Artigos e Materiais de Revistas Científicas - ODS/13

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.

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Rapid increase in the risk of heat-related mortality
(2023) LUTHI, Samuel; FAIRLESS, Christopher; FISCHER, Erich M.; SCOVRONICK, Noah; COELHO, Micheline De Sousa Zanotti Stagliorio; GUO, Yue Leon; GUO, Yuming; HONDA, Yasushi; HUBER, Veronika; KYSELY, Jan; LAVIGNE, Eric; ROYE, Dominic; RYTI, Niilo; SILVA, Susana; URBAN, Ales; GASPARRINI, Antonio; BRESCH, David N.; VICEDO-CABRERA, Ana M.
Heat-related mortality has been identified as one of the key climate extremes posing a risk to human health. Current research focuses largely on how heat mortality increases with mean global temperature rise, but it is unclear how much climate change will increase the frequency and severity of extreme summer seasons with high impact on human health. In this probabilistic analysis, we combined empirical heat-mortality relationships for 748 locations from 47 countries with climate model large ensemble data to identify probable past and future highly impactful summer seasons. Across most locations, heat mortality counts of a 1-in-100 year season in the climate of 2000 would be expected once every ten to twenty years in the climate of 2020. These return periods are projected to further shorten under warming levels of 1.5 ? and 2 ?, where heat-mortality extremes of the past climate will eventually become commonplace if no adaptation occurs. Our findings highlight the urgent need for strong mitigation and adaptation to reduce impacts on human lives.
The World Organization of Family Doctors Air Health Train the Trainer Program: lessons learned and implications for planetary health education
(2023) MCGUSHIN, Alice; BARROS, Enrique Falceto de; FLOSS, Mayara; MOHAMMAD, Yousser; NDIKUM, Achiri E.; NGENDAHAYO, Christophe; ODUOR, Peter A.; SULTANA, Sadia; WONG, Rachel; ABELSOHN, Alan
The World Organization of Family Doctors (WONCA) Air Health Train the Trainer Program was a pilot educational programme that focused on a key aspect of planetary health: the intersection of air pollution, human health, and climate change. In this Viewpoint, we-the coordinators of the training programme and some of the most active trainers-briefly describe the programme and discuss implementation successes, challenges, and lessons learned, which relate to the creation and use of training materials appropriate for health professionals in low-income and middle-income countries, strategies to improve the retention of trainers to deliver activities in their communities, and the development of stronger networks and further tools to support trainers. These findings could be applied to future education and training programmes.
Commentaries on Viewpoint: Hoping for the best, prepared for the worst: can we perform remote data collection in sport sciences?
(2022) CARNEIRO, M. A. S.; NUNES, P. R. P.; COSTA, B.; CASTRO-E-SOUZA, P.; LIMA, L. A.; LISBOA, F.; OLIVEIRA, G.; KASSIANO, W.; CYRINO, E. S.; ORSATTI, F. L.
to the editor: Remote data collection (1) is of growing interest, especially in sport nutrition, whereby a specific diet and/or supplement is prescribed in conjunction with exercise training. Verifying adherence to prescribed interventions and estimation of dietary intake is paramount. Food diaries, dietary recall, and remote food photography methods (2) are already commonplace for monitoring dietary intake with the integration of training data (i.e., power output, heart rate) collected from online platforms (e.g., TrainingPeaks, Strava) connected to participants’ own sports equipment (3) permitting the estimation of daily energy expenditure remotely (4). Researchers may therefore bridge the gap between laboratory and techniques classically used in field situations without the need for expensive laboratory equipment. It may also facilitate greater participation and compliance. For example, in a study by Bennett et al. (3), 495 training sessions and 165 testing sessions were performed remotely by 55 participants within a 2-mo period of national lockdown due to the COVID-19 pandemic. However, it is important to ensure that standardization and quality control are maintained across all participants, by providing clear instructions and frequent contact points. Familiarization sessions should be scheduled and used to verify the reliability of procedures. It is also recommended that all training and dietary intake data be visually inspected (i.e., review raw data) to ensure that protocols are followed correctly. Finally, when additional metabolic or body composition measurement is required, we suggest combining online training and nutritional prescription with laboratory-based testing (5). At a time where we all need to reduce our carbon footprint, remote data collection appears more relevant than ever. © IMechE 2018.
