Artigos

Conteúdo (article):

Popular Health, Environmental and Occupational Surveillance: an integrative literature review
Luiz Rons Caúla da Silva
Institution: Environment Secretariat, Cascavel-CE and Fiocruz Ceará
E-mail: luizronscs@gmail.com
Orcid: 0000-0002-5807-3478
Saulo da Silva Diógenes
E-mail: saulo.diogenes@ufc.br
Institutions: Universidade da Integração Internacional da Lusofonia Afro-Brasileira (Unilab) and Universidade Federal do Ceará (UFC)
Orcid: 0000-0001-8584-3936
Michele Neves Meneses
Institutions: Movimento Popular de Saúde (MOPS); Articulação Nacional de Movimentos e Práticas em Educação Popular em Saúde (ANEPS); Universidade Federal do Rio Grande do Sul (UFGRS) and Rio Grande City Hall.
E-mail: michelemeneses22@gmail.com
Orcid: 0000-0002-0933-7051
Felipe Bagatoli Silveira Arjona
Institution: EPSJV/FIOCRUZ
E-mail: felipe.bagatoli@fiocruz.br
Orcid: 0000-0001-6386-6352
Carlos André Moura Arruda
Institution: Centro Universitário Ateneu - UniATENEU
E-mail: andrecaninde@yahoo.com.br
Orcid: 0000-0001-8145-1599
Ana Cláudia de Araújo Teixeira
Institution: Fiocruz Ceará
E-mail: anaclaudiaat@gmail.com
Orcid: 0000-0003-2851-5260
Vanira Matos Pessoa
Institution: Fiocruz Ceará
E-mail: vanirapessoa@gmail.com
Orcid: 0000-0003-3676-9607
Fernando Ferreira Carneiro
Institution: Fiocruz Ceará
E-mail: fernandocarneirofiocruz@gmail.com
Orcid: 0000-0002-6625-9715

Abstract
The objective is to identify concepts, experiences, methods, and techniques in Popular Health, Environmental and Occupational Surveillance (VPSAT). This is an integrative review that used the descriptors: Community Participation, Public Health Surveillance, Environmental Health, and Occupational Health, using five databases: Virtual Health Library, EBSCOhost, Embase, Scopus and Web Of Science. The review selected 15 studies, based on the inclusion criteria: surveillance experiences with community protagonism; and exclusion criteria: research without primary data and developed only by the health service. The theoretical and methodological bases of the studies were identified as citizen science, popular education, and environmental justice; experiences such as participatory mapping and monitoring; methods such as action research, ‘do-it-yourself’, and community-based research; and techniques such as “Photovoice” and Community Journal. Low-income urban communities, indigenous peoples, young individuals, and workers stand out as the protagonists. The recognition of the VPSAT as an important source of data and intervention by public health systems and academia contributes to making health surveillance more dialogic and effective.
Keywords: Community Participation; Community-Based Participatory Research; Public Health Surveillance; Environmental Health; Occupational Health.

 
Vigilância Popular da Saúde, Ambiente e Trabalho (VPSAT): uma revisão integrativa da literatura

Resumo
Objetiva-se identificar concepções, experiências, métodos e técnicas em Vigilância Popular da Saúde, Ambiente e Trabalho (VPSAT). Trata-se de uma revisão integrativa com os descritores: participação da comunidade, vigilância em saúde, vigilância da saúde, saúde ambiental e saúde do trabalhador, envolvendo cinco bancos de dados: Biblioteca Virtual da Saúde, EBSCOhost, Embase, Scopus e Web Of Science. A revisão selecionou 15 estudos, a partir dos critérios de inclusão: experiências de vigilância com protagonismo comunitário; e exclusão: pesquisas sem dados primários e desenvolvidas apenas pelo serviço de saúde. Identificaram-se como bases teóricas e metodológicas dos estudos a ciência cidadã, educação popular e justiça ambiental; e experiências como mapeamentos e monitoramentos participativos; métodos como pesquisa-ação, “faça você mesmo” e investigação baseada na comunidade; e técnicas como “Photovoice” e Jornal Comunitário. Destacam-se as comunidades urbanas de baixa renda, indígenas, jovens e trabalhadores como protagonistas. O reconhecimento da VPSAT como importante fonte de dados e de intervenção pelos sistemas de saúde públicos e pela academia contribui para que a vigilância em saúde seja mais dialógica e efetiva.
Palavras-chave: Participação da Comunidade; Pesquisa Participativa Baseada na Comunidade; Saúde Ambiental; Saúde do Trabalhador; Vigilância em Saúde.
 
