Abstract
Abstract The agriculture and livestock sector (A&L) plays a strategic role in addressing the current economic crisis, particularly through food production and distribution, contributing to the preservation and recovery of populations affected by the coronavirus pandemic (COVID-19). Regarding employability in Brazil, it was observed that between March and June 2020, the balance between admissions and dismissals was negative. However, during this period, the A&L sector exhibited the least fluctuation. In this context, workplace accidents stand out, showing a reduction of approximately 30% in the analyzed period, except in the A&L sector, which maintained an average of 23,744 accidents per year. Given the economic importance of this sector, it is essential to preserve the physical and mental well-being of workers engaged in it. The study aimed to develop a discussion on occupational accidents in the A&L sector, highlighting its economic relevance and relating it to the accidents and illnesses associated with its activities. A systematic literature review was conducted, focusing on the A&L sector, Gross Domestic Product (GDP), and workplace accidents. Among the 33 economic activities analyzed, a higher incidence was identified in 12 of them, accounting for 80% of the accidents, with certified seed production being particularly noteworthy. This information supports the direction of efforts and the development of policies aimed at reducing accident and illness rates. It is estimated that the costs generated by workplace accidents impact up to 4% of the GDP, which could be avoided through the implementation of preventive measures focused on safety.
Keywords:
Occupational safety; Illness; Environmental risks
Resumo
Resumo O setor agropecuário desempenha um papel estratégico no enfrentamento da atual crise econômica, especialmente por meio da produção e distribuição de alimentos, contribuindo para preservação e recuperação das populações afetadas pela pandemia ocasionada pelo coronavírus (covid-19). No que se refere à empregabilidade no Brasil, observa-se que, entre março e junho de 2020, o saldo entre admissões e desligamentos foi negativo. Contudo, nesse período, o setor agropecuário apresentou a menor oscilação. Nesse contexto, destaca-se a ocorrência de acidentes de trabalho, que registraram uma redução de aproximadamente 30% no período analisado, com exceção do setor agropecuário, que manteve uma média de 23.744 acidentes por ano. Dada a importância econômica desse setor, torna-se fundamental preservar a integridade física e psíquica dos trabalhadores inseridos nesse ambiente. A pesquisa teve como objetivo desenvolver uma discussão sobre os acidentes ocupacionais no setor agropecuário, evidenciando sua relevância econômica e relacionando-a aos acidentes e adoecimentos associados às atividades desempenhadas. Foi realizada uma revisão sistemática da literatura, considerando o setor agropecuário, o Produto Interno Bruto (PIB) e os acidentes de trabalho. Entre as 33 atividades econômicas analisadas, identificou-se maior incidência em 12 delas, que correspondem a 80% dos acidentes, com destaque para a produção de sementes certificadas. Essas informações auxiliam o direcionamento de esforços e o desenvolvimento de políticas voltadas à redução dos índices de acidentes e adoecimentos. Estima-se que os custos gerados pelos acidentes de trabalho impactem até 4% do PIB, podendo ser evitados por meio da implementação medidas preventivas com foco na segurança.
Palavras-chave:
Segurança do trabalho
;
Adoecimento
;
Riscos ambientais
1 Introduction
According to the Instituto Brasileiro de Geografia e Estatística (IBGE), in the first quarter of 2022, the agriculture and livestock (A&L) sector contributed approximately BRL 183 billion to Brazil’s Gross Domestic Product (GDP) through food production and the supply of raw materials to industry. Given the new challenges resulting from the coronavirus pandemic, which causes COVID-19, this sector is observed to play a strategic role in addressing the current economic crisis, ensuring food availability in Brazil and worldwide (Bachewe et al., 2018; Beckman & Countryman, 2021).
For the Instituto de Pesquisa Econômica Aplicada (IPEA, 2020a), the A&L sector is “the first and most fundamental link in the food supply chain and one of the pillars of the hierarchy of basic human needs; its production and distribution are essential for the preservation and recovery of populations affected by the virus,” contributing to maintaining and generating jobs.
In May 2022, Brazil reported 41,729,858 active formal employment contracts, of which approximately 4.15% belonged to the A&L sector. It is worth noting that this figure does not include family farmers and informal workers, who are more common in this sector (Davis & Kotowski, 2007; Mascarenhas et al., 2015; Baraza & Cugueró-escofet, 2021). Between January 2020 and May 2022, the A&L sector showed the least fluctuation in the balance between admissions and dismissals, maintaining a positive balance in most months, even during the height of the pandemic, which began affecting Brazil in March 2020 (CAGED, 2022).
