Analysis of individuals with leukemia: cancer surveillance system limitations

Moraes, Elisane Silveira; Mello, Marcia Sarpa de Campos; Nogueira, Fernanda de Albuquerque Melo; Otero, Ubirani Barros; Carvalho, Flávia Nascimento de

doi:10.1590/1413-812320172210.18292017

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ARTICLE • Ciênc. saúde colet. 22 (10) • Oct 2017 • https://doi.org/10.1590/1413-812320172210.18292017 copy

Analysis of individuals with leukemia: cancer surveillance system limitations

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Cancer is the second leading cause of death in the world with great impact on public health and leukemia is a hematological cancer directly related to different exposures at work. This study aimed to describe the occupational profile of individuals diagnosed with leukemia. This is a cross-sectional study of cases registered between 2007 and 2011 in the Integrador RHC database. Individuals from 26 Brazilian states, aged 20 years or older, were included. Of the 7,807 cases of leukemia, Minas Gerais recorded the highest occurrence (1,351). Only 52% of the cases had information on occupation. Occupations with the greatest number of cases of leukemia were agricultural, forestry and fishing workers; services, stores and markets vendors; and workers in the production of industrial goods and services. These occupations are exposed to substances considered by literature as carcinogenic agents to humans. There was a high underreporting of occupational data, compromising the quality of information and, therefore, the effectiveness of the Brazilian health surveillance system. The RHC also does not provide information about the agent used during the working day, the exposure time during working life and data from previous occupations.

Leukemia; Occupational exposure; Hospital-based cancer records

CBO - Brazilian Classification of Occupations
0 Members of the armed forces, police and military firefighters
1 Senior members of public authorities, leaders of public and corporate interest organizations, managers
2 Science and the arts professionals
3 Mid-level technicians
4 Administrative service workers
5 Service, shop and market sellers workers
6 Agricultural, forestry and fishing workers
7 Workers in the production of industrial goods and services^(a)
8 Workers in the production of industrial goods and services^(b)
9 Workers in repair and maintenance services

UF of origin	Leukemia Cases	No occupation records	Occupation records available	% completion
Acre	29	17	12	41.4
Alagoas	131	57	74	56.5
Amapá	9	5	4	44.4
Amazonas	70	24	46	65.7
Bahia	414	199	215	51.9
Ceará	304	158	146	48.0
Distrito Federal	12	5	7	58.3
Espírito Santo	253	121	132	52.2
Goiás	8	2	6	75.0
Maranhão	143	83	60	42.0
Mato Grosso	98	53	45	45.9
Mato Grosso do Sul	89	56	33	37.1
Minas Gerais	1351	629	722	53.4
Para	217	135	82	37.8
Paraiba	207	101	106	51.2
Parana	870	359	511	58.7
Pernambuco	241	150	91	37.8
Piauí	223	124	99	44.4
Rio de Janeiro	1047	383	664	63.4
Rio Grande do Norte	267	204	63	23.6
Rio Grande do Sul	1082	597	485	44.8
Rondônia	8	5	3	37.5
Roraima	3	0	3	100.0
Santa Catarina	624	239	385	61.7
Sergipe	10	10	0	-
Tocantins	97	34	63	64.9
Total	7.807	3.750	4.057	52.0

