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Os acidentes de trabalho no Brasil são agravos que, pelo seu expressivo impacto na morbimortalidade da população, são importante problema de saúde pública, sendo, objeto prioritário das ações do Sistema Único de Saúde. O objetivo geral consistiu na análise do perfil dos casos e óbitos, notificados como acidentes de trabalho, em Minas Gerais no período de 2010 a 2019. Metodologicamente tratou-se de estudo transversal descritivo, a partir da análise de dados secundários das fichas de acidente de trabalho do Sistema de Informações de Agravos de Notificações (SINAN) e das declarações de óbito por acidentes de trabalho (Sistema de Informação de Mortalidade SIM). Foram calculadas as incidências e prevalências anuais, intervalos de confiança de 95% e análise espacial por meio de mapas temáticos, utilizando o software SPSS versão 19.0. Resultados: As maiores incidências ocorreram em 2018 e 2019 (1,4 e 1,39, por 1.000 trabalhadores, respectivamente). A maior taxa de mortalidade por AT foi em 2019 (0,07 por 1000 trabalhadores). Em relação a prevalência de AT: segundo Unidade Regional de Saúde (URS) destacaram-se Pirapora e Uberaba (23,9 e 22,6 por 1000 trabalhadores, respectivamente), por área de abrangência de Centro de Referência em Saúde do Trabalhador (CEREST) destacaram-se Poços de Caldas, Betim, Uberaba e Araxá (27,5, 24,5, 22,3 e 20,2 por 1000 trabalhadores, respectivamente). A taxa de mortalidade por AT: segundo URS destacaram-se Uberaba e Governador Valadares (1,1 e 1,0 por 1000 trabalhadores, respectivamente), já em relação aos CERESTs foram Araxá, Betim, Governador Valadares e Uberaba (1,7, 1,4, 1 e 0,9 por 1000 trabalhadores, respectivamente). Na análise municipal destaca-se Brumadinho com taxa de mortalidade de 15,5 por 1000 trabalhadores. Com relação ao perfil sociodemográfico predominaram os casos e óbitos no gênero masculino, na faixa etária de 18 a 39 anos. Negros representaram 52,8% (SINAN) e 54,5% (SIM) dos casos. Em relação a Escolaridade, 36,2% apresentaram o ensino fundamental incompleto (SINAN) e 38,9% ensino médio completo (SIM). A escolaridade apresentou significativo percentual de dados ignorados nos dois sistemas de informação (35,2% e 31%), assim com classificação étnico-racial (30,8% no SINAN e 1,6% no SIM). No SINAN predominaram os acidentes típicos (79,3%), com membros afetados (superior 47,5% e inferior 25,8%). Ocorreram em sua maioria nas instalações do contratante (53,3%), entre trabalhadores registrados com vínculo celetista (67,7%). Quanto a evolução a incapacidade temporária foi a mais frequente (69,8%) e o óbito por AT representou 4,3%. Em 57% dos casos foi emitida Comunicação de Acidente de Trabalho (CAT). Quanto as ocupações foram mais frequentes no SINAN e SIM, respectivamente: Trabalhadores da indústria extrativa e construção civil (17,8% e 17,6%), dos serviços (13,7% e 7,6%), da exploração agropecuária (12,1% e 10,2%) e de funções transversais (9,8% e 29,6%). Já a causa do acidente e causa básica do óbito, foram mais frequentes no SINAN o intervalo CID-10: W20-W49 - Exposição a forças mecânicas inanimadas (31,3%). No SIM foi o V40-V49 Ocupante de um automóvel traumatizado em um acidente de transporte (14,5%). Com concentração em ambos os sistemas, dos acidentes de transporte -V01 a V99, SINAN (19,5%) e SIM (53,1%) dos casos. Constatou-se que os dados sobre os AT estão difusos em vários sistemas. Porém ainda não existe vinculação dos casos entre os mesmos, o que contribui para o subdimensionamento, dificulta o processo de investigação dos AT e compromete a elucidação da real magnitude das estimativas de morbimortalidade relacionadas a ocorrência dos AT. Como produto técnico, foi elaborado um relatório com a caracterização geral do cenário epidemiológico de AT no estado de Minas Gerais e com recomendações dirigidas aos gestores municipais e Secretaria Estadual de Saúde de Minas Gerais e Coordenação-Geral de Saúde do Trabalhador do Ministério da Saúde.
