Perfil epidemiológico das internações hospitalares em dois municípios do Estado do Pará com características ambientais distintas

Abstract

Introduction: It is known that anthropic actions in the environment can lead to illness in the population that depends directly or indirectly on this system. This concern with environmental conditions and health effects has been observed since antiquity, and highlights that environmental problems go hand in hand with health problems, as man and society are affected in different dimensions. We know that environmental changes arising from human actions have a direct impact on society's quality of life, maximizing the risk of exposure to diseases. The impacts related to new forms of life have increased exposure profiles to chemical substances, contaminated environmental compartments and other destructive processes, which are cumulatively expressed in a new epidemiological profile. Objective: To analyze the epidemiological profile of patients hospitalized in two locations with different environmental exposures in the state of Pará. Methodology: This is an analytical cross-sectional study. Data from hospital admissions in the SUS of residents in cities of equivalent size and population, but with different sources of economy and subsistence, were used: Parauapebas is located in the Southeast region of the State of Pará; and Castanhal in the metropolitan region of Belém. The data collected refer to the period from January 2015 to December 2019. The basic sanitation data of the two regions were collected through the IBGE database. Descriptive analysis of all study variables was performed, in terms of their absolute and relative values. To test associations between qualitative variables, Pearson's chi-square test and/or Fisher's exact test were used. Prevalences were calculated by group of diseases, stratified by sex and age. Prevalence ratios were calculated considering the region of Carajás, more specifically Parauapebas, as the exposed region and the Metropolitan region of Belém, more specifically Castanhal, as the region not exposed to environmental contaminants. The significance level assigned in all tests was 5%. The statistical package used was SPSS 24.0 for Windows. Results: During the period studied, 97,328 admissions were registered in the two municipalities, with 55,737 admissions in Castanhal and 41,591 admissions in Parauapebas. Approximately 63.2% of admissions were male patients with female admissions representing 36.8% of records. It is observed that, after 2016, the number of hospitalizations grew over the years, with the municipality of Castanhal showing an apparently linear growth trend. In Parauapebas there was also an annual increase in admissions from 2016 onwards, with a downward trend in the last year of the series. In Castanhal, in addition to cases related to pregnancy, childbirth and puerperium (O00 - O99), which are the most frequent events with a prevalence of 28.7%, hospitalizations for injuries, poisoning and some other consequences of external causes (S00-S99 ) with a prevalence of 10.7% and those caused by respiratory diseases (J00-J99) with a prevalence of 10.3% are the two most frequent groups of hospitalizations, followed by diseases of the digestive system (K00-K99) with a prevalence of 7 .6%. In Parauapebas, hospitalizations related to pregnancy, childbirth and puerperium predominated (O00 ¿ O99) with a prevalence of 42.2%. Then there were those related to injuries, poisonings and some other consequences of external causes (S00-S99) with a prevalence of 13.2%, and those caused by diseases of the digestive system (K00-K99) with a prevalence of 7.1% and the diseases of the respiratory system (J00-J99). Conclusions: We can conclude that in two environmentally distinct municipalities we found different comorbidities profile, and even in those chapters that were similar in both locations, the growth percentage was higher in the city considered exposed.