Climate awareness, anxiety, and actions among youth: a qualitative study in a middle-income country
(2023) CHOU, Debora Tseng; NETO, Emilio Abelama; THOMAS, Isaiah; MARTIN, Andres; BENOIT, Laelia
Objectives: The impact of climate change on mental health is well established, but few studies have examined the perspectives of young people, especially in low-and middle-income countries (LMICs). In this qualitative study, we explored how Brazilian children and adolescents experience climate change. This approach can help inform environmental education, communication, and self-care strategies for this age group. Methods: We conducted focus groups with 50 children and adolescents aged 5 to 18 years in three locations in Brazil. We analyzed the data using an interpretative phenomenological analysis framework. Results: We identified three profiles of involvement with climate change: unaware, disengaged, and engaged. Profiles were largely related to different socioeconomic contexts. We analyzed each profile across the dimensions of space, time, emotions, and actions. Adults were portrayed by participants as stubborn deniers, as neutral influences, or as role models of knowledge and engagement. Due to their age and developmental level, young children had distinctive perceptions of climate change. Conclusion: Spatial and temporal perceptions of climate change are a key element for experiencing and engaging with environmental concerns and vary according to age and socioeconomic differences. Effective communication to foster climate action at individual and collective levels requires narratives that reach different ages. Replication of these findings in other LMICs is warranted.
Life Cycle Assessment Applied to End-of-Life Scenarios of Sargassum spp. for Application in Civil Construction
(2023) BUENO, Cristiane; ROSSIGNOLO, Joao Adriano; GAVIOLI, Leticia Missiatto; SPOSITO, Camila Cassola Assuncao; TONIN, Fernando Gustavo; VERAS, Mariana Matera; MORAES, Maria Julia Bassan de; LYRA, Gabriela Pitolli
Environmental risks and vulnerabilities in coastal regions include the massive deposits of brown algae of the genus Sargassum in regions such as the Caribbean, Gulf of Mexico, and northern Brazil. Efforts have been made to turn this problem into an opportunity by seeking new uses for this biomass in the sectors of food, agriculture, health, biofuels, bioremediation, and civil construction. Thus, this study aimed to produce quantitative data for different end-of-life scenarios of the Sargassum algae, seeking for potential applications of this macroalgae in the civil construction sector. For this purpose, we conducted a life cycle assessment (LCA) study of the Sargassum algae, in its natural destination, and evaluated its potential impact. This evaluation was then compared to the possible impacts of alternatives to their end of life, such as landfill disposal, drying and grinding to use as fibers or particles, burning the biomass to generate energy and fly ash, using a consequential LCA and the indicators of the ReCiPe 2016 method. For each of the proposed scenarios, the functional unit of 1 kg of the three types of unprocessed Sargassum algae that are found in the Brazilian deposits (natans I, natans VIII, and fluitans) was considered separately, and also for a composition that is closer to that found in the Brazilian deposits (50% fluitans, 15% natans I, and 35% natans VIII). The results for both natural decomposition scenarios demonstrated a dominant contribution to the categories of impact for climate change, marine eutrophication, and land use, thus justifying the search for new initiatives for the use of the algae. The burning process showed a significant contribution to most of the indicators, with emphasis on the massive generation of particulate, inherent to the biomass burning process; however, it showed a reduction in the magnitude of climate change emissions from around 47% to less than 2%. Finally, the proposed scenario of processing Sargassum biomass to obtain particles presented prevalence of magnitude for potential impact in most of the proposed indicators, due to the processes with high electricity consumption, but keeping climate change emissions' relative reduction from 47% to 6%. Thus, new studies may further investigate the potential of application of these materials in different products and components of civil construction.
Heat exposure and hospitalisation for epileptic seizures: A nationwide case-crossover study in Brazil
(2023) ZHANG, Yiwen; XU, Rongbin; YE, Tingting; YU, Wenhua; YU, Pei; CHEN, Zhuying; MAHENDRAN, Rahini; SALDIVA, Paulo Hilario Nascimento; COEL, Micheline de Sousa Zanotti Stagliorio; GUO, Yuming; LI, Shanshan
Climate change is increasing human exposure to heat, especially in tropical regions such as Brazil where temperature reaches up to 40 degrees C in summer. However, the association between heat exposure and epileptic seizures has not been well demonstrated in Brazil, where lifetime preva-lence of epilepsy can range from 11.9/1000 to 21/1000. We collected a total of 225,699 hospi-talisation records for epileptic seizures of 1816 municipalities in Brazil, during the hot season from 2000 to 2015, covering nearly 79% of the national population. We implemented a time -stratified case-crossover design combined with distributed lag model with further stratified in-vestigations regarding sex, age, socioeconomic status and region. We found temperature impact threshold was 26 degrees C in Brazil nationally. Every 1 degrees C increase from the threshold was associated with an overall 4.3% increased risk of hospitalisation for epileptic seizures on the current day of hospital admission and up to seven days before, which was most pronounced on the second-day exposure to heat. Females, individuals aged 20-30 and persons living in high-income or Southeast regions were more vulnerable. Our results highlight the enhanced risk of heat exposure for epi-lepsy patients and could contribute to epilepsy management, such as forecasting epileptic sei-zures. Multi-dimensional adaptive strategies were proposed, covering individual protection, occupational health surveillance, and urban planning management, aiming to reduce heat -induced hospitalisations for epilepsy, and be generalizable to other heat-related diseases.
