Como a pandemia de COVID-19 afetou a notificação de acidentes do trabalho em diferentes atividades econômicas e ocupações no Brasil? Um estudo ecológico usando o p-score / How did the COVID-19 pandemic affect occupational accident notification in different economic activities and occupations in Brazil? An ecological study using p-score

Resumo Objetivo: mensurar o impacto da pandemia de COVID-19 nas notificações de acidentes do trabalho (AT) no Brasil, por atividade econômica e ocupação. Métodos: estudo ecológico que utilizou os casos de AT registrados entre 2015 e 2020 no Anuário Estatístico da Previdência Social. Os AT foram analisados por setor de atividade econômica, ocupação e códigos da 10ª revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10). Uma adaptação do p-score foi aplicada para comparar os casos de AT pré-pandemia com os do primeiro ano da pandemia. Resultados: os p-scores variaram de -60,2%, para AT por nexo técnico epidemiológico, a -13,9%, para AT típico. As doenças do trabalho apresentaram p-score de 151,1%. Houve aumento notável nos casos de doenças ocupacionais dos capítulos I e X da CID-10. As notificações de AT diminuíram em todas as categorias de atividades econômicas, exceto nas de saúde humana e serviços sociais (p-score = 8,0%). Na maioria das categorias, os valores foram negativos, exceto nos subgrupos forças de segurança e profissionais de saúde de nível superior, técnico e gestores. Conclusão: houve redução geral na notificação de AT durante a pandemia de COVID-19 no Brasil, que evidenciou desigualdades entre diferentes setores de atividades e ocupações, além de mudança no perfil de adoecimento dos trabalhadores.

Abstract Objective: to assess the COVID-19 pandemic impact on Occupational Accident (OA) notifications in Brazil by economic activity and occupation. Methods: an ecological study was conducted using OA cases recorded in the Statistical Yearbook of Social Security from 2015 to 2020. Accidents were analyzed by sector of economic activity, occupation, and ICD-10 codes. Pre-pandemic cases were compared with the first year of the public health emergency scenario caused by Sars-Cov-2 using an adapted p-score. Results: p-scores ranged from -60.2% for technical-epidemiological Occupational Accidents to -13.9% for typical OA. Occupational diseases had a p-score of 151.1%. Cases of occupational diseases from ICD-10 chapters I and X showed a significant increase. OA notifications decreased in all CNAE sections, except for human health and social services activities (p-score = 8.0%). P-score values were negative in most CBO categories, except in subgroups such as security forces and high-level health professionals, technicians, and managers. Conclusion: Brazil registered a general reduction in OA notifications due to the pandemic, which evinced inequalities in different sectors and occupations, as well as changes in the illness profile of workers.

Occupational injuries and psychological support in Chinese nurses: a cross-sectional study / Lesiones laborales y apoyo psicológico en enfermeras chinas: un estudio transversal / Lesões ocupacionais e apoio psicológico em enfermeiras chinesas: um estudo transversal

ABSTRACT Objective: To assess the occupational injuries and psychological support received by nurses and to investigate the relationship between the two. Method: This was a nation-wide cross-sectional study of nurses working across 1858 hospitals in China. Data were collected using an online structured, self-administered questionnaire between 2016 and 2017. Results: Nearly half of respondents had experienced aggressive behavior from patients or their attendants; 13.4% respondents had experienced aggressive behavior on more than three occasions. 78.96% respondents had experienced needle-stick injuries and 51.22% had experienced psychological trauma. 20.5% respondents believed that hospitals do not pay any attention to occupational safety. 86.1% respondents expressed the need for little or moderate psychological support. Nurses who had experienced aggressive behavior expressed a greater need for psychological support. Nurses working at hospitals that adequately addressed the occupational safety issues expressed the lowest need for psychological support. Conclusion: We found a high prevalence of psychological stress and occupational injuries among nurses. Nursing managers need to address this issue and implement interventions to prevent and reduce injuries.

RESUMO Objetivo: Avaliar os acidentes de trabalho e o apoio psicológico recebido pelos enfermeiros e investigar a relação entre os dois. Método: Este foi um estudo transversal nacional de enfermeiras que trabalham em 1858 hospitais na China. Os dados foram coletados por meio de um questionário online estruturado e autoaplicável entre 2016 e 2017. Resultados: Quase metade dos entrevistados experimentou comportamento agressivo por parte dos pacientes ou de seus acompanhantes; 13,4% dos entrevistados experimentaram comportamento agressivo em mais de três ocasiões. 78,96% dos entrevistados sofreram ferimentos com agulhas e 51,22% sofreram traumas psicológicos. 20,5% dos entrevistados acreditam que os hospitais não dão atenção à segurança do trabalho. 86,1% dos entrevistados expressaram a necessidade de pouco ou moderado apoio psicológico. Enfermeiros que vivenciaram comportamento agressivo expressaram maior necessidade de apoio psicológico. Os enfermeiros que trabalham em hospitais que abordam de forma adequada as questões de segurança do trabalho expressam a menor necessidade de apoio psicológico. Conclusão: Encontramos alta prevalência de estresse psicológico e lesões ocupacionais entre os enfermeiros. Os gerentes de enfermagem precisam abordar essa questão e implementar intervenções para prevenir e reduzir lesões.

