Prevalência e fatores associados à hipertensão em trabalhadores do transporte coletivo urbano no Brasil / Prevalence and factors associated with hypertension in urban public transport workers in Brazil

Contexto: Os trabalhadores do transporte coletivo urbano têm grande importância social nas cidades. Estão expostos a condições de trabalho que causam adoecimento, ganhando destaque as doenças cardiovasculares. Objetivo: Caracterizar a produção científica sobre prevalência e fatores associados à hipertensão em trabalhadores do transporte coletivo urbano no Brasil. Métodos: Revisão integrativa realizada em abril e maio de 2016, nas bases de dados Scientific Eletronic Library Online e Literatura Latino-Americana e do Caribe em Ciências da Saúde, cujo acesso se deu por meio da Biblioteca Virtual em Saúde, com a utilização dos descritores: hipertensão; pressão arterial alta; doenças cardiovasculares; saúde do trabalhador; epidemiologia; fatores de risco; e da palavra-chave "motoristas de ônibus". Foram selecionados artigos publicados entre 2002 e 2016, em português, totalizando 13 trabalhos. Resultados: A maioria dos estudos era do tipo transversal, publicada em 2006, conduzida na Região Sudeste do Brasil. As prevalências da hiper-tensão variaram entre 5,7 e 49,2%. Os fatores associados encontrados foram: obesidade; problemas psiquiátricos menores; baixo consumo de sal; consumo de gordura animal; idade acima de 46 anos; e vibração no ônibus. Conclusão: A produção científica acerca do tema é restrita, reforçando a necessidade de aprofundamento no assunto. As prevalências encontradas, por vezes, foram alarmantes. Destacaram-se fatores associados relativos ao estilo de vida e trabalho, características do indivíduo e aqueles ligados diretamente ao posto de trabalho. Considerar a hipertensão como um fator ligado ao trabalho nessa classe ocupacional é importante, evidenciando a necessidade de instituir um programa permanente de melhoria da organização do trabalho para promover saúde.

Background: Urban public transport workers have major social relevance in cities. These workers are exposed to work conditions that cause illness, cardiovascular diseases in particular. Aim: To characterize the scientific literature on the prevalence of and factors associated with hypertension in urban public transport workers in Brazil. Methods: Integrative review conducted in April and May 2016 in databases Scientific Electronic Library Online and Latin American and Caribbean Health Sciences Literature, accessed via Virtual Health Library, using the following keywords: hypertension; high blood pressure; cardiovascular diseases; occupational health; epidemiology; risk factors; and "bus drivers" in Portuguese. Studies published in Portuguese from 2002 to 2016 were selected, resulting 13 articles. Results: Most of the studies had cross-sectional design, had been published in 2006 and conducted in the Southeastern region of Brazil. The prevalence of hypertension ranged from 5.7 to 49.2%. The associated factors found included: obesity; minor psychiatric disorders; low salt consumption; consumption of animal fat; age over 46 years old; and bus vibration. Conclusion: The scientific literature on the analyzed subject is scant, which reinforces the need for more thorough studies. The prevalence rates found were sometimes alarming. Lifestyle and individual work characteristics, as well as factors directly related to work stood out. Considering hypertension as a work-related factor is relevant for this class of workers, emphasizing the need to develop a permanent program for work organization improvement to promote their health.

Hospital-Wide Standardization of Warnings about Driving Motor Vehicles While Taking Drugs: An Example from Nagoya City East Medical Center (Part 2) / 医薬品情報学

<b>Objective: </b>When vehicular accidents occur as a result of impaired consciousness etc., because of adverse drug reactions, there is a risk that third parties may be harmed.  Till date, at Nagoya City East Medical Center (hereinafter, our hospital), the warnings about driving motor vehicles while taking drugs has varied depending on the doctor or pharmacist who provides the guidance.  Therefore, throughout our hospital, we aimed to standardize these warnings and to introduce measures to strictly enforce them.<br><b>Methods: </b>Among all the drugs used at our hospital, we identified those with warnings on the package insert about driving motor vehicles and classified them in accordance with “The Drug Administration Guidance Criteria Regarding the Driving of Vehicles,” created by our hospital on the basis of descriptions on the package insert and the level of risk of taking drugs.  We then standardized the warnings about driving motor vehicles while taking drugs, throughout our hospital.<br><b>Results: </b>Of the 1,416 drugs used at our hospital, we identified 294 (21%) with warnings about driving motor vehicles on the package insert, and more than half of these (158 drugs) had warnings about the prohibition of driving motor vehicles on the package insert.  As a result of classifying the drugs according to “The Drug Administration Guidance Criteria Regarding the Driving of Vehicles,” we identified 53 drugs with warnings about the prohibition of driving motor vehicles.  By the classification of the level of risk of taking drugs while driving motor vehicles and the hospital-wide standardization of the warnings about driving motor vehicles while taking drugs, we are now able to provide drug administration guidance in the form of warnings that are customized to the level of risk of using each drug.<br><b>Conclusion: </b>These measures have clarified the level of risk of taking each drug and warnings about driving motor vehicles while taking them.  In the future, we intend to cooperate with local pharmacies to intervene in the prescription of drugs outside well as inside hospitals.