Work accidents in Brazil are injuries that, due to their significant impact on the population's morbidity and mortality, are an important public health problem, being a priority object of the actions of the Unified Health System. The general objective consisted of analyzing the profile of cases and deaths , reported as work accidents, in Minas Gerais from 2010 to 2019. Methodologically, it was a descriptive cross-sectional study, based on the analysis of secondary data from work accident records from the Notifiable Diseases Information System (SINAN) and death certificates due to work accidents (Mortality Information System SIM). Annual incidences and prevalences, 95% confidence intervals and spatial analysis were calculated using thematic maps, using SPSS version 19.0 software. Results: The highest incidences occurred in 2018 and 2019 (1.4 and 1.39, per 1,000 workers, respectively). The highest mortality rate from TA was in 2019 (0.07 per 1000 workers). Regarding the prevalence of TA: according to the Regional Health Unit (URS), Pirapora and Uberaba stood out (23.9 and 22.6 per 1000 workers, respectively), by area covered by the Reference Center for Occupational Health (CEREST ) Poços de Caldas, Betim, Uberaba and Araxá stood out (27.5, 24.5, 22.3 and 20.2 per 1000 workers, respectively). The mortality rate due to AT: according to URS, Uberaba and Governador Valadares stood out (1.1 and 1.0 per 1000 workers, respectively), while in relation to CERESTs they were Araxá, Betim, Governador Valadares and Uberaba (1.7, 1.4, 1 and 0.9 per 1000 workers, respectively). In the municipal analysis, Brumadinho stands out with a mortality rate of 15.5 per 1000 workers. Regarding the sociodemographic profile, cases and deaths predominated in males, aged between 18 and 39 years. Black people represented 52.8% (SINAN) and 54.5% (SIM) of cases. In relation to Education, 36.2% had incomplete primary education (SINAN) and 38.9% completed secondary education (SIM). Education presented a significant percentage of ignored data in both information systems (35.2% and 31%), as well as ethnic-racial classification (30.8% in SINAN and 1.6% in SIM). In SINAN, typical accidents predominated (79.3%), with affected limbs (upper 47.5% and lower 25.8%). They mostly occurred at the contractor's facilities (53.3%), among workers registered with a CLT (67.7%). Regarding evolution, temporary disability was the most frequent (69.8%) and death due to TA represented 4.3%. In 57% of cases, a Work Accident Report (CAT) was issued. The occupations were most frequent in SINAN and SIM, respectively: Workers in the extractive industry and civil construction (17.8% and 17.6%), services (13.7% and 7.6%), agricultural exploration ( 12.1% and 10.2%) and transversal functions (9.8% and 29.6%). As for the cause of the accident and the underlying cause of death, the ICD-10 range: W20- W49 - Exposure to inanimate mechanical forces (31.3%) was more frequent in SINAN. In SIM it was V40-V49 Occupant of a car injured in a transport accident (14.5%). With a concentration in both systems, from transport accidents -V01 to V99, SINAN (19.5%) and SIM (53.1%) of cases. It was found that data on AT are diffuse across several systems. However, there is still no link between the cases, which contributes to undersizing, complicates the process of investigating TAs and compromises the elucidation of the real magnitude of morbidity and mortality estimates related to the occurrence of TAs. As a technical product, a report was prepared with the general characterization of the TA epidemiological scenario in the state of Minas Gerais and with recommendations addressed to municipal managers and the State Health Department of Minas Gerais and the General Coordination of Workers' Health of the Ministry of Health.