RESUMEN Objetivo: Evaluar las lesiones ocupacionales y el apoyo psicológico que reciben las enfermeras e investigar la relación entre ambos. Método: Este fue un estudio transversal a nivel nacional de enfermeras que trabajaban en 1858 hospitales en China. Los datos se recopilaron mediante un cuestionario autoadministrado estructurado en línea entre 2016 y 2017. Resultados: Casi la mitad de los encuestados había experimentado un comportamiento agresivo por parte de los pacientes o sus asistentes; El 13,4% de los encuestados había experimentado un comportamiento agresivo en más de tres ocasiones. El 78,96% de los encuestados había experimentado lesiones por pinchazos de aguja y el 51,22% había experimentado un trauma psicológico. El 20,5% de los encuestados cree que los hospitales no prestan atención a la seguridad laboral. El 86,1% de los encuestados expresó la necesidad de un apoyo psicológico escaso o moderado. Las enfermeras que habían experimentado un comportamiento agresivo expresaron una mayor necesidad de apoyo psicológico. Las enfermeras que trabajan en hospitales que abordaron adecuadamente los problemas de seguridad ocupacional expresaron la menor necesidad de apoyo psicológico. Conclusión: Encontramos una alta prevalencia de estrés psicológico y lesiones ocupacionales entre enfermeras. Los gerentes de enfermería deben abordar este problema e implementar intervenciones para prevenir y reducir las lesiones.

Acidentes de trabalho com exposição a material biológico em fisioterapeutas segundo vínculo formal e informal / Work accidents with exposure to biological material in physiotherapists according to formal and informal employment bonds

Trabalhadores de saúde, incluindo fisioterapeutas, estão sob maior risco de acidentes de trabalho com exposição à material biológico (At-bio), quando comparados a outros. OBJETIVO: Descrever perfil epidemiológico dos At-bio em fisioterapeutas, segundo vínculo de trabalho. MÉTODOS: Estudo de casuística das notificações de At-bio em fisioterapeutas registradas no Sistema de Informação de Agravos de Notificação, Brasil, 2008 a 2018. RESULTADOS: Foram 2.565 registros At-bio em fisioterapeutas, com crescimento de notificações (169,2%) no período, maioria entre os de vínculo formal (68,3%). Entre formais, a maioria foi do sexo feminino (82,7%), com idade entre 30 a 39 anos (46,8%) e raça/cor branca (69,6%). Entre informais, a maioria também foi feminina (85,3%), mais jovens, de 18 a 29 anos (62,2%) e raça/cor branca (69,8%). Em ambos os grupos, a ocupação específica foi fisioterapeuta geral, com casos evoluindo para alta paciente fonte negativa. Os formais tinham 1 a 6 anos de experiência ocupacional (44,8%) e registro de Comunicação do Acidente de Trabalho (CAT) em 58,1% dos casos. Nos informais, o tempo de experiência era menor que 1 ano (47,7%) e apenas 28,6% tiveram o registro da CAT. O uso dos Equipamentos de Proteção Individual (EPI) teve pequena diferença entre grupos, sendo luva, avental e máscaras os mais utilizados. CONCLUSÃO: Embora os At-bio sejam mais notificados em fisioterapeutas com vínculo formal, entre informais acontecem em mais jovens, com menor tempo de experiência e sem registro da CAT, além de pior registro de informações e abandono de evoluções, indicando maior vulnerabilidade, especialmente em relação às medidas de proteção social.

Health workers, including physiotherapists, are at greater risk of occupational injuries involving exposure to biological material (OI-bio), when compared to others. OBJECTIVE: To describe the epidemiological profile of OI-bio in physiotherapists, according to their work contracts (formal/informal). METHODS: A case study of work-related notifications by biological material in physiotherapists, registered in the Information System Notifiable Diseases, Brazil, from 2008 to 2018. RESULTS: There were 2,565 OI-bio records in physiotherapists, with an increase in notifications (169.2%) in the period. The majority among those with formal contracts (68.3%). Among formals, the majority were female (82.7%), aged between 30 and 39 years (46.8%) and white people (69.6%). Among the informal, the majority were also female (85.3%), younger, 18 to 29 years old (62.2%) and white people (69.8%). In both groups, the specific occupation was general physiotherapist, cases evolving to discharge from a negative patient/source. Formals had 1 to 6 years of occupational experience (44.8%) and record of Communication of Occupational Injury (COI) in 58.1% of cases. Among the informal, the work experience time was less than 1 year (47.7%) and only 28.6% had COI registration. The use of Personal Protective Equipment (PPE) had little difference between groups, with gloves, aprons and masks being the most used. CONCLUSION: Although OI-bio are more reported in physiotherapists with formal contract, among informal ones they occur in younger people, with less experience and without COI registration, in addition to worse information registration and abandonment of developments, indicating greater vulnerability, especially in relation to social protection measures.

A prevalência de lesões musculoesqueléticas em funcionários de empresas de funilaria automotiva em Teresina-PI / The prevalence of musculoskeletal injuries in employees of automotive functional companies in Teresina-PI

Os distúrbios osteomusculares relacionados ao trabalho são um conjunto de afecções comumente ligadas ao trabalho e podem ocorrer de forma combinada ou não ao uso repetido e forçado de grupos musculares e à manutenção de posturas inadequadas. Sua incidência vem aumentando gradativamente a cada ano, devido à influência de diversos fatores. OBJETIVOS: Identificar a prevalência de lesões musculoesqueléticas em funcionários de empresas automotivas. METODOLOGIA: Este estudo foi do quantitativo e qualitativo. Participaram da pesquisa 23 voluntários, os quais foram analisados por meio de uma avaliação física e socioeconômica, além de ser aplicado o Questionário Nórdico de Sintomas Osteomusculares. Os participantes foram observados durante a execução de suas atividades no seu ambiente de trabalho, onde foram analisadas as manutenções e compensações posturais e os principais movimentos durante as atividades. RESULTADOS: O estudo evidenciou dentre os participantes predomínio do sexo masculino, foi apresentada a distribuição da amostra em relação a faixa etária, escolaridade, tempo de serviço, função que exerce, percepção de esforço, além de relatar a existência de dor durante e/ou após ao horário de trabalho. CONCLUSÃO: Os resultados apontaram para a região da coluna lombar como sendo a de maior intensidade de distúrbios musculoesqueléticos relacionados ao trabalho entre o grupo de trabalhadores pesquisados. Foi observado que não há uma relação linear entre sintomas osteomusculares, avaliação hemodinâmica, idade e tempo de serviço. Por outro lado, a baixa escolarização esteve associada com o aumento da probabilidade de diagnóstico.

