Doença de Parkinson, mortalidade e uso de agrotóxicos no Brasil

Abstract

Ecological study of an analytical, descriptive nature, with a quantitative approach aimed to: analyze mortality from Parkinson's disease and its relationship with pesticide consumption in Brazil, and specific objectives: build a historical series of hospital morbidity and mortality from Parkinson's disease (PD) in Brazil from 2008 to 2020; analyze mortality from Parkinson's disease in the geographic mesoregions of Paraná and pesticide use from 2013 to 2020; and analyze the association between mortality rates from PD and pesticide use in Brazilian states and regions from 2010 to 2021. Data were collected from the Departamento de Informática do Sistema Único de Saúde (Datasus) to calculate morbidity and mortality rates of people with Parkinson's from 2008 to 2021 and from the Sistema de Monitoramento do Comércio e Uso de Agrotóxicos do Estado do Paraná (Siagro) for data on pesticide sales in municipalities of Paraná state. To identify pesticide sales, the study by Ribeiro et al. (2022) was used, which calculated the quantity of active ingredients in kilograms (kg) and planted area in hectares (ha) in Brazilian states. The results are presented in three articles: (1) Association of Parkinson's disease mortality and pesticide sales in Brazil, whose results showed a statistically significant trend of increasing mortality rates in all regions, with higher incidence of deaths among males. In the South region, a pronounced increase in mortality for both sexes were observed over the analyzed period. The analysis revealed a global spatial autocorrelation of PD mortality rate among Brazilian states from 2010 to 2021, with the state of Rio Grande do Sul showing significant correlation between PD and pesticide consumption. (2) Parkinson's disease mortality and pesticide sales in the state of Paraná. The highest average mortality rate was found in the North Central region, peaking in 2019 with 3.80 deaths/100,000 inhabitants. Significant association of mortality was found in all mesoregions with pesticide sales, age, education, and the Índice Ipardes de Desenvolvimento Municipal. (3) Hospital morbidity and mortality from Parkinson's disease in Brazil from 2008 to 2020, whose results showed an average of 875±166 hospitalizations per year, with a decrease in 2020. The most affected age group was between 60 and 79 years, in males, but an increase in cases was observed in younger people. The found mortality was 3333±759 per year, with a statistically significant curve growth over time and higher rates in Rio Grande do Sul and Rio de Janeiro. It is concluded that the association between PD and pesticide use should continue to be investigated with national scope studies, aiming to contribute empirical data and scientific evidence to support the adoption of promotion, prevention, and treatment measures for the disease, as well as measures to control pesticide use in our country. The current hegemonic model of agricultural production dependent on pesticides should be replaced by another, such as agroecology, which preserves the environment and human health.