Modification of temperature-related human mortality by area-level socioeconomic and demographic characteristics in Latin American cities
(2023) BAKHTSIYARAVA, Maryia; SCHINASI, Leah H.; SANCHEZ, Brisa N.; DRONOVA, Iryna; KEPHART, Josiah L.; JU, Yang; GOUVEIA, Nelson; CAIAFFA, Waleska Teixeira; O'NEILL, Marie S.; YAMADA, Goro; ARUNACHALAM, Sarav; DIEZ-ROUX, Ana V.; RODRIGUEZ, Daniel A.
Background: In Latin America, where climate change and rapid urbanization converge, non-optimal ambient temperatures contribute to excess mortality. However, little is known about area-level characteristics that confer vulnerability to temperature-related mortality. Objectives: Explore city-level socioeconomic and demographic characteristics associated with temperature-related mortality in Latin American cities. Methods: The dependent variables quantify city-specific associations between temperature and mortality: heatand cold-related excess death fractions (EDF, or percentages of total deaths attributed to cold/hot temperatures), and the relative mortality risk (RR) associated with 1 degrees C difference in temperature in 325 cities during 2002-2015. Random effects meta-regressions were used to investigate whether EDFs and RRs associated with heat and cold varied by city-level characteristics, including population size, population density, built-up area, age-standardized mortality rate, poverty, living conditions, educational attainment, income inequality, and residential segregation by education level. Results: We find limited effect modification of cold-related mortality by city-level demographic and socioeconomic characteristics and several unexpected associations for heat-related mortality. For example, cities in the highest compared to the lowest tertile of income inequality have all-age cold-related excess mortality that is, on average, 3.45 percentage points higher (95% CI: 0.33, 6.56). Higher poverty and higher segregation were also associated with higher cold EDF among those 65 and older. Large, densely populated cities, and cities with high levels of poverty and income inequality experience smaller heat EDFs compared to smaller and less densely populated cities, and cities with little poverty and income inequality. Discussion: Evidence of effect modification of cold-related mortality in Latin American cities was limited, and unexpected patterns of modification of heat-related mortality were observed. Socioeconomic deprivation may impact cold-related mortality, particularly among the elderly. The findings of higher levels of poverty and income inequality associated with lower heat-related mortality deserve further investigation given the increasing importance of urban adaptation to climate change.
Association Between Hydrological Conditions and Dengue Fever Incidence in Coastal Southeastern China From 2013 to 2019
(2023) LI, Chuanxi; WANG, Zhendong; YAN, Yu; QU, Yinan; HOU, Liangyu; LI, Yijie; CHU, Cordia; WOODWARD, Alistair; SCHIKOWSKI, Tamara; SALDIVA, Paulo Hilario Nascimento; LIU, Qiyong; ZHAO, Qi; MA, Wei
IMPORTANCE Dengue fever is a climate-sensitive infectious disease. However, its association with local hydrological conditions and the role of city development remain unclear. OBJECTIVE To quantify the association between hydrological conditions and dengue fever incidence in China and to explore the modification role of city development in this association. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study collected data between January 1, 2013, and December 31, 2019, from 54 cities in 4 coastal provinces in southeast China. The Standardized Precipitation Evapotranspiration Index (SPEI) was calculated from ambient temperature and precipitation, with SPEI thresholds of 2 for extreme wet conditions and -2 for extreme dry conditions. The SPEI-dengue fever incidence association was examined over a 6-month lag, and the modification roles of 5 city development dimensions were assessed. Data were analyzed in May 2022. EXPOSURES City-level monthly temperature, precipitation, SPEI, and annual city development indicators from 2013 to 2019. MAIN OUTCOMES AND MEASURES The primary outcome was city-level monthly dengue fever incidence. Spatiotemporal bayesian hierarchal models were used to examine the SPEI-dengue fever incidence association over a 6-month lag period. An interaction term between SPEI and each city development indicator was added into the model to assess the modification role of city development. RESULTS Included in the analysis were 70 006 dengue fever cases reported in 54 cities in 4 provinces in China from 2013 to 2019. Overall, a U-shaped cumulative curve was observed, with wet and dry conditions both associated with increased dengue fever risk. The relative risk [RR] peaked at a 1-month lag for extreme wet conditions (1.27; 95% credible interval [CrI], 1.05-1.53) and at a 6-month lag for extreme dry conditions (1.63; 95% CrI, 1.29-2.05). The RRs of extreme wet and dry conditions were greater in areas with limited economic development, health care resources, and income per capita. Extreme dry conditions were higher and prolonged in areas with more green space per capita (RR, 1.84; 95% CrI, 1.37-2.46). Highly urbanized areas had a higher risk of dengue fever after extreme wet conditions (RR, 1.80; 95% CrI, 1.26-2.56), while less urbanized areas had the highest risk of dengue fever in extreme dry conditions (RR, 1.70; 95% CrI, 1.11-2.60). CONCLUSIONS AND RELEVANCE Results of this study showed that extreme hydrological conditions were associated with increased dengue fever incidence within a 6-month lag period, with different dimensions of city development playing various modification roles in this association. These findings may help in developing climate change adaptation strategies and public health interventions against dengue fever.
