Sugarcane cutting work, risks, and health effects: a literature review

Leite, Marceli Rocha; Zanetta, Dirce Maria Trevisan; Trevisan, Iara Buriola; Burdmann, Emmanuel de Almeida; Santos, Ubiratan de Paula

doi:10.11606/S1518-8787.2018052000138

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review • Rev. Saúde Pública 52 • 2018 • https://doi.org/10.11606/S1518-8787.2018052000138 copy

Sugarcane cutting work, risks, and health effects: a literature review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

Describe the main work risks for sugarcane cutters and their effects on workers’ health.

METHODS

Critical review of articles, with bibliographic research carried out in the PubMed, SciELO Medline, and Lilacs databases. The following keywords were used: sugarcane workers, sugarcane cutters, sugarcane harvesting, cortadores de cana-de-açú car , and colheita de cana -de-açúcar . The inclusion criteria were articles published between January 1997 and June 2017, which evaluated working conditions and health effects on sugarcane cutters. Those that did not deal with the work impact of cutting burned and unburnt sugarcane in the cutter’s health were excluded. The final group of manuscripts was selected by the lead author of this study and reviewed by a co-author. Disagreements were resolved by consensus using the predefined inclusion and exclusion criteria and, where necessary, the final decision was made by consulting a third co-author.

RESULTS

From the 89 articles found, 52 met the selection criteria and were evaluated. Studies have shown that cutters work under conditions of physical and mental overload, thermal overload, exposure to pollutants, and are subject to accidents. The main effects observed were respiratory, cardiovascular, renal, musculoskeletal, heat stress, dehydration, genotoxic, and those due to accidents.

CONCLUSIONS

Work on the manual cutting of sugarcane, especially of burned sugarcane, exposes workers to various risks, with different health impacts. Risk reduction for exposure to pollution and thermal and physical overload is required as a measure to preserve the health of the worker.

Rural Workers; Health Status; Working Conditions; Occupational Risks; Occupational Health; Review

