ABSTRACT

Objective:

To describe the sociodemographic, socio-occupational profile, and effects on the health of artisanal fishers from the state of Pernambuco, Brazil, affected by the oil disaster-crime in Brazil in 2019.

Methods:

This is a cross-sectional epidemiological study, carried out in 16 municipalities on the coast of Pernambuco, with a sample made up of 1,259 artisanal fishers. A questionnaire containing 14 blocks was used, including socioeconomic issues, exposure to oil, among others. A descriptive analysis was carried out with calculation of simple frequencies and percentages.

Results:

Of those interviewed, 95.1% considered fishing as their main occupation and 97% were carrying out this activity. Among fishers, the most common fishing spot was the mangrove, and wood fire was used in the work process by around 60% of the population. Regarding health issues, 34.4% reported a severe headache or migraine and 28.2% reported burning eyes, within one to three months after the oil spill.

Conclusion:

According to the results, working, health, and lifestyle conditions were impacted by the oil disaster-crime. Further research should be carried out to better understand the damage caused by exposure to oil and its effects on the health of fishers. Observing the profile of people who live in artisanal fishing territories in Pernambuco is paramount for public policies and government actions that promote safe and sustainable territories.

Keywords:
Epidemiology; descriptive; Petroleum pollution; Public health; Environmental health

INTRODUCTION

The National Policy on Holistic Health of Rural, Forest and Water Populations (Política Nacional de Saúde Integral das Populações do Campo, da Floresta e das Águas – PNSIPCFA) considers artisanal fishing communities as “peoples and communities with ways of life, production, and social reproduction predominantly related to aquatic environments”¹1. Brasil. Portaria no 2.311, de 23 de outubro de 2014. Altera a Portaria no 2.866/GM/MS, de 2 de dezembro de 2011, que institui, no âmbito do Sistema Único de Saúde (SUS), a Política Nacional de Saúde Integral das Populações do Campo e da Floresta (PNSIPCF) [Internet]. 2014 [cited on July 29, 2024]. Available at: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2014/prt2311_23_10_2014.html
https://bvsms.saude.gov.br/bvs/saudelegi... . Artisanal fishers (AF) carry out small-scale fishing activities, either on land — such as shellfishing, in which they use wood fire in the fish processing stage, or on boats — fishing in rivers or open seas, for commercial purposes and, in addition to this condition, fishing assumes an affective and food consumption dimension for these populations²2. Rêgo RF, Müller JS, Falcão IR, Pena PGL. Vigilância em saúde do trabalhador da pesca artesanal na Baía de Todos os Santos: da invisibilidade à proposição de políticas públicas para o Sistema Único de Saúde (SUS). Rev Bras Saúde Ocup 2018; 43(Suppl 1): e10s. https://doi.org/10.1590/2317-6369000003618
https://doi.org/10.1590/2317-63690000036... .

AF have a way of life linked to the healthy and sustainable productive and subsistence conditions of the environment — seas, rivers, estuaries, mangroves, among others²2. Rêgo RF, Müller JS, Falcão IR, Pena PGL. Vigilância em saúde do trabalhador da pesca artesanal na Baía de Todos os Santos: da invisibilidade à proposição de políticas públicas para o Sistema Único de Saúde (SUS). Rev Bras Saúde Ocup 2018; 43(Suppl 1): e10s. https://doi.org/10.1590/2317-6369000003618
https://doi.org/10.1590/2317-63690000036... . These workers have relative work autonomy, threatened by development matrices that insert contexts of environmental injustice in the territories³3. Brandão CRA. A comunidade tradicional. In: Costa JBA, Luz C, orgs. Cerrados, gerais, sertão: comunidades tradicionais dos sertões roseanos. Montes Claros: Intermeios; 2010, p. 347-61.. Environmental injustice, according to Acselrad⁴4. Acselrad H. Ambientalização das lutas sociais – o caso do movimento por justiça ambiental. Estud Av 2010; 24(68): 103-19. https://doi.org/10.1590/S0103-40142010000100010
https://doi.org/10.1590/S0103-4014201000... , is the unequal exposure of populations to risk arising from the capital accumulation model, introducing, in historically vulnerable territories, new processes that amplify this condition such as: real estate speculation, advancement of the petrochemical industry, and implementation of tourist complexes that affect social, economic, ecological, and health issues⁵5. Ramalho CWN, Santos SO. O cotidiano das comunidades pesqueiras entre o petróleo e o novo coronavírus. In: Barros S, Medeiros A, Gomes EB, orgs. Conflitos socioambientais e violações de direitos humanos em comunidades tradicionais pesqueiras no Brasil: relatório 2021. 2a ed. Olinda: Conselho Pastoral dos Pescadores; 2021. p. 224-9.,⁶6. Santos MOS, Santos CPS, Alves MJCF, Gonçalves JE, Gurgel IGD. Oil in Northeast Brazil: mapping conflicts and impacts of the biggest disaster on the country’s coast. An Acad Bras Ciênc 2022; 94(suppl 2): e20220014. https://doi.org/10.1590/0001-3765202220220014
https://doi.org/10.1590/0001-37652022202... .