Food consumption in Brazil: influence of beef on environmental impact and nutritional quality of the diet
(2022) GARZILLO, Josefa Maria Fellegger; POLI, Vanessa Fadanelli Schoenardie; LEITE, Fernanda Helena Marrocos; STEELE, Euridice Martinez; MACHADO, Priscila Pereira; LOUZADA, Maria Laura da Costa; LEVY, Renata Bertazzi; MONTEIRO, Carlos Augusto
OBJECTIVE: To estimate beef consumption and its influence on carbon and water footprints, as well as to improve the nutritional quality of the Brazilian diet.METHODS: The amount of beef and other foods consumed was evaluated by two 24-hour food records in a representative sample of the Brazilian population >= 10 years of age (n = 32,853) from 2008 to 2009. The environmental impact of the diet considered the coefficients of the carbon footprint (gCO2and/kg) and the water footprint (liters/kg) of the foods, as well as their nutritional quality considering the nutrient composition of each food associated with the prevention of nutritional deficiencies or the increase/decrease in chronic disease risk. Linear and logistic regression models, crude and adjusted for sex, age, education, income, region, and area, were used to respectively study the association of fifths of the caloric contribution of beef with the environmental impacts of the diet and inadequate nutrient intake.RESULTS: Carbon and water footprints and protein, iron, zinc, vitamin B12, saturated fat, and sodium contents were higher in the fraction of the diet composed of beef, whereas fiber and added sugar contents were higher in the fraction composed by the other foods. Dietary beef contribution was directly associated with the carbon and water footprints of the diet and the risk of saturated fat and sodium excess, besides fiber insufficiency, inversely associated with the risk of protein, iron, zinc, and vitamin B12 insufficiency.CONCLUSION: Reducing beef consumption in Brazil would also reduce the carbon and water footprints of the diet, as well as the risk of chronic diseases related to food. Therefore, in order not to increase the risk of nutritional deficiencies, monitoring the increased intake of other foods rich in protein, iron, zinc, and vitamin B12 is suggested.
Association between ambient temperature and hospitalization for renal diseases in Brazil during 2000-2015: A nationwide case-crossover study
(2022) WEN, Bo; XU, Rongbin; WU, Yao; COELHO, Micheline de Sousa Zanotti Stagliorio; SALDIVA, Paulo Hilario Nascimento; GUO, Yuming; LI, Shanshan
Background Climate change is increasing the risks of injuries, diseases, and deaths globally. However, the association between ambient temperature and renal diseases has not been fully characterized. This study aimed to quantify the risk and attributable burden for hospitalizations of renal diseases related to ambient temperature. Methods Daily hospital admission data from 1816 cities in Brazil were collected during 2000 and 2015. A time-stratified case-crossover design was applied to evaluate the association between temperature and renal diseases. Relative risks (RRs), attributable fractions (AFs), and their confidence intervals (CIs) were calculated to estimate the associations and attributable burden. Findings A total of 2,726,886 hospitalizations for renal diseases were recorded during the study period. For every (1) over barC increase in daily mean temperature, the estimated risk of hospitalization for renal diseases over lag 0-7 days increased by 0 center dot 9% (RR = 1 center dot 009, 95% CI: 1 center dot 008-1 center dot 010) at the national level. The associations between temperature and renal diseases were largest at lag 0 days but remained for lag 1-2 days. The risk was more prominent in females, children aged 0-4 years, and the elderly >= 80 years. 7 center dot 4% ( 95% CI: 5 center dot 2-9 center dot 6%) of hospitalizations for renal diseases could be attributable to the increase of temperature, equating to 202,093 (95% CI: 141,554- 260,594) cases. Interpretation This nationwide study provides robust evidence that more policies should be developed to prevent heat-related hospitalizations and mitigate climate change.
