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ABSTRACT The goal of this study was to estimate the prevalence of environmental and occupational exposure to pesticides according to sociodemographic factors among cancer patients. It is a cross-sectional study with cancer patients in the state of Mato Grosso. The prevalence of environmental and occupational exposure to pesticides was calculated as to the variables gender, age, macro-region, and education. Pesticide use per agricultural crops in liters was estimated, and a thematic map was constructed following the macro-region of the agricultural economy. Of the 998 patients, most were female (54.9%), aged between 50 and 69 years old (50.1%), had less than eight years of schooling (60.7%), and resided in the South-Central macro-region (55.4%). Regarding environmental and occupational exposure, 53.1% of the patients live or have lived in a municipality with agricultural plantations; 17.4% lived near crops; 43.4% worked in agriculture, livestock, or extractivism; and 22.9% worked or work directly with pesticides. Environmental and occupational exposure was higher in males, in the older age groups, schooling from 0 to 4 years, and in the macro-regions with higher pesticide use. The study concluded that environmental and occupational exposure among cancer patients is associated to sociodemographic characteristics and macro-regions of the agricultural economy.

RESUMO O objetivo deste estudo foi estimar a prevalência de exposição ambiental e ocupacional aos agrotóxicos conforme fatores sociodemográficos entre pacientes com câncer. Trata-se de um estudo observacional de delineamento transversal com pacientes com câncer do estado de Mato Grosso. Foi calculada a prevalência de exposição ambiental e ocupacional aos agrotóxicos conforme as variáveis sexo, faixa etária, região e escolaridade. Foram estimados o uso de agrotóxicos por culturas agrícolas em litros e construído mapa temático segundo a macrorregião de economia agropecuária. Dos 998 pacientes, a maioria era do sexo feminino (54,9%), tinha entre 50 e 69 anos (50,1%), possuía menos de oito anos de escolaridade (60,7%) e residiam na macrorregião Centro-Sul (55,4%). Em relação à exposição ambiental e ocupacional, 53,1% dos pacientes moram ou moraram em município com plantação agrícola, 17,4% residiam próximo à lavoura, 43,4% trabalharam na agricultura, pecuária ou extrativismo e 22,9% trabalharam ou trabalham diretamente com agrotóxicos. A exposição ambiental e ocupacional foi maior no sexo masculino, nas faixas etárias mais elevadas, escolaridade de 0 a 4 anos e nas macrorregiões de maior uso de agrotóxicos. Conclui-se que a exposição ambiental e ocupacional entre pacientes com câncer se associou as características sociodemográficas e macrorregiões de economia agropecuária.

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RESUMO O objetivo deste estudo foi investigar a associação entre características sociodemográficas relacionadas à exposição ambiental e ocupacional e o autorrelato de intoxicação de pacientes com diagnóstico de câncer em Mato Grosso, Brasil. Trata-se de um estudo transversal, com 998 pacientes com câncer atendidos em hospitais de referência do estado. A variável dependente foi obtida a partir do autorrelato de algum sintoma de intoxicação nos últimos 5 anos e se a intoxicação foi decorrente ou não do trabalho/ocupação. A associação entre características sociodemográficas relacionadas à intoxicação e à exposição ambiental e ocupacional e o autorrelato de intoxicação foi avaliada pelo teste exato de Fisher. Do total de entrevistados, 7,4% (IC95%: 6,0; 9,2) referiram intoxicação, sendo 2,3% dos casos (IC95%: 1,5; 3,4) decorrentes do trabalho. Os fatores associados ao autorrelato de intoxicação decorrente do trabalho foram ser do sexo masculino, ter escolaridade menor que 4 anos, sintoma de dor de cabeça, intoxicação por agrotóxico agrícola, por via respiratória e ter trabalhado com agrotóxicos, amianto, metais pesados e poeira industrial. Conclui-se que os indivíduos com maior exposição ocupacional aos agrotóxicos e a outros produtos químicos referiram maior ocorrência de intoxicações decorrentes do trabalho.