INTRODUCTION
At the turn of the 21st century, with the intensification of environmental conflicts, several social movements and populations affected by large enterprises, such as agribusiness and ‘hydrobusiness’, mining and the polluting industry, carried out territorial experiences to analyze and face the health impacts resulting from the transformations of their territories, degradation, environmental pollution and precarious work. This demonstrates that health is a sensitive dimension in their lives and goes towards the construction of resistance1.
In response to conflicts, as well as the Covid-19 pandemic, experiences have been developed in popular health surveillance, which house initiatives of knowledges and practices that are born from territories and popular organization in defense of the right to health and life, but which, very often, are still disregarded, silenced and erased by the conceptions and institutional actions of surveillance in the Government health field 2,3. Currently, in the pandemic scenario, the Government’s response followed the same Health Surveillance model that has been practiced since the 19th century.
This model is mainly related to the control of diseases carried out by Government structures, anchored in the symbolic order of belligerent representations of the war against microbes and guided by the microbiology founded in the last third of the 19th century4. Terms such as “surveillance”, “control”, “sentinel event” and “campaign” belong to this military-inspired scenario, focused on the surveillance of patients and suspected cases, constituting an authoritarian, persecutory and punitive health policy, as elements that contribute to hinder popular participation in Health Surveillance 4.
The term “Popular Health, Environmental and Occupational Surveillance” (VPSAT, Vigilância Popular da Saúde, Ambiente e Trabalho ) is used by Carneiro and Pessoa3 to name surveillance practices that privilege the protagonism of communities and social movements in the setting of public health, the environment and workers’ health. It may involve different degrees of action by the Government, the academia and health workers, as long as they acknowledge the actors and popular knowledges and are involved in the participatory processes of a dialogical nature 3.
However, according to Rigotto and Aguiar5 (p. 50) in “a scenario of scientific controversy, permeated by conflicts of interest and by strong and powerful economic interests, which actively affect the Government and its public policies”, a chronic difficulty in the SUS working process regarding surveillance can be identified in the health, environmental and occupational areas.
In this scenario, the need to structure new conceptual and methodological bases for health, environmental and occupational surveillance is reinforced, developing territorialized strategies and participatory methods that facilitate the autonomy of the population and prevent segregation and exclusion in the processes, incorporating different knowledges and dimensions, such as economic, social, cultural, spiritual and ethical ones. In this sense, the Ecology of Knowledge framework developed by Boaventura de Sousa Santos 6 contributes to the VPSAT, as this concept promotes a dialogue between different types of knowledge that can be considered useful for the advancement of social struggles by those who intervene in them7.
The VPSAT emerges as a participatory process of alert and call to action related to the guarantee of both universal and constitutional human rights to health, an ecologically balanced environment and the defense of life. The “thinking and doing with” the communities becomes, in the VPSAT processes, a creative and innovative possibility to strengthen the SUS in the defense of life3,8. Therefore, this article aims to identify existing conceptions, experiences, methods and techniques in popular health, environmental and occupational surveillance at national and international levels.
METHODOLOGY
Method
The integrative literature review method was used, which, according to Mendes et al.9 (p. 759) “allows the synthesis of multiple published studies and overall conclusions regarding a study area”, in six steps: 1) identification of the research hypotheses or problem; 2) establishment of the inclusion and exclusion criteria for the studies; 3) retrieval of information from the selected studies; 4) evaluation of the studies included in the review; 5) interpretation of results; and 6) presentation of the review10. The items present in the checklist for systematic reviews and meta-analyses11 were adapted to report this study.
To apply the method, a group of eight researchers with academic and practical experience in the subject of the review was formed to discuss and decide on the creation of the research question, the definition of the search descriptors, the selection and evaluation of the studies, and the analysis and interpretation of results. The group met between August 2021 and June 2022, in which a pair was divided into peers (independent reviewers) to select and evaluate the studies. Peer review is an important step in deciding which publications should or should not be included in review studies.

Research question and data collection
To create the research question, the PICo strategy was used – an acronym for Population (P), Interest (I) and Context (Co)12,13, in which: (P) – community participation; (I) – conceptions, experiences, methods and techniques in popular surveillance; and (Co) – health, environmental and occupational surveillance. Thus, the following question was defined: “What is there of scientific production, considering community participation, related to conceptions, experiences, methods and techniques associated with popular health, environmental, and occupational surveillance?”
In this context, in September 2021, a literature search was carried out in five databases: Virtual Health Library (VHL), EBSCOhost, Embase, Scopus and Web Of Science (WOS) without restrictions regarding the year of publication and using the following language filters: Portuguese, English or Spanish. In the case of the VHL and EBSCOhost, full-text filtering was also used. With the exception of the VHL, the databases were accessed through the Journal Portal of the Coordination for the Improvement of Higher Education Personnel (CAPES, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior).
Indexed descriptors were used for the literature search, according to the DeCs/MeSh terms system: “community participation”, “public health surveillance”, “environmental health” and “Occupational Health”, and their respective descriptors in English and Spanish. Table 1 shows the search strategies adapted for each database. The identified studies, after filtering by language and full text, were exported to, organized and stored in Excel® spreadsheets for identification of duplicates and for the inclusion or exclusion of studies.
Table 1

