Title: SISTEMA NACIONAL DE VIGILNCIA EPIDEMIOLGICA BRASIL
11398 "Environmental and Occupational Health III
Section"
Test-retest Reliability of a questionnaire used
to Evaluate Programs for Preventing Mercury
Exposure from Gold Production
Volney de M. Câmara, Delma P.O. Souza, Maria
Izabel F. Filhote, Ronir R. Luiz, Camila O. Souza
Armando Meyer
Istanbul, Turkey - 29 April, 2009 Charles-Edward
Amory Winslow Room - 1100 AM
2 Universidade Federal do Rio de Janeiro Instituto
de Estudos em Saúde Coletiva (Federal
University of Rio de Janeiro Public Health
institute)
volney_at_iesc.ufrj.br Full Professor F.M. e
IESC/UFRJ Address Núcleo de Estudos de Saúde
Coletiva NESC/CCS/UFRJ Av. Brigadeiro
Trompowsky, s/n Praça da Prefeitura
Universitária Ilha do Fundão Rio de Janeiro,
Brazil - CEP 21949-900 Tel. (55 21)
2598-9271/9278/9279 Fax (55 21) 2270-0097
2598-9273 2545-6199
3MERCURY EXPOSURE IN THE AMAZON
JUST ONE MERCURY? METALLIC MERCURY AND
METHYLMERCURY These two forms are extremely
toxic mainly for the Nervous System
4We have Gold mining in the border of small
rivers alluvial
5Gold concentration by inclined boxes
Gold is presented as dust so Metallic mercury is
utilized to form a gold-mercury amalgam for
extraction became easier Usually for each 1 Kilo
of gold, it is used close 1 to 3 kilos of mercury
6Hg vapor emitted to the URBAN atmosphere without
treatment
URBAN EXPOSURE
Gold Burned again in Gold Shops
(GOLD needs to be purified as it holds 3 to 5
of mercury in its composition)
7BACKGROUND
Previous Study A study conducted in Poconé
(Central-West Brazil) mean levels of mercury in
the urine (HgU) of 365 residents not exposed
occupationally, that is, residents who lived near
the stores that commercialize gold, were 4 times
higher than the control group in
agricultural areas
Financial support (GTZ, PAHO) coord Câmara V.
and Silva, A.P. Institutions UFRJ/FM -
Universidade Federal do Rio de Janeiro/Faculdade
de Medicina AMBIOS Engenharia FIOCRUZ -
Fundação Oswaldo Cruz Universidade Federal do
Mato Grosso Centro de Tecnologia Mineral
CETEM/CNPq - Centro de Tecnologia Minera/
Prefeitura Municipal de Poconé.
8(No Transcript)
913 Persons from 4 families (HgU from 7.0 to 102.4
µg/L) reported that some other person from the
family extracted gold and burned the amalgam in
their kitchens.
10 11Development of the Educational for Health
Methodology
Evaluation of the educational program Comparison
of correct answers from a self-applied
questionnaire applied before and after the
educational activities.
12Example of Education for Health Activity
Developed Adolescents from Poconé decided to
create a play named Health is as precious as
gold in which a self-centered woman named
Teresa demands from her fiancée (Severino) a huge
amount of gold to become rich. As they burned the
gold inside the house, she develops mercury
intoxication, which threatens her life, making
her decide to give up working with gold. This
play was produced and presented in this School
and also in ten others.
13 14 The questionnaire presents information on
occupational experience, occupational accidents
and environmental health problems.
Main question Do the adolescents understand the
questions included in the questionnaire?
15 16METHODOLOGY
This questionnaire is self-applied and has 10
questions (Environmental and Occupational Health
questions). A test-retest reliability was
performed with a 21-day interval between the two
applications of the questionnaire The
questionnaire was answered for a random sample of
128 students who were in the 8th grade of
elementary school (15 to 18 years old).
17Reliability was evaluated by Kappa Coefficient
and McNemars chi-square test
Classification Kappa Coefficient values
between 0.81-1.00 almost perfect 0.61-0.80
substantial 0.41-0.60 moderate 0.21-0.40
weak 0.00-0.20 slight and, lt0 poor
18RESULTS
Three open-ended questions Almost perfect
agreement was obtained in the questions
concerning (1) What is pollution? k 0.885 95
CI 0.66 1.00 (2) State some causes of
pollution? K0.820 95 CI 0.68 0.97
Moderate agreement was obtained in the
questions concerning (3) What is an occupational
accident? k0.580, 95 CI 0.20 0.95
19Test-retest reliability of questions related to
the work environment among adolescents students.
Poconé, Central-west, Brazil.
20Test-retest reliability of questions related to
the work environment among adolescents students.
Poconé, Central-west, Brazil.
21CONCLUSIONS
Although the instrument presented some questions
that obtained moderate kappa values, it expressed
adequate reliability. It may therefore be
employed in the evaluation of educational
programs geared towards adolescents exposed to
mercury, in BRAZILIAN areas of gold
production. Among the limitations of the study,
we must mention the losses that occurred due to
the number of students that replied only once
because he or she were absent from class on the
other occasion.
22What we ALSO learned
The Environment is Essential for Understanding
Public Health
Thanks!