Fear for the future: Eco-anxiety and health implications, a systematic review
(2022) BOLUDA-VERDU, Inmaculada; SENENT-VALERO, Marina; CASAS-ESCOLANO, Mariola; MATIJASEVICH, Alicia; PASTOR-VALERO, Maria
Background: Although there is no standard definition for eco-anxiety, most authors define it as people's emotional reaction of concern, worry, anxiety, and fear in view of global Climate Change (CC) threats and concurrent environmental degradation. This systematic review was carried out to critically evaluate the evidence on eco-anxiety related to CC and its health implications in general populations. Methods: We performed a search for scientific articles in PubMed, Scopus, Embase, Web of Science, and Cochrane Central. Studies were included if they complied with the study objective. Selection of articles and data extraction were carried out independently by 2 reviewers. We used the Axis tool and JBI critical appraisal checklist to assess the quality of the studies. Results: A final sample of 12 articles was included in this review. The methodological quality of the studies was limited. A wide variety of eco-anxiety definitions was used in the different studies but further research is needed to provide conceptual clarity of the term eco-anxiety. Eco-anxiety was associated with functional impairment, symptoms of depression, anxiety, PTSD, stress and insomnia, lower self-rated mental health, and reluctance to have children. Moreover, habitual worry about global warming was associated with a pro-ecological worldview, a green self-identity and pro-environmental behavior, strongly suggesting a constructive nature. Indeed, pro -environmental behavior in the form of climate activism would buffer the impact of CCA cognitive-emotional impairment on MDD symptoms. However, sometimes engaging in pro-environmental behavior might not be successful in dealing with eco-anxiety, since individuals might perceive that their efforts do not help to mitigate the CC crisis. Conclusions: Results have to be interpreted with caution since the methodological quality of the studies was limited. However, they do suggest a link between eco-anxiety and negative mental health outcomes, mainly in younger generations, women, and poorer countries in the ""Global South"". Eco-anxiety may constitute a stressor to mental health, particularly if coping mechanisms are not successfully developed.
High ambient temperature and risk of hospitalization for gastrointestinal infection in Brazil: A nationwide case-crossover study during 2000-2015
(2022) ZHAO, Qi; LI, Shanshan; COELHO, Micheline S. Z. S.; SALDIVA, Paulo H. N.; HUXLEY, Rachel R.; GUO, Yuming
Background: The burden of gastrointestinal infections related to hot ambient temperature remains largely unexplored in low-to-middle income countries which have most of the cases globally and are experiencing the greatest impact from climate change. The situation is particularly true in Brazil.Objectives: Using medical records covering over 78 % of population, we quantify the association between high temper-ature and risk of hospitalization for gastrointestinal infection in Brazil between 2000 and 2015.Methods: Data on hospitalization for gastrointestinal infection and weather conditions were collected from 1814 Brazilian cities during the 2000-2015 hot seasons. A time-stratified case-crossover design was used to estimate the as-sociation. Stratified analyses were performed by region, sex, age-group, type of infection and early/late study period.Results: For every 5 degrees C increase in mean daily temperature, the cumulative odds ratio (OR) of hospitalization over 0-9 days was 1.22 [95 % confidence interval (CI): 1.21, 1.23] at the national level, reaching its maximum in the south and its minimum in the north. The strength of association tended to decline across successive age-groups, with infants < 1 year most susceptible. The effect estimates were similar for men and women. Waterborne and foodborne infections were more associated with high temperature than the 'others' and 'idiopathic' groups. There was no substantial change in the association over the 16-year study period.Discussion: Our findings indicate that exposure to high temperature is associated with increased risk of hospitalization for gastrointestinal infection in the hot season, with the strength varying by region, population subgroup and infection type. There was no evidence to indicate adaptation to heat over the study duration.
Health and Environmental Co-Benefits of City Urban Form in Latin America: An Ecological Study
(2022) AVILA-PALENCIA, Ione; SANCHEZ, Brisa N.; RODRIGUEZ, Daniel A.; PEREZ-FERRER, Carolina; MIRANDA, J. Jaime; GOUVEIA, Nelson; BILAL, Usama; USECHE, Andres F.; WILCHES-MOGOLLON, Maria A.; MOORE, Kari; SARMIENTO, Olga L.; ROUX, Ana V. Diez
We investigated the association of urban landscape profiles with health and environmental outcomes, and whether those profiles are linked to environmental and health co-benefits. In this ecological study, we used data from 208 cities in 8 Latin American countries of the SALud URBana en America Latina (SALURBAL) project. Four urban landscape profiles were defined with metrics for the fragmentation, isolation, and shape of patches (contiguous area of urban development). Four environmental measures (lack of greenness, PM2.5, NO2, and carbon footprint), two cause-specific mortality rates (non-communicable diseases and unintentional injury mortality), and prevalence of three risk factors (hypertension, diabetes, and obesity) for adults were used as the main outcomes. We used linear regression models to evaluate the association of urban landscape profiles with environmental and health outcomes. In addition, we used finite mixture modeling to create co-benefit classes. Cities with the scattered pixels profile (low fragmentation, high isolation, and compact shaped patches) were most likely to have positive co-benefits. Profiles described as proximate stones (moderate fragmentation, moderate isolation, and irregular shape) and proximate inkblots (moderate-high fragmentation, moderate isolation, and complex shape) were most likely to have negative co-benefits. The contiguous large inkblots profile (low fragmentation, low isolation, and complex shape) was most likely to have mixed benefits.