Subject(s)
Occupational Mortality , Epidemiology, Descriptive , Surveillance of the Workers Health , Unified Health System , Public Health , Cross-Sectional Studies , Academic DissertationABSTRACT
Background The influencing factors of noise hazards in the automotive manufacturing industry are complex, diverse, and mutually correlated, resulting in significant health impacts on workers. Objective To explore the application of generalized estimating equations (GEE) to analyze the factors affecting high-frequency hearing loss among noise-exposed workers in an automotive manufacturing company, guiding enterprises to scientifically carry out employee hearing protection programs. Methods The data of occupational health field evaluation and occupational health surveillance of an automobile manufacturing company for five consecutive years from 2018 to 2022 were collected, and 806 noise-exposed workers with pure tone hearing test results for all five consecutive years were selected as study participants. The retrieved indicators were gender, physical examination year, noise intensity, blood pressure, white blood cell counts, red blood cell counts, platelet counts, concentrations of hemoglobin, alanine transaminase, aspartate aminotransferase, smoking, drinking, etc. Gender, noise intensity, blood pressure, white blood cell counts, red blood cell counts, concentrations of hemoglobin, platelet counts, glutamate aminotransferase, glutamate aminotransferase, smoking, and drinking were set as independent variables, and occurrence of high-frequency hearing loss was set as a dependent variable, and GEE were constructed by using the statistical software of SPSS 20.0 to analyze the influencing factors of high-frequency hearing loss. Results Of the 806 workers, 698 were male (86.6%) and 108 were female (13.4%). The detection rates of high-frequency hearing loss in each year from 2018 to 2022 were 66.4% (535/806), 69.8% (563/806), 70.0% (564/806), 68.9% (555/806), and 68.2% (550/806), respectively. The detection rate of high-frequency hearing loss in the company was varied significantly by gender, lowered white blood cell counts, lowered red blood cell counts, lowered platelet counts, smoking, and drinking (P<0.05). The results of GEE analysis showed that after adjusting for selected confounding factors and excluding interaction effects, the risk of high-frequency hearing loss was higher in men than in women (P=0.001; OR=1.907, 95%CI: 1.286, 2.829); it was higher in workplace with disqualified noise intensity than in those without (P=0.043; OR=1.289, 95%CI: 1.009, 1.648); it was also higher in smokers than in non-smokers (P=0.004; OR=1.507, 95%CI: 1.137, 1.999). Conclusion Gender, noise intensity, and smoking are the main influencing factors of high-frequency hearing loss in noise-exposed workers in this automobile manufacturing company. Controlling smoking and reducing noise exposure intensity may reduce the occurrence of high-frequency hearing loss in workers.
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To revise GBZ 188 Technical Specification for Occupational Health Surveillance based on national laws, regulations, standards, specifications and legal documents of occupational disease, and combination with the actual situation in China. The main modifications are as follows: the occupational health surveillance for workers exposed to toluene (xylene may implement by reference), bromopropane, methyl iodide, ethylene oxide, chloroacetic acid, indium and its compounds, coal tar, coal tarasphalt, asphalt, β-naphthylamine, dust of metal and its compounds(tin, iron, antimony, barium and its compounds), hard metal dust, erionite dust, low temperature, laser, tick-borne encephalitis virus, Borrelia burgdorferi, and human immunodeficiency virus, for scraper or grind operators, and underground workers using squatting or kneeling position, crawling position, side-lying position, or shoulder position for a long period of time are included. The emergency health screening for workers exposed to arsenic, fluorine and its inorganic compounds, and acrylamide are included. The occupational medical examination (OME) for workers exposed to amino and nitro compounds of benzene, phosgene, monomethylamine, organic fluorine and dimethyl sulfate has been adjusted and made mandatory, with corresponding assessments required upon leaving the job. The special occupational health surveillance for workers exposed to mycobacterium tuberculosis and hepatitis virus is removed. The OME conclusion of reexamination is removed, and standardize recheck/additional inspection requirements. The optional items in OME performed before, during and after leaving post are removed, but the optional items in emergency medical examination are retained. Additional OME items are added. The Guideline for OME Summary Reports is added as informative appendix, and so on. The revised GBZ 188 Technical Specification for Occupational Health Surveillance is more scientific and practical.
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Technical Specifications for Occupational Health Surveillance (GBZ 188-2014) has played an important role in screening occupational contraindications and preventing occupational diseases since its implementation. However, during the use of occupational health examination, we found that the use of occupational contraindication on cardiovascular disease was not "homogenized" due to the differences in the understanding of various physical examination institutions. Therefore, this paper mainly discussed the connotation and quantitative standards of organic heart disease, arrhythmia, hypertension in the occupational contraindication cardiovascular disease in the specification for "homogenization".