Work-related musculoskeletal disorders are a set of common conditions that can affect the combined form or not use repeated and forced repeated and forced muscle groups and the maintenance of inappropriate postures. Its incidence gradually arrives each year, due to the influence of several factors. OBJECTIVES: To identify the prevalence of musculoskeletal injuries in employees of automotive companies. METHODOLOGY: This study was quantitative and qualitative. 23 volunteers participated in the research, which were analyzed by means of a physical and socioeconomic evaluation, in addition to being applied or the Nordic Musculoskeletal Questionnaire. Participants were observed during the performance of their activities in their work environment, where they were analyzed as postural maintenance and compensation and the main movements during activities. RESULTS: The study showed among the participants with a predominance of male gender, who received a distribution of the sample in relation to age group, education, length of service, functions they exercise, perception of effort, in addition to relating a variable of pain during and/or after working hours. CONCLUSION: The results pointed to a region of the lumbar spine as being the highest intensity of work-related skeletal muscle disorders among the group of workers surveyed. It was observed that there is no linear relationship between musculoskeletal symptoms, hemodynamic assessment, age and length of service. On the other hand, low schooling was associated with an increased probability of diagnosis.

Analysis of the severity of occupational injuries in the mining industry using a Bayesian network / 한국역학회지

OBJECTIVES: Occupational injuries are known to be the main adverse outcome of occupational accidents. The purpose of the current study was to identify control strategies to reduce the severity of occupational injuries in the mining industry using Bayesian network (BN) analysis. METHODS: The BN structure was created using a focus group technique. Data on 425 mining accidents was collected, and the required information was extracted. The expectation-maximization algorithm was used to estimate the conditional probability tables. Belief updating was used to determine which factors had the greatest effect on severity of accidents. RESULTS: Based on sensitivity analyses of the BN, training, type of accident, and activity type of workers were the most important factors influencing the severity of accidents. Of individual factors, workers’ experience had the strongest influence on the severity of accidents. CONCLUSIONS: Among the examined factors, safety training was the most important factor influencing the severity of accidents. Organizations may be able to reduce the severity of occupational injuries by holding safety training courses prepared based on the activity type of workers.

Analysis of the severity of occupational injuries in the mining industry using a Bayesian network / 한국역학회지

OBJECTIVES: Occupational injuries are known to be the main adverse outcome of occupational accidents. The purpose of the current study was to identify control strategies to reduce the severity of occupational injuries in the mining industry using Bayesian network (BN) analysis.METHODS: The BN structure was created using a focus group technique. Data on 425 mining accidents was collected, and the required information was extracted. The expectation-maximization algorithm was used to estimate the conditional probability tables. Belief updating was used to determine which factors had the greatest effect on severity of accidents.RESULTS: Based on sensitivity analyses of the BN, training, type of accident, and activity type of workers were the most important factors influencing the severity of accidents. Of individual factors, workers' experience had the strongest influence on the severity of accidents.CONCLUSIONS: Among the examined factors, safety training was the most important factor influencing the severity of accidents. Organizations may be able to reduce the severity of occupational injuries by holding safety training courses prepared based on the activity type of workers.

Spinal manipulation therapy: Is it all about the brain? A current review of the neurophysiological effects of manipulation / 中西医结合学报

Spinal manipulation has been an effective intervention for the management of various musculoskeletal disorders. However, the mechanisms underlying the pain modulatory effects of spinal manipulation remain elusive. Although both biomechanical and neurophysiological phenomena have been thought to play a role in the observed clinical effects of spinal manipulation, a growing number of recent studies have indicated peripheral, spinal and supraspinal mechanisms of manipulation and suggested that the improved clinical outcomes are largely of neurophysiological origin. In this article, we reviewed the relevance of various neurophysiological theories with respect to the findings of mechanistic studies that demonstrated neural responses following spinal manipulation. This article also discussed whether these neural responses are associated with the possible neurophysiological mechanisms of spinal manipulation. The body of literature reviewed herein suggested some clear neurophysiological changes following spinal manipulation, which include neural plastic changes, alteration in motor neuron excitability, increase in cortical drive and many more. However, the clinical relevance of these changes in relation to the mechanisms that underlie the effectiveness of spinal manipulation is still unclear. In addition, there were some major methodological flaws in many of the reviewed studies. Future mechanistic studies should have an appropriate study design and methodology and should plan for a long-term follow-up in order to determine the clinical significance of the neural responses evoked following spinal manipulation.