The process of vulnerability occurs through the correlations of social, economic, and political forces in the territories, causing direct impacts on decision-making in health management, the formation of territorial policies and actions aimed at prevention and recovery in cases such as the disaster-crime of the oil spill that hit the Brazilian coast in 2019, especially the Northeast region⁶6. Santos MOS, Santos CPS, Alves MJCF, Gonçalves JE, Gurgel IGD. Oil in Northeast Brazil: mapping conflicts and impacts of the biggest disaster on the country’s coast. An Acad Bras Ciênc 2022; 94(suppl 2): e20220014. https://doi.org/10.1590/0001-3765202220220014
https://doi.org/10.1590/0001-37652022202... ,⁷7. Porto MFS. Complexidade, processos de vulnerabilização e justiça ambiental: Um ensaio de epistemologia política. Rev Crit Cienc Sociais 2011; 93: 31-58. https://doi.org/10.4000/rccs.133
https://doi.org/10.4000/rccs.133... . This disaster-crime, considered a socio-environmental tragedy and one of the largest to occur in the South Atlantic and the largest on the Brazilian coast, caused environmental, socioeconomic, and health impacts, reflected in exposure to oil, food insecurity, economic vulnerability, and environmental contamination — mainly for artisanal fishing communities whose subsistence depends directly on fishing biodiversity⁵5. Ramalho CWN, Santos SO. O cotidiano das comunidades pesqueiras entre o petróleo e o novo coronavírus. In: Barros S, Medeiros A, Gomes EB, orgs. Conflitos socioambientais e violações de direitos humanos em comunidades tradicionais pesqueiras no Brasil: relatório 2021. 2a ed. Olinda: Conselho Pastoral dos Pescadores; 2021. p. 224-9.,⁶6. Santos MOS, Santos CPS, Alves MJCF, Gonçalves JE, Gurgel IGD. Oil in Northeast Brazil: mapping conflicts and impacts of the biggest disaster on the country’s coast. An Acad Bras Ciênc 2022; 94(suppl 2): e20220014. https://doi.org/10.1590/0001-3765202220220014
https://doi.org/10.1590/0001-37652022202... .

Regarding human health, hundreds of people were directly exposed to oil during beach cleaning activities, underestimating the effects on health⁵5. Ramalho CWN, Santos SO. O cotidiano das comunidades pesqueiras entre o petróleo e o novo coronavírus. In: Barros S, Medeiros A, Gomes EB, orgs. Conflitos socioambientais e violações de direitos humanos em comunidades tradicionais pesqueiras no Brasil: relatório 2021. 2a ed. Olinda: Conselho Pastoral dos Pescadores; 2021. p. 224-9.. Exposure to oil can have effects on mental and physical health, with genotoxic and immunotoxic repercussions and endocrine toxicity, which can manifest years after exposure, with women, older adults, and children being the most susceptible⁸8. Laffon B, Pasáro E, Valdiglesias V. Effects of exposure to oil spills on human health: updated review. J Toxicol Environ Health B Crit Rev 2016; 19(3-4): 105-28. https://doi.org/10.1080/10937404.2016.1168730
https://doi.org/10.1080/10937404.2016.11... .

Despite the cultural and productive importance of these populations, records of artisanal fishing workers are out of date, and existing data do not follow a standard of organization and standardization, making it difficult to obtain reliable information⁹9. Mendonça JT, Mattos SMG. Panorama da política pesqueira no Brasil em 2020. In: Barros S, Medeiros A, Gomes EB, orgs. Conflitos socioambientais e violações de direitos humanos em comunidades tradicionais pesqueiras no Brasil: relatório 2021. 2a ed. Olinda: Conselho Pastoral dos Pescadores; 2021. p. 189-93.. Associated with the lack of information on the profile of this population, there was a failure to monitor exposure and cases of poisoning during the oil disaster-crime, which led to difficulties in decision-making to tackle the disaster and implement social and health actions for affected communities¹⁰10. Freitas PAN, Machado RM, Silva ES, Santos MOS, Gurgel IGD. Derramamento de petróleo e responsabilização do Estado: desafios da pesca artesanal em Pernambuco/Brasil. SER Social 2023; 27(53): 314-40. https://doi.org/10.26512/ser_social.v25i53.46248
https://doi.org/10.26512/ser_social.v25i... . The lack of information also caused delays in activating contingency plans and negligence in some scenarios⁶6. Santos MOS, Santos CPS, Alves MJCF, Gonçalves JE, Gurgel IGD. Oil in Northeast Brazil: mapping conflicts and impacts of the biggest disaster on the country’s coast. An Acad Bras Ciênc 2022; 94(suppl 2): e20220014. https://doi.org/10.1590/0001-3765202220220014
https://doi.org/10.1590/0001-37652022202... .