Study eligibility and selection
The inclusion criteria comprised studies that addressed community/popular protagonism in an experience of surveillance in workers\' health and/or in health and the environment. The research group established four attributes that were considered as community/popular protagonism: 1) the initiatives arise from communities/territories through popular knowledges, not originating exclusively from health services; 2) the community generates its own data; 3) the surveillance occurs with the population as a protagonist through social technologies/simplified monitoring; 4) the community\'s articulation/relationship with the health service and the academia should occur from a participatory perspective (emancipatory and dialogical).
As exclusion criteria, the following were considered: 1) the collection of information was carried out only by the health services; 2) the study does not have primary data; 3) the unavailability of the full text in Portuguese, Spanish or English.
Considering these criteria, the study selection took place in two phases. In phase 1, two independent reviewers selected the studies by reading the titles and abstracts of all studies, according to the eligibility criteria. In case of disagreement, a third reviewer carried out a new reading to select or not the studies.
In phase 2, the reviewers independently read the full texts according to the eligibility criteria. In cases of disagreement, a third reviewer once again analyzed the studies to reach a final decision. The selection of the studies included in the review was carried out independently and “blindly”.
To assist in the analysis, the extraction of data and information from the studies was performed using instruments adapted and proposed by Ursi14 and Sousa et al.10. Data extractions were carried out by two independent reviewers and were later compared.
Assessment of methodological quality
The studies were evaluated according to the levels of evidence developed by Melnyk15 and Schenkman and Bousquat16, namely: I) high: meta-synthesis (qualitative studies) or meta-analysis (quantitative studies); II medium-high: evidence from a single qualitative or quantitative study; III) medium: synthesis of descriptive studies; IV) medium-low: evidence from a single descriptive study; and V) low: expert opinions, theoretical studies or essays.
The Joanna Briggs Institute (JBI)17 tools were used for critical assessment of the included studies. Two reviewers independently assessed the methodological quality, using two checklists corresponding to the design of the included studies: for qualitative research and for cross-sectional analytical studies. Disagreements were resolved by consensus and, when necessary, a third review author was consulted.
The selected articles were evaluated against the criteria of their respective checklists and the answers were classified using the parameters “yes”, which corresponded to high quality; “no”, to low quality; and “uncertain” for unknown quality. Based on this evaluation, it was possible to verify the possibility of bias in the study design, conduction and analysis, and the level of bias was classified according to the score obtained in these tools, as follows: A (06 to 10 points) are studies with good methodological quality and reduced bias; and B (up to 05 points) are those with satisfactory methodological quality, but increased potential for bias18.

Interpretation and analysis of bibliographic material
For purposes of the processing and analysis of the articles included in this review, the thematic analysis technique was used, in which each article was submitted to floating and exhaustive reading of the content, which was coded and categorized19. After this initial stage of processing the bibliographic material, the set of topics, already categorized, were discussed, problematized and interpreted in the light of theoretical references related to the object, defined here, namely: Popular participation 8,20, Popular Education 21, Participatory Monitoring 22,23 and Ecology of Knowledges6,24. After critical reading and systematization of the data, two categories were identified: Theoretical bases and concepts in popular surveillance; and Experiences, methods and techniques in VPSAT.
RESULTS AND DISCUSSION
Study characteristics and synthesis
Initially considering the search by title, abstract and descriptors, 908 publications were identified in the databases, including articles, theses, abstracts, reports and a video, of which 786 were eliminated after the reading of the title and the abstract, because they were duplicates or not related to the topic of interest. The full reading of the 122 pre-selected studies was then carried out, of which 107 were excluded and 15 articles were included in the review, as they met the inclusion criteria and answered the research question. Figure 1 shows the flowchart related to the publication selection process.
Figure 1

The synthesis of the publications included the author, year, level of evidence, place/country where the experience took place, method, theoretical basis, surveillance concepts/ terms, and is depicted in Table 2.
It can be observed that the first publication was in 2000 25, which demonstrates that it is a recent topic in national and international literature, followed by two (2006)26,27, one (2010) 28, one (2012)29, one ( 2015)30, two (2017)31,32, two (2018) 33,34, one (2019) 35, two (2020)36,37 and two (2021)38,39, increasing after the year 2015, which reflects the fact that it has been an expanding topic in the world’s literature. As for the origin of the studies, eight countries stand out, with most of the studies being from the United States of America (USA), with nine publications, followed by Brazil with two, and other countries with one publication only: Mexico, Canada, Israel / Palestine, Spain and USA and Zimbabwe and South Africa.
It can be observed that, as of 2017, there is a higher number of studies related to VPSAT, with an average of two per year. Another highlight is that of the fifteen selected studies, nine are from the US, while the other countries have an average of one article in this review. This may indicate that the topic has become emergent in recent years, but at the same time, it may have a limited academic visibility, especially on the Global South side, which faces greater research funding difficulties and tensions with the neo-extractivism development model.
Additionally, as shown in Table 2, the monitoring, participatory mapping and popular communication techniques were some highlights of the review. The innovation, in at least three studies, comprised the use of the “Photovoice” technique. The advancement of technologies developed for mobile phones allows this equipment to be strategic to the registration of social and environmental risk situations and decisively contribute to VPSAT actions and to demand actions by public agencies in the presence of the identified situations.
Table 2

