Northern Brazil Research Articles

Occupational accidents involving pesticides notified by SINAN.

The present article analyzed the number of pesticide accidents registered in Tocantins. In the case of occupational exposure to pesticides, the impact of pesticides on farmers is particularly great during direct handling or improper storage. This paper aims, through notifications of industrial accidents involving pesticides, to provide its target audience with information on notifications of accidents. To analyze notifications of occupational accidents with pesticides via SINAN in the state of Tocantins, northern Brazil, from 2012 to 2017. The research deals with an explanatory literature that provides greater familiarity with the problem, making it clear or structured. We can emphasize that pesticide poisoning is a serious public health problem. Among notifications of this event, 178 involved three types of pesticides, accounting for 12.35% of pesticide notifications. Furthermore, the most marketed pesticides are those whose formulation is based on the following active ingredients: glyphosate, 2,4-D, and mancozeb. After analyzing the data, we observed that the challenges brought by pesticide poisoning are related to the eligibility of the database of occupational accidents involving exogenous intoxications, being necessary to replace the use of agricultural pesticides, use pesticides safely for workers and the population, and seriously combat underreporting.

Correlates of Physical Activity in Brazilian Older Adults: The National Health Survey 2019.

Engagement in physical activity (PA) depends on intrapersonal, interpersonal/cultural, organizational, physical environment and political factors. Considering that it is important to understand this phenomenon in different populational contexts, this study aimed to investigate the factors related to engagement in PA according to sociodemographic aspects, eating habits, self-rated health, activities of daily living, noncommunicable diseases, mental health and public policies in Brazilian older people. This study had a cross-sectional design and used data from the Brazilian National Health Survey, 2019. Sample size was composed of 22,726 participants, aged 60 years or older, of both sexes, and all the data were collected by interview/questionnaire. According to the adjusted logistic regression, males were more active than females (OR = 1.59 (95% CI 1.40-1.80)), and those living in northern and northeastern Brazil were more likely to be inactive when compared to the southeastern region. Moreover, those with a higher educational level and income (OR = 1.36 (1.06-1.73) and OR = 1.60 (1.22-2.11)); with healthy eating habits (OR = 1.05 (1.03-1.06)); with positive self-rated health (OR = 2.67 (95% CI 1.51-4.71)); with better functional autonomy (OR = 1.22 (1.17-1.27)); and who reported that there was some public place (square, park, closed street, beach) to go for a walk, exercise or practice sport close to their home were more likely to be active (OR = 1.49 (1.34-1.67)). Sociodemographic factors, healthy eating habits, positive self-rated health, higher functioning in activities of daily living and living close to places where PA is practiced were associated with regular engagement in PA (i.e., ≥150 min/week).

Distribution Modeling and Gap Analysis of Shorebird Conservation in Northern Brazil

Migratory shorebirds are currently at significant risk, with populations of multiple species dropping globally, often due to habitat disruption and loss. The coast of northern Brazil, along the states of Pará and Maranhão, encompasses one of the broadest expanses of shorebird overwintering habitat for many shorebird species in the Atlantic Americas Flyway. Delineating how current management protects shorebird habitat is an important first step to identifying gaps in protections that then need to be prioritized. Different frameworks of conservation decision-making, such as focusing on flagship, umbrella, or biodiversity, can be used to prioritize what habitat needs to be protected. Understanding the effects of these different conservation perspectives is key to making informed management decisions. Multiple dates of Landsat 8 imagery at different tidal stages were used to identify intertidal habitats for further analysis. MaxEnt species distribution models were derived for each species using remote sensing and landscape metrics, as well as point-count survey data collected during the winters of 2016 and 2017. Landsat 8 and Sentinel 2 image data were included as direct inputs to the model rather than interpreted and mapped first into different habitat types. The resulting Maxent models successfully delineated between presence and absence locations for five of the eight target shorebird species. The model outputs were combined to map the intertidal habitat covered under several different management scenarios. These scenarios included using red knots as a flagship species, semipalmated sandpipers as an umbrella species, and species richness as a metric of shorebird diversity. Slightly more than 25% of delineated intertidal habitat was found to be included within a designated Marine Extractive Reserve, with three major gaps in current protections identified. The flagship, umbrella, and biodiversity perspectives result in different prioritizations of these distinct locations. While umbrella and diversity approaches are successful at protecting diverse communities, community assemblages of rarer or specialist species, such as the red knots, may fall outside their protective shadows. A hybrid approach that uses both diversity and the extent of rare flagship species produces results that best meet the management goals of identifying gaps in existing conservation to protect the most at-risk species while conserving the diverse assemblages they coexist with.