Subject(s)
Humans , Occupational Health , Cardiovascular System , Cardiovascular Diseases , Contraindications , Occupational DiseasesABSTRACT
Resumo Objetivo: estimar soroprevalências de arboviroses, sífilis, HIV e Hepatite B (VHB) em trabalhadores de saúde (TS). Métodos: inquérito entre TS selecionados por amostragem aleatória, em uma cidade da Bahia - Brasil. Pesquisa realizada em 2019 por meio de questionário estruturado, que coletou informações sociodemográficas, ocupacionais e de saúde. Testes imunocromatográficos rápidos foram utilizados para rastrear as infecções; dessa forma, resultados positivos para arboviroses, sífilis, HIV e VHB indicaram soropositividade para a respectiva infecção. Além disso, detecção simultânea de anticorpos para zika (ZIKV) e dengue (DENV) indicou soropositividade para infecção por flavivírus. Resultados: 453 TS foram incluídos, sendo 82,8% do sexo feminino. A maioria (55,1%) relatou contato com material biológico; 5,2% referiram acidentes com material biológico. Encontrou-se soroprevalência de 34,7% (IC95%:30,1-39,4) para dengue, 1,7% (IC95%:0,7-3,4) para zika, 9,9% (IC95%:7,2-13,2) para chikungunya e 39,9% (95%CI:35,2-44,7) para flavivírus (ZIKV+DENV); 21,9% (IC95%:18,1-26,2) foram negativos para todos os arbovírus. Soropositividade para arbovírus aumentou com a idade e foi maior entre agentes de combate a endemias. Três TS testaram positivo para VHB (HBsAg); nenhum para HIV. Conclusão: elevado percentual de TS estava exposto a agentes infecciosos (contato com material biológico e/ou exposição a arbovírus). Entre as condições necessárias à prevenção de infecções no ambiente de trabalho, destacam-se: monitoramento de infecções entre TS, vigilância dos ambientes laborais e medidas de controle de exposições ocupacionais, como disponibilidade de repelentes.
Abstract Objective: to estimate the seroprevalence of arboviruses, syphilis, HIV, and hepatitis B (HBV) in Healthcare Workers (HCW). Methods: a survey among HCW among was randomly selected in a city in Bahia-Brazil. The research used a structured questionnaire, which collected sociodemographic, occupational, and health information in 2019. Rapid immunochromatographic tests were used to track infections. Thus, positive results for arboviruses, syphilis, HIV, and HBV indicated seropositivity for the respective infection. In addition, simultaneous detection of antibodies for zika (ZIKV) and dengue (DENV) viruses indicated seropositivity for flavivirus infection. Results: a total of 453 HCW were included, 82.8% were women. Most HCW (55.1%) reported contact with biological material; 5.2% reported injuries with biological material. The seroprevalence was 34.7% (95%CI:30.1-39.4) for dengue, 1.7% (95%CI:0.7-3.4) for zika, 9.9% (95%CI:7.2-13.2) for chikungunya, and 39.9% (95%CI:35.2-44.7) for flavivirus (ZIKV+DENV); with 21.9% (95%CI:18.1-26.2) being negative to all arboviruses. Seropositivity to arboviruses increased with age and was higher among endemic disease control agents. Three HCW tested positive for HBV (HBsAg); no HIV cases were detected. Conclusion: a high percentage of HCW was exposed to infectious agents (contact with biological material and/or exposure to arboviruses). Among the necessary conditions for preventing infections in the work environment, the following stand out: monitoring of infectious diseases among HCW, surveillance of work environments, and measures to control occupational exposures, such as the availability of repellents.
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@#Objective To map the knowledge domain of occupational health research in China. Methods Articles were searched in the China Academic Journal Network Publishing Database using“occupational health”as the subject term. Journal sources were limited to the journals of China Social Science Citation Index and core journals of China and Chinese Science Citation Database. The search period starts in 1992 and ends on November 26，2021. The valid data was visually analyzed using CiteSpace softwere. Results A total of 2 351 papers related to occupational health from 1992 to 2021 were obtained. In the past 30 years，the number of articles with the title of“occupational health”has been on the rise and reached its peak in 2014. China Occupational Medicine，Chinese Journal of Industrial Hygiene and Occupational Diseases，and Chinese Journal of Industrial Medicine were the top three journals in terms of number of articles published，which produced 438，339 and 280 articles respectively. Chinese Center for Disease Control and Prevention and Guangdong Province Hospital for Occupational Disease Prevention and Treatment were the top two organizations in terms of number of articles published，which produced 169 and 116 articles respectively. Occupational medical examination，occupational health surveillance，and occupational health risk assessment were the three hot issues in the field of occupational health research. Conclusions In the past 30 years， occupational health research in China has achieved remarkable progress in terms of article publications and interdisciplinary cooperation，and future work should focus on the academic impact of articles and interdisciplinary research cooperation.
