ALFESIO LUIS FERREIRA BRAGA
Projetos de Pesquisa
Unidades Organizacionais
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
9 resultados
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- Ambient levels of air pollution induce clinical worsening of blepharitis(2012) MALERBI, Fernando Korn; MARTINS, Lourdes Conceicao; SALDIVA, Paulo Hilario Nascimento; BRAGA, Alfesio Luis FerreiraBackground: Even though air pollutants exposure is associated with changes in the ocular surface and tear film, its relationship to the clinical course of blepharitis, a common eyelid disease, had not yet been investigated. Our objective was to investigate the correlation between air pollution and acute manifestations of blepharitis. Method: We recorded all cases of changes in the eyelids and ocular surface, and rated clinical findings on a scale from zero (normal) to two (severe alterations). Daily values of carbon monoxide, particulate matter smaller than 10 mu m in diameter and nitrogen dioxide concentrations and meteorological variables (temperature and relative humidity) in the vicinity of the medical service were obtained. Specific linear regression models for each outcome were constructed including pollutants as independent variables (single pollutant models). Temperature and humidity were included as confounding variables. Results: increases of 28.8 mu g/m(3) in the concentration of particulate matter and 1.1 ppm in the concentration of CO were associated with increases in cases of blepharitis on the day of exposure (5 cases, 95% CI: 1-10 and 6 cases, 95% CI: 1-12, respectively). Conclusion: Exposure to usual air pollutants concentrations present in large cities affects, in a consistent manner, the eyes of residents contributing to the increasing incidence of diseases of the eyelid margin.
- 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.
conferenceObject Inflammation in traffic professional from Sao Paulo after pollutants emission control implementation(2012) GARCIA, Maria Lucia Bueno; MARTINS, Lourdes Conceicao; BRAGA, Alfesio; LEMOS, Miriam; PEREIRA, Luis; AFONSO, Paulo; SALDIVA, Paulo; UBIRATAN, Paula Santos- Avaliação da qualidade de vida relacionada à saúde de cortadores de cana-de-açúcar nos períodos de entressafra e safra(2012) CARVALHO JUNIOR, Luiz Carlos Soares de; RAMOS, Ercy Mara Cipulo; TOLEDO, Alessandra Choqueta de; CECCATO, Aline Duarte Ferreira; MACCHIONE, Mariangela; BRAGA, Alfesio Luis Ferreira; RAMOS, DioneiOBJECTIVE: To assess health-related quality of life in sugarcane cutters. METHODS: Longitudinal study conducted in a sugar and ethanol plant located in the western region of the State of Sao Paulo (Southeastern Brazil) from April (pre-harvest) to October (harvest) 2010. A total of 44 sugarcane cutters, smokers and non-smokers, was evaluated in three periods: pre-harvest, at the end of the third month during harvest and at the end of harvest. Health-related quality of life was assessed by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Analysis of variance for repeated measures and the Friedman test were performed to compare quality of life among the periods. To identify the frequency of workers whose score increased in the harvest periods compared to pre-harvest (positive responders), the Goodman test was used, considering the qualitative variables of the SF-36 domains. RESULTS: At the end of pre-harvest, 23% workers drop out of work; 27% were smokers. There was a significant decrease in the vitality domain at the end of harvest compared to pre-harvest. The dropouts presented higher score in the social aspect domain compared to the group that remained working. There was no difference in health-related quality of life between smokers and non-smokers. However, there was a higher percentage of positive responders among non-smokers in the physical, social and emotional domains in the third month of harvest and in the general health status and social domains at the end of harvest, compared to smokers. CONCLUSIONS: Health-related quality of life in sugarcane cutters was reduced after the harvest period in the vitality domain. The individuals who remained working during harvest are those with lower scores for social aspects, which demonstrates the need to promote health assistance policies for this specific population, particularly during sugar harvest.
- 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.
conferenceObject Exhaled nitric oxide in traffic professionals exposed to ambient urban air pollution(2012) OSHIRO, Claudia; KOGISO, Diogo; ROMANHOLO, Beatriz; MARTINS, Lourdes; BRAGA, Alfesio; SALDIVA, Paulo; GARCIA, Maria- 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.
- Redação e literatura científica Resultados – “Chegou a hora desta gente bronzeada mostrar seu valor”(2012) BRAGA, Alfesio Luis Ferreira
- Atmospheric pollution: influence on hospital admissions in paediatric rheumatic diseases(2012) VIDOTTO, J. P.; PEREIRA, L. A. A.; BRAGA, A. L. F.; SILVA, C. A.; SALLUM, A. M.; CAMPOS, L. M.; MARTINS, L. C.; FARHAT, S. C. L.Objective: To investigate the lag structure effects from exposure to atmospheric pollution in acute outbursts in hospital admissions of paediatric rheumatic diseases (PRDs). Methods: Morbidity data were obtained from the Brazilian Hospital Information System in seven consecutive years, including admissions due to seven PRDs (juvenile idiopathic arthritis, systemic lupus erythematosus, dermatomyositis, Henoch-Schonlein purpura, polyarteritis nodosa, systemic sclerosis and ankylosing spondylitis). Cases with secondary diagnosis of respiratory diseases were excluded. Daily concentrations of inhaled particulate matter (PM10), sulphur dioxide (SO2) nitrogen dioxide (NO2), ozone (O-3) and carbon monoxide (CO) were evaluated. Generalized linear Poisson regression models controlling for short-term trend, seasonality, holidays, temperature and humidity were used. Lag structures and magnitude of air pollutants' effects were adopted to estimate restricted polynomial distributed lag models. Results: The total number of admissions due to acute outbursts PRD was 1,821. The SO2 interquartile range (7.79 mu g/m(3)) was associated with an increase of 1.98% (confidence interval 0.25-3.69) in the number of hospital admissions due to outcome studied after 14 days of exposure. This effect was maintained until day 17. Of note, the other pollutants, with the exception of O-3, showed an increase in the number of hospital admissions from the second week. Conclusion: This study is the first to demonstrate a delayed association between SO2 and PRD outburst, suggesting that oxidative stress reaction could trigger the inflammation of these diseases. Lupus (2012) 21, 526-533.