Prevalence and factors associated with respiratory diseases and diarrhea in recyclable material cooperative workers in the city of São Paulo, Brazil: a cross-sectional study, 2013*

Souza, Gisele Ferreira de; Muto, Elizabeti Yuriko; Nascimento, Felipe Parra; Gouveia, Nelson

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Epidemiologia e Serviços de Saúde

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Original article • Epidemiol. Serv. Saúde 29 (3) • 2020 • https://doi.org/10.5123/S1679-49742020000300022 copy

Prevalence and factors associated with respiratory diseases and diarrhea in recyclable material cooperative workers in the city of São Paulo, Brazil: a cross-sectional study, 2013*

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

to analyze the prevalence of respiratory diseases and diarrhea among recyclable material cooperative workers in São Paulo City, Brazil, and associated factors.

Methods

this was a cross-sectional study conducted in three cooperatives, with data collected through structured interviews and measurement of environmental fungal concentration; Poisson regression was used to estimate prevalence ratios (PR).

Results

156 individuals were interviewed; the highest asthma, chronic obstructive pulmonary disease (COPD), and diarrhea prevalence rates occurred in cooperatives with higher total fungal concentration; highest adjusted prevalence of asthma was found in Cooperative A (PR=8.44 – 95%CI 1.09;65.37), and highest adjusted prevalence of diarrhea was found in Cooperative C (PR=2.09 – 95%CI 1.11;3.94), compared to Cooperative B; the highest COPD prevalence was found in smokers and former smokers (PR=8.66 – 95% CI 2.84;26.35).

Conclusion

fungal control measures must be adopted for disease prevention in recyclable material cooperatives.

Solid Waste Segregators; Occupational Health; Fungi; Respiratory Tract Diseases; Diarrhea; Cross-Sectional Studies

Variable	Total		Asthma		COPD		Diarrhea

	n	%	n	%	n	%	n	%
Total	156	100	17	11	50	32	53	34

Age (years) (N=156)

20-34	44	28	5	11	10	23	14	32
35-50	54	35	6	11	24	44	20	37
51-71	58	37	6	10	16	28	19	11

Sex (N=156)

Male	62	40	4	6	17	27	18	29
Female	94	60	13	14	33	35	27	29

Race/skin color (N=154)

White	35	23	2	6	9	26	9	26
Non-white	119	77	15	13	40	33	36	30

Schooling (complete years) (N=155)

≤8	124	79	13	11	44	36	36	29
≥9	31	21	4	13	5	16	9	29

Tobacco smoking (N=156)

Non-smoker	61	39	4	7	3	5	19	31
Smoker or former smoker	95	61	13	14	47	50	26	28

Use of mask (N=153)

Always	4	3	1	25	1	25	2	50
Occasionally or never	149	97	15	10	48	32	41	28

Use of gloves (N=153)

Always	105	69	15	14	39	37	34	32
Occasionally or never	48	31	2	4	11	23	10	21

Use of boots (N=154)

Always	136	88	15	11	44	33	38	28
Occasionally or never	18	12	2	11	6	33	6	33

Cooperatives (N=156)

A	35	22	4	12	12	35	9	26
B	58	37	2	3	15	26	11	19
C	63	41	11	18	23	36	25	40

Variables	A			B			C				Total^a

	Mean	SD	n	Mean	SD	n	Mean	SD	n	p-value	Mean	SD	n
Place

Weighing scales				280	35	2				–	280	35	2
Kitchen	363		1	356	11	2	288		1	–	341	36	4
Office	615	3	2				116		1	–	449	288	3
Conveyor belt	598		1	334	20	2	751	99	2	–	554	216	5
Compactor	457		1	289	135	2	680	158	2	–	479	222	5
Waste electrical and electronic equipment	540		1				378	98	2	–	432	116	3

Total	531	102	6	315	63	8	503	256	8	0.506	442	188	22

Fungi genera

Aspergillus spp.	137	24	6	63	30	8	120	60	8	0.009	104	51	22
Cladosporium spp.	237	80	6	51	18	8				<0.001	83	107	14
Fusarium spp.	76	43	6	70	23	8	124	103	8	0.247	91	69	22
Nigrospora spp.				30	16	8				–	11	17	8
Rhizopus spp.							130	95	8	–	47	85	8
Mucor spp.				2	2	6				–	1	1	6
Penicillium spp.	81	60	6	95	52	8	128	113	8	0.539	104	80	22
Non-sporogenous fungi				3	1	8				–	1	2	8

Variables	_crudePR	95%CI^a	p-value^b	_adjustedPR	95%CI^a	p-value^b
Age (years)			0.990			0.706