Knowledge of the general and unique aspects of these communities is essential to support social and health actions and policies that can be efficiently implemented in the territories. Thus, in this article we aim to describe and analyze the socio-occupational characteristics and some health effects of fishers exposed to the 2019 oil disaster-crime in the state of Pernambuco.

METHODS

This is a cross-sectional epidemiological study carried out in the Northeast region of Brazil with data collected in 16 municipalities on the coast of Pernambuco affected by the oil disaster-crime in 2019, namely: Cabo de Santo Agostinho, Ipojuca, Rio Formoso, Sirinhaém, Tamandaré, Barreiros, São José da Coroa Grande, Goiana, Igarassu, Itapissuma, Itamaracá, Recife, Jaboatão dos Guararapes, Paulista, Olinda, Abreu, and Lima.

A validated questionnaire containing 13 blocks of questions addressing variables of exposure to oil and characterization of the social, environmental, economic, and health conditions of the population interviewed was used as a research instrument¹¹11. Rêgo RCF, Machado LOR, Mota LSR, Caldas WM, Lima VMC, Muller JS. Pesquisa para monitorar os possíveis efeitos à saúde da exposição ao petróleo na população atingida pelo desastre de derramamento de Petróleo na Costa brasileira no ano de 2019: Relatório de Execução. Salvador: Universidade Federal da Bahia; 2024.. Another block with variables related to mental health was added to the original questionnaire, making a total of 14 blocks and 361 questions. To apply the questionnaire, the offline HCMaps application was used on electronic tablets , and each questionnaire took an average of 60 minutes to complete¹²12. Duarte KVN, Machado AS, Cesse EAP, Bezerra HMC, Chagas MBR, Carvalho EMF. Contribuições de um sistema tecnológico para a construção de ecomapas na atenção aos usuários hipertensos e diabéticos: estudo de caso com equipes NASF. Rev APS 2018; 21(4): 534-50. https://doi.org/10.34019/1809-8363.2018.v21.16411
https://doi.org/10.34019/1809-8363.2018.... . Data collection took place between September 2021 and August 2022.

The study population consisted of 12,472 fishers, registered in the 27 fishers’ colonies and/or associations on the coast of Pernambuco¹³13. Secretaria de Meio Ambiente e Sustentabilidade de Pernambuco. Cadastro de pescadores(as) atingidos(as) pelo derramamento de petróleo em Pernambuco. Recife: Secretaria de Meio Ambiente e Sustentabilidade de Pernambuco; 2019.. The inclusion criteria for participants were: individuals over 18 years of age and artisanal fishing workers who carried out the activity during the period of the oil disaster-crime. As an exclusion criterion, retired workers and/or those who were away from work during the oil disaster-crime were dismissed.

To define the sample, the coast of Pernambuco was stratified into three segments (North, Metropolitan, and South), adopting a study effect of 1.5 with a prevalence of 40% for health effects¹⁴14. Zock JP, Rodríguez-Trigo G, Rodríguez-Rodríguez E, Espinosa A, Pozo-Rodríguez F, Gómez F, et al. Persistent respiratory symptoms in clean-up workers 5 years after the Prestige oil spill. Occup Environ Med 2012; 69(7): 508-13. https://doi.org/10.1136/oemed-2011-100614
https://doi.org/10.1136/oemed-2011-10061... , error of 3.5%, and confidence of 95%, resulting in a minimum sample size of 1,065 individuals. A 25% possibility of losses was added to the sample value, resulting in a sample of 1,331 people. Due to the number of registered people being approximately 1/3 of the total population, a proportional distribution was carried out for each coast and subsequently by the associations/colonies of each municipality. After completing the fieldwork, the research inclusion and exclusion criteria were adapted, obtaining a final sample of 1,259 people, exceeding the minimum sample size expected by approximately 18%.

For this study, blocks related to sociodemographic, health, and work conditions were considered, using the following variables: sex, age group, race/skin color, education, main occupation, work in fishing/shellfishing, work other than fishing, fishing spots, type of stove used for work, interruption of activity due to the oil spill, damage caused to usual fishing areas, location of oil while fishing, and main frequencies of symptoms presented in the period of one to three months after the start of the oil spill (nasal congestion, itchy or runny nose, severe headache or migraine, watery or itchy eyes, burning eyes). For data analysis, the absolute and relative percentage frequencies of the selected variables were calculated using the R v. 4.2.1 computational platform — available free of charge on cran.r-project.org.