Assessment of physical violence against research assistants and nurses in an university hospital / Evaluación de la violencia física contra investigadores asociados y enfermeras en un hospital universitario / Avaliação da violência física contra assistentes de pesquisa e enfermeiros em um hospital universitário

Abstract: 14. The aim of this study was to determine the prevalence of physical violence and related factors among assistants and nurses. This cross-sectional study was included 166 research assistants and 209 nurses who worked at the University Hospital. The data was collected with a self-administered questionnaire. As 12.0% participants had a history of physical violence at workplace within the last 6 months. The perpetrator was a patient relative in 41 (78.8%) and the patient himself/herself in 18 (34.6%).The most common place of violence was emergency unit for the assistants and in-patient unit for the nurses. The emergency unit was observed to have a higher incidence of violence than other departments. One of every ten health care workers appears to be a victim of physical workplace violence. Between health care workers with patient/the relatives of the patient of the impact on relations the close of violence to be examined separately according to occupational groups. As a result, professional differences between nurses and doctors should be taken into consideration while investigating health violence. Each professions of healthcare have different professional practice and ethical obligations on the relationship between health care provider and patient /relatives.

Resumen: 18. El objetivo de este estudio consiste en determinar la prevalencia de la violencia física y otros factores relacionados contra investigadores asociados y enfermeras. Este estudio transversal incluyó 166 investigadores asociados y 209 enfermeras trabajadores del hospital universitario. Los datos fueron recolectados mediante un cuestionario autoadministrado. 12% de los participantes informaron de violencia física en su lugar de trabajo en los últimos seis meses. El perpetrador fue un familiar de un paciente en 41 de los casos (78,8%) y pacientes en 18 casos (34,6%). La unidad de emergencia fue el lugar más común donde ocurrió la violencia para los investigadores asociados y la unidad de pacientes para las enfermeras. Se observó que la unidad de emergencia tuvo una mayor incidencia de violencia que otras unidades. Uno de cada 10 trabajadores de la salud es víctima de violencia física en el trabajo. Se examinó separadamente, según grupos de trabajo, el impacto en las relaciones de la violencia contra trabajadores de la salud por parte de pacientes o familiares de estos. Como resultado, se aconseja tener en consideración diferencias profesionales entre médicos y enfermeras cuando se investiga la violencia en el cuidado de la salud. Cada profesión del cuidado de la salud tiene diferentes prácticas profesionales y obligaciones éticas entre el proveedor de salud y el paciente y familiares.

Resumo: 22. O objetivo deste estudo foi determinar a prevalência de violência física e fatores relacionados entre assistentes e enfermeiros/as. Este estudo transversal incluiu 166 assistentes de pesquisa e 209 enfermeiras que trabalhavam no Hospital Universitário. Os dados foram coletados através de um questionário autoaplicável. Como resultado, 12,0% participantes apresentaram um histórico de violência física no local de trabalho nos últimos 6 meses. Como autores da violência foram identificados: os familiares dos pacientes em 41 questionários (78,8%) e o paciente em si em 18 (34,6%). O local mais comum de violência foi a unidade de emergência para os assistentes de pesquisa e a unidade de internação hospitalar para os enfermeiros/as. Na unidade de emergência, observou-se que há uma maior incidência de violência do que em outros departamentos. Um de cada dez trabalhadores na área de saúde demonstra ser vítima de violência física no local de trabalho. O impacto das relações de violência entre profissionais de saúde e pacientes/familiares deve ser examinado separadamente, de acordo com cada grupo ocupacional. Como resultado, diferenças profissionais entre médicos e enfermeiros/as devem ser consideradas ao investigar violência na área da saúde. Cada profissional de saúde possui diferentes práticas profissionais e obrigações éticas na relação entre médico e paciente / familiares.

Internações hospitalares por acidentes relacionadas ao trabalho notificadas na Bahia / Hospitalizations work-related reported in the state of Bahia

Introdução: Os acidentes e as doenças relacionadas ao trabalho são evitáveis na maioria das vezes e compreendidos como fatos imprevistos e não propositais causadores de lesões e traumas com diferentes magnitudes e repercussões para o trabalhador. Objetivo: Descrever as características das internações hospitalares por acidentes relacionadas ao trabalho na Bahia. Material e Métodos: Estudo quantitativo, descritivo e de vigilância baseado nas notificações de internações hospitalares por acidentes de trabalho na Bahia, no período de 2014. Foram utilizados dados do Departamento de Informática do Sistema Único de Saúde (DATASUS), com base no Sistema de Informação Hospitalar (SIH). As variáveis foram às características sócio-demográficas, listas das causas (Classificação Internacional de Doença ­ CID 10) da internação, tempo de permanência e óbitos. Resultados: Verificou-se no estudo que os homens tiveram a maior frequência de internações relacionadas a acidentes de trabalho com 67,5%. Iniciativas de vigilância são necessárias devido ao perfil de internação, o qual destacou trabalhadores em faixa etária produtiva no mercado de trabalho entre 18 a 35 anos e adultos entre 36 a 59 anos, os quais apresentaram ambos, índices equivalentes a 39,6% cada. Foi observado que o perfil predominante foi devido a trauma na cabeça (30,9%). As notificações apontam a média de permanência entre 1 a 7 dias (93,8%). Do total de 1097 internados, 1,1% foram a óbito no ano de 2014. Conclusões: Apesar das subnotificações, os achados revelaram um expressivo número de internações hospitalares por acidentes de trabalho graves comparado aos acidentes de trabalho fatais. [AU]

