Questionário de exposição ao asbesto: adaptação de instrumento estrangeiro para a realidade brasileira

Abstract

In Brazil, practically all cases of asbestosis and asbestos-related cancers are not identified, recorded, or indemnified, thus configuring an invisibility of these pathologies in the country. One consequence of such invisibility is the perpetuation of asbestos in our environment, insofar as the low rates in official statistics are used as an argument in favor of the maintenance of the controlled use, at the expense of the fibers complete banishment. In this scenario, making a questionnaire that investigates asbestos exposure in a standardized way available to the Brazilian health system is utterly important in order to lower the non-acknowledgment and the underreporting of these pathologies. The aim of this study has been to devise a questionnaire that could investigate the several types of asbestos exposure (occupational, paraoccupational, and environmental) in the Brazilian context and that could be used by the health system. It is a qualitative study that was developed in three consecutive stages: search for questionnaires in literature and in foreign registers of mesothelioma, selection of questionnaires, and their adaptation for the Brazilian reality. This last stage comprised a pre-test, when the adapted questionnaire was applied by means of interviews with two sets of patients: with and without known asbestos exposure. Two questionnaires were selected to be adapted for the Brazilian reality: the French and Italian mesothelioma register questionnaires. During the adaptation process, several modifications were made into these instruments with a view to obtaining a questionnaire suitable for the Brazilian context. During the pre-test of this instrument, it was noted that some questions were not understood by the two tested groups, which led researchers to the conclusion that photographic resources were needed to assist in the comprehension of the questionnaire. The conclusion has been reached that the present study plays a pioneering role by developing the first Brazilian questionnaire on asbestos exposure. However, some steps are still to be taken before this instrument can be made available for the Brazilian health system and then contribute to decrease the invisibility of asbestos-related diseases in the country.