ABSTRACT The aim of this study was to investigate the association between sociodemographic characteristics, related to environmental and occupational exposure and self-report of intoxication in patients diagnosed with cancer in Mato Grosso, Brazil. This is a cross-sectional study, with 998 cancer patients seen at referral hospitals in the state. The dependent variable was obtained from the self-report of some intoxication symptom in the last 5 years and whether or not the intoxication was caused by work/occupation. The association between sociodemographic characteristics, related to intoxication and environmental and occupational exposure and self-report of intoxication was assessed by Fisher's exact test. Of all respondents, 7.4% (95%CI: 6.0; 9.2) reported intoxication, and 2.3% (95%CI: 1.5; 3.4) were work-related. Factors associated with self-reported work-related intoxication were being male, having less than 4 years of education, headache, intoxication by agricultural pesticides, by respiratory route and having worked with pesticides, asbestos, heavy metals and industrial dust. It was concluded that individuals with higher occupational exposure to pesticides and other chemicals reported higher occurrence of poisoning due to work.

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Objetivo: analisar a distribuição espacial e temporal dos indicadores de acidentes de trabalho (AT) e de outros agravos à saúde relacionados à produção agropecuária de Mato Grosso, no período de 2008 a 2017. Métodos: trata-se de estudo ecológico, com análise de tendência e correlação entre indicadores de produção agropecuária, florestal, mineral e AT. Resultados: as atividades econômicas do agronegócio com maior contribuição aos AT foram: abate e fabricação de produtos de carnes (16,9%) e agricultura (12,3%). Taxas de AT mais elevadas foram observadas nos municípios considerados os maiores produtores agropecuários (Paranatinga, Barra do Garças, Alta Floresta e Sorriso). Evidenciou-se que 58,4% dos AT no estado foram relacionados ao agronegócio. Foi encontrada correlação positiva e significativa entre o valor adicionado bruto e a taxa de incidência (r = 0,303; p < 0,001), mortalidade (r = 0,368; p < 0,001) e letalidade (r = 0,390; p < 0,001) por AT. Identificou-se tendência crescente na variação percentual anual de 7,3% (IC95%: 6,1;8,6) do esforço produtivo (hectare/habitante), de 6,2% (IC95%: 5,2;7,3) do esforço produtivo (exposição agrotóxico/habitante) e de 6,2% (IC95%: 4,1;8,3) das internações por neoplasias, bem como do crescimento da produção agrícola, dos insumos agrícolas e dos agravos à saúde. Conclusão: a maioria dos AT foram relacionados ao agronegócio, predominantemente nas atividades de frigoríficos e agricultura. Houve correlação positiva entre indicadores de produção agropecuária e de ocorrências e mortes por AT.

Objective: to analyze the spatial and temporal distribution of occupational accident (OA) indicators and other agribusiness-related health issues in Mato Grosso, Brazil, from 2008 to 2017. Methods: ecological study using trend analysis and correlation calculation between agricultural, forestry, mineral production and OA indicators. Results: slaughtering and meat production (16.9%) and agriculture (12.3%) were the agribusiness activities with the highest contribution to OA. Municipalities considered the largest agricultural producers (Paratininga, Barra do Garças, Alta Floresta and Sorriso) showed the highest OA rates. Of the OA registered in the state, 58.4% were agribusiness-related. Gross value added presented a positive and significant correlation with the incidence rate (r = 0.303; p < 0.001), mortality (r = 0.368; p < 0.001) and lethality (r = 0.390; p < 0.001) by OA. Analysis showed an increasing trend in the annual percentage variation of 7.3% (95%CI: 6.1;8.6) in productive effort (hectare/ inhabitant), 6.2% (95%CI: 5.2;7.3) in productive effort (pesticide exposure/inhabitant), and 6.2% (95%CI: 4.1;8.3) in hospitalizations for neoplasms, as well as the growth of agricultural production, agricultural inputs, and health problems. Conclusion: most OAs were related to agribusiness, mainly in meatpacking plants and agriculture. There was a positive correlation between indicators of agricultural production and occupational-related accidents and deaths.