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@#Objective To map the knowledge domain of occupational health research in China. Methods Articles were searched in the China Academic Journal Network Publishing Database using“occupational health”as the subject term. Journal sources were limited to the journals of China Social Science Citation Index and core journals of China and Chinese Science Citation Database. The search period starts in 1992 and ends on November 26，2021. The valid data was visually analyzed using CiteSpace softwere. Results A total of 2 351 papers related to occupational health from 1992 to 2021 were obtained. In the past 30 years，the number of articles with the title of“occupational health”has been on the rise and reached its peak in 2014. China Occupational Medicine，Chinese Journal of Industrial Hygiene and Occupational Diseases，and Chinese Journal of Industrial Medicine were the top three journals in terms of number of articles published，which produced 438，339 and 280 articles respectively. Chinese Center for Disease Control and Prevention and Guangdong Province Hospital for Occupational Disease Prevention and Treatment were the top two organizations in terms of number of articles published，which produced 169 and 116 articles respectively. Occupational medical examination，occupational health surveillance，and occupational health risk assessment were the three hot issues in the field of occupational health research. Conclusions In the past 30 years， occupational health research in China has achieved remarkable progress in terms of article publications and interdisciplinary cooperation，and future work should focus on the academic impact of articles and interdisciplinary research cooperation.
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According to the research on the pathogenesis of the hidden hearing loss in recent years, the occurrence of the hidden hearing loss is earlier than the permanent hearing threshold shift. This paper reviews the risk factors of hidden hearing loss, the pathogenesis of noise-induced hidden hearing loss, and the detection methods of hidden hearing loss. To explore the significance of hidden hearing loss in occupational health surveillance, and to provide reference for hearing protection of workers exposed to noise and hearing loss early in the future.
Subject(s)
Humans , Hearing , Hearing Loss, Noise-Induced , Noise, Occupational , Occupational Diseases , Occupational Exposure , Occupational HealthABSTRACT
Objective To investigate the status of occupational health surveillance in Xiacheng District of Hangzhou City from 2014 to 2017, and to provide basis for occupational hygienic supervision Methods Data on occupational health surveillance in Xiacheng District from 2014 to 2017 were collected, and the trend of occupational health surveillance was analyzed.The differences of occupational health surveillance among different hazardous agents, economic types, industries and scales were compared. Results There was no significant difference in rates of pre-job and on-job occupational medical examination from 2014 to 2017, and the rate of off-job occupational medical examination showed an increasing trend.There were statistical difference in on-the-job occupational medical examination rates among empolying units of different economic types, industries and scales.There were statistical differences in the detection rates of occupational contraindication among empolying units of different economic types, hazardous agents.There was no significant difference in the detection rates of suspected occupational diseases among empolying units. Conclusion The occupational health surveillance showed a phenomenon of "emphasizing on-the-job, neglecting pre-job and off-the-job" in Xiacheng District.Supervision department should pay more attention on manufacturing, collective and private economic.It is necessary to focus on the protection of staff contacts with chemical and physical agents. It is suggested that relevant departments should strengthen the propaganda and supervision of occupational health surveillance, according to the nature, characteristics of the employing units and types of their hazardous agents.
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Objective@#To develop occupational radiation disease and occupational health monitoring system for radiation workers in order to identify the current status of occupational health management of radiation workers in China.@*Methods@#In compliance with the relevant laws, regulations and standards in China, the system design was completed according to wide variety of needs.@*Results@#An occupational health monitoring system for radiation workers was initially established. The system consisted of four modules and three levels of users to make sure.@*Conclusions@#Through the collection of data, some key risk points existing in radiology diagnosis and treatment have been identified in relation to occupational radiation disease, so as to provide scientific basis for health administrative department to carry out decision-making and revision of laws and regulations.
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Objective@#To establish the national occupational radiation disease reporting system and learn about the incidence of occupational radiation sickness in radiation workers.@*Methods@#In accordance with the relevant regulations, standards and literatures available in China, the system was designed and implemented to survey the requirements of diagnosis institutions of occupational radiation sickness and administrative departments.@*Results@#The system was initially established with expectant functions. The system functional modules consisted of case reporting, case information enquiry, statistical analysis and system management. The diagnosis institutions of occupational radiation sickness had used the system to report the cases diagnosed in 2017.@*Conclusions@#The system achieved the standardized case reporting for the institutions of occupational radiation sickness, and provided scientific data for the health surveillance of radiation workers and decisions of governments.
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Objective To develop occupational radiation disease and occupational health monitoring system for radiation workers in order to identify the current status of occupational health management of radiation workers in China. Methods In compliance with the relevant laws, regulations and standards in China, the system design was completed according to wide variety of needs. Results An occupational health monitoring system for radiation workers was initially established. The system consisted of four modules and three levels of users to make sure. Conclusions Through the collection of data, some key risk points existing in radiology diagnosis and treatment have been identified in relation to occupational radiation disease, so as to provide scientific basis for health administrative department to carry out decision-making and revision of laws and regulations.
