Ecological association between socioeconomic, occupational and sanitation factors and the occurrence of scorpionism in Brazil, 2007-2019

Almeida, Ana Caroline Caldas de; Mise, Yukari Figueroa; Carvalho, Fernando Martins; Silva, Rejâne Maria Lira da

doi:10.1590/S1679-49742021000400021

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Original Article • Epidemiol. Serv. Saúde 30 (4) • 2021 • https://doi.org/10.1590/S1679-49742021000400021 linkcopy

Ecological association between socioeconomic, occupational and sanitation factors and the occurrence of scorpionism in Brazil, 2007-2019^*

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To analyze ecological association between socioeconomic, occupational and sanitation characteristics and scorpionism in Brazil.

Methods This was an ecological study with data on scorpion sting accidents reported on the Notifiable Health Conditions Information System (2007-2019). Negative binomial regression was used to estimate incidence rate ratios (IRR) and confidence intervals (95%CI).

Results In the study period there were 1,079,333 scorpion sting accidents, with a cumulative incidence rate of 41.5/100,000 inhabitants. In the adjusted analysis, there was association with the municipal percentages of: women (IRR=1.65 - 95%CI 1.18;2.30) and men (IRR=0.90 - 95%CI 0.88;0.91) working in the construction industry, women (IRR=1.21 - 95%CI 1.18;1.25) and men (IRR=0.73 - 95%CI 0.69;0.77) working in domestic service, women (IRR=1.03 - 95%CI 1.02;1.04) and men (IRR=0.93 - 95%CI 0.92;0.93) working in farming, households with refuse collection (IRR=0.99 - 95%CI 0.98;0.99) and households with refuse left nearby (IRR=1.02 - 95%CI 1.01;1.02), expected years of schooling (IRR=0.88 - 95%CI 0.83;0.92), and unemployment rate (IRR=1.07 - 95%CI 1.05;1.09).

Conclusion Scorpionism was associated with precarious infrastructure/sanitation, job availability, education and female occupation.

Keywords:
Scorpion Sting; Social Determinants of Health; Epidemiology; Ecological Studies; Occupational Health

Municipal descriptor	Municipal variables	Description of municipal variables
Occupational	Men working in domestic service	Percentage of men working in domestic service
	Women working in domestic service	Percentage of women working in domestic service
	Men working in farming	Percentage of men working in farming
	Women working in farming	Percentage of women working in farming
	Men working in the construction industry	Percentage of men working in the construction industry
	Women working in the construction industry	Percentage of women working in the construction industry
Socioeconomic	Annual per capita income	Average income per person (currency: BRL)
	Poor population	Percentage of the population in a situation of poverty
	Human development index (HDI)	HDI expressed as a percentage
	Social vulnerability index (SVI)	SVI expressed as a percentage
	Illiteracy rate	Percentage of the illiterate population aged ≥18 years
	Expected number of years of schooling	Average number of years of schooling that a generation of children would have at 18 years
	Unemployment rate	Percentage of unemployed people of economically active age
Infrastructure/Sanitation	Households with water supply	Percentage of households with water supply
	Households with refuse collection	Percentage of households with refuse collection
	Households with refuse left nearby	Percentage of households with refuse left nearby
	Households with sewage nearby	Percentage of households with sewage nearby

Municipal variables	Average percentage	Median percentage	Standard deviation	Minimum	Maximum
Occupational (%)
Men working in the construction industry	6.22	5.81	2.90	0.11	24.22
Women working in the construction industry	0.13	0.08	0.16	0.00	1.57
Men working in domestic service	0.57	0.36	0.75	0.00	12.13
Women working in domestic service	5.53	5.39	2.26	0.00	19.85
Men working in farming	25.96	27.48	12.68	0.01	65.61
Women working in farming	10.13	8.66	7.34	0.00	37.73
Infrastructure/sanitation (%)
Households with refuse collection	70.26	74.10	21.85	0.00	100.00
Households with water supply	69.10	72.60	19.93	0.00	100.00
Households with refuse left nearby	3.31	0.86	6.24	0.00	90.43
Households with sewage nearby	12.96	2.24	22.22	0.00	100.00
Socioeconomic
Illiteracy rate (%)	17.40	14.11	10.70	0.97	47.64
Expected number of years of schooling (average)	9.46	9.47	1.10	4.34	12.83
Human development index (HDI) (%)	65.97	67.00	7.21	42.00	86.00
Social vulnerability index (SVI) (%)	35.16	33.40	13.01	9.00	78.40
Poor population (%)	23.20	18.12	17.92	0.00	78.59
Annual per capita income (currency: BRL)	493.65	467.74	243.27	96.25	2,043.74
Unemployment rate (%)	6.19	5.66	3.66	0.00	38.45

