Trajetória do uso de benzodiazepínicos por população atingida por rompimento de barragem de rejeitos em Brumadinho: um estudo longitudinal.

Abstract

Mining poses significant threats to human health and the environment. The 2019 Córrego do Feijão mine dam collapse in Brumadinho, Minas Gerais, not only claimed lives but also had lasting health impacts on the affected population. From a mental health perspective, understanding the use of psychotropic drugs, such as benzodiazepines (BZDs), whose use for more than four weeks is not recommended for most individuals, can enable the identification of health and pharmaceutical care needs among specific groups of people affected by the disaster. With this in mind, this study aimed to identify the use of BZDs in Brumadinho after the dam colapse and associated factors. This is a population-based cohort study, part of the Brumadinho Health Project, with 1,427 participants. The use of BZDs was analyzed at three time points (t0 - 2021; t1 - 2022; t2 - 2023) through group-based trajectory modeling, allowing the identification of distinct profiles of use over time. Baseline factors (t0) associated with the identified trajectories were evaluated through multivariate analysis based on logistic regression. Two main patterns of use were identified: Trajectory 1 - group with a low probability of BZDs use over time; and Trajectory 2 - group with an increased probability of BZDs use over time. Approximately 9% of individuals were allocated to Trajectory 2, which was positively associated with the perception of worsening health after the disaster (OR = 2.21; 95% CI = 1.16-4.21; p = 0.016). The Trajectory 2 suggests the existence of a significant group of people with lasting mental health impacts after the disaster, confirmed by its positive association with the perception of worsening health. Furthermore, identifying individuals who continually use BZDs may be a strategy for prioritizing for providing ongoing monitoring and psychosocial support, as well as implementing strategies that provide appropriate pharmacotherapy in the context of mental health issues.