Patient care in cystic fibrosis centers: a real-world analysis in Brazil.

To analyze the characteristics of cystic fibrosis (CF) care centers (CFCCs) in Brazil. A questionnaire was sent to the coordinators of all 51 registered CFCCs between May and September of 2021. The response rate was 100%. Southeastern Brazil is the region where most of the CFCCs in the country are located (21 centers; 41%), followed by the southern and northeastern regions (11 centers each; 21.5%), the central-western region (6; 12%), and the northern region (2; 4%). A total of 4,371 patients with CF were cared for in Brazil during the study period, ranging from 7 to 240 patients per center (mean, 86 patients/center; median, 75 patients/center); 2,197 patients (50%) were cared for in centers in the southeastern region of the country, particularly in the state of São Paulo (33%), the remaining patients being treated in southern Brazil (1,014 patients, 23%), northeastern Brazil (665 patients, 15%), central-western Brazil (354 patients, 8%), and northern Brazil (141 patients, 4%). Overall, 47 centers (92%) reported having an incomplete multidisciplinary team; 4 (8%) lacked essential team members; 6 (12%) lacked a physical therapist; 5 (10%) lacked a dietitian; 17 (33%) lacked outpatient nursing care; 13 (25%) lacked outpatient social work services; 14 (27%) lacked a psychologist; and 32 (63%) lacked a clinical pharmacist. Seven CFCCs (14%) in the northern and northeastern regions of Brazil reported that the quality of newborn screening for CF was poor. All centers reported having difficulties in accessing CF medications. Brazilian CFCCs experience multiple problems, including inadequate staffing, infrastructure, testing, and medication supply. There is an urgent need to regulate the implementation of CF referral centers and an appropriate network structure for the diagnosis and follow-up of CF patients using optimal treatment recommendations.

Spatio-temporal variation of dissolved inorganic nutrients and chlorophyll a in a tropical Amazon estuary in northern Brazil

Resumo O presente estudo foi desenvolvido no estuário do furo do Muriá ou Maripanema, localizado no setor Costa Atlântica do Salgado, norte do Brasil, com o objetivo de conhecer a dinâmica dos nutrientes dissolvidos na interface água-ar e os mecanismos de interação desses nutrientes com os parâmetros abióticos e bióticos (clorofila a). Esse sistema sofre a influência da sazonalidade, que envolve aspectos dos regimes de marés. Para tal, foi avaliada a variabilidade espacial e temporal dos nutrientes inorgânicos dissolvidos em conjunto com os parâmetros físico-químicos por meio de diagramas de mistura, razões estequiométricas e análise de componentes principais. O N-amoniacal foi a forma mais representativa de nitrogênio inorgânico dissolvido em ambas as estações com valores máximos de ~199 μM, subsidiando a produtividade primária, com valor máximo de clorofila a de 122 μg.m-3. O elevado nível de N-amoniacal esteve associado também ao lançamento de efluentes domésticos, à aquicultura e à degradação da matéria orgânica que ocorrem nas áreas de manguezais ao longo do furo do Muriá. O fosfato, entre os nutrientes dissolvidos, foi o que mais sofreu ação neutralizadora, com baixas concentrações, de forma a não oferecer sinais de eutrofização. As concentrações de sílica sofreram influência das variações de marés e fluxos das águas. No geral, os resultados obtidos permitiram observar uma entrada excessiva de nutrientes ao longo do furo do Muriá, com oscilações em suas concentrações influenciadas pela sazonalidade, pelas marés e pelas atividades antrópicas, indicando um ambiente altamente dinâmico que influencia diretamente a produtividade primária da região.

Genomic Diversity of the Rarely Observed Genotype of the Mycobacterium tuberculosis Central Asian (CAS) Lineage 3 from North Brazil.