Occupational Safety and Health Staging Framework for Decent Work
(2022) SCHULTE, Paul A.; IAVICOLI, Ivo; FONTANA, Luca; LEKA, Stavroula; DOLLARD, Maureen F.; SALMEN-NAVARRO, Acran; SALLES, Fernanda J.; OLYMPIO, Kelly P. K.; LUCCHINI, Roberto; FINGERHUT, Marilyn; VIOLANTE, Francesco S.; SENEVIRATNE, Mahinda; OAKMAN, Jodi; LO, Olivier; ALFREDO, Camila H.; BANDINI, Marcia; SILVA-JUNIOR, Joao S.; MARTINEZ, Maria C.; COTRIM, Teresa; OMOKHODION, Folashade; FISCHER, Frida M.
The 2030 United Nations Goal 8 for sustainable development focuses on decent work. There is utility in identifying the occupational safety and health aspects of Goal 8, as they pertain to the four pillars of decent work: job creation, social protection, rights of workers, and social dialogue. A workgroup of the International Commission on Occupational Health and collaborators addressed the issue of decent work and occupational safety and health (OSH) with the objective of elaborating a framework for guidance for practitioners, researchers, employers, workers, and authorities. This article presents that framework, which is based on an examination of the literature and the perspectives of the workgroup. The framework encompasses the intersection of the pillars of decent (employment creation, social protection, rights of workers, and social dialogue) work with new and emerging hazards and risks related to various selected determinants: new technologies and new forms of work; demographics (aging and gender); globalization; informal work; migration; pandemics; and OSH policies and climate change. The OSH field will need an expanded focus to address the future of decent work. This focus should incorporate the needs of workers and workforces in terms of their well-being. The framework identifies a starting point for the OSH community to begin to promote decent work.
Ultra-processed food intake and diet carbon and water footprints: a national study in Brazil
(2022) GARZILLO, Josefa Maria Fellegger; POLI, Vanessa Fadanelli Schoenardie; LEITE, Fernanda Helena Marrocos; STEELE, Euridice Martinez; MACHADO, Priscila Pereira; LOUZADA, Maria Laura da Costa; LEVY, Renata Bertazzi; MONTEIRO, Carlos Augusto
OBJECTIVE: To study the association between ultra-processed food consumption and carbon and water footprints of the Brazilian diet. METHODS: Cross-sectional analysis on data collected in 2008-2009 on a probabilistic sample of the Brazilian population aged 10 years (n = 32,886). Individual food intake was assessed using two 24-hour food records, on non-consecutive days. The environmental impact of individual diets was calculated by multiplying the amount of each food by coefficients that quantify the atmospheric emissions of greenhouse gases in grams of carbon dioxide equivalent (carbon footprint) and freshwater use in liters (water footprint), both per gram or milliliter of food. The two coefficients consider the food life cycle 'from farm to fork.' Crude and adjusted linear regression models and tests for linear trends assessed the association between the ultraprocessed food contribution to total energy intake (quintiles) and the diet carbon and water footprints. Potential confounders included age, sex, education, income, and region. Total energy intake was assessed as a potential mediation variable. RESULTS: In the crude models, the dietary contribution of ultra-processed foods was linearly associated with the carbon and water footprints of the Brazilian diet. After adjustment for potential confounders, the association remained significant only regarding the diet water footprint, which increased by 10.1% between the lowest and highest quintile of the contribution of ultra-processed foods. Additional adjustment for total energy intake eliminated this association indicating that the dietary contribution of ultra-processed foods increases the diet water footprint by increasing energy intake. CONCLUSIONS: The negative impact of ultra-processed foods on the diet water footprint, shown for the first time in this study, adds to the negative impacts of these foods, already demonstrated regarding dietary nutrient profiles and the risk for several chronic noncommunicable diseases. This reinforces the recommendation to avoid ultra-processed foods made in the official Brazilian Dietary Guidelines and increasingly in dietary guidelines of other countries.