Topics covered	Authors	Number of articles
Mucociliary clearance	Ferreira-Ceccato et al. ²⁰20. Ferreira-Ceccato AD, Ramos EMC, Carvalho LCS Jr, Xavier RF, Teixeira MFS, Raymundo-Pereira PA, et al. Short-term effects of air pollution from biomass burning in mucociliary clearance of Brazilian sugarcane cutters . Respir Med . 2011;105(11):1766-8. https://doi.org/10.1016/j.rmed.2011.08.003 https://doi.org/10.1016/j.rmed.2011.08.0... ; Goto et al. ¹⁹19. Goto DM, Lança M, Obuti CA, Barbosa CMG, Saldiva PHN, Zanetta DMT, et al. Effects of biomass burning on nasal mucociliary clearance and mucus properties after sugarcane harvesting . Environ Res . 2011;111(5):664-9. https://doi.org/10.1016/j.envres.2011.03.006 https://doi.org/10.1016/j.envres.2011.03...	2
Respiratory symptoms	Prado et al. ¹⁸18. Prado GF, Zanetta DM, Arbex MA, Braga AL, Pereira LA, Marchi MR, et al. Burnt sugarcane harvesting: particulate matter exposure and the effects on lung function, oxidative stress, and urinary 1-hydroxypyrene . Sci Total Environ . 2012;437:200-8. https://doi.org/1016/j.scitotenv.2012.07.069 https://doi.org/1016/j.scitotenv.2012.07... ; Ferreira-Ceccato et al. ²⁰20. Ferreira-Ceccato AD, Ramos EMC, Carvalho LCS Jr, Xavier RF, Teixeira MFS, Raymundo-Pereira PA, et al. Short-term effects of air pollution from biomass burning in mucociliary clearance of Brazilian sugarcane cutters . Respir Med . 2011;105(11):1766-8. https://doi.org/10.1016/j.rmed.2011.08.003 https://doi.org/10.1016/j.rmed.2011.08.0...	2
Pulmonary function	Prado et al. ¹⁸18. Prado GF, Zanetta DM, Arbex MA, Braga AL, Pereira LA, Marchi MR, et al. Burnt sugarcane harvesting: particulate matter exposure and the effects on lung function, oxidative stress, and urinary 1-hydroxypyrene . Sci Total Environ . 2012;437:200-8. https://doi.org/1016/j.scitotenv.2012.07.069 https://doi.org/1016/j.scitotenv.2012.07... ; Goto et al. ¹⁹19. Goto DM, Lança M, Obuti CA, Barbosa CMG, Saldiva PHN, Zanetta DMT, et al. Effects of biomass burning on nasal mucociliary clearance and mucus properties after sugarcane harvesting . Environ Res . 2011;111(5):664-9. https://doi.org/10.1016/j.envres.2011.03.006 https://doi.org/10.1016/j.envres.2011.03...	2
Inflammatory markers and oxidative stress	Prado et al. ¹⁸18. Prado GF, Zanetta DM, Arbex MA, Braga AL, Pereira LA, Marchi MR, et al. Burnt sugarcane harvesting: particulate matter exposure and the effects on lung function, oxidative stress, and urinary 1-hydroxypyrene . Sci Total Environ . 2012;437:200-8. https://doi.org/1016/j.scitotenv.2012.07.069 https://doi.org/1016/j.scitotenv.2012.07... ; Barbosa et al. ¹⁴14. Barbosa CM, Terra-Filho M, Albuquerque AL, Di Giorgi D, Grupi C, Negrão CE, et al. Burnt sugarcane harvesting: cardiovascular effects on a group of healthy workers, Brazil . PLoS One . 2012;7(9):e46142. https://doi.org/10.1371/journal.pone.0046142 https://doi.org/10.1371/journal.pone.004... ; Santos et al. ³¹31. Paula Santos U, Zanetta DM, Terra-Filho M, Burdmann EA. Burnt sugarcane harvesting is associated with acute renal dysfunction . Kidney Int . 2015;87(4):792-9. https://doi.org/10.1038/ki.2014.306 https://doi.org/10.1038/ki.2014.306...	3
Pulmonary disease	Sacchi et al. ⁷⁹79. Sacchi FP, Croda MG, Estevan AO, Ko AI, Croda J. Sugar cane manufacturing is associated with tuberculosis in an indigenous population in Brazil. Trans R Soc Trop Med Hyg . 2013;107(3):152-7. https://doi.org/10.1093/trstmh/trs089 https://doi.org/10.1093/trstmh/trs089...	1
Cardiovascular effects	Barbosa et al. ¹⁴14. Barbosa CM, Terra-Filho M, Albuquerque AL, Di Giorgi D, Grupi C, Negrão CE, et al. Burnt sugarcane harvesting: cardiovascular effects on a group of healthy workers, Brazil . PLoS One . 2012;7(9):e46142. https://doi.org/10.1371/journal.pone.0046142 https://doi.org/10.1371/journal.pone.004... ; Vilela et al. ¹³13. Vilela RAG, Laat EF, Luz VG, Silva AJN, Takahashi MAC. Pressão por produção e produção de riscos: a “maratona” perigosa do corte manual da cana-de-açúcar . Rev. Bras Saude Ocup. 2015;40(131):30-48. https://doi.org/10.1590/0303-7657000075413 https://doi.org/10.1590/0303-76570000754...	2
Renal effects	Garcia-Trabanino et al. ⁴⁵45. Garcia-Trabanino R, Jarquín E, Wesseling C, Johnson RJ, González-Quiroz M, Weiss I, et al. Heat stress, dehydration, and kidney function in sugarcane cutters in El Salvador: a cross-shift study of workers at risk of Mesoamerican nephropathy . Environ Res . 2015;142:746-55. https://doi.org/10.1016/j.envres.2015.07.007 https://doi.org/10.1016/j.envres.2015.07... ; Laws et al. ⁵⁸58. Laws RL, Brooks DR, Amador JJ, Weiner DE, Kaufman JS, Ramirez-Rubio O, et al. Changes in kidney function among Nicaraguan sugarcane workers . Int J Occup Environ Health . 2015;21(3):241-50. https://doi.org/10.1179/2049396714y.0000000102 https://doi.org/10.1179/2049396714y.0000... ; Laws et al. ⁵⁹59. Laws RL, Brooks DR, Amador JJ, Weiner DE, Kaufman JS, Ramírez-Rubio O, et al. Biomarkers of kidney injury among Nicaraguan sugarcane workers . Am J Kidney Dis . 2016;67(2):209-17. https://doi.org/10.1053/j.ajkd.2015.08.022 https://doi.org/10.1053/j.ajkd.2015.08.0... ; López-Marin et al. ⁶⁰60. López-Marín L, Chávez Y, García XA, Flores WM, Garcia YM, Herrera R, et al. Histopathology of chronic kidney disease of unknown etiology in Salvadoran agricultural communities. MEDICC Rev . 2014 [cited 2017 Mar 14];16(2):49-54. Available from: http://www.medicc.org/mediccreview/index.php?issue=28&id=354&a=va http://www.medicc.org/mediccreview/index... ; Murray et al. ¹²12. Murray KO, Fischer RS, Chavarria D, Duttmann C, Garcia MN, Gorchakov R, et al. Mesoamerican nephropathy: a neglected tropical disease with an infectious etiology? Microbes Infect . 2015;17(10):671-5. https://doi.org/10.1016/j.micinf.2015.08.005 https://doi.org/10.1016/j.micinf.2015.08... ; Peraza et al. ⁴¹41. Peraza S, Wesseling C, Aragon A, Leiva R, García-Trabanino RA, Torres C, et al. Decreased kidney function among agricultural workers in El Salvador . Am J Kidney Dis . 2012;59(4):531-40. https://doi.org/10.1053/j.ajkd.2011.11.039 https://doi.org/10.1053/j.ajkd.2011.11.0... ; Roncal-Jimenez et al. ⁶¹61. Roncal-Jimenez C, García-Trabanino R, Barregard L, Lanaspa MA, Wesseling C, Harra T, et al. Heat stress nephropathy from exercise-induced uric acid crystalluria: a perspective on Mesoamerican nephropathy . Am J Kidney Dis . 2016;67(1):20-30. https://doi.org/10.1053/j.ajkd.2015.08.021 https://doi.org/10.1053/j.ajkd.2015.08.0... ; Santos et al. ³¹31. Paula Santos U, Zanetta DM, Terra-Filho M, Burdmann EA. Burnt sugarcane harvesting is associated with acute renal dysfunction . Kidney Int . 