Introduction: The occupational injuries (OI) and work related diseases known as unforeseen and unintentional facts are often avoidable. The OI and work related diseases can cause injuries and traumas with different magnitudes and repercussions for the worker. Objetive: to describe the characteristics of hospitalization due accidents workers-related in Bahia. Material e Methods: Quantitative, descriptive and vigilance study based on the notifications of hospitalization for occupational accidents in Bahia, during 2014. Data from the Information Technology Department of the Public Health Care System (DATASUS) were used, based on the Hospital Information System (SIH). The variables of interest used were: sociodemographic characteristics, list of causes (Internacional Classification of Diseases - ICD-10) of hospitalization, length of stay and deaths. Results: It was found in the study that male workers had the highest internment index by 67.5% due to occupational injuries. Surveillance initiatives are necessary due to the hospitalization profile, which highlighted workers in production phase in the labor market between 18 to 35 years old and also adults between 36 to 59 years old presented both, indices equivalent to 39.6% each. The predominant profile of the victims was due to head trauma (30.9%). The notifications indicate the hospital length of stay was around 1 to 7 days (93.8%). Only 1.1% of the total of 1097 admitted died in 2014. Conclusion: Despite the data are underreported, the findings revealed an impressive number of hospitalizations due to serious OI compared to fatal OI. [AU]

Prevalência e fatores associados aos acidentes de trabalho em uma indústria metalmecânica / Prevalence and factors associated with work accidents in a metal-mechanic company

Introdução: Os acidentes de trabalho vitimam mais de 700 mil trabalhadores anualmente no Brasil. Dos três setores econômicos o maior responsável pelos acidentes de trabalho no país é o industrial. Dentro desse setor, a indústria metalúrgica e a metalmecânica se destacam pela proporção de afastamentos decorrentes de acidentes e agravos relacionados ao trabalho. Objetivo: Analisar os riscos ocupacionais existentes e o perfil associado aos acidentes de trabalho ocorridos em uma indústria do setor metalmecânico no período 2007 a 2015. Métodos: Estudo transversal, realizado em indústria a partir das análises dos dados das comunicações de acidentes de trabalho (CAT) emitidas pela empresa. Resultados: O perfil sociodemográfico e ocupacional predominante dos acidentados na indústria estudada foi o trabalhador do sexo masculino, entre 18 e 29 anos, caucasiano, casado ou em união estável, com nível superior incompleto, soldador/montador e com menos de 5 anos de serviço. As lesões mais frequentes produzidas pelos acidentes ocorridos no período estudado foram: fraturas, luxações, distensões, contusões, escoriações, cortes e amputações; e os agentes causadores mais comuns foram peças de metal. As maiores taxas de acidentes de trabalho ocorreram nos anos de 2008 e 2012, anos associados a períodos de recessão econômica que atingiram o setor metalmecânico. Conclusão: Os registros de acidentes estudados, no qual predominaram os afastamentos por mais de 15 dias, para além da indicação de um setor com perfil de riscos de acidentes graves, podem expressar uma estratégia seletiva patronal, que optou pela omissão do registro dos acidentes de menor gravidade.

Background: Work accidents affect more than 700,000 workers in Brazil each year. Among the three economic sectors, industry is the one that contributes with most work accidents in the country. Metallurgical and metal-mechanic companies stand out within this sector as a function of the frequency of leaves resulting from work-related accidents and illnesses. Objective: To analyze the occupational profile and hazards associated with work accidents at a metal-mechanic company for the period from 2007 to 2015. Methods: Cross-sectional study that analyzed data available in work accident report forms issued by the employer. Results: The sociodemographic and occupational profile predominantly associated with work accidents at the investigated company included: male gender, age 18 to 29 years old, white people, married or in stable union, with incomplete higher education, welders/assemblers and less than 5 years of work at the company. The most frequent types of injuries caused by accidents were fractures, dislocations, strains, contusions, excoriations, cuts and amputations. The most common causative agents were metal parts. The highest accident rates corresponded to 2008 and 2012, in which years economic recession hit the metal-mechanic segment. Conclusion: In addition to pointing to an economic sector with a high-risk work accident profile, the analyzed work accidents ­ the predominant consequence of which was leave for more than 15 days ­ might express a selective strategy from the company, which chose not to record less serious accidents.

A systematic review of the effectiveness of interventions to reduce motor vehicle crashes and their injuries among the general and working populations / Revisión sistemática de la efectividad de las intervenciones para reducir las colisiones de vehículos de motor y lesiones Asociados Resultantes en la población general y la población económicamente activa / Revisão sistemática da efetividade de intervenções para reduzir os acidentes de trânsito e ferimentos na população geral e na população ativa

ABSTRACT Objective To summarize the best available international scientific evidence on the effectiveness of interventions to reduce motor vehicle collisions and their consequences among the working and general populations. Methods A broad and systematic review was conducted of the literature available in biomedical databases and grey literature. At least two investigators working in parallel performed data extraction, synthesis, and risk of bias analysis. Results Forty-one studies with low to moderate risk of bias were included. Of these, 18 had an ecological design (time series), 10 were quasi-experimental, one was a population survey, one was a randomized clinical trial, and 11 were systematic reviews. Conclusions The interventions that most consistently show a positive effect on incidence, morbidity, and mortality due to motor vehicle collisions are national policies or programs that: regulate, enforce, and penalize driving under the influence of alcohol; improve driving safety and driver conditions; improve road infrastructure with the purpose of preventing collisions; and educate and penalize drivers with a history of road violations.