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Objective To establish the national occupational radiation disease reporting system and learn about the incidence of occupational radiation sickness in radiation workers. Methods In accordance with the relevant regulations, standards and literatures available in China, the system was designed and implemented to survey the requirements of diagnosis institutions of occupational radiation sickness and administrative departments. Results The system was initially established with expectant functions. The system functional modules consisted of case reporting, case information enquiry, statistical analysis and system management. The diagnosis institutions of occupational radiation sickness had used the system to report the cases diagnosed in 2017. Conclusions The system achieved the standardized case reporting for the institutions of occupational radiation sickness, and provided scientific data for the health surveillance of radiation workers and decisions of governments.
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Objective@#To find out the status of the monitoring of production environment and physical condition of occupational victims in Sichuan in recent 5 years.@*Methods@#Data of health supervision of workers with toxic and harmful activity and occupational health examination in Sichuan Province during 2012-2016, monitoring of occupational harmful factors in Sichuan Province during 2014-2016 were collected from the Network direct reporting system. Descriptive analysis was conducted to analyze the result in May 2017.@*Results@#The detection rate of suspected occupational diseases in 23964 enterprises was 1.79% (13392/748291) . The exceeding standard rate of dust, noise, xenobiotic were 32.58% (5089/15622) , 20.28% (4897/24152) and 4.80% (1016/21145) respectively. In addition, state-owned enterprises, state-owned enterprises and collective enterprises showed the highest over-standard rate of dust, noise and exogenous chemical poisons, with the over-standard rate of 69.93% (828/1184) , 29.08% (608/2091) and 11.80% (42/356) respectively. The exceeding rate of dust, noise and exogenous chemical poisons was 32.76% (740/2259) , 28.72% (444/1546) and 7.39% (114/1543) , respectively. Most of the enterprises with higher over-standard rate of dust and chemical poisons are located in Suining City, Panzhihua City, Guangyuan City and Ziyang City.@*Conclusion@#The focus of occupational hazards in Sichuan is dust and noise, followed by benzene.
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Objective@#To analyze the occupational health surveillance data of toxic and harmful workers in Ningbo, and provide scientific basis for making protective measures.@*Methods@#To export the occupational health surveillance data of toxic and harmful workers reported by occupational health examination institutions in Ningbo during the January 1, 2011 to December 31, 2017 from the China Information System for Disease Control and Prevention, and analyze the trend of the suspected occupational disease and occupational contraindication detection rate, and compare the the health status of workers in different industry nature, economic type, enterprise scale and occupational hazards.@*Results@#From 2011 to 2017, the number of occupational health surveillance of toxic and harmful workers in Ningbo was increasing year by year. The detection rates of suspected occupational diseases and occupational contraindications generally showed a downward trend (P<0.05) . In 2017, the distribution of occupational health care for toxic and harmful workers in Ningbo was mainly based on manufacturing (187 681/220 895, 84.96%) , private economic enterprises (103 960/220 895, 47.06%) and small enterprises (100 357/220 895, 45.43%) , Workers exposed to chemical poisons had the largest number of physical examinations (101 813/220 895, 46.09%) . The highest detection rates of suspected occupational diseases were mining industry (2/1225, 0.16%) , collective economic enterprises (4/2622, 0.15%) and small enterprises (88/100 357, 0.09%) . The highest detection rates of occupational contraindications were rental and business services (16/1 320, 1.21%) , private economic enterprises (1 190/103 960, 1.14%) and small enterprises (995/100 357, 0.99%) . In addition, workers exposed to dust had the highest detection rate of suspected occupational diseases (57/46 740, 0.12%) and workers exposed to physical factors had the highest detection rate of occupational contraindications (1207/69 567, 1.74%) . There were significant differences between the detection rate of suspected occupational disease and occupational contraindication in different industries, economic types, enterprise scale and occupational hazards (P<0.05) .@*Conclusion@#The occupational health surveillance of toxic and harmful workers in Ningbo has been strengthened year by year, attention should be paid to small, private enterprises, and strengthen the supervision of occupational health and further standardize the work of occupational health examination so as to effectively protect the health of the occupational population.