2015;87(4):792-9. https://doi.org/10.1038/ki.2014.306 https://doi.org/10.1038/ki.2014.306... ; Wesseling et al. ⁶²62. Wesseling C, Wendel de Joode B, Crowe J, Rittner R, Sanati NA, Hogstedt C, et al. Mesoamerican nephropathy: geographical distribution and time trends of chronic kidney disease mortality between 1970 and 2012 in Costa Rica . Occup Environ Med . 2015;72(10):714-21. https://doi.org/10.1136/oemed-2014-102799 https://doi.org/10.1136/oemed-2014-10279... ; Wesseling et al. ¹¹11. Wesseling C, Aragón A, González M, Weiss I, Glaser J, Bobadilla NA, et al. Kidney function in sugarcane cutters in Nicaragua: a longitudinal study of workers at risk of Mesoamerican nephropathy . Environ Res . 2016;147:125-32. https://doi.org/10.1016/j.envres.2016.02.002 https://doi.org/10.1016/j.envres.2016.02... ; Wesseling et al. ⁶³63. Wesseling C, Aragón A, González M, Weiss I, Glaser J, Rivard CJ, et al. Heat stress, hydration and uric acid: a cross-sectional study in workers of three occupations in a hotspot of Mesoamerican nephropathy in Nicaragua . BMJ Open . 2016;6(12):e011034. https://doi.org/10.1136/bmjopen-2016-011034 https://doi.org/10.1136/bmjopen-2016-011... ; Wijkström et al. ⁴⁶46. Wijkström J, González-Quiroz M, Hernandez M, Trujillo Z, Hultenby K, Ring A, et al. Renal morphology, clinical findings, and progression rate in Mesoamerican nephropathy . Am J Kidney Dis . 2017;69(5):626-36. https://doi.org/10.1053/j.ajkd.2016.10.036 https://doi.org/10.1053/j.ajkd.2016.10.0...	12
Miscellaneous infections (toxoplasmosis, leptospirosis, and brucellosis)	Adesiyun et al. ⁶⁴64. Adesiyun A, Rahaman S, Bissessar S, Dookeran S, Stewart-Johnson A, Hilaire MG. Seroprevalence of toxoplasmosis, leptospirosis and brucellosis in sugarcane field-workers in Trinidad and Tobago . West Indian Med J . 2010;59(1):14-9. Available from: http://caribbean.scielo.org/pdf/wimj/v59n1/v59n1a04.pdf http://caribbean.scielo.org/pdf/wimj/v59...	1
Quality of life assessment	Carvalho-Junior et al. ⁶⁵65. Carvalho Junior LCS, Ramos EMC, Toledo AC, Ceccato ADF, Macchione M, Braga AL, et al. Assessment of health-related quality of life of sugarcane cutters in the pre-harvest and harvest periods . Rev Saude Publica . 2012;46(6):1058-65. https://doi.org/10.1590/S0034-89102012000600016 https://doi.org/10.1590/S0034-8910201200...	1
Stress, physical and mental symptoms	Priuli et al. ⁶⁶66. Priuli RMA, Moraes MS, Chiaravalloti RM. The impact of stress on the health of sugar cane cutters . Rev Saude Publica . 2014;48(2):225-31. https://doi.org/10.1590/S0034-8910.2014048004798 https://doi.org/10.1590/S0034-8910.20140...	1
Frequency of sick leave due to occupational diseases	Ferreira-Ceccato et al. ⁶⁷67. Ceccato ADF, Carvalho Junior LCS, Cuissi RC, Monteschi M, Oliveira NG, Padovani CR, et al. Absenteísmo por doença ocupacional de trabalhadores rurais no setor canavieiro. Cad Saude Publica . 2014;30(10):2169-76. https://doi.org/10.1590/0102-311X00026413 https://doi.org/10.1590/0102-311X0002641...	1
Ergonomic assessment of the work	Abrahão et al. ¹⁶16. Abrahão RF, Gonzaga MC, Braunbeck OA. Protective gloves on manual sugar cane cutting are really effective? Work . 2012;41 Suppl 1:4963-6. https://doi.org/10.3233/wor-2012-0039-4963 https://doi.org/10.3233/wor-2012-0039-49...	1
Occurrence of fungi in the ocular conjunctiva	Dalfré et al. ⁶⁸68. Dalfré JT, Rodrigues JPB, Donato BG, Giancoli Neto A, Carvalho JL, Oliveira DIA, et al. Microbiota fúngica da conjuntiva, da cana-de-açúcar e de anemófilos da região canavieira de Monte Belo - Minas Gerais. Arq Bras Oftalmol . 2007;70(3):445-9. https://doi.org/10.1590/S0004-27492007000300011 https://doi.org/10.1590/S0004-2749200700...	1
Risk of lung and oral cavity cancer	Amre et al. ⁶⁹69. Amre DK, Infante-Rivard C, Dufresne A, Durgawale PM, Ernst P. Case-control study of lung cancer among sugar cane farmers in India. Occup Environ Med . 1999 [cited 2017 Mar 14];56(8):548-52. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1757779/pdf/v056p00548.pdf https://www.ncbi.nlm.nih.gov/pmc/article... ; Coble et al. ⁷⁰70. Coble JB, Brown LM, Hayes RB, Huang WY, Winn DM, Gridley G, et al. Sugarcane farming, occupational solvent exposures, and the risk of oral cancer in Puerto Rico . J Occup Environ Med . 2003;45(8):869-74. https://doi.org/10.1097/01.jom.0000083034.56116.0f https://doi.org/10.1097/01.jom.000008303...	2
Exposure to potentially carcinogenic agents and genotoxic effects	Prado et al. ¹⁸18. Prado GF, Zanetta DM, Arbex MA, Braga AL, Pereira LA, Marchi MR, et al. Burnt sugarcane harvesting: particulate matter exposure and the effects on lung function, oxidative stress, and urinary 1-hydroxypyrene . Sci Total Environ . 2012;437:200-8. https://doi.org/1016/j.scitotenv.2012.07.069 https://doi.org/1016/j.scitotenv.2012.07... ; Bosso et al. ⁴⁷47. Vale Bosso RM, Amorim LMF, Andrade SJ, Rossini A, Marchi MRR, Ponce de Leon A, et al. Effects of genetic polymorphisms CYP1A1, GSTM1, GSTT1 and GSTP1 on urinary 1-hydroxypyrene levels in sugarcane workers . Sci Total Environ . 2006;370(2-3):382-90. https://doi.org/10.1016/j.scitotenv.2006.07.025 https://doi.org/10.1016/j.scitotenv.2006... ; Martinez-Vanezuela et al. ⁴⁸48. Martinez-Valenzuela C, Rodríguez-Quintana AR, Meza E, Waliszewski SM, Amador-Muñóz O, Mora-Romero A, et al. Cytogenetic biomonitoring of occupationally exposed workers to ashes from burning of sugar cane in Ahome, Sinaloa, México . Environ Toxicol Pharmacol . 2015;40(2):397-401. https://doi.org/10.1016/j.etap.2015.07.010 https://doi.org/10.1016/j.etap.2015.07.0... ; Silveira et al. ⁷¹71. Silveira HC, Schmidt-Carrijo M, Seidel EH, Scapulatempo-Neto C, Longatto-Filho A, Carvalho AL, et al. Emissions generated by sugarcane burning promote genotoxicity in rural workers: a case study in Barretos, Brazil . Environ Health . 2013;12(1):87. https://doi.org/10.1186/1476-069x-12-87 https://doi.org/10.1186/1476-069x-12-87...	4