Mycobacterium tuberculosis (Mtb) Central Asian Strain (CAS) Lineage 3 (L3) genotype is predominantly found in East-Africa, Central-Asia, Western-Asia, and South-Asia; however, a new spoligotyping CAS/SIT2545 was found in northern regions of Brazil. We aimed to characterize and describe the genetic diversity and perform a phylogenetic assessment of this novel genotype. We performed 24-MIRU-VNTR loci and Whole-genome sequencing (WGS) of six Brazilian isolates previously spoligotyped. The libraries were prepared using a Nextera-XT kit and sequenced in a NextSeq 550 Illumina instrument. We performed lineage assignment and genomic characterization. From publicly available genomes of Mtb L3 and other lineages, we created a robust dataset to run the MTBSeq pipeline and perform a phylogenetic analysis. MIRU-VNTR and WGS confirmed CAS/SIT2545 belongs to L3. Out of 1691 genomes, 1350 (79.83%) passed in quality control (genomic coverage > 95%). Strain 431 differed in 52 single nucleotide variants (SNV), confirming it does not belong to the same transmission chain. The eight genomes from a global dataset clustered closer to Brazilian strains differed in >52 SNVs. We hypothesized L3 and L1 were introduced in Brazilian Northern in the same historical event; however, there is a need for additional studies exploring the genetic diversity of Mtb Brazilian Northern.

Profile of oropharyngeal dysphagia patients in a teaching hospital in Northern Brazil: a descriptive cross-sectional study.

The aim of this study was to describe the profile of patients with oropharyngeal dysphagia in a teaching hospital in the public health system in northern Brazil. This is a descriptive cross-sectional study. All procedures of this study were approved by the ethics committee. A convenience sample composed of participants aged >18 years, of both sexes, with any underlying pathology admitted to the medical clinic on exclusive oral feeding, alternatively enteral or gastric tube feeding (Gastrostomy), or associated by both routes, whose swallowing assessment was performed by a Speech-Language Pathologist. Data from the database/medical records were investigated from March 2020 to September 2021. The sample consisted of 44 patients diagnosed with oropharyngeal dysphagia, with a higher frequency of males (63.64%) aged over 60 years (70.45%). Almost half of the evaluated patients were diagnosed with neurological disorders (47.73%) and had dysphagia associated with other underlying diseases (31.82%). Excluding patients with neurological disorders, trauma/polytrauma, and respiratory disorders from the last group, some patients (11.36%) had two concomitant underlying diseases. According to the sample of this study, the profile of oropharyngeal dysphagia patients includes pneumonia, respiratory failure, bronchoaspiration, and the consequent need for ventilatory support.

Association between the Arg72Pro Genotypes in the TP53 Gene and Ile655Val in the HER2 Gene and the Risk of Developing Breast Cancer in the Population of Amapá, Northern Brazil.

The polymorphisms Arg72Pro in the TP53 gene (rs1042522) and Ile655Val in the HER2 gene (rs1136201) have been related to susceptibility to several types of cancer. Different studies show the association of these polymorphisms with breast cancer, so our aim in this study was to investigate whether the Arg72Pro and Ile655Val polymorphisms have any influence on the risk of developing breast cancer in women from the city of Macapá, Amapá, located in the brazilian amazon region. We then analyzed 80 DNA samples from women with breast cancer and 83 DNA samples from women without the disease, by the Restriction Fragment Length Polymorphism - Polymerase Chain Reaction (PCR-RFLP) technique. The genotype frequencies for rs1042522 were Ar/Arg 23.7%, Arg/Pro 47.5% and Pro/Pro 28.5% in patients and in controls Ar/Arg 69.8%, Arg/Pro 19.2% and Pro/Pro 10.8%. For the HER-2 gene the frequency of Ile/Ile, Ile/Val and Val/Val genotypes was 82.5%, 17.5% and 0% in the patients and 75.9%, 20.4% and 3.6% in the controls. The presence of at least one altered allele in rs1042522 and rs1136201 polymorphisms was found in 91.25% of patient samples. This study found a significant association between the Arg/Pro and Pro/Pro genotypes in the TP53 gene and the Ile/Val genotype in the HER-2 gene and breast cancer risk, however, we emphasize that more studies need to be carried out in the investigated population to consolidate our results.