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Resumo Os raros questionários existentes no Brasil que abordam retorno ao trabalho são físicos e/ou psicológicos e não abrangem questões relativas ao ambiente de trabalho. O Obstacles to Return-to-Work Questionnaire (ORTWQ) é multidimensional, inclui fatores biopsicossociais, ambientais e tem se mostrado útil como preditor de retorno ao trabalho. Este estudo tem como objetivo discutir a importância, para a Vigilância em Saúde do Trabalhador, de questionários que identificam os obstáculos para retorno ao trabalho, bem como traduzir e adaptar culturalmente o ORTWQ para uso no contexto brasileiro. Cinco etapas foram seguidas para a adaptação cultural: tradução, síntese, retrotradução, avaliação por comitê de especialistas e pré-teste. Antes do pré-teste, o Índice de Validade de Conteúdo foi verificado e considerado adequado quando ≥ 0,8. Foi retirado do questionário, o termo "aumentar as horas de trabalho", uma vez que o regime de retorno parcial ao trabalho é raro no Brasil. Participaram do pré-teste 40 sujeitos. A versão brasileira do ORTWQ mostrou-se adequada e o tempo médio para preenchimento foi de 14 minutos. Outros estudos devem avaliar as qualidades psicométricas desse questionário.
Abstract The few existing questionnaires addressing return to work in Brazil are medical and/or psychological and do not examine work environment-related issues. The Obstacles to Return-to-Work Questionnaire (ORTWQ) is multidimensional, including biopsychosocial and environmental factors, and has proven useful in the return to work issue. The scope of this study is to describe the translation and cultural adaptation process of ORTWQ for use in the Brazilian context. It also discusses aspects related to work and the importance for health professionals to identify obstacles to return to work for occupational health vigilance. For the cultural adaptation process, there were five steps: translation, synthesis, back translation, evaluation by an expert committee and the pre-test process. Before the pre-test phase, the Content Validity Index was checked and was considered adequate when it was ≥ 0.8. The expression "increase working hours" was withdrawn from the questionnaire, since the partial returnto-work regime is rare in Brazil. The sample for the pre-test involved 40 individuals. The average time for completing ORTWQ was 14 minutes and the Brazilian version of ORTWQ proved to be adequate. Further studies should assess psychometric qualities of the questionnaire.
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Humans , Male , Female , Adolescent , Adult , Young Adult , Cross-Cultural Comparison , Surveys and Questionnaires , Cultural Characteristics , Return to Work , Psychometrics , Time Factors , Translations , Brazil , Reproducibility of Results , Occupational Health , Language , Middle AgedABSTRACT
Objective To evaluate the performance of the main indicators in the blood analysis of an occupational health exam ination agency by Sigma verification of performance chart and guide quality improvement.Methods Collected blood testing laboratory internal quality control (IQC) data in October 2016 and 2016 second national external quality assessment (EQA) results of the blood analysis laboratory in the agency.Regarded the accumulated coefficient of variability as the estimation value of imprecision.Used the percentage difference in EQA results as the estimation value of bias (％) of the laboratory.The total allowable error in health industry standard WS/T406-2012 was adopted as the quality specification (％).Sigma verification of performance chart of the main eight projects in the blood analysis were drawn with professional software.Results The sigma value of WBC reached σ≥6 level,as the first-class performance,and the sigma values of HGB in the 4≤σ ＜5 level,test performance was good.The sigma value of Hct,HCV and MCHC all were in the 3≤σ＜4 level,as the critical level,and the sigma values of RBC,platelet and MCH in the 2≤σ＜3 level,as poor performance.Conclusion Sigma verifica tion of performance chart could reflect the level of the laboratory testing performance on different test items of blood count,promote the quality improvement.
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Objective To analyze the changes in distribution of occupational radiation cases reported from 2013 to 2017 in China and learn about the occupational health risks of radiation workers.Methods Descriptive analyses were made of regional distribution,disease category distribution,occupation category distribution and exposure mode distribution of these cases,according to the reports (2013-2017) of occupational radiation sickness from " Occupational Health of Radiation Workers Management System".Results There were 54 diagnostic radiology agencies for occupational radiation sickness in China that covered all provinces,autonomous regions and municipalities except Tibet and Production and Construction Corps of Xinjiang.A total of 106 new cases were reported from 2013 to 2017.Most of the cases were radiogenic neoplasm (43.40％),and chronic radiation sickness were from external exposure (16.98％) and radiation cataract (16.04％).Most of the cases (70.75％) were engaged in medical application and a small part of the cases (13.21％) engaged in industry application.Chronic exposure (80.19％) was the most frequent form of exposure mode,but acute exposure (5.66％) was very few.A part of cases (14.15％) were reported without exposure mode.Conclusions The morbidity of occupational radiation sickness declined generally in China and occupational health management of key workers should be strengthened continuously.