All studies are similar regarding the use of participatory research methodologies in the face of complex environmental problems, highlighting those related to air quality. This may indicate that even in the face of large-scale problems it is possible for the community to contribute with protagonism to the surveillance. It is noteworthy that vulnerable populations, especially those at environmental risk, such as urban communities, indigenous people, poor young individuals and workers, are the social groups that stand out in the research.
Assessment of methodological quality of the included studies
Table 3, available in the Open Science Framework platform repository (https://osf.io/5PTWJ), under identification DOI 10.17605/OSF.IO/6JB7V, shows that all publications had bias level classification: A (06 to 10 points), which are the studies with good methodological quality and reduced bias. Of these, five studies 25,26,29,32,38 (33.3%) reached the maximum score, meeting all the criteria of critical and methodological evaluation.
In the case of the publications that were evaluated with the qualitative checklist, Table 3 shows that the Criteria of Ethical Approval (Q9) was absent in five studies 33,34,36,37,39 and was not clear in two publications30,31; that is, of 13 publications that were evaluated with this instrument, seven (54%) did not state their process of ethical approval. Additionally, Table 3 clearly shows that in two studies37.39 the relationship between the researcher and the participants was not addressed and in another two 31,36 it was not clear (Q7).
Regarding the assessment of the methodological quality instrument for cross-sectional analytical studies, two studies was evaluated. In both 27,36, of the eight answered questions, it was not possible to identify the confounding factors (Q5) or whether strategies were established to deal with these factors (Q6). One confounding factor is the difference between comparison groups and it might influence the direction of study results 17.

Theoretical bases and conceptions in popular surveillance
This category seeks to dialogue with the concepts, foundations and principles that support the studies included in this review and which are closely related to VPSAT. Prado et al.39 highlight the importance of participatory mapping for decision-making on the uses of soil and development processes. A community engaged in the mapping of Environmental Justice produces local knowledge that generate environmental indicators of territory evaluation and identify cases of environmental injustice, key elements for the surveillance process 39.
In this sense, health research gains power with community involvement/engagement, including several activities such as consultation, information dissemination, collaboration in decision-making, creation of partnerships with interested parties and seeking guidance from community leaders. This engagement must guarantee to the communities and researchers the respect to the sociocultural, political and economic context of the territory where it is conducted32.
Community engagement and the use of the citizen science approach have been crucial for public health practices, such as establishing independent air quality monitoring networks. The big challenge remains the long-term funding of these initiatives 31.
Positivist science based on the "biomedical model" and "hard science" considers community knowledge as "data contamination" during the investigation process. The limitations of methods for evaluating exposure to risks in environmental health of positivist science fail to provide satisfactory subsidies for community-based studies. Moreover, quantitative studies are not enough to account for the complexity of the impact assessment of health contaminants. From this perspective, some studies discuss that it is necessary to dialogue in the sense of effective risk communication, to meet the community of each territory that is affected by risk and is not restricted only to the academic sphere as a transfer of information to peers, but inaccessible to the community field25.
According to Nolan et al.38 the approach to structural violence and participatory research illuminate studies on the iniquities of exposures and refine the mitigation strategies. Promoting a more equitable relationship between communities and researchers in these types of studies is not simple and requires: the guarantee of community participation in all stages of the research process; the recognition of popular knowledges, so they are not treated as anecdotic or subjective; and the training of community members for conducting community-based research 38. In this sense, popular education and the ecology of knowledges are important reference concepts that strengthen this path towards a more dialogical research 21,24.
The work by Lambert et al.,27 about industrial contamination, gives rise to the concept of environmental justice. In contrast to a traditional science that makes the community an “object” of research, environmental justice seeks to engage the population in actions, combining the methodological rigor of research with the action for community claim. Popular protagonism is necessary for the construction of a participatory science focusing on facing environmental injustices and their impact on human health.
The experiences of popular education inspired by Paulo Freire21 constitute influences in the process of interaction between traditional and scientific knowledges in the construction of VPSAT processes. For Gil Sevalho4, Civil Health Surveillance is founded in local culture and popular education, becoming a health surveillance aspect that embodies popular participation and contributes to social transformation, complementing the traditional epidemiological surveillance. Paulo Freire sought to build a liberating education, in a dialogical proposal between leaderships and the population, in which the subjects meet to transform the world while collaborating 21.
Among the studies analyzed in this review, it is clear how close they are to the thinking of Paulo Freire and Boaventura Santos, along with the methodological paths implicated with dialogue, based on the different knowledges and permeated with the experienced reality. Popular education is used as a methodological inspiration 28,29,36,39, being a useful instrument to analyze the local context through the knowledges and previous experiences to better understand the determinants of problem situations and the creation of proposals for solutions and actions29,36. It is a process of materialization of the popular protagonism of communities, in which participatory means of sharing knowledge are provided for the construction of more effective public policies to promote and protect the health of these communities28. Other studies have addressed the implementation of community education or education in health without mentioning the influence of the Freire method25,33,37.
Therefore, the aspects of theoretical approaches identified in this review can be used as a theoretical basis of support for the structuring of the VPSAT concept that is being developed in Brazil. It has been observed, in participatory research processes, an interest by Brazilian popular movements in using this term to establish life promotion actions against the current Brazilian development model. The concept of Ecology of Knowledges is more contemporary compared to popular education, and has contributed, in epistemological terms, to justify this choice in research processes and VPSAT.