Development and Assessment of a Brazilian Pilot Massive Open Online Course in Planetary Health Education: An Innovative Model for Primary Care Professionals and Community Training
(2021) FLOSS, Mayara; ILGENFRITZ, Carlos Augusto Vieira; RODRIGUES, Ylana Elias; DILDA, Anna Claudia; CORREA, Ana Paula Borngraeber; MELO, Diego Azevedo Conte de; BARROS, Enrique Falceto; GUZMAN, Carlos Alberto Faerron; DEVLIN, Erin; SALDIVA, Paulo Hilario Nascimento; KHOO, Su-Ming; GONCALVES, Marcelo Rodrigues
Introduction: Planetary health (PH) has emerged as a leading field for raising awareness, debating, and finding solutions for the health impacts of human-caused disruptions to Earth's natural systems. PH education addresses essential questions of how humanity inhabits Earth, and how humans affect, and are affected by, natural systems. A pilot massive open online course (MOOC) in PH was created in Brazil in 2020. This MOOC capitalized on the global online pivot, to make the course accessible to a broader audience. This study describes the process of course creation and development and assesses the impact evaluation data and student outcomes of the PH MOOC.Methods: The PH MOOC pilot was launched in Brazilian Portuguese, using the TelessaudeRS-UFRGS platform on 4/27/2020 and concluded on 7/19/2020 with a total load of 80 h. It was composed of 8 content modules, pre and post-test, 10 topics in a forum discussion, and an optional action plan. This study analyzes the course database, profile of participants, answers to questionnaires, forum interaction, and action plans submitted.Results: Two thousand seven hundred seventy-seven participants enrolled in the course, of which 1,237 (44.54%) gave informed consent for this study. Of the 1,237 participants who agreed to participate in the research, 614 (49.8%) completed the course, and 569 (92.67%) were accredited by TelessaudeRS-UFRGS. The majority of the participants were concerned with climate change, trained in the health area, and worked in primary health care in places that lacked ongoing sustainability programs. Two hundred forty-one action plans were submitted, major topics identified were food and nutrition, infectious diseases, and garbage and recycling.Discussion: The use of the PH lens and open perspective of the course centered the need to communicate planetary health topics to individuals. The local plans reflected the motto of ""think global and act local."" Brazil presents a context of an unprecedented social, political, and environmental crisis, with massive deforestation, extensive fires, and biomass burning altering the biomes, on top of an ongoing necropolitical infodemic and COVID-19 pandemic. In the face of these multiple challenges, this MOOC offers a timely resource for health professionals and communities, encouraging them to address planetary challenges as fundamental health determinants.
Carbon footprint of the Brazilian diet
(2021) GARZILLO, Josefa Maria Fellegger; MACHADO, Priscila Pereira; LEITE, Fernanda Helena Marrocos; STEELE, Euridice Martinez; POLI, Vanessa Fadanelli Schoenardie; LOUZADA, Maria Laura da Costa; LEVY, Renata Bertazzi; MONTEIRO, Carlos Augusto
OBJECTIVE: To estimate the carbon footprint of the Brazilian diet and of sociodemographic strata of this population. METHODS: Carbon footprint of the diet was estimated based on data from two 24-hour diet records, obtained in 2008 and 2009, from a probabilistic sample of the Brazilian population aged 10 years and over (n = 34,003) and on environmental impact coefficients of food and culinary preparations consumed in Brazil (gCO2e/kg). Means with 95% confidence intervals of food consumption (kcal/person/day) and the carbon footprint of the diet (gCO2e/person/day and in gCO2e/2,000kcal) were calculated for the population as a whole and for strata according to sex, age, income, education, macro-regions and Federative Unit. Linear regression models were used to identify significant differences (p < 0.05) in the dietary carbon footprint of different sociodemographic strata. RESULTS: The average carbon footprint of the Brazilian diet was 4,489gCO2e/person/day. It was higher for males, for the age group from 20 to 49 years and for the North and Midwest regions, and tended to increase with income and education. The pattern of association of footprint with sociodemographic variables did not change substantially with adjustment for differences in the amount of food consumed, except for a reduction in the relative excess of the footprint among males and an increase in the relative excess of the footprint in the Midwest region. CONCLUSION: The carbon footprint of the Brazilian diet exceeds by about 30% the footprint of the human diet, which could simultaneously meet the nutritional requirements of a healthy diet and the global goal of containing the increase in the planet's average temperature. The pattern of association of this footprint with sociodemographic variables can help identify priority targets for public actions aimed at reducing the environmental impacts of food consumption in Brazil.