Given the importance of this sector to the economy, various technologies and equipment have been employed in A&L activities. However, in some situations, this interaction with workers can result in accidents or illnesses, affecting both workers and companies in terms of productivity and economic outcomes (Gallego et al., 2021).
Work should be regarded as a dignified means by which individuals earn compensation to satisfy their needs and acquire goods and services. However, this is not the outcome when deaths, amputations, and injuries occur.
According to the Anuário Estatístico de Acidentes do Trabalho (AEAT), 445,814 workplace accidents occurred in Brazil in 2020. A reduction in numbers is observed when compared to 2018 (586,017) and 2019 (586,857), reflecting the decline in industrial and service activities directly impacted by the COVID-19 pandemic (AEAT, 2020).
It is important to note that these statistics only account for accidents that were officially reported via the Comunicação de Acidente do Trabalho (CAT), involving workers with formal employment contracts. Estimates suggest that if informal and self-employed workers were included, this number could be up to seven times higher, according to a study conducted by the Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho (FUNDACENTRO), an institution linked to the Ministry of Economy (Ramos, 2020).
According to data from the International Labor Organization (ILO), approximately 2.3 million deaths occur annually worldwide due to inadequate work processes, with economic costs ranging from 1.8 to 6% of a country’s GDP, averaging 4% (Takala et al., 2014; Bermudes, 2018; Gallego et al., 2021).
Recognizing the strategic position of the A&L sector in the national economy and the number of accidents and illnesses it faces, this study aims to discuss occupational risks in the A&L sector, highlighting its contribution to GDP and employability during the pandemic. It identifies the number of workplace accidents and illnesses and examines which Classificação Nacional de Atividades Econômicas (CNAE) categories are most frequently affected.
The importance of discussing workplace accidents in the A&L sector is evident, as it allows for identifying the activities with the highest incidence, aiding in directing efforts and developing strategies for occupational safety policies.
2 Material and methods
To construct the current state of the art, a systematic literature review was conducted using the multicriteria methodology Methodi Orinatio, divided into nine steps. This methodology allows for ranking articles based on impact factor, citation count, and year of publication to generate a portfolio ranking of the articles used (Pagani et al., 2015, 2018; Campos et al., 2018; Paula et al., 2020).
In steps 1 and 2, the research intent was established, and exploratory searches were conducted in the Scopus, Science Direct, Web of Science, and SciELO databases.
In steps 3 and 4, keywords were combined, and the following search syntax was applied in the databases: (“agriculture and husbandry sector” OR “agricultural sector” OR “agricultural and livestock sector”) AND (“GDP” OR “gross national product” OR “gross domestic product”), which resulted in 1209 articles; (“agriculture and husbandry sector” OR “agricultural sector” OR “agricultural and livestock sector”) AND (“occupational accident” OR “work accident” OR “labor accidents” OR “occupational injuries” OR “accident at work” OR “workplace accidents”), which resulted in 76 articles; (“GDP” OR “gross national product” OR “gross domestic product”) AND (“occupational accident” OR “work accident” OR “labor accidents” OR “occupational injuries” OR “accident at work” OR “workplace accidents”), which resulted in 117 articles.
In step 5, filtering procedures were applied to remove duplicates, conference papers, books, book chapters, and articles outside the scope of this research by analyzing titles, abstracts, and keywords. This filtering resulted in 306 selected articles.
In steps 6 and 7, the impact factor (IF) and publication year of each article were obtained through the CAPES portal, and citation count (Ci) was gathered using Google Scholar. These variables were then substituted into the InOrdinatio equation, resulting in an ordered portfolio of scientific articles (Equation 1):
The value of α in the equation ranges from 1 to 10 and is determined by the researcher. For this study, α was set at 10 to prioritize more recent articles. In steps 8 and 9, with the portfolio of articles organized, systematic reading and analysis were conducted on the articles selected for use in this research.