VPSAT experiences, methods and techniques
Popular participation comprises the multiple actions of different social forces to focus on the creation, performance, supervision and evaluation of public policies and/or services intended for the community20. Thus, this concept houses the conception of “involvement of the community members in the tasks of this community”, that is, to do it by and for themselves, which leads to the idea of community protagonism.
According to Santos24, the combination of popular knowledge and community practices associated to surveillance techniques can be used as guidance for health care models and bring actions closer to the real needs and the reorganization of the relationship between subjects, professionals, users and the environment. In this context, VPSAT emerges, which, for Carneiro and Pessoa3 (p.5) “is not intended to replace the role of the Government, but to be the expression of the need for greater community participation in surveillance, as highlighted in the National Health Surveillance Policy”.
Among the experiences in popular surveillance depicted in this review, it is observed that community mapping has been a practice adopted by the communities30,39. Based on a Public Participation Geographic Information Systems (PPGIS), these mappings are ways that community members found to independently identify problems and solutions to participate and focus on decisions about their territories. These are techniques that allow the mapping of priorities related to indicators, such as radioactive waste28; sewage disposal26.29; diseases such as schistosomiasis and malaria32; particulate materials, particularly the inhalable ones such as MP10 31,37 and MP2.536; global warming gases, such as nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2) 30,38; noise 38; risk areas, for instance, abandoned places and clandestine dumps 30,39.
Rey-Mazon et al.33 conducted a study involving three case studies on “citizen surveillance” based on the “Do-It-Yourself” (DIY) method, open source technologies developed by Public Laboratory of Open Technology and Science (PUBLICLAB). They presented ways to perform community monitoring using simple, easily accessible and low-cost techniques and materials, such as aerial mapping of risk areas using kites or balloons for photographic registration, exercising aerial surveillance with safety and ways to easily identify evidence of poor water quality through a monitor device designed by students, indicated, for instance, by the color of the fluid.
The authors remember that by using beautiful and flashy materials, such as a large red balloon in the air or a beautiful kite coupled to simple cameras, in addition to attracting the attention of those involved, generally young people, also demystifies the use of technology and stimulates participants to make suggestions and even assemble their own monitoring devices, which would be unlikely to happen if drones or other specialized technology resources were used, for example 33. In the specific case of the study conducted in Israel/Palestine, special attention was paid to the type of device that would be used, given the constant military surveillance in the airspace that endangered the physical integrity of the local participants. The choice of kites allowed the greater engagement of young people and the exchange of knowledges with researchers who had no experience with the activity of flying kites in the region 33.
As for the mapping activities, the local knowledge of the community gave meaning to the photos, in addition to allowing the empowerment and problematization of the uses of urban space in Castellón, Spain, and the “surveillance of the surveilled” in the case of Israel/Palestine. The companies that perform these services charge for these data, and the possibility that the communities can autonomously generate their own aerial mapping data with an adequate resolution is an innovative one. Having a view beyond the walls and limits imposed by the Government and the private sector allowed the stimulation of what the authors called “civic imagination”, favoring the collective construction of more viable solutions that better meet the demands of the community. Another relevant issue concerns the safety of making data that can expose communities public, given that the areas of study are often areas of intense conflicts, which should be discussed, agreed on and respected by those involved 33.
In Tijuana, Mexico, the community monitoring results pointed to specific environmental challenges in this border town, including clandestine dumps. The results achieved from the surveillance of these areas contributed to the creation of the urban planning for the entire city by the identification of problems and land verification by the residents 39.
In Charleston, South Carolina, USA, from a mapping tool developed by community leaders in a community-university-government partnership, it was possible to address environmental risks in places where the communities were in danger through research, community training, and action plans. From this partnership, an “Environmental Justice” (EJ) radar was designed to help community members learn more about local environmental dangers and share information, using a website that acts as an online portal where the interested parties can visualize the areas of concern or environmental risks to the communities 30.
Moreover, the use of the photovoice technique in two studies involving community mapping and one on participatory ergonomics was observed. For Flum et al.28 this technique is an important tool, as it is an effective way for workers to identify occupational risks and other dangerous or inadequate situations not recognized or valued by the leadership, allowing them to be more active in relation to health and safety. In addition, according to Wilson et al.30, in addition to the workers, the residents and community organizations have also used this technique to identify and act on environmental risks not registered in their territories or that have consequences for other environmental health issues.