Large occupation groups		N	%
GG 0	Members of the armed forces. police and military firefighters	54	0.69
GG 1	Senior members of public authorities. Leaders of public and corporate interest organizations. managers	266	3.41
	Merchant	196	2.51
	Senior member of the Executive and Judiciary Branches. Senior public servant	41	0.53
	Directors and managers	29	0.37
GG 2	Science and the arts professionals	394	5.05
	Chemist. Physicist.	2	0.03
	Agronomist, civil, electric and mechanical engineers. Architect. Decorator.	33	0.42
	Biologist. Bacteriologist / Pharmacologist. Doctor. Dentist. Veterinarian. Pharmacist. Nutritionist. Nurse.	54	0.69
	Social worker. Psychologist. Therapist.	14	0.18
	Systems Analyst. Economist. Accountant. Lawyer.	57	0.73
	Higher education teacher.	37	0.47
	Primary and secondary schoolteacher.	133	1.70
	Artists.	33	0.42
	Librarian/Archivist.	3	0.04
	Religious.	6	0.08
	Secretary.	19	0.24
	Jobs / Salaries analyst; tax technician.	3	0.04
GG 3	Mid-level technicians	188	2.41
	Accounting and Administration technicians. Insurance analyst.	29	0.37
	Biology, chemical analysis, nursing/laboratory, production control technician; midwife; nursing staff; agricultural administrator	61	0.78
	Mining, building, electronics/telecommunications, mechanic; technical drawing technician; designer; computer programmer; computer operator. sound/cinema operator; pilots and the like	41	0.53
	Pre-school and professional training teachers	8	0.10
	Servants of justice and other public agents	17	0.22
	Buyer; sales agent; external salesman; broker; service sale agent	32	0.41
GG 4	Administrative service workers	149	1.91
	Administrative agent; office assistants and accounting/cashier; chief administrative officer and others	110	1.41
	Dactylographer/stenographer; typist	3	0.04
	Postman / messenger; Telephone operator / telegraph operator; Booth attendant; front desk clerk	32	0.41
	Supply/storage worker	4	0.05
GG 5	Service. shop and market sellers workers	999	12.80
	Domestic / Domestic service workers	518	6.64
	Building services workers	106	1.36
	Sales manager. Salesperson. Ambulant / day laborer. Other trade professionals	159	2.04
	Hairdresser/beauty worker; launderer/dyer	48	0.61
	Police officer; firefighter; security guard; Other security workers	94	1.20
	Customs broker/public transport inspector	6	0.08
	Butler / housekeeper; cook; waiter; commissioner; workers in building administration services; travel agent / tour guide	51	0.65
	Other works/services	17	0.22
GG 6	Agricultural. forestry and fishing workers	1027	13.15
	Farming workers	427	5.47
	Agricultural workers	533	6.83
	Livestock workers	11	0.14
	Forestry workers	1	0.01
	Fishing workers	55	0.70
GG 7	Workers in the production of industrial goods and services	848	10.86
	Master of civil construction; miner / construction site worker; other mineral extraction and beneficiation workers; molding machine workers; ceramist and other glass/ceramic workers; brickwork/parquetry worker; glazier; other civil construction workers; civil construction machine operator; works and metal structures painter; other painters; mason/plasterer.	307	3.93
	Wood treatment workers; other chemical workers; joiner; wood plowing machine operator; carpenter and other woodworking workers	57	0.73
	Weaver; knitwear weaver; textile finishing worker; other textile workers; leather/skin tanner; tailor/dressmakers; modeler/cutter; serial-couturier; embroiderer/serger; Other sewing workers; shoemaker; shoe manufacturing and finishing workers.	98	1.26
	Toolmaker/modeler; turner/milling machine worker; machine-tool operator; Metal sharpening and polishing workers; other machining work; mechanical adjuster; Machine builder	23	0.29
	Electric and electronic assemblers; installations electrician and other electrical workers	39	0.50
	Plumber / pipe installer; Welder / flame cutter; plating/boiler worker; assembler of metal structures; jeweler/goldsmith	41	0.53
	Typographic composer; typographic printer; photographic laboratory worker; other graphic works	9	0.12
	Stevedore / loader; Other commodity handlers; Other manual workers	34	0.44
	Vehicle driver. Train driver/stoker; maneuvering agent/assistant; animal drivers and other drivers	240	3.07
GG 8	Workers in the production of industrial goods and services	64	0.82
	Fusion oven operator; other metallurgy/steel workers; glass oven operator	23	0.29
	Sugar manufacture and refining worker; food industry worker; baker/confectioner; Cachaça, beer, wine and other beverage manufacture workers; other food manufacture and preservation workers.	26	0.33
	Fixed machine operator	15	0.19
GG 9	Workers in repair and maintenance services	68	0.87
	Vehicles, aircraft and machinery maintenance mechanics; other mechanical work.	66	0.85
	Railway agent	2	0.03
	Total completed	4057	52.00
	Not applicable	556	7.12
	Work not classified according to occupation	1627	20.84
	Without information	1567	20.07
	Total not completed	3750	48.00
Total		7807	100.00

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[1] Collaborators

FN Carvalho, MSC Mello and UB Otero worked in design and outline or data review and interpretation; paper writing or critical review; approval of the version to be published. Flávia Nascimento de Carvalho; ES Moraes participated in design and outline or data review and interpretation; in paper writing or critical review. FAM Nogueira participated in paper writing or critical review.