Greenhouse gas emissions, water footprint, and ecological footprint of food purchases according to their degree of processing in Brazilian metropolitan areas: a time-series study from 1987 to 2018
(2021) SILVA, Jacqueline Tereza da; GARZILLO, Josefa Maria Fellegger; RAUBER, Fernanda; KLUCZKOVSKI, Alana; RIVERA, Ximena Schmidt; CRUZ, Gabriela Lopes da; FRANKOWSKA, Angelina; MARTINS, Carla Adriano; LOUZADA, Maria Laura da Costa; MONTEIRO, Carlos Augusto; REYNOLDS, Christian; BRIDLE, Sarah; LEVY, Renata Bertazzi
Background The consumption of ultra-processed foods has increased worldwide and has been related to the occurrence of obesity and other non-communicable diseases. However, little is known about the environmental effects of ultra processed foods. We aimed to assess the temporal trends in greenhouse gas emissions (GHGE), water footprint, and ecological footprint of food purchases in Brazilian metropolitan areas, and how these are affected by the amount of food processing. Methods In this time-series study, we used data from five Brazilian Household Budget Surveys (1987-88, 1995-96, 2002-03, 2008-09, 2017-18) to calculate GHGE, water footprint, and ecological footprint per 1000 kcal of food and beverages purchased. Food items were classified into NOVA food groups: unprocessed or minimally processed foods (G1); processed culinary ingredients (G2); processed foods (G3); and ultra-processed foods (G4). We calculated the proportion each NOVA food group contributes to daily kcal per person. Linear regression was performed to evaluate trends of the environmental impacts across the years. Findings Between 1987-88 and 2017-18, diet-related GHGE increased by 21% (from 1538.6 g CO2 equivalent [CO(2)e] per 1000 kcal [95% CI 1473.3-1604.0] to 1866.0 g CO(2)e per 1000 kcal [1788.0-1944.0]; p(trend)<0.0001), diet-related water footprint increased by 22% (from 1447.2 L/1000 kcal [95% CI 1400.7-1493.8] to 1769.1 L/1000 kcal [1714.5-1823.7]; ptrend<0.0001), and diet-related ecological footprint increased by 17% (from 9.69 m2/1000 kcal [95% CI 9.33-10.05] to 11.36 m(2)/1000 kcal [10.91-11.81]; ptrend<0.0001). We found that the change in the environmental indicators over time varied between NOVA food groups. We did not find evidence of a change in the environmental indicators for G1 foods over time. GHGE from G2 foods decreased by 18% (ptrend<0.0001), whereas GHGE from G4 foods increased by 245% (p(trend)<0.0001). The water footprint from G2 foods decreased by 17% (ptrend<0.0001) whereas the water footprint from G4 foods increased by 233% (ptrend<0.0001). The ecological footprint from G2 foods decreased by 13% (ptrend<0.0001), whereas the ecological footprint from G3 foods increased by 49% (ptrend<0.0001) and from G4 foods increased by 183% (ptrend<0.0001). We found no significant change in contribution by any other NOVA food groups to any of the three environmental indicators over the study period. Interpretation The environmental effects of the Brazilian diet have increased over the past three decades along with increased effects from ultra-processed foods. This means that dietary patterns in Brazil are becoming potentially more harmful to human and planetary health. Therefore, a shift in the current trend would be needed to enhance sustainable healthy food systems. Funding Science and Technologies Facilities Council-Global Challenges Research Fund.
The role of the Brazilian Unified Health System in combating the global syndemic and in the development sustainable food systems
(2021) MACHADO, Alisson Diego; BERTOLINI, Ana Maria; BRITO, Leticia da Silva; AMORIM, Mirelly dos Santos; GONCALVES, Monica Rocha; SANTIAGO, Raquel de Andrade Cardoso; MARCHIONI, Dirce Maria; CARVALHO, Aline Martins de
The undernutrition and obesity pandemics associated with climate change are a global syndemic. They have a point of convergence, which is the unsustainable current food systems. This paper aims to discuss the role of public health policies, particularly the Brazilian Unified Health System (SUS) in the context of Primary Health Care, in combating the global syndemic and in the development of sustainable food systems. In this scenario, the National Food and Nutrition Policy is a leading intersectoral tool for an adequate and healthy diet and food and nutrition security. Also, the Dietary Guidelines for the Brazilian population is a strategic tool to support food and nutrition education. We highlight the need to articulate health, agriculture, and environmental policies to achieve sustainable development. Thus, SUS can be the arena to promote the main discussions on this topic, potentiating individual, group, and institutional actions to provide a fairer, healthy, and sustainable food system.
Environmental air pollution: respiratory effects
(2021) SANTOS, Ubiratan de Paula; ARBEX, Marcos Abdo; BRAGA, Alfesio Luis Ferreira; MIZUTANI, Rafael Futoshi; CANCADO, Jose Eduardo Delfini; TERRA-FILHO, Mario; CHATKIN, Jose Miguel
Environmental air pollution is a major risk factor for morbidity and mortality worldwide. Environmental air pollution has a direct impact on human health, being responsible for an increase in the incidence of and number of deaths due to cardiopulmonary, neoplastic, and metabolic diseases; it also contributes to global warming and the consequent climate change associated with extreme events and environmental imbalances. In this review, we present articles that show the impact that exposure to different sources and types of air pollutants has on the respiratory system; we present the acute effects-such as increases in symptoms and in the number of emergency room visits, hospitalizations, and deaths-and the chronic effects-such as increases in the incidence of asthma, COPD, and lung cancer, as well as a rapid decline in lung function. The effects of air pollution in more susceptible populations and the effects associated with physical exercise in polluted environments are also presented and discussed. Finally, we present the major studies on the subject conducted in Brazil. Health care and disease prevention services should be aware of this important risk factor in order to counsel more susceptible individuals about protective measures that can facilitate their treatment, as well as promoting the adoption of environmental measures that contribute to the reduction of such emissions.

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