Work process on the health of sugarcane cutters	Alessi et al. ⁵⁵55. Alessi NP, Navarro VL. Saúde e trabalho rural: o caso dos trabalhadores da cultura canavieira na região de Ribeirão Preto, São Paulo, Brasil. Cad Saude Publica . 1997;13 Supl 2:S111-21. https://doi.org/10.1590/S0102-311X1997000600010 https://doi.org/10.1590/S0102-311X199700... ; Alves ¹⁷17. Alves F. Por que morrem os cortadores de cana? Saude Soc . 2006;15(3):90-8. https://doi.org/10.1590/S0104-12902006000300008 https://doi.org/10.1590/S0104-1290200600... ; Galiano et al. ⁷²72. Galiano AM, Vettorassi A, Navarro VL. Trabalho, saúde e migração nos canaviais da região de Ribeirão Preto (SP), Brasil: o que percebem e sentem os jovens trabalhadores? Rev Bras Saude Ocup. 2012;37(125):51-64. https://doi.org/10.1590/S0303-76572012000100009 https://doi.org/10.1590/S0303-7657201200... ; Moraes et al. ⁷³73. Moraes MS, Lopes JCC, Priuli RMA. Questões socioeconômicas, laborais e de saúde na cadeia produtiva do agronegócio da cana-de-açúcar na região do Noroeste Paulista . Saude Soc . 2013;22(3):673-86. https://doi.org/10.1590/S0104-12902013000300003 https://doi.org/10.1590/S0104-1290201300... ; Ribeiro ⁸8. Ribeiro H, Ficarelli TRA. Queimadas nos canaviais e perspectivas dos cortadores de cana-de-açúcar em Macatuba, São Paulo . Saude Soc. 2010;19(1):48-63. https://doi.org/10.1590/S0104-12902010000100005 https://doi.org/10.1590/S0104-1290201000... ; Rocha et al. ⁵⁷57. Rocha FLR,Palucci Marziale MHP, Robazzi MLCC. Poverty as a predisposing factor of illness tendencies in sugar cane workers . Rev Lat Am Enfermagem . 2007;15 Nº Espec:736-41. https://doi.org/10.1590/S0104-11692007000700004 https://doi.org/10.1590/S0104-1169200700... ; Rocha et al. ⁹9. Rocha FLR, Marziale MHP, Hong OS. Work and health conditions of sugar cane workers in Brazil . Rev Esc Enferm USP . 2010;44(4):978-83. https://doi.org/10.1590/S0080-62342010000400017 https://doi.org/10.1590/S0080-6234201000... ; Rosa e Navarro. ⁷⁴74. Rosa LA, Navarro VL. Trabalho e trabalhadores dos canaviais: perfil dos cortadores de cana da região de Ribeirão Preto (SP) . Cad Psicol Soc Trab . 2014;17(1):143-60. https://doi.org/11606/issn.1981-0490.v17i1p143-160 https://doi.org/11606/issn.1981-0490.v17... ; Scopinho et al. ⁷⁵75. Scopinho RA, Eid F, Vian CEF, Silva PRC. Novas tecnologias e saúde do trabalhador: a mecanização do corte da cana-de-açúcar . Cad Saude Publica . 1999;15(1):147-62. https://doi.org/10.1590/S0102-311X1999000100015 https://doi.org/10.1590/S0102-311X199900... ; Vilela et al. ¹³13. Vilela RAG, Laat EF, Luz VG, Silva AJN, Takahashi MAC. Pressão por produção e produção de riscos: a “maratona” perigosa do corte manual da cana-de-açúcar . Rev. Bras Saude Ocup. 2015;40(131):30-48. https://doi.org/10.1590/0303-7657000075413 https://doi.org/10.1590/0303-76570000754... ; Bitencourt et al. ⁴⁹49. Bitencourt DP, Ruas AC, Maia PA. Análise da contribuição das variáveis meteorológicas no estresse térmico associada à morte de cortadores de cana-de-açúcar . Cad Saude Publica . 2012;28(1):65-74. https://doi.org/10.1590/S0102-311X2012000100007 https://doi.org/10.1590/S0102-311X201200...	11
Musculoskeletal disorders	de Anchieta Messias et al. ⁵⁶56. Messias IA, Okuno E. Study of postures in sugarcane cutters in the Pontal of Paranapanema-SP, Brazil. Work . 2012;41 Suppl 1:5389-91. https://doi.org/10.3233/wor-2012-0828-5389 https://doi.org/10.3233/wor-2012-0828-53... ; Phajan et al. ³⁷37. Phajan T, Nilvarangkul K, Settheetham D, Laohasiriwong W. Work-related musculoskeletal disorders among sugarcane farmers in north-eastern Thailand. Asia Pac J Public Health . 2014;26(3):320-7. https://doi.org/10.1177/1010539514528026 https://doi.org/10.1177/1010539514528026...	2
Thermal overload	Bodin et al. ⁵⁰50. Bodin T, García-Trabanino R, Weiss I, Jarquín E, Glaser J, Jakobsson K, et al. Intervention to reduce heat stress and improve efficiency among sugarcane workers in El Salvador: Phase 1 . Occup Environ Med . 2016;73(6):409-16. https://10.1136/oemed-2016-103555 https://10.1136/oemed-2016-103555... ; Crowe et al. ³⁸38. Crowe J, Moya-Bonilla JM, Román-Solano B, Robles-Ramírez A. Heat exposure in sugarcane workers in Costa Rica during the non-harvest season. Glob Health Action . 2010;3(1):1-9. https://doi.org/10.3402/gha.v3i0.5619 https://doi.org/10.3402/gha.v3i0.5619... ; Crowe et al. ¹⁵15. Crowe J, Wesseling C, Solano BR, Umaña MP, Ramirez AR, Kjellstrom T, et al. Heat exposure in sugarcane harvesters in Costa Rica . Am J Ind Med . 2013;56(10):1157-64. https://doi.org/10.1002/ajim.22204 https://doi.org/10.1002/ajim.22204... ; Crowen et al. ¹1. Food and Agricultural Organization of the United Nations (FAO). Prodution. Crops. Rome; 2016 [cited 2018 Feb 16]. Available from: http://www.fao.org/faostat/en/#data/QC http://www.fao.org/faostat/en/#data/QC... ⁰; Roscani et al. ⁵¹51. Roscani RC, Bitencourt DP, Maia PA, Ruas AC. Risco de exposição à sobrecarga térmica para trabalhadores da cultura de cana-de-açúcar no Estado de São Paulo, Brasil . Cad Saude Publica . 2017;33(3):e00211415. https://doi.org/10.1590/0102-311x00211415 https://doi.org/10.1590/0102-311x0021141... ; Vilela et al. ¹³13. Vilela RAG, Laat EF, Luz VG, Silva AJN, Takahashi MAC. Pressão por produção e produção de riscos: a “maratona” perigosa do corte manual da cana-de-açúcar . Rev. Bras Saude Ocup. 2015;40(131):30-48. https://doi.org/10.1590/0303-7657000075413 https://doi.org/10.1590/0303-76570000754...	6
Body composition/hydration and nutritional status	Cortez et al. ⁵²52. Delgado Cortez O. Heat stress assessment among workers in a Nicaraguan sugarcane farm. Glob Health Action . 2009;2. https://doi.org/10.3402/gha.v2i0.2069 https://doi.org/10.3402/gha.v2i0.2069... ; Chiarello et al. ⁵³53. Chiarello P, Scatena Sobrinho P, Vieira MNCM, Diez Garcia RW. Protein-energy supplements to preserve nutritional status of sugar cane cutters . Occup Med (Lond) . 2006;56(8):575-7. https://doi.org/10.1093/occmed/kql103 https://doi.org/10.1093/occmed/kql103... ; Florêncio et al. ⁷⁶76. Florencio T, Ferreira H, Cavalcante JC, Assunção ML, Sawaya AL. Short stature and food habits as determining factors for the low productivity of sugarcane labourers in the State of Alagoas, north-eastern Brazil . Arch Latinoam Nutr . 2008 [cited 2017 Mar 14];58(1):33-9. Available from: https://www.alanrevista.org/ediciones/2008/1/art-5/ https://www.alanrevista.org/ediciones/20... ; Luz et al. ⁷⁷77. Luz VG, Correa Filho HR, Silva AJN, Laat EF, Vilela RAG, Silva FOC, et al. Migrant labor and wear-out in manual sugarcane harvesting in Sao Paulo, Brazil . Cienc Saude Coletiva . 2012;17(10):2831-40. https://doi.org/10.1590/S1413-81232012001000030 https://doi.org/10.1590/S1413-8123201200... ; Luz et al. ⁵⁴54. Luz VG, Zangirolani LTO, Vilela RAG, Corrêa Filho HR. Consumo alimentar e condições de trabalho no corte manual de cana de açúcar no estado de São Paulo . Saude Soc. 2014;23(4):1316-28. https://doi.org/10.1590/S0104-12902014000400016 https://doi.org/10.1590/S0104-1290201400...	5
Dermatological changes	Miranda et al. ⁷⁸78. Miranda AMO, Soares LG, Ferrari TM, Silva DG, Falabella MEV, Tinoco EMB. Prevalence of actinic cheilitis in a population of agricultural sugarcane workers . Acta Odontol Latinoam . 2012 [cited 2017 Mar 14];25(2):201-7. Available from: http://www.scielo.org.ar/pdf/aol/v25n2/v25n2a08.pdf http://www.scielo.org.ar/pdf/aol/v25n2/v...	1