To characterize the A&L sector’s representativeness in terms of GDP, in addition to the method previously described, data produced by IBGE were utilized. The calculation of GDP involves various datasets and information produced by IBGE and external sources, including: Balanço de Pagamentos (Banco Central); Declaração de Informações Econômico-Fiscais da Pessoa Jurídica - DIPJ (Secretaria da Receita Federal); Índice de Preços ao Produtor Amplo - IPA (FGV); Índice Nacional de Preços ao Consumidor Amplo - IPCA (IBGE); Produção Agrícola Municipal - PAM (IBGE); Pesquisa Anual de Comércio - PAC (IBGE); Pesquisa Anual de Serviços - PAS (IBGE); Pesquisa de Orçamentos Familiares - POF (IBGE); Pesquisa Industrial Anual - Empresa - PIA-Empresa (IBGE); Pesquisa Industrial Mensal - Produção Física - PIM-PF (IBGE); Pesquisa Mensal de Comércio - PMC (IBGE); Pesquisa Mensal de Serviços - PMS (IBGE) (IBGE, 2022b).
Employment data were obtained from the Cadastro Geral de Empregados e Desempregados – CAGED portal. Data from the Novo CAGED, introduced in January 2020, were used, which replaced the previous system with the Sistema de Escrituração Digital das Obrigações Fiscais, Previdenciárias e Trabalhistas (e-Social). During the transition period, the Novo CAGED incorporated information from the e-Social, CAGED, and Empregador Web systems (CAGED, 2022).
This study exclusively used data from the Novo CAGED, as it provides a broader range of information (e-Social and Empregador Web), including temporary contracts registered in e-Social, which were optional in the previous CAGED system until 2020. Experts note that comparisons between the two systems are not viable (CNN, 2022). In Brazil, workplace accidents are categorized based on the economic activity conducted by the company. The Classificação Nacional de Atividades Econômicas (CNAE) has a five-level hierarchy (sections, divisions, groups, classes, and subclasses). The last level offers detailed identification of the economic activity of production units, which can involve either legal entities or self-employed professionals (IBGE, 2015).
This classification aims to group units based on production similarity, according to the nature or use of the products; however, it is not rigid. The CNAE-Subclasses version 2.2 is hierarchically structured into five levels, comprising 21 sections, 87 divisions, 285 groups, 673 classes, and 1329 subclasses. Each category, from section to subclass, is identified by a code and a denomination (IBGE, 2015). Table 1 presents the hierarchical organization of CNAE 2.0/CNAE-Subclasses 2.2.
It is observed that the coding model is mixed, consisting of a letter to indicate the first level of classification groupings, the section, and numeric codes for the remaining levels of aggregation: division, group, and class. From the second level onward, the model is aggregative, with the code for each more detailed grouping level incorporating the previous one. Thus, the subclass code (seven digits) incorporates the class code (four digits + check digit), which, in turn, incorporates the group code (three digits) to which it belongs, and this, the respective division code (two digits) (IBGE, 2015). The description above can be observed in Table 2:
Using the CNAE, it is possible to obtain statistical data related to the economic activity being researched. In this study, the number of workplace accidents in the A&L sector, classified under Section A (agriculture, livestock, forestry production, fishing, and aquaculture), was analyzed (IBGE, 2015).
3 Results and discussion
Firstly, it is necessary to highlight the representativeness of the sector in Brazil’s economy, using GDP and employment as indicators. Subsequently, statistical data on work-related accidents and illnesses in the sector, based on CNAE classifications, will be presented.
3.1 Gross Domestic Product
GDP is considered a flow indicator of new goods and final services produced over a given period (monthly, quarterly, or annually). It is measured at consumer prices, including taxes on marketed products. This implies that if a country remains stagnant over a year (producing nothing), its GDP will be zero (IBGE, 2022b).
GDP allows for various analyses, such as comparisons between economies of different countries, GDP per capita, historical trends, and the contribution of different economic sectors, among others. Hence, GDP is considered a comprehensive indicator of a country’s economy (IBGE, 2022b).
Before the pandemic, following declines in 2015 and 2016, GDP experienced three years of positive results, with increases of 1.3% in both 2017 and 2018, and closing 2019 with a 1.1% growth, amounting to approximately BRL 7.3 trillion (IBGE, 2020).
In 2020, the first year reflecting the impact of the COVID-19 pandemic in Brazil, GDP fell by 4.1% compared to 2019, marking the lowest rate since 1996 and totaling BRL 7.4 trillion in 2020. This decline reflects reductions in industry (-3.5%) and services (-4.5%), while A&L posted a 2% growth, driven mainly by productivity gains and increased agricultural production (IBGE, 2021).