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OBJECTIVE: To describe the methodological and operational aspects of the "Project for surveillance of cancer and its associated factors: population-based and hospital-based registry" (VIGICAN), in the state of Mato Grosso (MT), Brazil. METHODS: VIGICAN was divided into two projects: a university extension one, which updated the data from the Population-based Cancer Registry (PBCR) of MT in the 2008-2016 period; and a research project, which collected primary data, through individual interviews and analysis of medical records of people with a diagnosis of cancer, aged 18 years or older, treated at reference hospitals for oncology. To analyze the factors associated with cancer, the following variables were collected: socioeconomic and demographic, social support, health status and behavior, and environmental exposure. RESULTS: In the 2008-2016 period, approximately one hundred thousand cases of cancer (incident and prevalent) were reported in the PBCR Cuiabá and PBCR Interior. After validation procedures, 50 thousand incident cases were elected. The survey interviewed 1,012 patients, 38.2% living in the municipalities of Cuiabá and Várzea Grande, 60.4% in small cities of the state, and 1.4% in other states. Preliminary data showed that the majority were women (55.0%) and younger than 60 years of age (54.3%). Among the interviewees, 7.2% reported smoking tobacco, 15.5% consumed alcoholic beverages (15.5%), and 32.7% lived nearby crops. CONCLUSION: The development of these projects allowed the integration of education with health services and will enable the recognition of specificities and different exposure scenarios and factors associated with cancer in the Mato Grosso territory.

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OBJECTIVE: To analyze the trend of standardized cancer mortality rate in the state of Mato Grosso according to health regions, from 2000 to 2015. METHODS: Ecological time series study with data on deaths by cancer from the Mortality Information System. The rates were standardized using direct method and calculated by year and health regions. The annual percentage changes (APC) and respective confidence interval (95%CI) were obtained through simple linear regression. Thematic maps were built to show the spatial distribution of rates. RESULTS: There were 28,525 deaths by cancer registered in Mato Grosso, with the main types being lung, prostate, stomach, breast and liver cancer. The highest mortality rates were found in regions Médio Norte, Baixada Cuiabana and Sul Mato-Grossense. From 2000 to 2015, an upward trend was seen in the mortality rate by cancer in Mato Grosso (APC=0.81%; 95%CI 0.38-1.26), and in four health regions, Garças Araguaia (APC=2.27%; 95%CI 1.46-3.08), Sul Mato-Grossense (APC=1.12%; 95%CI 0.28-1.97), Teles Pires (APC=1.93%; 95%CI 0,11-3,74) and Vale dos Arinos (APC=2.61%; 95%CI 1.10-4.70), while the other regions remained stable. CONCLUSION: In the state of Mato Grosso and in the four health regions, cancer mortality rate showed a growing trend. The results point to the need to consider regional differences when thinking about actions for cancer prevention, control and assistance.

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OBJECTIVE: To estimate the mortality trend and to analyze the potential years of life lost (PYLL) due to leukemias and lymphomas in Brazil and Mato Grosso, from 2001 to 2019. METHODS: Time-series study on deaths from leukemias and lymphomas with data obtained from the Mortality Information System. Trends were calculated by age group by the Joinpoint regression method, using calendar year as regressor variable, estimated annual percentage change (APC) and mean annual percentage change, considering 95% confidence intervals. PYLL rates were collected from the Cancer Mortality Atlas. RESULTS: In Brazil, the mortality rate trend remained stable for both diseases in the period: leukemias (APC=0.2; 95%CI 0.0-0.3) and lymphomas (APC=0.2; 95%CI 0.4-0.1). In Mato Grosso state, the rate for leukemias was also stable (APC=0.3; 95%CI 1.0-1.6). For lymphomas, the trend was ascendant (APC=2.3; 95%CI 0.5-4.2), but descending among people younger than 59 years. For leukemias, PYLL rates were 64 and 65/100,000 in Brazil and Mato Grosso, respectively. For lymphomas, 27 and 22/100,000, respectively, with the highest rates found among males. CONCLUSION: The behavior of mortality rates from leukemia and lymphoma in Mato Grosso was different from that observed nationally, with an upward trend for lymphomas and no differences between age groups for both diseases. PYLL rates for leukemias were similar, while for lymphomas they were higher among men and lower in Mato Grosso when compared to Brazil.