Similar to the Photovoice, in Brazil, Renata de Toledo26 produced a community journal that aimed to socialize and discuss health and environmental issues with the participation of all (those who created it and other readers) in the construction of knowledges and skills aimed at empowerment. That is, here is an example of articulation/relationship of the community with the health service and academia from an emancipatory and dialogical perspective. The journal was a technique used to broadcast the wishes of the community for changes, as well as the work that had been developed by the students of a course, as well as being an opportunity to "translate" information previously made available in a technical report of that study, started in 2005, using a more accessible format and content to the entire local population29.
In this sense, the authors dialogue with the proposal of “intercultural translation” of Santos6, which allows meeting the abyssal thinking, and results in epistemicide, embracing the ecology of knowledges, valuing and recognizing the existence of a multitude of types of knowledge beyond the scientific type, because “preference should be given to the types of knowledge that guarantee the greater participation of the social groups involved in the conception, performance, control and enjoyment of intervention” (p. 51).
From the perspective of building knowledge and skills focused on popular empowerment, the Nuclear Risk Management for Native Communities (NRMNC) project in Nevada, Utah, and southern California, has developed over a four-year period, several educational materials about nuclear risk issues: basic books on radiation, radionuclide data sheets, data sheets on health risk methodologies and visual guides on specific local contamination; in addition to several extensive toxicological profiles on contaminants25.
The construction of these materials occurred with community engagement, in which community residents affected by nuclear contamination participated and applied interviews to develop a community exposure profile, constructed community maps, as well as attended workshops over a four-year period to construct educational materials. A pointed out risk management method is community-based research, which is a way to create knowledge that involves learning from research and applying what is learned to collective problems through social action 25.
High-quality studies on the consequences of environmental exposure for health are expensive and time-consuming, creating a situation of “undone science”, that is, one that perpetuates the lack of information on these impacts 35. Considering this context, the community itself sometimes assumes the task of trying to prove their suspicions that harmful exposures can lead to diseases, by producing studies in a timely manner. In Merrimack, USA, a project assessed the local response to the contamination of the public water systems and water from local wells by per- and polyfluoroalkyl substances (PFAS), through a health research led and managed by a local defense group. The community-based health research aimed to define the risks and dangers faced by the residents, documenting the potential impacts of contaminants to reduce the risks to which they are exposed35.
Community air monitoring in which community members play important roles in determining the study design, location and implementation of monitors and data collection was another technique adopted in surveillance research. In a study conducted at Imperial County, California, USA, young individuals were decisive actors in characterizing spatial variability of air pollutant concentrations and using technologies for data collection 38. They selected priority locations for monitoring and produced information on air quality in real time at community level by establishing a community air monitoring network (CAMN), which started having its information stored, processed, displayed and disseminated by the community itself in the virtual space called “ Identifying violations that affect neighborhoods ”(IVAN), which was used to denounce these violations on the internet38.
Young individuals worked in the monitoring of air quality employing the Youth Participatory Action Research (YPAR) method, which emphasizes strength-based engagement, an equitable inclusion of the community in all aspects of the research, co-learning between researchers and members of the community, equitable distribution of resources, local training, research and action, addressing local priorities and sustained engagement 38. Through YPAR, young individuals bring perspectives and new hopes, often marginalized ones, helping researchers and communities to transform their reality based on deeper understandings of how structural violence and eco-apartheid interact to probabilistically determine social and constructed environments that profoundly affect the health of the community members 38.
According to Michelle Wong37, although air monitoring projects with community involvement may require substantial funding, time and diversified experience of the team, they can result in better project results and strengthen the community\'s capacity, sustainability and resilience to deal with environmental and health conditions.
English et al. 31 have shown that, with the community monitoring, there is increased knowledge and capacity by the community to organize and maintain monitors, and the community partners are now allowed to start and collect air data by themselves. For Wong37 these practices demonstrate that communities have experience and resources to substantially contribute to air monitoring projects when they have equitable leadership roles and several mechanisms for significant involvement.
Table 4 shows a brief description of the main experiences, methods and techniques of VPSAT, identified in this integrative review.
Table 4