Even with the 4.1% GDP decline in 2020, breaking a three-year growth streak, the overall performance was not worse thanks to the 2% increase in A&L that year (Beckman & Countryman, 2021; IBGE, 2021).
Globally, GDP comparisons showed a 4% decrease in the U.S. and a 9% drop in Europe in 2020, with global GDP declining by approximately 5%. In contrast, China’s GDP grew by 1.7% during the same year (Beckman & Countryman, 2021).
In 2021, Brazil’s GDP reached BRL 8.7 trillion, closing the year with 4.6% growth. In the first quarter of 2022, it amounted to BRL 2.2 trillion. Economic growth in 2021 stemmed from increases in industry (4.5%) and services (4.7%), which together account for about 90% of the country’s GDP. However, the A&L sector contracted by 0.2% because of frosts and prolonged droughts (IBGE, 2022a).
As shown in Table 3, the A&L sector contributed BRL 183.6 billion to GDP in the first quarter of 2022.
Given the challenges arising from the COVID-19 pandemic, it is necessary to adopt a new perspective on Brazil’s A&L GDP. In this context, the A&L sector plays a strategic role in addressing the ongoing crisis (Schoeninger et al., 2019; Santos et al., 2020).
The Ministry of Agriculture, Livestock, and Supply (MAPA), through Ordinance No. 116 of March 26, 2020, defines services, activities, and products essential to the functioning of food, beverage, and agricultural input supply chains. This aimed to ensure uninterrupted operations during the public emergency declared by the government to address the pandemic crisis (MAPA, 2020).
Key activities listed in the Ordinance include worker and cargo transportation within these supply chains, fuel production and distribution, storage and distribution of goods, agricultural and livestock product processing chains, and agricultural input supply chains essential for continuous production cycles, thereby securing crop preparation, planting, and food supply (IPEA, 2020b).
Despite the positive performance of the A&L sector, it is premature to quantify the crisis’s impact. The outlook remains optimistic, given the expected recovery in Chinese market demand. However, according to IPEA (2020b), risks persist, requiring ongoing monitoring of the domestic market’s evolution, where protein consumption adjustments might occur if prices rise, favoring lower-priced proteins.
3.2 Employment generation
Figure 1 presents monthly statistical data on formal employment in Brazil, detailing admissions, dismissals, and net balances.
Information panel of the Novo CAGED showing the admissions, dismissals, and net balances from January 2020 to May 2022. Source: Adapted from CAGED (2022).
It is observed that in March, April, May, and June 2020, the balance between admissions and dismissals was negative—the worst period during the temporal analysis—because of the pandemic’s effects and market uncertainties.
According to the Novo CAGED, formal employment in Brazil grew in May 2022, recording a net balance of 277,018 jobs. This result stemmed from 1,960,960 admissions and 1,683,942 dismissals. The total number of active formal employment ties in 2020 was 37,912,813, while in May 2022, it totaled 41,729,858 (CAGED, 2022).
In March and April 2020 (Figure 2), all sectors (A&L, trade, construction, industry, and services) reported negative balances. In May, only the A&L sector recorded a positive balance (14,791), and in June, the A&L (37,709) and civil construction (15,566) sectors had positive balances.
Information panel of the Novo CAGED: monthly net balances by major economic activity groups. Source: Adapted from CAGED (2022).
With the progress of vaccination, the establishment of health protocols, and increased public awareness, the most affected sectors—services, trade, and industry—have shown a growth trend since then. It is observed that the A&L sector exhibited the least fluctuation, maintaining a positive balance in most months.
The International Labor Organization (ILO) estimates that the A&L sector employed approximately 874 million workers globally in 2020, representing nearly 27.4% of the global workforce. Furthermore, at least 210,000 farming workers die annually, meaning they are three times more likely to die in this work compared to other sectors. A study conducted by the European Commission in 15 countries concluded that A&L is among the three most dangerous sectors (Agovino, 2014; OIT, 2020; Baraza & Cugueró-escofet, 2021).
