IntroduçãoA mensuração da exposição a agentes cancerí-genos nos ambientes de trabalho é uma tarefa complexa, pois, habitualmente configuram-se situações ambientais com múltiplas exposições. Por outro lado, o câncer é doença com longo período de latência, assim, a avaliação retrospectiva da exposição requer instrumentos que recuperem informações sobre as experiências do indivíduo em passado distante ao do diagnóstico da doença.A estimativa da fração atribuível a exposições ocupacionais para o câncer é variável, entre 4% e 40%, dependendo do tipo de tumor, da população estudada e da metodologia empregada 1 . Argumenta-se que a exposição ocupacional a cancerígenos seria maior nos trabalhadores dos países em desenvolvimento, como decorrência das precárias condições de trabalho e do uso de tecnologia obsoleta 2 .A Agência Internacional para a Pesquisa sobre Câncer (International Agency for Research on Cancer -IARC) da Organização Mundial da Saúde reconhece atualmente 88 agentes, grupos de agentes ou circunstâncias, como cancerígenos para os humanos, dos quais 23 são encontrados principalmente em ambientes ocupacionais e 13 constituem-se em processos de trabalho 3 .No Brasil, a legislação específica do Ministério do Trabalho e Emprego (MTE) proíbe o uso

To improve intervention measures in workers' health involves the adoption of approaches aimed at implementing inspection of the workplace, using ethical interventions with impact on the Brazilian Health System. Instruments include risk assessment, information flows, and identification of workers' morbidity and mortality characteristics. Such measures are planned with four operational bases: trade unions, production sector, sentinel event, and microregion, establishing a new dynamic relationship between epidemiological investigations and health interventions aimed at changing the work process associated with occupational injuries and diseases.

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Somatic mutations in the TP53 gene are the most frequently observed genetic alterations in human malignancies, including breast cancer, which is one of the leading causes of death among women in Brazil. In our study, we determined the frequency and the pattern of TP53 mutations in malignant breast tumors from 120 patients living in Rio de Janeiro, Brazil. TP53 mutations were found in 20% of the tumors, which contained a diversity of mutation types: missense (62.5%), nonsense (8.3%), silent (4.2%), intronic (12.5%), insertion (4.2%) and deletion (8.3%). Of a total of 15 missense mutations, 4 were observed at Arg248 and 2 at Cys242, which are directly involved in DNA binding and in zinc binding, respectively. A subgroup of 51 patients was analyzed with respect to the relation between the presence of TP53 mutations and classical risk factors and with tumor and patient characteristics. For this analysis, we used logistic regression and, in order to obtain more precise confidence intervals, they were recalculated using a bootstrap resampling technique. Our results demonstrate that these mutations are not statistically associated with the risk factors or the patients' characteristics. However, the presence of TP53 mutations is strongly associated with the aggressiveness of the tumors, measured by Elston classification (OR ‫؍‬ 11.97 and 95% CI of 2.24 -307.05). This finding is in agreement with previous studies, which report the presence of TP53 mutations in tumors with poor prognosis. This correlation between tumor aggressiveness and TP53 mutations could be a crucial variable for the treatment and prognosis of breast cancer. © 2002 Wiley-Liss, Inc. Key words: TP53 gene; breast cancer; risk factors; clinicopathologic features; Rio de Janeiro, Brazil; Elston gradeBreast cancer is one of the leading causes of death among women in Brazil. The Brazilian expected mortality rate for 2001 is 9.9 women per 100,000, whereas the highest incidence was estimated to be in the State of Rio de Janeiro: 82 women per 100,000. 1 The etiology of breast cancer is rather complex and, although 10 -15% of the patients have a family history of the disease, only a small proportion can be explained by mutations in genes such as BRCA1 and BRCA2.The different geographic distribution of cases and evidence from migration studies suggest that some environmental and/or lifestyle factors may be related to the development of breast cancer. 2 Reproductive history, family history of breast cancer, cigarette smoking and alcohol consumption are generally cited as risk factors of breast cancer. However, how these factors contribute to trigger the molecular mechanisms of tumor initiation and progression is not completely understood. 3 Mutations in the tumor suppressor gene, TP53, are the most common genetic alterations seen in human cancer. 4 This gene encodes a 393 amino acid nuclear phosphoprotein that acts as a transcription factor and is implicated in nearly all pathways involved in cell proliferation control: modulation of cell-cycle progression, apopto...

The authors evaluate the work process and its effect on workers' health in a cement factory in the State of Rio de Janeiro. The interactive methodology consisted of different approaches to assessing the workplace through the incorporation of various institutions working in the field of Workers' Health, professionals from different backgrounds, and the trade union, valorizing the workers' experience and actively contributing to the surveillance process under the Unified National Health System (SUS). Levels of particulate matter and noise were measured. The mean level of free crystalline silica in the particulate matter was 2%, resulting in a tolerance limit as specified under Brazilian legislation (NR-15), or 2.0mg/m3. The concentration of particles both in samples collected in the workers' respiratory zone and in area samples varied from 3.59 to 52.44mg/m3. Noise varied from 83dB to 110dB. The majority of the values were higher than the maximum limits set by Brazilian legislation. These results, together with the opinions expressed by the workers themselves, showed an unhealthy workplace and work process, placing the workers' health at risk.