Effects of urbanization on the diversity of testate amoebae (Protist, Rhizopoda) in a stream of the southwestern Amazon basin (Igarapé São Francisco in Acre state, Brazil)

We investigated the diversity of testate amoebae in an urban stream located within the Igarapé São Francisco Environmental Protection Area in Acre, northern Brazil, during the dry season, and evaluated the factors mediating the structure of this protist community. We collected 108 water samples for the analysis of the testate amoeba community and the limnological variables at six sampling points on the stream, between July and September 2018. We used a Redundancy Analysis (RDA) to verify the influence of environmental variables on the protist community. We recorded 76 species of testate amoebae from eight families, with most records from the families Difflugiidae, Arcellidae, Centropydae and Netzeliidae. More than half (49) of the species were recorded in Acre for the first time. The abundance of the amoebae of the family Trigonopiridae was regulated by the dissolved oxygen concentrations and the pH, while that of the Netzeliidae, Dif-flugiidae and Lesquereusidae was influenced by the pH, chloride concentrations, and the depth and transparency of the water. In the case of the family Arcellidae, abundance was determined by the turbidity and transparency of the water and the nitrate concentrations, while that of Centropyxis sp. was associated with the concentrations of thermotolerant coliforms. These findings indicate that, while the São Francisco stream is subject to anthropogenic impacts, it still presents adequate conditions for these organisms in some of its stretches. The abundance of these amoebae was influenced primarily by the productivity of the system, as indicated by the high protist densities recorded in the areas in which primary productivity was highest. These findings support the use of these protists in studies that investigate the most appropriate indicator organisms that respond to anthropogenic impacts and shifts in environmental quality.The results of the present study demonstrated the importance of this aquatic ecosystem for the biodiversity of the study area, and the need to further expand our knowledge on the adaptations and interactions of the aquatic communities of the Amazon region.

New records in Thismia (Thismiaceae) for Pará state, northern Brazil

Abstract In the present study, we present new geographic distribution records of Thismia hyalina and T. melanomitra for Pará State, increasing the number of species of Thismiaceae in this state to three, with the previous register of T. singeri. The three species can be separated by the thickness of the roots, the presence of tuberous stems, outer tepal shape and colour, inner tepal shape and colour, and mitre presence. The description, taxonomic, ecological and geographic distribution comments along with photo plates of the studied species are presented.

Cave-dwellers Diploexochus (Isopoda, Armadillidae): new species and new records of the genus from Brazil

Two new species of Diploexochus are described. Diploexochus spinatus sp. nov. from Lapa do Honorato cave, located in the municipality of Iuiu, and Diploexochus obscurus sp. nov. from Água Escura I cave, located in the municipality of Carinhanha, both in the southwest of Bahia State, northeastern Brazil. Both species are likely to occur in caves due to anthropogenic impacts in the surrounding area (such as deforestation) and/or looking for the stable microclimatic conditions found in the subterranean realm. Additionally, D. echinatus is recorded in a cave in the municipality of Rurópolis, Pará State, northern Brazil. These represent the first records of the genus for subterranean environments.

BIOMETRY OF CARANGID FISH AS BY-CATCH IN ARTISANAL PINK SHRIMP FISHING IN THE AMAZON ESTUARY

The analysis of morphometry and length-weight relationships (LWR) contribute to the expansion of the set of information available for the conservation of fishery resources, being fundamental to mitigate the anthropogenic effects caused in the natural environment by artisanal shrimp fishing. The aim of this study was to analyze the morphometry and estimate the LWR for two species of fish of the family Carangidae (Oligoplites spp.) in an estuarine Amazon region, Northern Brazil. In the Guajará-Mirim estuary, the seasonality of the seasons (rainy and dry periods) mainly affects water salinity, with greater frequency of the O. saurus species in the rainy season and O. palometa in the less rainy one, the differences between the morphometric measures of the species of the genus Oligoplites captured by the shrimp trawl, indicate the occurrence of small individuals, with the species O. palometa showing negative allometric growth and O. saurus positive allometric, , being the first records of LWR estimates, contributing to the bioecological knowledge of the species.

CONFIRMAÇÃO DA OCORRÊNCIA DA Panulirus laevicauda (LATREILLE, 1817) NO GRANDE SISTEMA DE RECIFES DA AMAZÔNIA, AMAPÁ, BRASIL

The spiny lobsters of the genus Panulirus White, 1847 are widely exploited and commercialized in northern and northeastern Brazilian coastal regions. One of the species, the smoothtail spiny lobster Panulirus laevicauda (Latreille, 1817) had its distribution demarcated from Amapá to Santa Catarina State, but it was dubiously recorded in northern coast from industrial fishing samples, without collected material or photographs for taxonomic identification. Based on this, we report the occurrence of P. laevicauda in the northern region of Brazil (Amapá State) through material collected. The male specimen was collected on November 07th, 2022, at the depth of 84.5m, during commercial fishery operations of the red snapper Lutjanus purpureus (Poey, 1866), at the area of the Great Amazon Reef System (GARS) (04°45’29.849”N; 050°39’41.567”W). The current record confirms the occurrence of the species in Northern Brazil and it is the first report for the GARS.