LIMITATIONS
The review was performed according to the DeCs/MeSh terms system. However, because it does not contain the “Popular Surveillance” descriptor, some studies that employed this keyword, but did not use the descriptors that were selected for this review, may not have been selected. Thus, it is recommended to create some descriptors in the scope of surveillance, such as: “Popular Surveillance”, “Civil Surveillance”, “Citizens’ Surveillance” and “Community Surveillance”, as it will contribute to the visibility of studies in the area.
Moreover, the study used only the descriptor “Community Participation” for the literature search, not appropriating other common terminologies such as “social participation” and “action research”, “empowerment” and “social control”, which may have limited the number of identified articles that were included in this review.
Finally, no search for study publications was applied that used other methods, for instance, on websites, organizations, quotations and gray literature, using only the databases that are described in the methodology of this research. It is noteworthy that 11 studies selected for full-text reading were not recovered, as they were included in paid databases that cannot be accessed through the Capes Journal Portal.

FINAL CONSIDERATIONS
This review identified theoretical and methodological bases (citizen science, environmental justice, popular education and community surveillance), experiences (community mapping and monitoring), methods (action research, “do it yourself”-DIY- and community-based research) and techniques (“photovoice” and community journal) that can be used as references for the VPSAT practices.
The research results suggest that this strong involvement of communities in popular surveillance projects generated greater awareness, knowledge, capacity to confront challenges, infrastructure and influence from a partnership between the community, health services and research institutions.
Moreover, the main findings of this study indicate the importance of the adopted experiences and methodologies in which the community is a protagonist in data generation from the collection and systematic production of information based on participatory and simplified monitoring strategies. This is considered one of the main characteristics of VPSAT proposed herein.
Therefore, the recognition of VPSAT as an important source of data and intervention by health systems and academia can contribute for the surveillance of institutional health to become more dialogical and effective. Overall, these studies reinforce the importance of popular participation as a way of enhancing the field of health surveillance in the defense of life.

SOURCES OF FUNDING
Programa Inova Fiocruz: Edital Emergências em Saúde Pública; and Fiocruz Ceará.