Authors/Study	Study	Results
Ferreira-Ceccato et al. ²⁰20. Ferreira-Ceccato AD, Ramos EMC, Carvalho LCS Jr, Xavier RF, Teixeira MFS, Raymundo-Pereira PA, et al. Short-term effects of air pollution from biomass burning in mucociliary clearance of Brazilian sugarcane cutters . Respir Med . 2011;105(11):1766-8. https://doi.org/10.1016/j.rmed.2011.08.003 https://doi.org/10.1016/j.rmed.2011.08.0... (2011) Panel study, with repeated measurements.	Nasal mucociliary clearance in 45 sugarcane cutters State de São Paulo, Brazil	Reduction of the transit time of saccharin, on the first day of harvest compared to the pre-harvest period.
Goto et al. ¹⁹19. Goto DM, Lança M, Obuti CA, Barbosa CMG, Saldiva PHN, Zanetta DMT, et al. Effects of biomass burning on nasal mucociliary clearance and mucus properties after sugarcane harvesting . Environ Res . 2011;111(5):664-9. https://doi.org/10.1016/j.envres.2011.03.006 https://doi.org/10.1016/j.envres.2011.03... (2011) Panel study, repeated measurements	Nasal mucociliary clearance of 27 sugarcane cutters State de São Paulo, Brazil	Increased in the transit time of nasal mucus after six months of harvest.
Prado et al. ¹⁸18. Prado GF, Zanetta DM, Arbex MA, Braga AL, Pereira LA, Marchi MR, et al. Burnt sugarcane harvesting: particulate matter exposure and the effects on lung function, oxidative stress, and urinary 1-hydroxypyrene . Sci Total Environ . 2012;437:200-8. https://doi.org/1016/j.scitotenv.2012.07.069 https://doi.org/1016/j.scitotenv.2012.07... (2012) Panel study, repeated measurements	Respiratory symptoms, lung function, markers of oxidative stress, and exposure to aromatic hydrocarbons in 113 cutters of burnt sugarcane State de São Paulo, Brazil	Higher incidence of respiratory symptoms, decreased pulmonary function, oxidative stress, increase of 1-hydroxypyrene (1-OH) during the harvest, compared to the pre-harvest period.
Sacchi et al. ⁷⁹79. Sacchi FP, Croda MG, Estevan AO, Ko AI, Croda J. Sugar cane manufacturing is associated with tuberculosis in an indigenous population in Brazil. Trans R Soc Trop Med Hyg . 2013;107(3):152-7. https://doi.org/10.1093/trstmh/trs089 https://doi.org/10.1093/trstmh/trs089... (2013) Case-control study	Risk factors for pulmonary and extrapulmonary tuberculosis among indigenous peoples in Brazil	Indigenous workers in sugarcane plants are 6.8 times more likely to have tuberculosis.
Barbosa et al. ¹⁴14. Barbosa CM, Terra-Filho M, Albuquerque AL, Di Giorgi D, Grupi C, Negrão CE, et al. Burnt sugarcane harvesting: cardiovascular effects on a group of healthy workers, Brazil . PLoS One . 2012;7(9):e46142. https://doi.org/10.1371/journal.pone.0046142 https://doi.org/10.1371/journal.pone.004... (2012) Panel study, repeated measurements	Effects of burned cane harvest on blood markers and cardiovascular system in 28 sugarcane cutters State de São Paulo, Brazil	Increase in blood pressure and blood coagulability during the harvest period compared to the pre-harvest period.
Garcia-Trabanino et al. ⁴⁵45. Garcia-Trabanino R, Jarquín E, Wesseling C, Johnson RJ, González-Quiroz M, Weiss I, et al. Heat stress, dehydration, and kidney function in sugarcane cutters in El Salvador: a cross-shift study of workers at risk of Mesoamerican nephropathy . Environ Res . 2015;142:746-55. https://doi.org/10.1016/j.envres.2015.07.007 https://doi.org/10.1016/j.envres.2015.07... (2015) Cross-sectional study	Thermal stress, dehydration, biomarkers of renal function and their possible associations in 189 sugarcane cutters of El Salvador	The average temperature of the working day was 34 °C-36 °C before noon and 39 °C-42 °C at noon. There was a reduction in the glomerular filtration rate in 14% of the workers, and an increase in serum creatinine, uric acid, and urea.
Laws et al. ⁵⁸58. Laws RL, Brooks DR, Amador JJ, Weiner DE, Kaufman JS, Ramirez-Rubio O, et al. Changes in kidney function among Nicaraguan sugarcane workers . Int J Occup Environ Health . 2015;21(3):241-50. https://doi.org/10.1179/2049396714y.0000000102 https://doi.org/10.1179/2049396714y.0000... (2015) Longitudinal study	Changes in renal function over six months of sugarcane harvest in 284 Nicaraguan workers	Decreased renal function during the harvest.
Laws et al. ⁵⁹59. Laws RL, Brooks DR, Amador JJ, Weiner DE, Kaufman JS, Ramírez-Rubio O, et al. Biomarkers of kidney injury among Nicaraguan sugarcane workers . Am J Kidney Dis . 2016;67(2):209-17. https://doi.org/10.1053/j.ajkd.2015.08.022 https://doi.org/10.1053/j.ajkd.2015.08.0... (2016) Prospective cohort study.	Changes in renal injury markers of 284 Nicaraguan rural workers	Of the seven categories of workers studied, sugarcane cutters presented a higher risk of renal damage.
López-Marin et al. ⁶⁰60. López-Marín L, Chávez Y, García XA, Flores WM, Garcia YM, Herrera R, et al. Histopathology of chronic kidney disease of unknown etiology in Salvadoran agricultural communities. MEDICC Rev . 2014 [cited 2017 Mar 14];16(2):49-54. Available from: http://www.medicc.org/mediccreview/index.php?issue=28&id=354&a=va http://www.medicc.org/mediccreview/index... (2014) Cross-sectional study	Histopathological characterization of chronic kidney disease (CKD) in patients from agricultural communities, including sugarcane cutters El Salvador	Presence of chronic tubulointerstitial nephropathy with glomerular and secondary vascular injury.
Murray et al. ¹²12. Murray KO, Fischer RS, Chavarria D, Duttmann C, Garcia MN, Gorchakov R, et al. Mesoamerican nephropathy: a neglected tropical disease with an infectious etiology? Microbes Infect . 2015;17(10):671-5. https://doi.org/10.1016/j.micinf.2015.08.005 https://doi.org/10.1016/j.micinf.2015.08... (2015) Review study	Evaluation of potential pathogens responsible for Mesoamerican nephropathy in Nicaragua	Infectious pathogens present in urine and rodent feces are thought to expose workers during the cultivation and harvesting of cane and are associated with CKD.
Peraza et al. ⁴¹41. Peraza S, Wesseling C, Aragon A, Leiva R, García-Trabanino RA, Torres C, et al. Decreased kidney function among agricultural workers in El Salvador . Am J Kidney Dis . 2012;59(4):531-40. https://doi.org/10.1053/j.ajkd.2011.11.039 https://doi.org/10.1053/j.ajkd.2011.11.0... (2012) Cross-sectional study	Prevalence of decreased renal function in men and women (farmers) in five communities in El Salvador	Agricultural work on sugarcane and cotton plantations was associated with decreased renal function.
Roncal-Jimenez et al. ⁶¹61. Roncal-Jimenez C, García-Trabanino R, Barregard L, Lanaspa MA, Wesseling C, Harra T, et al. Heat stress nephropathy from exercise-induced uric acid crystalluria: a perspective on Mesoamerican nephropathy . Am J Kidney Dis . 2016;67(1):20-30. https://doi.org/10.1053/j.ajkd.2015.08.021 https://doi.org/10.1053/j.ajkd.2015.08.0... (2015) Cross-sectional study	Increased uric acid concentrations as a possible cause of kidney damage. Review and pilot study evaluating 10 sugarcane cutters in El Salvador	Serum levels of uric acid increased after a work shift and reached hyperuricemia (≥ 7.0 mg/dL).
Santos et al. ³¹31. Paula Santos U, Zanetta DM, Terra-Filho M, Burdmann EA. Burnt sugarcane harvesting is associated with acute renal dysfunction . Kidney Int . 2015;87(4):792-9. https://doi.org/10.1038/ki.2014.306 https://doi.org/10.1038/ki.2014.306... (2014) Longitudinal panel study with repeated measurements	Effect of work cutting burned sugar cane on the renal function of 28 workers State de São Paulo, Brazil	Decreased glomerular filtration rate at the end of the work shift, in all evaluated patients, and, in 18.5% of them, the increase in serum creatinine was consistent with acute kidney injury (AKI).
Wesseling et al. ⁶²62. Wesseling C, Wendel de Joode B, Crowe J, Rittner R, Sanati NA, Hogstedt C, et al. Mesoamerican nephropathy: geographical distribution and time trends of chronic kidney disease mortality between 1970 and 2012 in Costa Rica . Occup Environ Med . 2015;72(10):714-21. https://doi.org/10.1136/oemed-2014-102799 https://doi.org/10.1136/oemed-2014-10279... (2015) Review study	Risk assessment of CKD mortality in rural workers Costa Rica	Mortality due to CKD in men was higher in areas with hot and dry climate, lower altitude, and extensive production of sugarcane.