Persistent Xerophthalmia in a Patient with Rheumatological Disease and Priiviary Sjogren’s Syndrome: Case Report from Northern Brazil

This case study aims to contribute to the literature in order to highlight the importance of this collaboration between medical specialties. A female patient R.N.N. F, age 66, from the city of Manaus, with a previous diagnosis of Sjogren’s syndrome in regular follow-up by the Rheumatology team at the Araujo Lima outpatient clinic and referred to the Ophthalmology sector for complementary evaluation related to visual discomfort. The fundoscopy performed in the patient was within normal limits, but the symptoms experienced by her proved to be an important clinical finding, which has ratified the need for regular and multidisciplinary follow-up. This report unequivocally demonstrates that even in the face of tests considered within the expected limits for a given population, the clinical presentation can be specific and particular for each analyzed individual. Early screening exams should contemplate the patient in a holistic and individualized way whenever possible.

Insights into dung beetle (Coleoptera: Scarabaeidae: Scarabaeinae) distribution along an elevational gradient in a tepui table-top mountain in the Brazilian Amazon

Abstract Elevational gradients are excellent models to understand species distribution across sites with marked shifts in environmental conditions. In northern South America, tepuis are table-top mountains with elevations above 1000 m and high biodiversity and endemism levels. In this study, we assessed the effect of elevation on dung beetle (Coleoptera: Scarabaeidae: Scarabaeinae) assemblage structure (species richness, abundance, and biomass) in Tepequém, a tepui located in northern Brazil. Dung beetles were sampled with pitfall traps within seven elevational bands from 250 to 850 m. A total of 83 individuals from 14 species were collected, Oxysternon festivum (Linnaeus, 1758) and an unidentified Onthophagus species being the most abundant. Elevation did not affect beetle species richness and biomass. However, species composition from 750 to 850 m differed statistically from that recorded at lower elevations. Our results suggest that beetle assemblages possess a bimodal distribution along an altitudinal gradient on the Tepequém. The contrasting vegetation structure of tepuis between highlands (shrubland savannah vegetation) and lowlands (tropical rainforest) explains the different composition of the assemblages. This study should be considered as a starting point in improving our understanding of the dung beetle diversity of tepuis, which present a unique singular relationship between elevation and species diversity.

Profile of oncological and breast repair surgeries in northern Brazil: Analysis of the last decade

Profile of oncological and breast repair surgeries in northern Brazil: Analysis of the last decade

NOVAS OCORRÊNCIAS DE PEIXE-LEÃOPterois volitans (LINNAEUS, 1758) NA PESCADO PARGO Lutjanus purpureus (POEY, 1866) NA COSTA NORTE DO BRASIL/New occurrences of lionfish Pterois volitans(Linnaeus, 1758) on the fisheries of the red snapper Lutjanus purpureus (Poey, 1866) onthe north coast of Brazil

The bioinvasion of the lionfish Pterois volitans is increasingly being observed along thenorthern coast of Brazil, leading to risks to the environment, such as biodiversity reduction,and to the human health, due to incidents with the animal. Thus, we report new occurrencesof lionfish at the Great Amazon Reef System (GARS), caught by commercial fishing of thered snapper Lutjanus purpureus (Poey, 1866), along the continental shelf of the AmapáState, northern Brazil. Eight specimens of P. volitans were collected, between the depths of80,5 to 100 m, in August 2022. They were photographed in situ. The presence of P. volitansin commercial fisheries may indicate a large abundance of it in the region of Amazonianreefs, leading to risks to the environment and expanding the colonization in other regionsand other ecosystems, thus making urgent the creation of management plans to control theinvasion in Brazilian waters.