RESUMEN Objetivo Resumir la mejor evidencia disponible a nivel internacional sobre la efectividad de las intervenciones para reducir el número de colisiones de vehículos de motor y sus consecuencias en la población general y la población económicamente activa. Métodos Revisión amplia y sistemática de la bibliografía contenida en las bases de datos biomédicas y la literatura gris. Al menos dos investigadores trabajando en paralelo realizaron la extracción de datos, la síntesis y el análisis del riesgo de sesgo. Resultados Se incluyeron 41 estudios con un riesgo de sesgo bajo o moderado. De ellos, 18 tenían un diseño ecológico (series de tiempo), 10 eran cuasiexperimentales, 1 era una encuesta poblacional, 1 era un ensayo clínico aleatorizado y 11 eran revisiones sistemáticas. Conclusiones Las intervenciones que muestran más sistemáticamente un efecto positivo sobre la incidencia, la morbilidad y la mortalidad por colisiones de vehículos de motor son las políticas o programas nacionales que reglamentan, hacen cumplir los reglamentos y sancionan a quienes conducen bajo los efectos del alcohol; mejoran la seguridad al conducir y con respecto a los conductores; mejoran la infraestructura vial a fin de prevenir las colisiones; y educan y sancionan a los conductores con antecedentes de infracciones de las leyes de tránsito.

RESUMO Objetivo Sintetizar as melhores evidências científicas internacionais disponíveis sobre a efetividade das intervenções para reduzir os acidentes de trânsito e suas consequências na população geral e na população ativa. Métodos Foi realizada uma ampla revisão sistemática da literatura em bases de dados biomédicas e da literatura cinzenta. A extração e a síntese dos dados e a análise de risco de viés foram conduzidas em paralelo por, pelo menos, dois pesquisadores. Resultados Foram selecionados para análise 41 estudos com risco de viés baixo a moderado. Destes, 18 possuíam design ecológico (série temporal), 10 eram estudos quase-experimentais, um estudo era um levantamento populacional, um era um estudo clínico randomizado e 11 eram revisões sistemáticas. Conclusões As intervenções que sistematicamente demonstraram um efeito positivo na incidência, morbidade e mortalidade de acidentes de trânsito são as políticas ou programas nacionais para regulamentar, cumprir as leis e aplicar sanções aos condutores que dirigem sob influência de álcool, melhorar a segurança e condições para condução de veículos, melhorar a infraestrutura viária visando evitar acidentes e educar e multar os condutores com histórico de infrações.

Prevalência da lombalgia ocupacional em costureiras da cidade de Toritama/PE / Prevalence of occupational low back pain in seamstress from the city of Toritama/PE

A lombalgia atinge até 84% da população brasileira, causa frequente de morbidade e incapacidade representando um alto índice de absenteísmo no trabalho. As costureiras se mantêm sentadas por longos períodos de tempo, o que pode gerar danos laborais irreversíveis a longo prazo. Devido à falta de conhecimento do setor têxtil em relação aos riscos e danos que a atividade laboral pode apresentar é de suma importância destacar a prevalência da lombalgia nas costureiras nesse setor. O objetivo deste estudo foi identificar a prevalência de lombalgia ocupacional em costureiras na cidade de Toritama/PE. Tratou-se de um estudo transversal e descritivo no qual cartas de anuência foram enviadas as empresas participantes. As costureiras que participaram da pesquisa assinaram o Termo de Consentimento Livre e Esclarecido e podiam a qualquer momento retirar seu consentimento. Foi aplicado o Quebec Back Pain Disability Questionnaire para avaliar o quanto a dor lombar pode afetar as Atividades de Vida Diária, e para avaliação da intensidade da dor foi aplicada a Escala Visual Analógica. Este estudo identificou que 55,4% das costureiras avaliadas apresentaram lombalgia associada a um nível médio de dor de 2,64, tomando como parâmetro uma escala que varia de 0 a 10. Concluiu-se, desta forma, que há uma alta prevalência de dor lombar na população estudada. (AU)

Low back pain affects up to 84% of the population, and is a frequent cause of morbidity and disability with high rate of absenteeism at work. The seamstresses remain seated for long periods of time, which can cause irreversible long-term damage labor. Due to lack of knowledge of the textile sector in relation to the risks and damage that the work activity can provide, is important to highlight the prevalence of low back pain in the seamstresses in the industry. The aim of this study was to identify the prevalence of occupational low back pain in seamstresses in the city of Toritama/PE. This was a descriptive study in which consent letters of the participating companies were sent. The seamstresses who participated signed the Informed Consent and could at any time withdraw their consent. It was applied Quebec Back Pain Disability Questionnaire to assess how low back pain can affect the Activities of Daily Living, and for evaluation of pain intensity was applied the Visual Analogue Scale. This study found that 55.4% of the evaluated seamstresses showed low back pain associated with a mean level of 2.64 pain using as a parameter a scale ranging from 0 to 10. It was concluded, therefore, that there is a high prevalence of pain back in the studied population. (AU)

Occupational hand injuries: a current review of the prevalence and proposed prevention strategies for physical therapists and similar healthcare professionals / 中西医结合学报

Hand injury is the second most common work-related musculoskeletal injury among physical therapists (PTs) and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. PTs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury.

Impacts of Return-to-Work Type and Period on Job Retention in Workers with Occupational Injuries and Diseases

BACKGROUND: Despite the necessity of job retention in achieving return-to-work (RTW) goals, many workers leave their jobs after returning to work. The objective of this study was to examine the impacts of RTW type and period on job retention in Korean workers with occupational injuries and diseases. METHODS: Data were derived from the Panel Study of Worker's Compensation Insurance, including data from 2,000 systemically sampled workers who had finished recuperation in 2012; three waves of survey data were included in the analyses. Workers who returned to work (n = 1,610) were included in the analysis of the relationship between RTW type and job retention, and 664 workers who returned to their original workplaces were included in the analysis of the relationship between RTW period and job retention. The participants completed a questionnaire, and administrative data were provided by workers' compensation insurance. RESULTS: A Cox proportional-hazards regression analysis showed an increased hazard ratio (HR) for non-retention of 2.66 (95% confidence interval, 2.11–3.35) in reemployed workers compared to that in workers returning to their original workplaces. Among workers returning to their original workplaces, HRs for non-retention were increased in workers with a RTW period of 13–24 months (3.03 [1.52–6.04]) and > 24 months (5.33 [2.14–13.25]) compared to workers with a RTW period of ≤ 3 months. CONCLUSION: RTW type and period were significantly related to job retention, suggesting that policies for promoting job retention rate should be implemented.