3.3 Workplace accidents
According to data from the ILO and the World Health Organization (WHO), approximately 5–7% of all deaths in industrialized countries are related to occupational diseases or injuries. In developing countries like Brazil, this percentage is slightly lower due to a higher prevalence of non-occupational health issues (Takala et al., 2014).
Under Law 8.213/91, a workplace accident is defined as an incident that occurs during the worker’s employment, causing bodily harm or functional disturbance, which results in death, loss, or reduction of work capacity, whether permanent or temporary (Brasil, 1991).
In contrast to the increase in active formal employment ties and admissions, 445,814 workplace accidents were recorded in 2020. Human error is inherent; however, such errors should not lead to illness, limb amputation, or even death. Preventive strategies must be developed to identify errors and act to prevent them from escalating into workplace accidents, prioritizing identified risk situations according to their severity. Accidents not only result in significant loss of life but also generate financial, social, and personal costs (Fernández-Muñiz et al., 2018; Shao et al., 2019).
According to the Statistical Yearbook of Workplace Accidents, 586,857 labor accidents occurred in Brazil in 2019, prior to the pandemic. The state of São Paulo ranked first nationally, followed by Minas Gerais, Rio Grande do Sul, and Paraná (AEAT, 2020; Ramos, 2020).
These figures represent only formal employees, excluding informal and self-employed workers, where underreporting remains a significant issue. CAGED recorded approximately 38 million formal employees in 2018, corresponding to 15,000 cases per million workers. If workplace accidents were considered an infectious disease, their contagion capacity would be five times higher than that of the coronavirus (Ramos, 2020).
Workplace accidents can be categorized as follows: simple medical assistance (medical care with prompt recovery for work); incapacity with absence under 15 days (temporary incapacity for work with costs borne by the employer); incapacity with absence exceeding 15 days (similar to the previous category but includes entitlement to accident-related benefits paid by the National Social Security Institute (INSS)); permanent incapacity (permanent inability to work, either partially or totally); death (the worker's fatality). These categories are represented in Figure 3 (AEAT, 2018; Dias et al., 2019).
Distribution of resolved workplace accidents by outcome in Brazil in 2019. Source: Adapted from AEAT (2019).
Brazil ranks third globally in workplace accident-related deaths, behind only the United States and China (Proteção, 2020). The historical data on workplace accidents from 2006 to 2020, obtained from the INFOLOGO AET database on the Ministry of Labor and Social Security website, reveal a historical average of 655,832 accidents per year from 2006 to 2019. When compared to 2020 (445,814 accidents), this represents a reduction of approximately 30%, reflecting the decrease in industrial and service activities directly impacted by the COVID-19 pandemic (INFOLOGO AET, 2022).
This decline in the number of accidents is linked to the economic crisis. Historically, similar patterns have been observed, such as in a study conducted in Spain from 1994 to 2014, making it unreasonable to attribute this reduction to improvements in workplace safety and health conditions (Fernández-Muñiz et al., 2018).
Another relevant piece of information concerns the number of accidents in the A&L sector (CNAE 2.0 Division including Agriculture, Livestock, and Related Services, Forestry Production, Fishing, and Aquaculture), with approximately 23,744 (3.6%) accidents annually. These were classified according to the CNAE, as shown in Figure 4 (INFOLOGO AET, 2022).
Average number of workplace accidents in 2018, 2019, and 2020 classified under the CNAE 2.0 categories of Agriculture, Livestock, and Related Services, Forestry Production, Fishing, and Aquaculture in Brazil. Source: Adapted from INFOLOGO AET (2022).
As observed in Figure 4, of the 33 CNAE categories within the A&L sector, 12 account for over 80% of the sector’s accidents. The top category is certified seed production (CNAE 0141), followed by sugarcane cultivation (CNAE 0113) and soybean cultivation (CNAE 0115). Next are cattle farming (CNAE 0151), agricultural support activities (CNAE 0161), poultry farming (CNAE 0155), forestry production-planted forests (CNAE 0210), orange cultivation (CNAE 0131), cultivation of permanent crops other than oranges and grapes (CNAE 0133), cultivation of permanent crops other than coffee and cocoa (CNAE 0139), grape cultivation (CNAE 0132), and cereal cultivation (CNAE 0111).
Work conditions have evolved over time, particularly with the adoption of new technologies aimed at increasing productivity and, at least theoretically, reducing workers’ physical effort. However, if such technologies are not used properly or fail to consider workplace safety, they can lead to various problems (Goel et al., 2021; López-toro et al., 2021).