Wesseling et al. ¹¹11. Wesseling C, Aragón A, González M, Weiss I, Glaser J, Bobadilla NA, et al. Kidney function in sugarcane cutters in Nicaragua: a longitudinal study of workers at risk of Mesoamerican nephropathy . Environ Res . 2016;147:125-32. https://doi.org/10.1016/j.envres.2016.02.002 https://doi.org/10.1016/j.envres.2016.02... (2016) Longitudinal panel study with repeated measurements	Evaluation of renal function markers in 29 sugarcane cutters Nicaragua	A 9% decrease in the glomerular filtration rate, increased creatinine and serum urea and NGAL after 2 months of work.
Wesseling et al. ⁶³63. Wesseling C, Aragón A, González M, Weiss I, Glaser J, Rivard CJ, et al. Heat stress, hydration and uric acid: a cross-sectional study in workers of three occupations in a hotspot of Mesoamerican nephropathy in Nicaragua . BMJ Open . 2016;6(12):e011034. https://doi.org/10.1136/bmjopen-2016-011034 https://doi.org/10.1136/bmjopen-2016-011... (2016) Cross-sectional study	Evaluation of risk factors for CKD among sugarcane cutters, construction workers, and small farmers Nicaragua	Thermal stress, dehydration, and kidney failure were the most common findings among sugarcane cutters and increased uric acid was associated with reduced renal function.
Wijkström et al. ⁴⁶46. Wijkström J, González-Quiroz M, Hernandez M, Trujillo Z, Hultenby K, Ring A, et al. Renal morphology, clinical findings, and progression rate in Mesoamerican nephropathy . Am J Kidney Dis . 2017;69(5):626-36. https://doi.org/10.1053/j.ajkd.2016.10.036 https://doi.org/10.1053/j.ajkd.2016.10.0... (2017) Case series	Renal histopathological evaluation of 19 sugarcane workers Nicaragua	16 renal biopsies presented glomerulosclerosis, glomerular hypertrophy, chronic glomerular ischemia, tubulointerstitial damage, and mild vascular alterations.
Adesiyun et al. ⁶⁴64. Adesiyun A, Rahaman S, Bissessar S, Dookeran S, Stewart-Johnson A, Hilaire MG. Seroprevalence of toxoplasmosis, leptospirosis and brucellosis in sugarcane field-workers in Trinidad and Tobago . West Indian Med J . 2010;59(1):14-9. Available from: http://caribbean.scielo.org/pdf/wimj/v59n1/v59n1a04.pdf http://caribbean.scielo.org/pdf/wimj/v59... (2010) Cross-sectional study	Prevalence of toxoplasmosis, leptospirosis, and brucellosis in sugarcane workers on the island of Trinidad	High risk of acute toxoplasmosis and, to a lesser extent, leptospirosis.
Carvalho-Junior et al. ⁶⁵65. Carvalho Junior LCS, Ramos EMC, Toledo AC, Ceccato ADF, Macchione M, Braga AL, et al. Assessment of health-related quality of life of sugarcane cutters in the pre-harvest and harvest periods . Rev Saude Publica . 2012;46(6):1058-65. https://doi.org/10.1590/S0034-89102012000600016 https://doi.org/10.1590/S0034-8910201200... (2012) Longitudinal study	Health-related quality of life assessment of 44 sugarcane cutters from the West of the State of São Paulo, Brazil	Quality of life, measured by questionnaire, was reduced at the end of the harvest period.
Priuli et al. ⁶⁶66. Priuli RMA, Moraes MS, Chiaravalloti RM. The impact of stress on the health of sugar cane cutters . Rev Saude Publica . 2014;48(2):225-31. https://doi.org/10.1590/S0034-8910.2014048004798 https://doi.org/10.1590/S0034-8910.20140... (2014) Longitudinal study	Stress levels and prevalence of physical and mental symptoms in 114 sugarcane workers State de São Paulo, Brazil	The work process of the cane cutter can cause stress, symptoms of burn out, exhaustion, physical and psychological symptoms after the harvest period.
Ferreira-Ceccato et al. ⁶⁷67. Ceccato ADF, Carvalho Junior LCS, Cuissi RC, Monteschi M, Oliveira NG, Padovani CR, et al. Absenteísmo por doença ocupacional de trabalhadores rurais no setor canavieiro. Cad Saude Publica . 2014;30(10):2169-76. https://doi.org/10.1590/0102-311X00026413 https://doi.org/10.1590/0102-311X0002641... (2014) Cross-sectional retrospective descriptive study	Frequency of sick leave due to occupational diseases by sugarcane cutters State de São Paulo, Brazil	Musculoskeletal diseases followed by respiratory diseases at the end of the harvest were more prevalent.
Abrahão et al. ¹⁶16. Abrahão RF, Gonzaga MC, Braunbeck OA. Protective gloves on manual sugar cane cutting are really effective? Work . 2012;41 Suppl 1:4963-6. https://doi.org/10.3233/wor-2012-0039-4963 https://doi.org/10.3233/wor-2012-0039-49... (2012) Cross-sectional study	To evaluate the impact of glove use on the safety, efficacy, and comfort of 82 sugarcane cutters State de São Paulo, Brazil	Results reveal general inadequacy of gloves used due to lack of adhesion to the machete, inadequacy in size, and hardening of the glove by contact with sucrose and ashes present in sugarcane.
Dalfré et al. ⁶⁸68. Dalfré JT, Rodrigues JPB, Donato BG, Giancoli Neto A, Carvalho JL, Oliveira DIA, et al. Microbiota fúngica da conjuntiva, da cana-de-açúcar e de anemófilos da região canavieira de Monte Belo - Minas Gerais. Arq Bras Oftalmol . 2007;70(3):445-9. https://doi.org/10.1590/S0004-27492007000300011 https://doi.org/10.1590/S0004-2749200700... (2007) Cross-sectional study	Occurrence of fungi in the ocular conjunctiva of 100 sugarcane cutters Minas Gerais, Brazil	Of the 100 workers evaluated, 64 presented one or more genera of fungi, with higher incidence in the more advanced age groups.
Amre et al. ⁶⁹69. Amre DK, Infante-Rivard C, Dufresne A, Durgawale PM, Ernst P. Case-control study of lung cancer among sugar cane farmers in India. Occup Environ Med . 1999 [cited 2017 Mar 14];56(8):548-52. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1757779/pdf/v056p00548.pdf https://www.ncbi.nlm.nih.gov/pmc/article... (1999) Case-control study	Investigate the risk of lung cancer among sugarcane producers Maharashtra, India	Risk of lung cancer doubled in workers on sugarcane farms.
Coble et al. ⁷⁰70. Coble JB, Brown LM, Hayes RB, Huang WY, Winn DM, Gridley G, et al. Sugarcane farming, occupational solvent exposures, and the risk of oral cancer in Puerto Rico . J Occup Environ Med . 2003;45(8):869-74. https://doi.org/10.1097/01.jom.0000083034.56116.0f https://doi.org/10.1097/01.jom.000008303... (2003) Case-control study	The relationship between occupational exposures and oral cavity or pharynx cancer (n = 367) Puerto Rico	High cancer risks were observed among sugarcane producers and in individuals with high cumulative exposure to solvents.
Bosso et al. ⁴⁷47. Vale Bosso RM, Amorim LMF, Andrade SJ, Rossini A, Marchi MRR, Ponce de Leon A, et al. Effects of genetic polymorphisms CYP1A1, GSTM1, GSTT1 and GSTP1 on urinary 1-hydroxypyrene levels in sugarcane workers . Sci Total Environ . 2006;370(2-3):382-90. https://doi.org/10.1016/j.scitotenv.2006.07.025 https://doi.org/10.1016/j.scitotenv.2006... (2006) Longitudinal study	To evaluate the concentrations of 1-hydroxypyrene in the urine of 39 sugarcane workers State de São Paulo, Brazil	The level of 1-OHP in urine was 9 times higher in exposed workers compared to those not exposed.
Martinez-Vanezuela et al. ⁴⁸48. Martinez-Valenzuela C, Rodríguez-Quintana AR, Meza E, Waliszewski SM, Amador-Muñóz O, Mora-Romero A, et al. Cytogenetic biomonitoring of occupationally exposed workers to ashes from burning of sugar cane in Ahome, Sinaloa, México . Environ Toxicol Pharmacol . 2015;40(2):397-401. https://doi.org/10.1016/j.etap.2015.07.010 https://doi.org/10.1016/j.etap.2015.07.0... (2015) Cross-sectional study	To determine the chromosomal damage in oral mucosa in workers exposed to burnt sugarcane in Mexico (n = 60) compared to non-exposed workers (n = 60)	Higher presence of chromosomal micronuclei in oral mucosa and nuclear abnormalities in exposed workers, compared to non-exposed individuals.