Isolated Complete Popliteus Tendon Rupture Following a Trivial Occupational Injury

@#Traumatic rupture of the popliteus tendon is a rare type of knee injury. Most reported cases had occurred in athletes or following high impact trauma. We report a case of a 23-year-old male with an isolated complete popliteus tendon rupture that was diagnosed arthroscopically. The patient worked as a general labourer in a sawmill. He fell at his workplace and presented with acute painful fixed flexion of the right knee. Initially he was suspected to have a meniscus tear. Diagnostic arthroscopy of the knee was carried out; and diagnosis of popliteal tendon rupture was established. The patient was subsequently managed conservatively by arthroscopic debridement. He was allowed to mobilize the knee as tolerated after the surgery. He was well with a full knee range of movement and was able to walk normally at six weeks after surgery. This article highlights the possibility of complete popliteus tendon rupture following a minor occupational injury in a previously normal knee.

Multifocal osteonecrosis secondary to occupational exposure to aluminum / Osteonecrose multifocal secundária à exposição ocupacional ao alumínio

ABSTRACT Multifocal osteonecrosis is a rare disease; chronic use of corticosteroids is considered the main risk factor. Patients with chronic renal failure can develop aluminum toxicity, which can lead to osteomalacia and encephalopathy. An association between osteonecrosis and aluminum toxicity has been reported among patients with dialytic renal insufficiency. Occupational exposure to aluminum rarely causes lung disease and no cases of bone lesions resulting from exposure to this metal have been reported. In this manuscript, we describe a novel case of a patient with multifocal osteonecrosis associated with chronic occupational exposure to aluminum. Level of Evidence IV, Case Report.

RESUMO A osteonecrose multifocal é uma doença rara. O uso crônico de corticoides é considerado seu principal fator de risco. Em pacientes com insuficiência renal crônica é descrita a intoxicação por alumínio, causando osteomalácia e encefalopatia. A relação entre osteonecrose e toxicidade pelo alumínio já foi relatada em estudos que envolveram pacientes com insuficiência renal dialítica. A exposição ocupacional ao alumínio pode, raramente, ocasionar doenças pulmonares. Não existem casos relatados de lesões ósseas decorrentes da exposição a esse metal. Descrevemos neste artigo, o relato inédito de um paciente com osteonecrose multifocal associada à exposição ocupacional crônica ao alumínio. Nível de Evidência IV, Relato de Caso.

Health, work, and development: agribusiness and accidents in a state in the Brazilian Amazon region / Saúde, trabalho e desenvolvimento: agronegócios e acidentes em um estado da região Amazônica

Abstract Introduction Mato Grosso is one of the Brazilian states with the highest agribusiness growth, which is accompanied by deforestation and an increase in occupational injuries. Objective To assess some factors associated with agribusiness-related severe occupational injuries in Mato Grosso. Method Occupational injury notifications were provided by the System of Information of Notifiable Injuries (SINAN). The production sectors, considered the dependent variables, were classified as forestry/wood industry, animal husbandry, and plant husbandry. Some sociodemographic, care, and type of injury-related variables were selected and considered the independent variables. We conducted a spatial analysis of the density of occupational injury. The associations were identified by calculating the proportion ratio (PR) by the chi-square test and considered significant when p-value < 0.05. Results and conclusion The highest rates of severe occupational injuries occurred in municipalities with intense plant and animal husbandry, and forestry/wood industry activities. In plant husbandry severe occupational injuries were more common in men, adults, non-whites, illiterates, and rural areas. However, in animal husbandry and forestry/wood industry, severe occupational injuries were more common in adults, and full recoveries were less frequent.

Resumo Introdução O Mato Grosso é um dos estados brasileiros com maior crescimento do agronegócio, acompanhado pelo desmatamento e pelo aumento da ocorrência de acidentes de trabalho. Objetivo Avaliar alguns fatores associados aos acidentes graves na agropecuária em Mato Grosso. Método As notificações de acidentes foram fornecidas pelo Sistema de Informação de Agravos de Notificação (SINAN). Os setores produtivos foram classificados em produção de madeira, pecuária e agricultura, e considerados como variáveis dependentes. Algumas variáveis sociodemográficas, de atendimento e de tipificação do acidente foram selecionadas e consideradas como independente. Realizou-se uma análise espacial de densidade das taxas de acidentes de trabalho. Identificaram-se as associações por meio do cálculo da razão de proporções (RP) pelo teste do qui-quadrado, considerando-se como resultados estatisticamente significantes aqueles com p-valor <0,05. Resultados e conclusão As maiores taxas de acidentes de trabalho graves ocorreram nos municípios de intensas atividades da agricultura, pecuária e exploração de madeira. Na agricultura, houve maiores proporções de acidentes graves entre homens, adultos, não brancos, analfabetos e na zona rural. Em relação à pecuária e à madeira, essa proporção foi maior entre os trabalhadores adultos e com menores taxas de cura.