Work condition analyses involve examining equipment, tasks performed, ergonomic aspects, and, most importantly, environmental comfort factors. These include workplace characteristics that may affect workers, such as exposure to thermal stress, which rural workers often face (Borg et al., 2021).
To ensure work environments provide maximum comfort, safety, and performance for workers, Brazil’s Minister of State approved, through Ordinance No. 3.214 of June 8, 1978, the Regulatory Standards (NRs), which currently encompass 38 standards. These aim to safeguard workers’ health and safety in specific economic sectors (Bermudes, 2018; SIT, 2021).
Accidents typically occur because of unsafe acts and conditions. Unsafe conditions include situations in the work environment that endanger workers, such as defective machines and equipment or the lack of Personal Protective Equipment (PPE). Unsafe acts refer to the worker’s behavior during task execution, whether consciously or not, such as exceeding maximum speed limits or running a red light (Shao et al., 2019).
Rural workers may encounter numerous risk factors during their activities, such as noise, vibrations, heat, cold, gases, engulfment, falls from different levels, venomous animals, and dust. When tolerance limits are exceeded, these risks can result in illnesses, explosions, drowning, or suffocation. A lack of knowledge about prevention mechanisms remains the leading cause of accidents in these environments (Gouveia et al., 2013; Mota, 2015; Bermudes, 2018; Dias et al., 2019; Santos et al., 2020).
A study addressing the A&L sector conducted in the United States identified that the most frequent causes of injuries were animal bites and kicks, and falls caused by animals (36%); falls from tractors and rollovers (24%); and falls from other agricultural machinery and accidents involving moving parts (28%). These issues are exacerbated by the use of temporary labor (Davis & Kotowski, 2007; Fernández-Muñiz et al., 2018).
An example is the frequent accidents occurring in storage units as agribusiness continues to set production and profit records. This is a collateral effect of the sector’s modernization that is not widely recognized (Fellet, 2018). Data collected by BBC News Brasil from 2009 to July 2018 revealed 106 worker deaths in grain silos in Brazil. These figures include only cases reported in the media involving bulk food storage. The leading states in these incidents align with those with the highest grain production: Mato Grosso (28 deaths), Paraná (20 deaths), Rio Grande do Sul (16 deaths), and Goiás (9 deaths) (Fellet, 2018).
This research highlights the importance of the A&L sector to Brazil’s economic development. However, it underscores the need to implement measures focusing on improving the working conditions of those involved in this field.
4 Conclusion
The A&L sector plays a strategic role in addressing the crisis caused by the COVID-19 pandemic, contributing to food production and supplying raw materials for industry, making it essential for the preservation and recovery of populations affected by the disease.
The sector’s employment net balance remained positive in most months of 2020, the peak of the pandemic, showing less fluctuation compared to other sectors.
Among the 33 economic activities classified within the A&L sector, a more significant incidence of workplace accidents was observed in 12 of them, notably certified seed production, sugarcane cultivation, soybean cultivation, cattle farming, agricultural support activities, and poultry farming. Together with other activities mentioned throughout this study, these account for 80% of the accidents.
It is estimated that the cost of workplace accidents impacts up to 4% of the GDP, a figure that could be reduced through preventive measures focused on workplace safety.
This information supports the allocation of efforts and the development of public and private policies aimed at reducing accident and illness rates in the sector, prioritizing economic activities with the highest incidence of workplace accidents.
Statement on Data Availability
The data used are available on digital platforms.
Acknowledgements
The research had the financial support of the University-Business Innovation Program (Itaipu Technology Park) and the company APTA Safety at Work, Federal Technological University of Paraná (UTFPR) and State University of Western Paraná (UNIOESTE).
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Financial support: This research was financially supported by research grants from the Itaipu Technological Park (public call for proposals, Notice. CE. 002.2021) and the company APTA occupational safety.
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How to cite:
Kuhn, P. D., Christ, D., Coelho, S. R. M., & Brun, S. A. (2025). Agriculture and livestock sector: GDP, employment, and workplace accidents during the COVID-19 pandemic. Gestão & Produção, 32, e0323. https://doi.org/10.1590/1806-9649-2025v32e0323
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Editor-in-Chief
Dr. Pedro Munari