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OBJECTIVE: To estimate the prevalence of occupational and environmental exposure according to sociodemographic factors in cancer patients treated at reference hospitals in the state of Mato Grosso, Brazil. METHODS: This is a cross-sectional study on cancer patients aged 18 years or older. The prevalence of exposure to pesticides, asbestos, lead, heavy metals, formaldehyde, benzene, exposure to industrial dust, and handling of other chemical substances were calculated according to sex, age group, and level of education. RESULTS: A total of 1,012 patients were interviewed (55.0% women, 45.6% aged 60 years or older, and 56.8% had less than five years of formal education). Pesticides (22.8%), industrial dust (10.7%), and benzene (10.1%) were the most frequent exposures. Occupational and environmental exposure was higher in men for all evaluated exposures, except for formaldehyde, which was higher in women. Exposure to pesticides, industrial dust, benzene, asbestos, and heavy metals increased with age and were more frequent among those with lower level of education. CONCLUSION: Approximately one in five cancer patients treated at reference hospitals in Mato Grosso reported having been exposed to pesticides, and one in ten were exposed to industrial dust and benzene, with greater exposure among men, older individuals, and those with lower level of education.

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RESUMO As etapas que envolvem a cadeia produtiva de commodities agrícolas produzem possibilidades diferenciadas de vulnerabilidade nas populações, afetando a situação de saúde dos povos indígenas. O uso de agrotóxicos é uma atividade intrínseca aos monocultivos. A exposição a essas substâncias gera desfechos negativos agudos e crônicos na saúde humana e contaminação no ambiente. De modo a contribuir com o debate no campo da Saúde Coletiva, o texto direciona as discussões ao estado de Mato Grosso, onde estão vários povos indígenas, enfrentando a produção de commodities e desfechos em saúde relacionados com os agrotóxicos. Para isso, recorremos à determinação socioambiental do processo saúde-doença, organizando uma matriz de indicadores que enfatizam as escolhas e as omissões do Estado nas questões ambientais, incorporando historicidade nos processos de adoecimento. Os impactos da cadeia de commodities agrícolas e as exposições por agrotóxicos em territórios indígenas são um problema intersetorial que se vincula a violação de direitos humanos, direito à terra, à saúde e à segurança alimentar e nutricional. As respostas devem ser consideradas em uma perspectiva articulada entre os setores econômico, político, ambiental e da saúde, com participação e decisão da população indígena nas etapas dos processos.

ABSTRACT The stages involving the agricultural supply chain produce different possibilities of vulnerability in populations, affecting the health situation of indigenous peoples. The use of pesticides is an activity intrinsic to monocultures. The exposure to these substances generates acute and chronic negative outcomes in human health and contamination in the environment. In order to contribute to the debate in Public Health, the text directs the discussions to the state of Mato Grosso, where are several indigenous peoples, facing the production of commodities and health outcomes associated to pesticides. For that, we resort to the socio-environmental determination of the health-disease process, organizing a matrix of indicators that emphasize the choices and omissions of the State in environmental issues, incorporating historicity in the processes of illness. The impacts of the agricultural commodities chain and exposures by pesticides in indigenous territories are an intersectoral problem that is linked to the violation of basic social rights, such as the right to land, health, and food and nutritional security. The responses must be considered in an articulated perspective between the economic, political, environmental, and health sectors, with participation and decision by the indigenous population in the stages of the processes.

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RESUMO O estudo analisou o perfil sociodemográfico e condições de saúde da população residente em municípios mato-grossenses entre 2016 e 2017. Trata-se de estudo qualiquantitativo de base populacional, autorreferido. Entrevistaram-se moradores adultos, com base em questionário com 172 questões, referentes às informações familiares e individuais. Aplicaram-se 1.379 questionários válidos, totalizando 4.778 indivíduos. A maioria referiu morar em áreas urbanas em distâncias inferiores a 1 km das áreas de lavoura (98%), baixa escolaridade (43%), renda menor que 3 salários mínimos (68%) e utilizar agrotóxicos de uso doméstico (71,8%). As morbidades mais citadas foram: problemas respiratórios, intoxicações agudas, transtornos psicológicos, doenças renais e cânceres. Identificou-se a subnotificação de intoxicações por agrotóxicos de 1 para 20 casos em Campos de Júlio; 1 para 77 casos em Campo Novo do Parecis e 100% de subnotificação em Sapezal. Encontraram-se associações entre as variáveis sociodemográficas e de exposição aos agrotóxicos e as morbidades referidas, considerando o p-valor=0,05 e nível de significância de 95%. O uso crescente de agrotóxicos associado a cenários políticos e econômicos favoráveis ao agronegócio demonstraram a importância da Vigilância Popular em Saúde, pois ela é uma estratégia do Sistema Único de Saúde que permite evidenciar os impactos negativos causados na saúde humana e ambiental.