RESULTS

Among the 1,259 individuals participating in the study, 852 (67.7%) were women, 616 (48.9%) aged between 45 and 59 years, and 1,068 (84.8%) people declared themselves to be brown or Black; in relation to education, 71 (5.6%) were illiterate and 699 (55.6%) had some elementary school (Table 1).

Artisanal fishing was considered the main occupation by 1,197 (95.1%) interviewees, and 1,208 (95.9%) were working in the fishing production process. Among those who carried out activities other than fishing, there were 62 (26.2%) individuals. Regarding the artisanal fishing work environment, 644 (51.2%) had the mangrove as their workplace. In turn, the wood-burning stove for work is used by 756 (60%) of them (Table 2).

Regarding the fishing activity and the oil disaster-crime, 1,094 (86.9%) interviewees interrupted their work activity due to the oil spill. As for damage to regular fishing areas, 1,205 (95.7%) respondents reported damage caused by the disaster and 873 (69.3%) found oil while fishing (Table 3).

Among the symptoms self-reported by the population after exposure, during the period of one to three months after the oil disaster-crime, the neurological symptoms headache or migraine were two of the most frequent, accounting for 433 (34%) individuals, followed by the ocular system symptom burning eyes, for 355 (28.2%) people, and by nasal congestion, itchy or runny nose, symptoms of the respiratory system, for 336 (26.7%) individuals (Table 3).

DISCUSSION

The majority of participants in this study are women and Black people with education level up to some elementary school, aged between 45 and 59 years, who consider fishing as their main occupation and are currently working. The mangrove was the environment most frequently mentioned as a fishing spot, and wood fire used during the work process was reported by more than half of the participants. We verified that most of the interviewees stopped fishing during the event and that the disaster caused damage to fishing areas. As for the oil exposure, a large percentage encountered oil while working, and about 1/3 of respondents reported symptoms related to the nervous, ocular, and respiratory systems.

In the sample, 67.7% of respondents were women, a statistic similar to recent data from the Brazilian Ministry of Fisheries and Aquaculture (2023)¹⁵15. Brasil. Ministério da Pesca e Aquicultura. Brasil tem mais de 1 milhão de pescadores profissionais e 49% são mulheres [Internet]. 2023 [cited on July 29, 2024]. Available at: https://www.gov.br/mpa/pt-br/assuntos/noticias/brasil-tem-mais-de-1-milhao-de-pescadores-profissionais-e-49-sao-mulheres#:~:text=De%20acordo%20com%20o%20recente,de%20participação%20feminina%20no%20of%C3%ADcio
https://www.gov.br/mpa/pt-br/assuntos/no... , which released information on the artisanal fishing population, showing a greater number of fisherwomen compared to fishermen in Pernambuco¹⁵15. Brasil. Ministério da Pesca e Aquicultura. Brasil tem mais de 1 milhão de pescadores profissionais e 49% são mulheres [Internet]. 2023 [cited on July 29, 2024]. Available at: https://www.gov.br/mpa/pt-br/assuntos/noticias/brasil-tem-mais-de-1-milhao-de-pescadores-profissionais-e-49-sao-mulheres#:~:text=De%20acordo%20com%20o%20recente,de%20participação%20feminina%20no%20of%C3%ADcio
https://www.gov.br/mpa/pt-br/assuntos/no... . Pena et al.¹⁶16. Pena PGL, Martins V, Rego RF. Por uma política para a saúde do trabalhador não assalariado: o caso dos pescadores artesanais e das marisqueiras. Rev Bras Saúde Ocup 2013; 38(127): 57-68. https://doi.org/10.1590/S0303-76572013000100009
https://doi.org/10.1590/S0303-7657201300... identified that most artisanal fishing workers work in shellfishing, in mangroves and on the sand, and this is a predominantly female work. Although women play a prominent role in fishing, they are often made invisible¹⁷17. Gomes TMD, Lima MAG, Freitas MCS. Marisqueiras da Ilha das Fontes: descrição do trabalho e da tradição incorporadas na pesca artesanal. In: Fernandes RCP, Lima MAG, Araújo TM. Tópicos em saúde, ambiente e trabalho: um olhar ampliado. Salvador: EDUFBA; 2014. p. 129-52. https://doi.org/10.7476/9786556300122.0008
https://doi.org/10.7476/9786556300122.00... ,¹⁸18. Flores MG, Medeiros ACLV, Peixinho BC, Nepomuceno MM, Nascimento EF, Gurgel AM, et al. Processos críticos protetores e destrutivos no trabalho das pescadoras artesanais do litoral Pernambucano, Brasil. Ciênc Saúde Coletiva 2024; 29(7): e03612024. https://doi.org/10.1590/1413-81232024297.03612024
https://doi.org/10.1590/1413-81232024297... .