Silveira et al. ⁷¹71. Silveira HC, Schmidt-Carrijo M, Seidel EH, Scapulatempo-Neto C, Longatto-Filho A, Carvalho AL, et al. Emissions generated by sugarcane burning promote genotoxicity in rural workers: a case study in Barretos, Brazil . Environ Health . 2013;12(1):87. https://doi.org/10.1186/1476-069x-12-87 https://doi.org/10.1186/1476-069x-12-87... (2013) Cross-sectional study	Genotoxic effect on burned sugarcane cutters (n = 23), compared to the control population (n = 30) Barretos, SP, Brazil	The frequencies of micronuclei in the cells of the mouth and blood were higher in sugarcane cutters.
Alessi et al. ⁵⁵55. Alessi NP, Navarro VL. Saúde e trabalho rural: o caso dos trabalhadores da cultura canavieira na região de Ribeirão Preto, São Paulo, Brasil. Cad Saude Publica . 1997;13 Supl 2:S111-21. https://doi.org/10.1590/S0102-311X1997000600010 https://doi.org/10.1590/S0102-311X199700... (1997) Qualitative study	Assessment of the work process in sugarcane cutter’s health in Ribeirão Preto, SP, Brazil	Daily exposure of cane cutters to physical, chemical, and biological loads, translates into several diseases, traumas, or accidents related to them.
Alves ¹⁷17. Alves F. Por que morrem os cortadores de cana? Saude Soc . 2006;15(3):90-8. https://doi.org/10.1590/S0104-12902006000300008 https://doi.org/10.1590/S0104-1290200600... (2006) Review study	To analyze the processes of production and working day in the manual cutting of sugarcane State de São Paulo, Brazil	Cane cutters’ deaths related to overwork and payment per production.
Anchieta Messias et al. ⁵⁶56. Messias IA, Okuno E. Study of postures in sugarcane cutters in the Pontal of Paranapanema-SP, Brazil. Work . 2012;41 Suppl 1:5389-91. https://doi.org/10.3233/wor-2012-0828-5389 https://doi.org/10.3233/wor-2012-0828-53... (2012) Cross-sectional exploratory study	Evaluation of the posture in the work of a group of sugarcane cutters Pontal do Paranapanema, SP, Brazil	The movements and postures adopted during the work can predispose the cutters to repetitive strain injuries.
Galiano et al. ⁷²72. Galiano AM, Vettorassi A, Navarro VL. Trabalho, saúde e migração nos canaviais da região de Ribeirão Preto (SP), Brasil: o que percebem e sentem os jovens trabalhadores? Rev Bras Saude Ocup. 2012;37(125):51-64. https://doi.org/10.1590/S0303-76572012000100009 https://doi.org/10.1590/S0303-7657201200... (2012) Qualitative study	Evaluation of the reasons of young people seeking work as sugarcane cutters and how they perceived their working conditions and health repercussions (n = 14) Ribeirão Preto, SP, Brazil	The data suggest that the migration of young workers in search of work was not an option, but the only alternative to the reality in their region of origin. They have expressed hopelessness about their prospects and concern about the possible consequences for their health.
Moraes et al. ⁷³73. Moraes MS, Lopes JCC, Priuli RMA. Questões socioeconômicas, laborais e de saúde na cadeia produtiva do agronegócio da cana-de-açúcar na região do Noroeste Paulista . Saude Soc . 2013;22(3):673-86. https://doi.org/10.1590/S0104-12902013000300003 https://doi.org/10.1590/S0104-1290201300... (2013) Cross-sectional study	To characterize the socioeconomic profile, the motivation, the perception of the impacts of the work on health, and the relationship with the health system of migrants who cut sugarcane Mendonça, SP, Brazil	The majority of the workers (90%) came from the Northeast region of Brazil; were between 18 and 30 years old; 86% considered the salary and formal employment the motivators for this type of work; 92% considered their health good, although 48% felt some type of body pain attributed to work fatigue, and 87% self-medicates.
Phajan et al. ³⁷37. Phajan T, Nilvarangkul K, Settheetham D, Laohasiriwong W. Work-related musculoskeletal disorders among sugarcane farmers in north-eastern Thailand. Asia Pac J Public Health . 2014;26(3):320-7. https://doi.org/10.1177/1010539514528026 https://doi.org/10.1177/1010539514528026... (2014) Cross-sectional analytical study	Prevalence and factors associated with work-related musculoskeletal disorders among 540 sugarcane workers Thailand	The prevalence of musculoskeletal disorders in the 7 days before the interview was 83%. The associated factors were: repetitive movements, inadequate postures, and vigorous efforts.
Ribeiro ⁸8. Ribeiro H, Ficarelli TRA. Queimadas nos canaviais e perspectivas dos cortadores de cana-de-açúcar em Macatuba, São Paulo . Saude Soc. 2010;19(1):48-63. https://doi.org/10.1590/S0104-12902010000100005 https://doi.org/10.1590/S0104-1290201000... (2010) Qualitative descriptive study	To portray the situation in which rural workers live in Macatuba, SP, observing their economic and social conditions, in the context of the implementation of the law that prohibits the burning of sugarcane and the mechanization of cutting, which bring an end to this type of employment (n = 40)	We evaluated 27 men and 13 women who received wages according to productivity. Part of them agreed with the ban to burnings because it eliminates much of the pollution they breathe, improving their quality of life.
Rocha et al. ⁵⁷57. Rocha FLR,Palucci Marziale MHP, Robazzi MLCC. Poverty as a predisposing factor of illness tendencies in sugar cane workers . Rev Lat Am Enfermagem . 2007;15 Nº Espec:736-41. https://doi.org/10.1590/S0104-11692007000700004 https://doi.org/10.1590/S0104-1169200700... (2007) Qualitative descriptive study	Assessment of individual, social, labor, and environmental factors predisposing to illness in 39 sugarcane cutters State de São Paulo, Brazil	The main individual determinants of illness were physical exertion and accelerated work rate, intense heat, dust, soot, and presence of venomous animals. Poverty is the main social determinant of illness.
Rocha et al. ⁹9. Rocha FLR, Marziale MHP, Hong OS. Work and health conditions of sugar cane workers in Brazil . Rev Esc Enferm USP . 2010;44(4):978-83. https://doi.org/10.1590/S0080-62342010000400017 https://doi.org/10.1590/S0080-6234201000... (2010) Exploratory study with a quantitative approach	To analyze the work and life situations that may offer health risks to 39 workers involved in the manual and mechanized cutting of sugarcane State de São Paulo/Brazil	During work, workers are exposed to long daily shifts and work environments with multiple health hazards, and respiratory, musculoskeletal, psychological, and accidental impacts.
Rosa e Navarro. ⁷⁴74. Rosa LA, Navarro VL. Trabalho e trabalhadores dos canaviais: perfil dos cortadores de cana da região de Ribeirão Preto (SP) . Cad Psicol Soc Trab . 2014;17(1):143-60. https://doi.org/11606/issn.1981-0490.v17i1p143-160 https://doi.org/11606/issn.1981-0490.v17... (2014) Qualitative descriptive study	A total of 13 sugarcane cutter migrants were evaluated to understand the profile of the workers and to investigate their working conditions Ribeirão Preto, SP, Brazil	The workers are hired according to their capacity of production, physical resistance, and disposition of subordination to superiors. The production gain implies overexploitation of the labor force, which has repercussions on health conditions.
Scopinho et al. ⁷⁵75. Scopinho RA, Eid F, Vian CEF, Silva PRC. Novas tecnologias e saúde do trabalhador: a mecanização do corte da cana-de-açúcar . Cad Saude Publica . 1999;15(1):147-62. https://doi.org/10.1590/S0102-311X1999000100015 https://doi.org/10.1590/S0102-311X199900... (1999) Qualitative descriptive study	Evaluation by interviews conducted in the field, the consequences of mechanized cutting of sugarcane State de São Paulo, Brazil	The use of mechanical harvesters reduces physical, chemical, and mechanical labor loads, but accentuates mental and physiological loads. Observed reduction in the number of accidents at work, but increased severity.