ABSTRACT The study analyzed the socio-demographic profile and health conditions of the population living in Mato Grosso municipalities between 2016 and 2017. It is a quali-quantitative, self-referred, populationbased study. Adult residents were interviewed on the basis of a structured questionnaire with 172 questions concerning family and individual information. A total of 1,379 valid questionnaires were applied, totaling 4,778 individuals. Most reported living in urban areas at distances of less than 1 km from farming areas (98%), low schooling (43%), average income below 3 minimum wages (68%), and using agrochemicals for domestic use (71.8%). The most commonly cited morbidities were: respiratory problems, acute intoxications, psychological disorders, kidney diseases, and cancers. Underreporting of pesticide poisoning was identified, from 1 to 20 cases in Campos de Júlio; 1 to 77 cases in Campo Novo do Parecis, and 100% underreporting in Sapezal. Associations were found between sociodemographic variables and exposure to agrochemicals and the mentioned morbidities, considering the p-value=0.005 and 95% significance level. The increasing use of agrochemicals associated with political and economic scenarios favorable to agribusiness interests demonstrated the need to develop strategies for Popular Health Surveillance, highlighting the negative impacts of this production model on human and environmental health.

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RESUMO O processo de produção do agronegócio químico-dependente é um dos maiores geradores de riscos, desastres socioambientais e sanitários de caráter pandêmico. Ele atua na determinação social da saúde-doença-danos ambientais, levando a situações críticas, riscos e vulnerabilidades, exploração humana, intoxicações agudas e crônicas e degradações ecológicas como efeitos de suas formas danosas de estabelecer inter-relações entre produção-ambiente-sociedade. O setor tem contribuído diretamente para a crise ecológica e sanitária globalizada ao dar origem a sindemias, insegurança alimentar, contaminação das águas, alimentos além de produzir doenças infecciosas novas e/ou reemergentes. Neste ensaio crítico, com base nos estudos do Núcleo de Estudos Ambientais e Saúde do Trabalhador da Universidade Federal de Mato Grosso, demonstram-se diferentes elementos ameaçadores, destrutivos, degradantes e violadores do direito à saúde dos trabalhadores e ambiental nos principais elos da cadeia produtiva do agronegócio. Em seguida, utilizando também análises de documentos públicos, normativas do Estado e dados de sistemas de vigilância em saúde, evidenciam-se os processos de contaminação de alimentos e água decorrentes dos agrotóxicos, bem como apresenta-se uma crítica às tendências políticas que giram em torno do agronegócio. Por fim, destaca-se a necessidade premente de uma transição agroecológica enquanto resposta às doenças e às sindemias do agronegócio.

ABSTRACT The production process of the chemical-dependent agribusiness is one of the largest generators of risk, socio-environmental, and sanitary disasters of a pandemic nature. It acts on the social determination of health-disease-environmental damages, leading to critical situations, risks and vulnerabilities, human exploitation, acute and chronic poisoning, and ecological degradations as the effects of their harm to establish interrelations between production-environment-society. The sector has contributed directly to the globalized ecological and sanitary crisis by giving rise to syndemics, food insecurity, water and contamination, besides producing new and/or reemergious infectious diseases. In this critical essay, based on the studies of the Nucleus for Environmental Studies and Workers Health of the Federal University of Mato Grosso, different elements that are menacing, destructive, degrading, and violators of workers' right to health and environmental health are demonstrated in the main links in the production chain of agribusiness. Next, using public document analyses, state regulations, and data from health surveillance systems, the processes of food and water contamination arising from agrochemicals are exposed, as well as a criticism of the political tendencies that revolves around agribusiness. Finally, we highlight the pressing need of an agroecological transition as a response to the diseases and syndemics of agribusiness.