The proportion of Black people interviewed was similar to that found in the study by Mesquita and Quinamo¹⁹19. Mesquita B, Quinamo T. Justiça azul e pesca artesanal no centro do debate do derramamento de petróleo no Brasil. In: Fundação Joaquim Nabuco. Impactos socioeconômicos e ambientais da contaminação por petróleo nas praias do litoral da região nordeste do Brasil – Relatório parcial [Internet]. Recife: Fundação Joaquim Nabuco; 2020. p. 1-40 [cited on May 08, 2024]. Available at: https://www.gov.br/fundaj/pt-br/composicao/dipes-1/grupos-de-pesquisa-fundaj-cnpq/nucleos-e-centros/centro-integrado-de-estudos-georreferenciados-cieg/petroleo-nas-praias/IMPACTOS_SOCIOECONOMICOS_E_AMBIENTAIS_NAS_PRAIAS_DO_LITORAL_NORDESTE.pdf
https://www.gov.br/fundaj/pt-br/composic... , reinforcing the historicity and Black representation in the history of artisanal fishing in Brazil¹⁷17. Gomes TMD, Lima MAG, Freitas MCS. Marisqueiras da Ilha das Fontes: descrição do trabalho e da tradição incorporadas na pesca artesanal. In: Fernandes RCP, Lima MAG, Araújo TM. Tópicos em saúde, ambiente e trabalho: um olhar ampliado. Salvador: EDUFBA; 2014. p. 129-52. https://doi.org/10.7476/9786556300122.0008
https://doi.org/10.7476/9786556300122.00... ,¹⁸18. Flores MG, Medeiros ACLV, Peixinho BC, Nepomuceno MM, Nascimento EF, Gurgel AM, et al. Processos críticos protetores e destrutivos no trabalho das pescadoras artesanais do litoral Pernambucano, Brasil. Ciênc Saúde Coletiva 2024; 29(7): e03612024. https://doi.org/10.1590/1413-81232024297.03612024
https://doi.org/10.1590/1413-81232024297... ,²⁰20. Ramalho CWN. A formação histórica da pesca artesanal: origens de uma cultura do trabalho apoiada no sentimento de arte e de liberdade. Cadernos de Estudos Sociais 2008; 24(2): 261-85.. There is a concentration of people between 45 and 59 years old, which creates a generational issue in the work and maintenance of artisanal fishing¹⁶16. Pena PGL, Martins V, Rego RF. Por uma política para a saúde do trabalhador não assalariado: o caso dos pescadores artesanais e das marisqueiras. Rev Bras Saúde Ocup 2013; 38(127): 57-68. https://doi.org/10.1590/S0303-76572013000100009
https://doi.org/10.1590/S0303-7657201300... .

The context of socio-environmental injustice and racism is largely responsible for the lack of or difficulty in accessing formal education in artisanal fishing territories, which has a negative impact on health and the construction of a dignified and happy life²¹21. Souza VM, Loureiro CFB. Povos tradicionais caiçaras, educação escolar e justiça ambiental na Península da Juatinga, Paraty-RJ. Ambiente & Educação: Revista de Educação Ambiental 2018; 23(1): 54-78. https://doi.org/10.14295/ambeduc.v23i1.7214
https://doi.org/10.14295/ambeduc.v23i1.7... . Alencar and Maia²²22. Alencar CAG, Maia LP. Perfil socioeconômico dos pescadores brasileiros. Arq Ciên Mar 2011; 44(3): 12-9. https://doi.org/10.32360/acmar.v44i3.149
https://doi.org/10.32360/acmar.v44i3.149... show in their study that around 75% of Brazilian fishers did not complete elementary school. In the Northeast, around 69.4% of fishers have some elementary school¹⁹19. Mesquita B, Quinamo T. Justiça azul e pesca artesanal no centro do debate do derramamento de petróleo no Brasil. In: Fundação Joaquim Nabuco. Impactos socioeconômicos e ambientais da contaminação por petróleo nas praias do litoral da região nordeste do Brasil – Relatório parcial [Internet]. Recife: Fundação Joaquim Nabuco; 2020. p. 1-40 [cited on May 08, 2024]. Available at: https://www.gov.br/fundaj/pt-br/composicao/dipes-1/grupos-de-pesquisa-fundaj-cnpq/nucleos-e-centros/centro-integrado-de-estudos-georreferenciados-cieg/petroleo-nas-praias/IMPACTOS_SOCIOECONOMICOS_E_AMBIENTAIS_NAS_PRAIAS_DO_LITORAL_NORDESTE.pdf
https://www.gov.br/fundaj/pt-br/composic... , a proportion similar to that found in the present study. There is a need for educational strategies that value popular and scientific knowledge together, so that the way of life of these communities and the work process of these fishers can be understood and integrated — thus valuing artisanal fishing, the mobilization of traditional knowledge, and the guarantee of the right to decent work, health, and life¹⁶16. Pena PGL, Martins V, Rego RF. Por uma política para a saúde do trabalhador não assalariado: o caso dos pescadores artesanais e das marisqueiras. Rev Bras Saúde Ocup 2013; 38(127): 57-68. https://doi.org/10.1590/S0303-76572013000100009
https://doi.org/10.1590/S0303-7657201300... ,²³23. Carvalho IGS, Rêgo RCF, Larrea-Killinger C, Rocha JCS, Pena PGL, Machado LOR. Por um diálogo de saberes entre pescadores artesanais, marisqueiras e o direito ambiental do trabalho Ciênc Saúde Coletiva 2014; 19(10): 4011-22. https://doi.org/10.1590/1413-812320141910.09432014
https://doi.org/10.1590/1413-81232014191... ,²⁴24. Nascimento CHV, Rodrigues GG. Impactos socioambientais e implicações na pesca artesanal das comunidades beneficiárias da RESEX Acaú-Goiana. PerCursos 2022; 23(53): 240-61. https://doi.org/10.5965/1984724623532022240
https://doi.org/10.5965/1984724623532022... .