Independent municipal variables	Bivariate			Multivariate
Independent municipal variables	IRR^b	Standard error	95%CI^c	IRR^b	Standard error	95%CI^c
Occupational (%)
Men working in the construction industry	1.16	0.01	1.14;1.19	0.90	0.01	0.88;0.91
Women working in the construction industry	31.44	5.55	22.24;44.45	1.65	0.28	1.18;2.30
Men working in domestic service	0.84	0.02	0.79;0.89	0.73	0.02	0.69;0.77
Women working in domestic service	1.39	0.02	1.35;1.42	1.21	0.02	1.18;1.25
Men working in farming	0.95	0.00	0.94;0.95	0.93	0.00	0.92;0.93
Women working in farming	0.92	0.00	0.92;0.93	1.03	0.01	1.02;1.04
Infrastructure/sanitation (%)
Households with refuse collection	1.03	0.00	1.02;1.03	0.99	0.00	0.98;0.99
Households with water supply	1.03	0.00	1.03;1.03
Households with refuse left nearby	1.07	0.01	1.05;1.08	1.02	0.00	1.01;1.02
Households with sewage nearby	1.00	0.00	0.99;1.00
Socioeconomic
Illiteracy rate (%)	0.93	0.00	0.93;0.94
Expected number of years of schooling (years)	1.27	0.03	1.20;1.34	0.88	0.02	0.83;0.92
Human development index (HDI) (%)	1.11	0.00	1.10;1.11
Social vulnerability index (SVI) (%)	0.96	0.00	0.96;0.97
Poor population (%)	0.96	0.00	0.96;0.96
Annual per capita income (currency: BRL)	1.00	0.00	1.00;1.00
Unemployment rate (%)	1.20	0.01	1.18;1.22	1.07	0.01	1.05;1.09

Variable	Working in the construction industry (%)		Working in domestic service (%)		Working in farming (%)		Households with refuse collection (%)	Households with refuse left nearby (%)	Expected number of years of schooling	Unemployment rate (%)
Variable	Men	Women	Men	Women	Men	Women	Households with refuse collection (%)	Households with refuse left nearby (%)	Expected number of years of schooling	Unemployment rate (%)
Men working in the construction industry (%)	1.00
Women working in the construction industry (%)	-0.12	1.00
Men working in domestic service (%)	0.09	-0.20	1.00
Women working in domestic service (%)	0.08	0.03	-0.12	1.00
Men working in farming (%)	0.04	0.07	0.29	0.10	1.00
Women working in farming (%)	0.26	0.27	0.07	0.04	-0.33	1.00
Households with refuse collection (%)	0.03	0.19	-0.02	0.12	0.30	0.51	1.00
Households with refuse left nearby (%)	-0.05	0.01	-0.03	-0.06	-0.03	0.14	0.11	1.00
Expected number of years of schooling	-0.01	0.06	0.02	0.03	-0.04	0.15	-0.14	0.07	1.00
Unemployment rate (%)	0.01	-0.12	-0.04	0.00	0.18	0.00	-0.04	-0.09	0.11	1.00

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Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 (61) 3315-3464 - Brasília - DF - Brazil
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[TFN2] Source: Brazilian Institute of Geography and Statistics (IBGE), 2010 Demographic Census.

Ecological association between socioeconomic, occupational and sanitation factors and the occurrence of scorpionism in Brazil, 2007-2019*

Abstract

Ecological association between socioeconomic, occupational and sanitation factors and the occurrence of scorpionism in Brazil, 2007-2019^*