20-34	1.00			1.00		0.706
35-50	0.98	0.32;3.02		0.77	0.21;2.91
51-71	0.93	0.30;2.85		0.82	0.23;2.88

Sex			0.159			0.104

Male	1.00			1.00
Female	2.17	0.74;6.36		2.58	0.82;8.07

Race/skin color			0.296			0.510

White	1.00			1.00
Non-white	2.14	0.51;8.95		1.59	0.40;6.35

Schooling (complete years)			0.710			0.515

≤8	1.00			1.00
≥9	1.22	0.43;3.50		1.37	0.54;3.50

Tobacco smoking			0.170			0.280

Non-smoker	1.00			1.00
Smoker or former smoker	2.11	0.72;6.20		1.68	0.66;4.28

Use of mask			0.317			0.857

Always	1.00			1.00
Occasionally or never	0.41	0.07;2.38		0.83	0.10;6.65

Use of gloves			0.099			0.032

Always	1.00			1.00
Occasionally or never	0.3	0.71;1.26		0.18	0.04;0.86

Use of boots			0.396			0.564

Always	1.00			1.00
Occasionally or never	0.71	0.25;4.04		0.58	0.09;3.73

Cooperatives			0.061			0.041

A	3.41	0.66;17.75		8.44	1.09;65.37
B	1.00			1.00
C	5.06	1.17;22.00		3.94	0.88;17.54

Variables	crude^PR	_95%CI^a	p-value^b	adjusted^PR	_95%CI^a	p-value^b
Age (years)			0.132			0.378

20-34	1.00			1.00
35-50	1.16	0.67;2.03		1.35	0.69;2.62
51-71	0.61	0.30;1.20		0.63	0.31;1.30

Sex			0.112			0.988

Male	1.00			1.00
Female	0.26	0.60;1.65		1.00	0.59;1.68

Race/skin color			0.675			0.801

White	1.00			1.00
Non-white	1.14	0.61;2.13		1.08	0.59;2.00

Schooling (complete years)			0.979			0.859

≤8	1.00			1.00
≥9	0.99	0.53;1.84		0.94	0.48;1.83

Tobacco smoking			0.640			0.269

Non-smoker	1.00			1.00
Smoker or former smoker	0.89	0.54;1.46		0.73	0.42;1.28

Use of mask			0.255			0.229

Always	1.00			1.00
Occasionally or never	0.55	0.20;1.53		0.58	0.23;1.42

Use of gloves			0.182			0.306

Always	1.00			1.00
Occasionally or never	0.66	0.35;1.22		0.69	0.34;1.41

Use of boots			0.640			0.918

Always	1.00			1.00
Occasionally or never	1.18	0.58;2.41		1.04	0.50;2.15

Cooperatives			0.064			0.043

A	1.4	0.64;3.03		1.83	0.74;4.53
B	1.00			1.00
C	2.09	1.13;3.87		2.09	1.11;3.94

Variables	_crudePR	95%CI^a	p-value^b	_adjustedPR	95%CI^a	p-value^b
Age (years)			0.052			0.455

20-34	1.00			1.00
35-50	1.96	1.05;3.65		1.36	0.77;2.40
51-71	1.23	0.62;2.46		1.04	0.57;1.90

Sex			0.303			0.092

Male	1.00			1.00
Female	1.29	0.79;2.11		1.47	0.94;2.30

Race/skin color			0.448			0.941

White	1.00			1.00
Non-white	1.27	0.68;2.35		1.02	0.62;1.66

Schooling (complete years)			0.063			0.248

≤8	1.00			1.00
≥9	0.45	0.19;1.04		0.63	0.29;1.38

Tobacco smoking			<0.001			<0.001

Non-smoker	1.00			1.00
Smoker or former smoker	10.17	3.30;31.33		8.66	2.84;26.35

Use of mask			0.767			0.561

Always	1.00			1.00
Occasionally or never	1.3	0.23;7.24		1.62	0.32;8.33

Use of gloves			0.116			0.229

Always	1.00			1.00
Occasionally or never	0.63	0.35;1.12		0.65	0.32;1.32

Use of boots			0.950			0.795

Always	1.00			1.00
Occasionally or never	1.02	0.51;2.06		0.91	0.46;1.80

Cooperatives			0.439			0.516

A	1.36	0.72;2.57		1.36	0.65;2.85
B	1.00			1.00
C	1.41	0.82;2.44		1.12	0.71;1.78

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[1] CORRESPONDENCE: Gisele Ferreira de Souza – Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, Av. Dr. Arnaldo, no. 455, São Paulo, SP, Brazil. Postcode: 01246-903 . E-mail: giselefsouza@usp.br