The government structure of artisanal fishing in the country presents conditions that often delegitimize the representative and autonomous exercise of fishers²⁵25. Gonçalves JE, Machado RM, Gurgel AM, Rego RCF, Santos MOS, Gurgel IGD. Determinação social da saúde de trabalhadores da pesca artesanal em desastres com petróleo. Sustainability in Debate 2023; 14(2): 55-67. https://doi.org/10.18472/SustDeb.v14n2.2023.49625
https://doi.org/10.18472/SustDeb.v14n2.2... . The relationship of these individuals with the territory and work is traced based on worldviews and cultural, social, and identity constructs that go beyond extractive and purely commercial logic¹⁶16. Pena PGL, Martins V, Rego RF. Por uma política para a saúde do trabalhador não assalariado: o caso dos pescadores artesanais e das marisqueiras. Rev Bras Saúde Ocup 2013; 38(127): 57-68. https://doi.org/10.1590/S0303-76572013000100009
https://doi.org/10.1590/S0303-7657201300... ,²⁰20. Ramalho CWN. A formação histórica da pesca artesanal: origens de uma cultura do trabalho apoiada no sentimento de arte e de liberdade. Cadernos de Estudos Sociais 2008; 24(2): 261-85.. This means that any change or alteration that has an impact on the fishing work process can create scenarios of food insecurity — as part of the fish is for personal consumption —, socioeconomic insecurity, changes in the traditional way of life, and harm to physical and mental health¹⁰10. Freitas PAN, Machado RM, Silva ES, Santos MOS, Gurgel IGD. Derramamento de petróleo e responsabilização do Estado: desafios da pesca artesanal em Pernambuco/Brasil. SER Social 2023; 27(53): 314-40. https://doi.org/10.26512/ser_social.v25i53.46248
https://doi.org/10.26512/ser_social.v25i... ,²⁶26. Santos MOS, Alves SG, Mertens FAG, Gurgel IGD, Augusto LGS. Excluídas pelo desenvolvimento: mulheres e o complexo industrial portuário de Suape. Revista de Geografia 2016; 33(3): 117-40..

The mangrove, where more than half of the participants in this study work, was directly affected by the oil spill in 2019. This ecosystem is considered a natural nursery and, therefore, very sensitive to environmental changes, which can cause damage to the genetic structure of species that live or reproduce in this habitat, triggering cascading effects of micro- and macroecological proportions²⁷27. Silva BRL, Rodrigues GG. Pescadoras e pescadores artesanais silenciados. Impactos socioambientais do derramamento de petróleo nas comunidades pesqueiras em Pernambuco. Mares: Revista de Geografia e Etnociências 2020; 2(2): 73-84.,²⁸28. Silva FR, Schiavetti A, Malhado ACM, Ferreira B, Sousa CVP, Vieira FP, et al. Oil spill and socioeconomic vulnerability in marine protected areas. Front Mar Sci 2022; 9: 859697. https://doi.org/10.3389/fmars.2022.859697
https://doi.org/10.3389/fmars.2022.85969... .

