enzymes and plasma malonaldehyde during the non-harvesting and harvesting periods. The environmental assessment was determined from PM2.5 concentration. PM2.5 level increased from 8 mu g/m(3) during the non-harvesting period to 23.5 mu g/m(3) in the town and 61 mu g/m(3) on the plantations during the harvesting period. Wheezing, coughing, sneezing, and breathlessness increased significantly in both groups during the harvesting period, but more markedly in workers. A decrease in lung function and antioxidant enzyme activity was observed in both populations during harvesting; this decrease was greater among the sugarcane workers. The urinary 1-hydroxypyrene levels only increased in the sugarcane workers during the harvesting period. The malonaldehyde levels were elevated in both groups, with a higher increase observed in the workers. This research demonstrates the exposure of sugarcane workers and the inhabitants of a neighbouring town to high PM2.5 concentrations during the sugarcane harvest period. This exposure was higher among the sugarcane workers, as illustrated by both higher PM2.5 concentrations in the sugarcane fields and higher urinary 1-hydroxypyrene levels in the volunteers in this group. The higher incidence of respiratory symptoms, greater decrease in lung function and more marked elevation of oxidative stress markers among the sugarcane workers during the harvest confirms the greater effect magnitude in this population and a dose-dependent relationship between pollution and the observed effects.
- A poluição do ar e o sistema respiratório(2012) ARBEX, Marcos Abdo; SANTOS, Ubiratan de Paula; MARTINS, Lourdes Conceicao; SALDIVA, Paulo Hilario Nascimento; PEREIRA, Luiz Alberto Amador; BRAGA, Alfesio Luis FerreiraOver the past 250 years since the Industrial Revolution accelerated the process of pollutant emission, which, until then, had been limited to the domestic use of fuels (mineral and vegetal) and intermittent volcanic emissions air pollution has been present in various scenarios. Today, approximately 50% of the people in the world live in cities and urban areas and are exposed to progressively higher levels of air pollutants. This is a non-systematic review on the different types and sources of air pollutants, as well as on the respiratory effects attributed to exposure to such contaminants. Aggravation of the symptoms of disease, together with increases in the demand for emergency treatment, the number of hospitalizations, and the number of deaths, can be attributed to particulate and gaseous pollutants, emitted by various sources. Chronic exposure to air pollutants not only causes decompensation of pre-existing diseases but also increases the number of new cases of asthma, COPD, and lung cancer, even in rural areas. Air pollutants now rival tobacco smoke as the leading risk factor for these diseases. We hope that we can impress upon pulmonologists and clinicians the relevance of investigating exposure to air pollutants and of recognizing this as a risk factor that should be taken into account in the adoption of best practices for the control of the acute decompensation of respiratory diseases and for maintenance treatment between exacerbations.