Vilela et al. ¹³13. Vilela RAG, Laat EF, Luz VG, Silva AJN, Takahashi MAC. Pressão por produção e produção de riscos: a “maratona” perigosa do corte manual da cana-de-açúcar . Rev. Bras Saude Ocup. 2015;40(131):30-48. https://doi.org/10.1590/0303-7657000075413 https://doi.org/10.1590/0303-76570000754... (2015) Longitudinal study	Study of determinants that intensify the workload and affect the health of 40 sugarcane cutters Piracicaba, SP, Brazil	The accelerated pace of work associated with payment per production is the main factor responsible for the increase in the physical exhaustion among workers.
Bitencourt et al. ⁴⁹49. Bitencourt DP, Ruas AC, Maia PA. Análise da contribuição das variáveis meteorológicas no estresse térmico associada à morte de cortadores de cana-de-açúcar . Cad Saude Publica . 2012;28(1):65-74. https://doi.org/10.1590/S0102-311X2012000100007 https://doi.org/10.1590/S0102-311X201200... (2012) Case study	Contribution of the climate to the occurrence of 14 deaths of sugarcane cutters State of São Paulo, Brazil	The precarious social, economic, and working conditions of these workers do not allow us to point out the atmospheric factor as the predominant cause of the deaths.
Bodin et al. ⁵⁰50. Bodin T, García-Trabanino R, Weiss I, Jarquín E, Glaser J, Jakobsson K, et al. Intervention to reduce heat stress and improve efficiency among sugarcane workers in El Salvador: Phase 1 . Occup Environ Med . 2016;73(6):409-16. https://10.1136/oemed-2016-103555 https://10.1136/oemed-2016-103555... (2016) Longitudinal study with repeated measures	To assess the feasibility of providing an intervention (adequate water replacement and programmed rest periods) during sugarcane cutting to avoid heat stress and dehydration without decreasing productivity (n = 60) El Salvador	Post-intervention water consumption increased by 25%. The symptoms associated with thermal stress and dehydration decreased. Daily individual production increased from 5.1 to 7.3 tons/person/day.
Crowe et al. ³⁸38. Crowe J, Moya-Bonilla JM, Román-Solano B, Robles-Ramírez A. Heat exposure in sugarcane workers in Costa Rica during the non-harvest season. Glob Health Action . 2010;3(1):1-9. https://doi.org/10.3402/gha.v3i0.5619 https://doi.org/10.3402/gha.v3i0.5619... (2010) Observational and exploratory study	Conditions of heat stress in 130 sugarcane workers in Costa Rica in the pre-harvest period.	Risk of thermal stress for workers in pre-harvest tasks, which occurs even during periods of less intensive work.
Crowe et al. ¹⁵15. Crowe J, Wesseling C, Solano BR, Umaña MP, Ramirez AR, Kjellstrom T, et al. Heat exposure in sugarcane harvesters in Costa Rica . Am J Ind Med . 2013;56(10):1157-64. https://doi.org/10.1002/ajim.22204 https://doi.org/10.1002/ajim.22204... (2013) Cross-sectional study	To describe the working conditions and quantify the heat exposure by sugarcane cutters (n = 105) Costa Rica	Cane cutters perform strenuous work under high temperatures, with no recommended breaks.
Crowe et al. ¹⁰10. Crowe J, Nilsson M, Kjellstrom T, Wesseling C. Heat-related symptoms in sugarcane harvesters. Am J Ind Med . 2015;58(5):541-8. https://doi.org/10.1002/ajim.22450 https://doi.org/10.1002/ajim.22450... (2015) Cross-sectional study	Prevalence of complaints of heat exposure and health effects by 106 sugarcane cutters compared to 63 controls, workers in other activities Costa Rica	Symptoms of heat and dehydration (headache, tachycardia, cramps, fever, nausea, dizziness), hand or foot edema, and dysuria were more frequent in cane cutters than controls.
Roscani et al. ⁵¹51. Roscani RC, Bitencourt DP, Maia PA, Ruas AC. Risco de exposição à sobrecarga térmica para trabalhadores da cultura de cana-de-açúcar no Estado de São Paulo, Brasil . Cad Saude Publica . 2017;33(3):e00211415. https://doi.org/10.1590/0102-311x00211415 https://doi.org/10.1590/0102-311x0021141... (2017) Cross-sectional study	Estimates of thermal overload in sugarcane cutters over a period of four years State de São Paulo, Brazil	The estimated IBUTG values exceed the limits of tolerance in the areas of sugarcane activity.
Miranda et al. ⁷⁸78. Miranda AMO, Soares LG, Ferrari TM, Silva DG, Falabella MEV, Tinoco EMB. Prevalence of actinic cheilitis in a population of agricultural sugarcane workers . Acta Odontol Latinoam . 2012 [cited 2017 Mar 14];25(2):201-7. Available from: http://www.scielo.org.ar/pdf/aol/v25n2/v25n2a08.pdf http://www.scielo.org.ar/pdf/aol/v25n2/v... (2012) Cross-sectional study	Prevalence of actinic cheilitis in 1,950 sugarcane cutters exposed to the sun, compared to the control group (n = 150)	The prevalence of 9.2% (n = 141) of actinic cheilitis was observed among the population that had been exposed to the sun. However, no cases were found among the individuals in the control group.
Cortez et al. ⁵²52. Delgado Cortez O. Heat stress assessment among workers in a Nicaraguan sugarcane farm. Glob Health Action . 2009;2. https://doi.org/10.3402/gha.v2i0.2069 https://doi.org/10.3402/gha.v2i0.2069... (2009) Longitudinal study with repeated measures	Evaluation of the effect of hydration on the increase of labor productivity in workers exposed to high temperatures (n = 22) Nicaragua	Workers with higher water consumption increased production from 5.5 to 8 tons/day of cut cane.
Chiarello et al. ⁵³53. Chiarello P, Scatena Sobrinho P, Vieira MNCM, Diez Garcia RW. Protein-energy supplements to preserve nutritional status of sugar cane cutters . Occup Med (Lond) . 2006;56(8):575-7. https://doi.org/10.1093/occmed/kql103 https://doi.org/10.1093/occmed/kql103... (2006) Longitudinal study with repeated measures	Impact of the use of protein and electrolyte supplements on weight and body composition of 15 sugarcane cutters Serrana, SP, Brazil	Observed reductions in body fat percentage and improvement in hydration at the end of the sugarcane harvest and 8 months after the beginning of the diet.
Florêncio et al. ⁷⁶76. Florencio T, Ferreira H, Cavalcante JC, Assunção ML, Sawaya AL. Short stature and food habits as determining factors for the low productivity of sugarcane labourers in the State of Alagoas, north-eastern Brazil . Arch Latinoam Nutr . 2008 [cited 2017 Mar 14];58(1):33-9. Available from: https://www.alanrevista.org/ediciones/2008/1/art-5/ https://www.alanrevista.org/ediciones/20... (2008) Cross-sectional study	Evaluation of dietary pattern, nutritional status, and stature of 62 sugarcane cutters and possible associations with worker productivity Alagoas, Brazil	Workers with normal BMI were the most productive compared to those with low or overweight BMI. Taller individuals had higher productivity and higher energy intake.
Luz et al. ⁷⁷77. Luz VG, Correa Filho HR, Silva AJN, Laat EF, Vilela RAG, Silva FOC, et al. Migrant labor and wear-out in manual sugarcane harvesting in Sao Paulo, Brazil . Cienc Saude Coletiva . 2012;17(10):2831-40. https://doi.org/10.1590/S1413-81232012001000030 https://doi.org/10.1590/S1413-8123201200... (2012) Longitudinal study with repeated measures	Evaluation of the evolution of the body composition of 30 cane cutters between the beginning and the end of the harvest Piracicaba, SP, Brazil	Significant loss of body fat and weight in the first half of the crop and elevation of creatine kinase over the harvest period.
Luz et al. ⁵⁴54. Luz VG, Zangirolani LTO, Vilela RAG, Corrêa Filho HR. Consumo alimentar e condições de trabalho no corte manual de cana de açúcar no estado de São Paulo . Saude Soc. 2014;23(4):1316-28. https://doi.org/10.1590/S0104-12902014000400016 https://doi.org/10.1590/S0104-1290201400... (2014) Semi-quantitative observational study	Description of working conditions, feeding, and hydration of 30 sugar cane cutters, under observation for 15 days Piracicaba, SP, Brazil	Workers drink 5 to 10 liters of water per day. Feeding during the harvest did not guarantee food and nutritional security. Work on manual cane harvesting is strenuous and payment per production can be an aggravating health factor.

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Ubiratan Paula Santos Instituto do Coração – HCFMUSP Divisão de Pneumologia Av. Dr. Enéas Carvalho de Aguiar, 44 05403-000 São Paulo, SP, Brasil E-mail: pneubiratan@incor.usp.br