Trauma Registry of the Pan-American Trauma Society: One year of experience in two hospitals in southwest Colombia / Registro de Trauma de la Sociedad Panamericana de Trauma: Un año de experiencia en dos hospitales en el suroccidente colombiano

Abstract Background: Trauma information systems are needed to improve decision making and to identify potential areas of intervention. Objective: To describe the first year of experience with a trauma registry in two referral centers in southwest Colombia. Methods: The study was performed in two referral centers in Cali. Patients with traumatic injuries seen between January 1 and December 31, 2012, were included. The collected information included demographics, mechanism of trauma, injury severity score (ISS), and mortality. A descriptive analysis was carried out. Results: A total of 17,431 patients were registered, of which 67.8% were male with an average age of 30 (±20) years. Workplace injuries were the cause of emergency consultations in 28.2% of cases, and falls were the most common mechanism of trauma (37.3%). Patients with an ISS ≥15 were mostly found in the 18-35-year age range (6.4%). Most patients who suffered a gunshot wound presented an ISS ≥15. A total of 2.5% of all patients died, whereas the mortality rate was 54% among patients with an ISS ≥15 and a gunshot wound. Conclusion: Once the trauma registry was successfully implemented in two institutions in Cali, the primary causes of admission were identified as falls and workplace injuries. The most severely compromised patients were in the population range between 18 and 35 years of age. The highest mortality was caused by gunshot wounds.

Resumen Introducción: Los sistemas de información en trauma son requeridos para mejorar la toma de decisiones e identificar potenciales áreas de intervención. Objetivo: Describir el primer año de experiencia del registro de trauma en dos centros de referencia de trauma del suroccidente Colombiano. Métodos: Estudio realizado en dos centros de referencia de Cali. Se incluyeron pacientes con trauma o lesiones externas entre el 1-Ene y el 31-Dic-2012. Se recolectó información demográfica, relacionada con mecanismos de trauma, severidad (ISS) y mortalidad. Se presenta un análisis descriptivo. Resultados: Se registraron 17,431 pacientes. El 67.8% de los pacientes eran de género masculino con edad promedio de 30 (±20) años. Las lesiones laborales fueron causa de consulta a urgencias en un 28.2%, y las caídas el mecanismo de trauma más frecuente (37.3%). Los pacientes con ISS ≥15 en su mayoría se encontraban en el rango de edad de 18-35 años (6.4%). El 28% de los pacientes que sufrieron lesión por arma de fuego presentaron un ISS ≥15. El 2.5% de los pacientes murieron y aquellos pacientes con ISS ≥15 y lesión por arma de fuego presentaron mortalidad del 54%. Conclusión: una vez se logró implementar el registro de trauma en dos instituciones en Cali, se identificó que la principal causa de ingreso fue secundaria a caídas y las lesiones laborales. Los pacientes más severamente comprometidos están en el rango de población entre 18 a 35 años. La mayor mortalidad se presentó secundario a lesiones de causa externa por arma de fuego.

Occupational accidents related to cattle slaughter in Mato Grosso, Brazil / Acidentes de trabalho relacionados ao abate de bovinos em Mato Grosso, Brasil

Resumo Introdução A criação de gado no sul da Amazônia tem crescido rapidamente, sendo que o Mato Grosso é um dos primeiros estados na produção de carne. Esse crescimento permitiu a contratação de mais trabalhadores para a atividade de refrigeração, trazendo um aumento de acidentes de trabalho nesse setor. Objetivo Analisar a influência de abate de gado nos acidentes de trabalho e sua distribuição espacial no estado de Mato Grosso, Brasil. Métodos Estudo ecológico que investigou a autocorrelação espacial global das taxas de acidentes de trabalho e o número de bovinos abatidos em municípios de Mato Grosso, usando a estatística Moran “global” pelo método LISA e, posteriormente, uma regressão múltipla espacial, tendo como variáveis de exposição o abate de cabeças de gado e, como variável resposta, a taxa de acidentes de trabalho. Resultados Foram encontrados padrões espaciais globais na distribuição do número de cabeças de gado abatidas. Na regressão múltipla, foram observadas correlações estatisticamente significantes entre o número de bovinos abatidos e a taxa de acidentes de trabalho. Conclusão O abate de gado está relacionado ao aumento do número de acidentes de trabalho no Estado de Mato Grosso, Brasil.

Abstract Introduction Cattle rising in the southern Amazon have grown rapidly, being Mato Grosso one of the top states in meat production. This growth led to the hiring of more workers to the chilling activity, increasing the number of workplace accidents in this sector. Objective To analyze the influence of slaughter cattle on occupational accidents and their spatial distribution in the state of Mato Grosso, Brazil. Methods This is the first ecological study investigating the global spatial autocorrelation of the occupational accident rate and the number of slaughtered cattle in Mato Grosso municipalities; this study used the statistic Moran “global” by LISA method and subsequently held a spatial linear regression, with cattle slaughter exposure variables and as an outcome it showed the rate of workplace accidents. Results The study showed a global spatial pattern of number of cattle slaughtered. Statistically significant correlations were observed, in multiple regression analysis, between the number of cattle slaughtered and rate of occupational accidents. Conclusion The cattle slaughter is related to the increase of industrial accidents in the State of Mato Grosso, Brazil.

Hospital Qualities Related to Return to Work from Occupational Injury after Controlling for Injury Severity as Well as Occupational Characteristics

We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2nd, 3rd, and 4th quartiles, respectively, compared to the 1st quartile. The RR (95% CI) in the 2nd, 3rd, and 4th quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1st quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.