 
REFERENCES
1. Rigotto RM, Aguiar ACP, Pontes AGV, Diógenes SS, Bernardo EM. Desvelando as tramas entre saúde, trabalho e ambiente nos conflitos ambientais: aportes epistemológicos, teóricos e metodológicos. Tramas para a justiça ambiental: diálogo de saberes e práxis emancipatórias. 1. ed. Fortaleza: Edições UFC; 2018. p. 163–214.
2. Corrêa HR, Segall-Corrêa AM. Lockdown ou vigilância participativa em saúde? Lições da Covid-19. Saúde em Debate [online]; 2020. p. 5-10.
3. Carneiro FF, Pessoa VM. Iniciativas de organização comunitária e Covid-19: esboços para uma vigilância popular da saúde e do ambiente. Trabalho, Educação e Saúde, v. 18, n. 3, 2020.
4. Sevalho G. Apontamentos críticos para o desenvolvimento da vigilância civil da saúde. Physis; 2016. 26 (2).
5. Rigotto RM, Aguiar ACP. Invisibilidade ou invisibilização dos efeitos crônicos dos agrotóxicos à saúde? Desafios à ciência e às políticas públicas; 2015. p.50.
6. Santos BS. Para além do pensamento abissal: das linhas globais a uma ecologia de saberes. Novos estud. CEBRAP; 2007. (79).
7. Carneiro FF, Krefta NM, Folgado CAR. A Praxis da Ecologia de Saberes: entrevista de Boaventura de Sousa Santos. Tempus – Actas De Saúde Coletiva; (2014). 8(2), p. 331-338.
8. Valla VV, Assis M, Carvalho M. Participação Popular e os Serviços de Saúde: O Controle Social como Exercício da Cidadania. Rio de Janeiro; Escola Nacional de Saúde Pública/Fiocruz; 1993.
9. Mendes KDS, Silveira RCCP, Galvão CMaria. Revisão Integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Enferm, Florianópolis; 2008. 17(4): 758-64.
10. Sousa LMM, Marques-Vieira CMA, Severino SSP, Antunes AV. A metodologia de Revisão Integrativa da Literatura em Enfermagem. Revista Investigação em Enfermagem; 2017. p. 17-26.
11. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, col. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Ver; 2021. 10, 89.
12. Lockwood C, Porrit K, Munn Z, Rittenmeyer L, Salmond S, Bjerrum M, col. Chapter 2: Systematic reviews of qualitative evidence. In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. 2020.
13. Santos CMR, Crispim MO, Silva TTM, Souza RCR, Frazão CMFQ, Frazão IS. Reiki como cuidado de enfermagem às pessoas em sofrimento psíquico: revisão integrativa. REBEn; 2021.
14. Ursi ES. Prevenção de lesões de pele no perioperatório: Revisão Integrativa da Literatura. Dissertação (Mestrado em Enfermagem) - USP, Ribeirão Preto; 2005. p. 128.
15. Melnyk BM. Evidence-based practice in nursing & healthcare: a guide to best practice. Fourth edition, Philadelphia: Wolters Kluwer Health; 2019.
16. Schenkman S, Bousquat AEM. Alteridade ou austeridade: uma revisão acerca do valor da equidade em saúde em tempos de crise econômica internacional. Ciênc. Saúde Colet; 2019. 24 (12).
17. Joanna Briggs Institute (JBI). Critical Appraisal Tools. https://jbi.global/critical-appraisal-tools. (acessado em 10/Nov/2021).
18. Toledo MM, Takahashi RF, De-La-Torre-Ugarte-Guanilo MC. Elementos de vulnerabilidade individual de adolescentes ao HIV/AIDS. REBEn, São Paulo; 2010. p.6.
19. Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 14. ed. São Paulo: Hucitec; 2014.
20. Valla VV. Sobre a participação popular: uma questão de perspectiva. Cadernos de Saúde Pública, Rio de Janeiro; 1998.
21. Freire P. Pedagogia do oprimido. 50ed - Rio de Janeiro: Paz e Terra, 2011. p. 253.
22. Breilh J. De la vigilancia convencional al monitoreo participativo. Ciênc. Saúde Colet.; 2003. p. 937-951.
23. Breilh J. Epidemiologia crítica: ciência emancipadora e interculturalidade. Rio de Janeiro: Fiocruz; 2006.
24. Santos BS, Meneses MP (Orgs.) Epistemologias do Sul. Biblioteca Nacional de Portugal; 2009.
25. Quigley D, Handry D, Goble R, Sanchez V, George P. Participatory research strategies in nuclear risk management for native communities. J Health Commun; 2000. 5(4):305-31.
26. Toledo RF. Educação, saúde e meio ambiente: uma pesquisa-ação no Distrito de Iauaretê do Município de São Gabriel da Cachoeira/AM. Tese (Doutorado em Saúde Pública) - USP, São Paulo; 2006.
27. Lambert T, Guyn L, Lane S. Development of local knowledge of environmental contamination in Sydney, Nova Scotia: environmental health practice from an environmental justice perspective. Sci Total Environ; 2006. 15;368(2-3):471-84.
28. Flum M, Siqueira CE, DeCaro A, Redway S. Photovoice in the Workplace: A Participatory Method to Give Voice to Workers to Identify Health and Safety Hazards and Promote Workplace Change – a study of University Custodians. Am J Ind Med; 2010. 53(11): 1150–1158.
29. Toledo RF, Giatti LL, Pelicioni MCF. Mobilização Social em Saúde e Saneamento em Processo de Pesquisa-ação em uma Comunidade Indígena no Noroeste Amazônico. Saúde Soc. São Paulo; 2012. p. 206-218.
30. Wilson SM, Murray RT, Jiang C, Dalemarre L, Burwell-Naney K, Fraser-Rahim H. Environmental Justice Radar: A Tool for Community-Based Mapping to Increase Environmental Awareness and Participatory Decision Making. Progress in Community Health Partnerships: Research, Education, and Action; 2015. 9(3), 439-446.
31. English, Paul, Olmedo L, Bejarano E, Lugo H, Murillo E, Seto E, col. The Imperial County Community Air Monitoring Network: A Model for Community-based Environmental Monitoring for Public Health Action. Environ Health Perspect; 2017. 125(7): 074501.
32. Musesengwa R, Chimbari MJ. Experiences of community members and researchers on community engagement in an Ecohealth project in South Africa and Zimbabwe. BMC Med Ethics; 2017.
33. Rey-Mazón P, Keysar H, Dosemagen S, Dignazio C, Blair D. Public Lab: Community-Based Approaches to Urban and Environmental Health and Justice. Sci Eng Ethics; 2018. p. 971–997.
34. Barzyk T, Huang H, Williams R, Kaufman Amanda, Essoka J. Advice and Frequently Asked Questions (FAQs) for Citizen-Science Environmental Health Assessments. Int J Environ Res Public Health; 2018. 15(5): 960.
35. Panikkar B, Lemmond B, Allen L, DiPirro C, Kasper S. Making the invisible visible: results of a community-led health survey following PFAS contamination of drinking water in Merrimack, New Hampshire. Environ Health; 2019.
36. Johnston J, Juarez Z, Navarro S, Hernandez A, Gutschow W. Youth Engaged Participatory Air Monitoring: A ‘Day in the Life’ in Urban Environmental Justice Communities. Int J Environ Res Public Health; 2020. 17(1): 93.
37. Wong M, Wilkie A, Garzón-Galvis C, King G, Olmedo L, Bejarano E, col. Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border. Int J Environ Res Public Health; 2020. 17(3): 1092.
38. Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe": Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health; 2021. 11;18(2):554.
39. Prado C, Colectivo Salud y Justicia Ambiental, Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health; 2021. 18(3): 1349.