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Resumo Introdução: pescadores são uma das maiores e mais tradicionais categorias de trabalhadores no mundo. Para reduzir lacunas do conhecimento sobre os problemas de saúde relacionados a essa atividade e desenvolver ações com o Sistema Único de Saúde (SUS), em 2006 foram iniciados estudos e ações dirigidos aos trabalhadores da pesca artesanal e mariscagem, envolvendo 13 municípios, na Baía de Todos os Santos, nos estado da Bahia. Objetivo: discutir resultados alcançados em intervenções e estudos realizados, para subsidiar ações de vigilância em saúde do trabalhador (Visat) da pesca. Métodos: foram referidos e discutidos estudos qualitativos e quantitativos desenvolvidos a partir de pesquisa participativa de base comunitária. Resultados: os estudos e intervenções revelaram as condições de trabalho e os riscos ocupacionais dessa atividade, sobretudo a exposição excessiva a movimentos repetitivos, e possibilitaram a quantificação da prevalência das lesões por esforço repetitivo e distúrbio osteomuscular relacionado ao trabalho (LER/Dort). Também contribuíram para analisar a qualidade de vida desses trabalhadores, a organização dos serviços de diagnóstico, a adaptação de protocolo clínico de LER/Dort e a capacitação das Equipes da Estratégia Saúde da Família atuantes em territórios pesqueiros. Conclusão: os estudos e as intervenções indicaram a possibilidade de reprodutibilidade desta experiência no âmbito da Visat no SUS.
Abstract Introduction: fishermen are one of the largest and most traditional categories of workers in the world. In order to address the knowledge gaps in health problems related to this activity, and to develop actions together with the Unified Health System (SUS), in 2006 a set of studies and activities aimed at artisanal fishermen and shellfish gatherers was initiated, involving 13 municipal districts in Baía de Todos os Santos, Bahia, Brazil. Objective: to discuss results achieved in interventions and studies carried out with the purpose of subsidizing actions concerning fishermen's occupational health surveillance (Visat). Methods: we discuss and refer to qualitative and quantitative studies developed through community-based participatory research. Results: studies and interventions revealed artisanal fishermen's working conditions and occupational risks, especially those related to repetitive movements leading to high RSI/RMSDs prevalence. The results also contributed to the analysis of the workers' quality of life, organization of diagnostic services, adaptation of the RSI/WRMSDs clinical protocol, and training the Family Health Strategy Teams operating in fishing territories. Conclusion: the studies and interventions indicate the possibility of reproducing this experience within the framework of Visat at SUS.
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Introducción: Un protocolo, en términos generales, es definido como un acuerdo entre profesionales expertos en un determinado tema y en el cual se han esclarecido las actividades a realizar ante una determinada tarea. Objetivo: elaborar un protocolo para la vigilancia de la salud laboral que contribuya a promover el bienestar físico-mental y social de los trabajadores. Materiales y Métodos: están referidos a los tipos de investigación utilizados: exploratorios, descriptivos y explicativos. En cuanto a los métodos empíricos aplicados se incluyen la revisión bibliográfica, el método científico inductivo-deductivo y el análisis y la síntesis. Resultados: se desarrolla el protocolo de vigilancia de la salud laboral con los diferentes subprotocolos: Medicina preventiva y del trabajo; Prevención secundaria; Higiene industrial; Seguridad industrial; y Organización, gestión y control. Conclusiones: se destaca que la elaboración del protocolo de vigilancia de la salud laboral constituye una guía para los empresarios de los diferentes aspectos y estructuras organizativas que deben tenerse en cuenta en las empresas (AU).
Introduction: a protocol, in general terms, is an agreement between professionals with expertise in a definite theme in which the activities to carry out certain task have been clarified. Objective: to work a protocol out for the occupational health surveillance that could contribute promoting the workers’ physic-mental and social welfare. Materials and Methods: the kinds of research used are exploratory, descriptive and explicative ones. The used empirical methods are bibliographic review, the inductive-deductive scientific method, analysis and synthesis. Results: the protocol of occupational health surveillance is worked out with its different sub-protocols: Preventive and occupational medicine, Secondary prevention, Industrial hygiene, Industrial security, and Organization, management and control. Conclusions: it is highlighted that working the protocol of occupational health surveillance is a guide for the businessmen of the different organizational aspects and structures that have to be taken into account in the enterprises (AU).