In addition to the repercussions on the environment, the effects on human health due to exposure to oil are diverse, affecting physical and mental health, and can be acute or chronic in the short, medium, or long term⁸8. Laffon B, Pasáro E, Valdiglesias V. Effects of exposure to oil spills on human health: updated review. J Toxicol Environ Health B Crit Rev 2016; 19(3-4): 105-28. https://doi.org/10.1080/10937404.2016.1168730
https://doi.org/10.1080/10937404.2016.11... ,²⁹29. Aguilera F, Mendez J, Pásaro E, Laffon B. Review on the effects of exposure to spilled oils on human health. J Appl Toxicol 2010; 30(4): 291-301. https://doi.org/10.1002/jat.1521
https://doi.org/10.1002/jat.1521... . D’Andrea and Reddy³⁰30. D’Andrea MA, Reddy GK. The development of long-term adverse health effects in oil spill cleanup workers of the deepwater horizon offshore drilling rig disaster. Front Public Health 2018; 6: 117. https://doi.org/10.3389/fpubh.2018.00117
https://doi.org/10.3389/fpubh.2018.00117... demonstrated the development of changes or worsening of hematological, hepatic, pulmonary, and cardiac functions in people who worked in the cleanup during the oil spill on the Deepwater Horizon platform, even after seven years of exposure³⁰30. D’Andrea MA, Reddy GK. The development of long-term adverse health effects in oil spill cleanup workers of the deepwater horizon offshore drilling rig disaster. Front Public Health 2018; 6: 117. https://doi.org/10.3389/fpubh.2018.00117
https://doi.org/10.3389/fpubh.2018.00117... .

There is also evidence of the development of headaches and ocular and respiratory symptoms even after 12 months after initial exposure to oil, recording a decrease in respiratory symptoms in relation to the first 30 days³¹31. Na JU, Sim MS, Jo IJ, Song HG. The duration of acute health problems in people involved with the cleanup operation of the Hebei Spirit oil spill. Mar Pollut Bull 2012; 64(6): 1246-51. https://doi.org/10.1016/j.marpolbul.2012.03.013
https://doi.org/10.1016/j.marpolbul.2012... . In terms of age, Jung et al.³²32. Jung SC, Kim KM, Lee KS, Roh S, Jeong WC, Kwak SJ, et al. Respiratory effects of the hebei spirit oil spill on children in taean, Korea. Allergy Asthma Immunol Res 2013; 5(6): 365-70. https://doi.org/10.4168/aair.2013.5.6.365
https://doi.org/10.4168/aair.2013.5.6.36... showed that children who lived near the Hebei Spirit oil spill disaster in South Korea had a higher prevalence of respiratory symptoms than those who lived far from the oil spill area³²32. Jung SC, Kim KM, Lee KS, Roh S, Jeong WC, Kwak SJ, et al. Respiratory effects of the hebei spirit oil spill on children in taean, Korea. Allergy Asthma Immunol Res 2013; 5(6): 365-70. https://doi.org/10.4168/aair.2013.5.6.365
https://doi.org/10.4168/aair.2013.5.6.36... .

Among the oil components, 16 aromatic hydrocarbons (acenaphthene, acenaphthylene, anthracene, benzo[a]anthracene, benzo[a]pyrene, benzo[b]fluoranthene, benzo[ghi]perylene, benzo[k]fluoranthene, chrysene, dibenzo[a,h]anthracene, fluoranthene, fluorene, indeno [1,2,3-cd]pyrene, phenanthrene, pyrene, and naphthalene) are under priority monitoring by the United States Environmental Protection Agency — USEPA³³33. Gioda A, Tonietto GB, Leon AP. Exposição ao uso da lenha para cocção no Brasil e sua relação com os agravos à saúde da população. Ciênc Saúde Coletiva 2019; 24(8): 3079-88. https://doi.org/10.1590/1413-81232018248.23492017
https://doi.org/10.1590/1413-81232018248... . Benzene is considered a carcinogenic substance for which there is no safe exposure threshold, classified as a chemical that is highly harmful to human health³⁴34. United Nations Environmental Programme, Chemicals. Regionally based assessment of persistent toxic substances: Eastern and Western South America regional report [Internet]. Switzerland: Global Environment Facility; 2002 [cited on July 10, 2024]. Available at: https://digitallibrary.un.org/record/487296?ln=ar&v=pdf
https://digitallibrary.un.org/record/487... . The compound enters the body primarily through the respiratory tract, causing acute symptoms — such as headache, nausea, tachycardia, difficulty breathing, and loss of consciousness — and chronic symptoms — such as immune deficiency, dysregulation of the hematological system with a propensity for cancer, among other effects³⁵35. Sheikh M, Poustchi H, Pourshams A, Khoshnia M, Gharavi A, Zahedi M, et al. Household fuel use and the risk of gastrointestinal cancers: the Golestan Cohort Study. Environ Health Perspect 2020; 128(6): 67002. https://doi.org/10.1289/EHP5907
https://doi.org/10.1289/EHP5907... .