Influence of climatic phenomena and deforestation on hydroenvironmental fragility, Gurupi River watershed, Northern Brazil

In recent decades, climatic and anthropogenic pressures have caused serious environmental problems. The joint analysis of geo-environmental variables, through geoprocessing techniques, can support the estimation of the contribution of each environmental component to hydro-environmental fragility (HF). The aim of this work was to analyze the contribution of climatic phenomena and deforestation in the HF of the Gurupi River Watershed (GRW). Precipitation data were extracted from the Climate Hazards Group InfraRed Precipitation with Stations (CHIRPS); land use and cover were obtained from the MapBiomas Project; drainage network was acquired from the National Water and Sanitation Agency (ANA); slope data were gathered from the National Institute for Space Research (INPE); soil data were obtained from the Brazilian Agricultural Research Corporation (EMBRAPA); geomorphological units were extracted from the Brazilian Institute of Geography and Statistics (IBGE); and rock data were based on the Geological Survey of Brazil (CPRM). For the mapping of HF, the Analytic Hierarchy Process (AHP) was adopted to weigh the importance of each variable in four extreme precipitation year scenarios (1989, 2012, 2015, and 2019). It was observed that spatial precipitation is considerably different in extreme years. Results showed that deforestation has increased over the years; and that static geo-environmental variables (drainage, slope, soils, geomorphological units, and rocks) have larger feature domains that favor the increase of HF in the GRW. The HF of the GRW showed significant differences in the analyzed scenarios. Policies and environmental conservation programs are needed in the GRW.

Pharmacological Characteristics of the Hydroethanolic Extract of Acmella oleracea (L) R. K. Jansen Flowers: ADME/Tox In Silico and In Vivo Antihypertensive and Chronic Toxicity Evaluation.

Acmella oleracea (L.) R. K. Jansen, popularly known as jambu in Northern Brazil, is widely used in folk medicine and local cuisine. Its consumption in different ways reinforces the need for safety assessments. In this study, the major compounds found in the hydroethanolic extract of A. oleracea flowers (EHFAO) were characterized by ultra-performance liquid mass spectrometry (UHPLC-ESI-QTOF-MS/MS). The effects of oral administration of 100/mg/kg of EHFAO extract over 60 days in male spontaneously hypertensive (SHR) and Wistar (WR) rats and the in silico ADME/Tox predictions, lipophilicity, and water solubility were accomplished for the compounds identified. Spilanthol was detected as the foremost major compound at a concentration of 97.7%, followed by 1.53% scopoletin and 0.77% d-limonene. The treatment with EHFAO did not alter the animals´ weight over the studied period. Moderate alterations were observed solely in the hepatic enzymes AST (WR = 97 UI/L and SHR = 150 UI/L ∗ p < 0.05) and ALT (WR = 55 UI/L and SHR = 95 UI/L ∗ p < 0.05), while no relevant histopathological alterations were found. The in-silico study confirmed the in vivo findings, as the identified compounds were considered highly bioactive orally, due to their drug similarity profiles, adequate lipid solubility, bioavailability, and pharmacokinetics. Therefore, the chronic treatment with EHFAO was found safe at the concentration of 100/mg/kg, with no interference in the blood pressure levels neither appreciable toxic effects.

COVID-19 EM TRABALHADORES DA SAÚDE: UM ESTUDO ECOLÓGICO A PARTIR DE DADOS DO SINAN, 2020-2021

ABSTRACT Objective: to analyze the epidemiological and occupational profile of health workers notified for COVID-19 in Brazil, in the years 2020 and 2021. Method: this is an ecological study, which used data from the Information System of Notifiable Diseases (SINAN) and the Annual Social Information List (RAIS), from the years 2020 and 2021. Sociodemographic and occupational variables were analyzed. The prevalence rates of COVID-19 in health workers were calculated, modeled by Poisson regression in the Stata 14 software. Results: in 2020 and 2021, 35,545 health workers were affected by COVID-19. A higher prevalence of the disease was observed in females (79.0%), between 30 and 49 years (65.5%) and in blacks and browns (41.4%). Higher rates were observed in women (793.9/100,000 in 2020), young workers (839.9/100,000 in 2020), non-whites (1,497.4/100,000 in 2020) and in northern Brazil, with 1,688.1 cases per 100,000 workers in 2020. Nursing professionals, physicians and physical therapists had the highest rates of the disease in 2020 and 2021. Conclusion: there was a difference between the sexes, as well as social, racial and occupational inequities that reflect the need to expand health surveillance measures in order to ensure greater prevention, protection and assistance to health workers.