Pesticides poisoning in Brazil: the official notification system and challenges to conducting epidemiological studies

O Brasil ?? um dos l??deres mundiais em consumo de agrot??xicos e os trabalhadores expostos s??o numerosos e diversificados. As intoxica????es agudas s??o a face mais vis??vel do impacto destes produtos na sa??de. A avalia????o dos v??rios sistemas oficiais de informa????o que notificam os casos de intoxica????es concluiu que nenhum deles responde adequadamente ao papel de sistema de vigil??ncia. Na pr??tica, s?? se registram os casos agudos e mais graves. Uma importante lacuna ?? a informa????o de exposi????o a agrot??xicos: a avalia????o da ??nica fonte oficial (os Receitu??rios Agron??micos) revelou muitas limita????es. A revis??o das publica????es brasileiras aponta um crescimento quantitativo e qualitativo dos estudos nesta ??rea, com v??rios tipos de abordagens. O impacto da intensa carga qu??mica e o enorme contingente de trabalhadores expostos s??o duas importantes raz??es para o desenvolvimento da pesquisa epidemiol??gica sobre intoxica????es por agrot??xicos, que no Brasil ainda tem um vasto campo para se desenvolver. Abstract: Brazil is one of the world leaders in pesticide consumption and exposed workers are numerous and diversified. Acute poisonings are just the most visible aspect of pesticide impact on human health. An assessment of many official information systems that notify pesticide poisoning concluded that none of them performed appropriately the role of a surveillance system. Only acute and severe cases are notified. One of the main gaps concerns exposure information: the only official source (the Agronomic Prescriptions) has many limitations and is not available for research. A review of published articles in Brazil shows a quantitative and qualitative increase of studies in this area with many different approaches. The impact of such a high chemical burden and the huge numbers of workers exposed are two important reasons for the development of an epidemiological research on pesticide poisoning, an issue that has still a vast field to cover in Brazil