Smoke from the use of wood-burning stoves during seafood processing is another factor of chemical exposure resulting from the work process of this population and which has health effects¹⁶16. Pena PGL, Martins V, Rego RF. Por uma política para a saúde do trabalhador não assalariado: o caso dos pescadores artesanais e das marisqueiras. Rev Bras Saúde Ocup 2013; 38(127): 57-68. https://doi.org/10.1590/S0303-76572013000100009
https://doi.org/10.1590/S0303-7657201300... . The smoke released during wood burning can be responsible for worsening respiratory diseases and increasing the risk of developing various types of cancer in the gastrointestinal tract³⁶36. International Agency for Research on Cancer. Arsenic, metals, fibres, and dusts. A review of human carcinogens [Internet]. Lyon: IARC; 2012 [cited on July 11, 2024]. Available at: https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Arsenic-Metals-Fibres-And-Dusts-2012
https://publications.iarc.fr/Book-And-Re... ,³⁷37. Agency for Toxic Substances and Disease Registry. 2007 CER­CLA priority list of hazardous substances [Internet]. Atlanta: ATSDR; 2007 [cited on July 11, 2024]. Available at: https://www.atsdr.cdc.gov/spl/supportdocs/appendix-e.pdf
https://www.atsdr.cdc.gov/spl/supportdoc... , causing greater harm to health when associated with the effects of intoxicants such as pesticides or oil compounds.

The intervention of large-scale projects in the territories, such as the implementation of petrochemical and automobile complexes and the occurrence of natural or technological disasters, such as the one that occurred in 2019, lead to the consequent contamination of the coastal ecosystem, increasing the risks inherent in work processes and introducing other harms to the environment, health, life, and social reproduction in these communities¹⁰10. Freitas PAN, Machado RM, Silva ES, Santos MOS, Gurgel IGD. Derramamento de petróleo e responsabilização do Estado: desafios da pesca artesanal em Pernambuco/Brasil. SER Social 2023; 27(53): 314-40. https://doi.org/10.26512/ser_social.v25i53.46248
https://doi.org/10.26512/ser_social.v25i... ,²³23. Carvalho IGS, Rêgo RCF, Larrea-Killinger C, Rocha JCS, Pena PGL, Machado LOR. Por um diálogo de saberes entre pescadores artesanais, marisqueiras e o direito ambiental do trabalho Ciênc Saúde Coletiva 2014; 19(10): 4011-22. https://doi.org/10.1590/1413-812320141910.09432014
https://doi.org/10.1590/1413-81232014191... ,²⁴24. Nascimento CHV, Rodrigues GG. Impactos socioambientais e implicações na pesca artesanal das comunidades beneficiárias da RESEX Acaú-Goiana. PerCursos 2022; 23(53): 240-61. https://doi.org/10.5965/1984724623532022240
https://doi.org/10.5965/1984724623532022... ,²⁶26. Santos MOS, Alves SG, Mertens FAG, Gurgel IGD, Augusto LGS. Excluídas pelo desenvolvimento: mulheres e o complexo industrial portuário de Suape. Revista de Geografia 2016; 33(3): 117-40..

In this study, we could observe vulnerabilities historically intertwined in the social reproduction of these communities in Brazil. There is a profile of low levels of education, predominantly Black people, who depend on artisanal fishing work and survive on their relationship with the environment and Anthropocene interventions. The interruption of work and the damage caused to the fishing environment can be seen as a possible factor impacting the living conditions and food sovereignty of these people. Freitas et al.¹⁰10. Freitas PAN, Machado RM, Silva ES, Santos MOS, Gurgel IGD. Derramamento de petróleo e responsabilização do Estado: desafios da pesca artesanal em Pernambuco/Brasil. SER Social 2023; 27(53): 314-40. https://doi.org/10.26512/ser_social.v25i53.46248
https://doi.org/10.26512/ser_social.v25i... emphasize the impacts of the oil spill on these communities.

In relation to health, the presence of symptoms suggests the need for further investigation into the health and illness process of these communities, and actions could be implemented to monitor health risks and the people exposed during the oil spill in order to detect early the damage caused and the effects on the health of these communities⁸8. Laffon B, Pasáro E, Valdiglesias V. Effects of exposure to oil spills on human health: updated review. J Toxicol Environ Health B Crit Rev 2016; 19(3-4): 105-28. https://doi.org/10.1080/10937404.2016.1168730
https://doi.org/10.1080/10937404.2016.11... .

The limitations of this study include the fact that it is a cross-sectional study that considers exposure and effect at the same point in time, not allowing long-term monitoring of these individuals and possible memory biases. Our results contribute to identifying the exposure process and the frequency of health complaints reported by fishers, requiring further studies to delve deeper into this topic and enable a greater understanding between exposure to oil and the health of these populations.

Observing the profile of people living in artisanal fishing territories in Pernambuco is paramount for thinking about strategies for implementing public policies and government actions to combat socio-environmental injustices and environmental racism, promoting healthy and sustainable territories that live in interdependence with the environment.

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