Work-related asthma / Asma relacionada ao trabalho

ABSTRACT Work-related asthma (WRA) is highly prevalent in the adult population. WRA includes occupational asthma (OA), which is asthma caused by workplace exposures, and work-exacerbated asthma (WEA), also known as work-aggravated asthma, which is preexisting or concurrent asthma worsened by workplace conditions. In adults, the estimated prevalence of OA is 16.0%, whereas that of WEA is 21.5%. An increasing number of chemicals used in industrial production, households, and services are associated with the incidence of adult-onset asthma attributable to exposure to chemicals. This review article summarizes the different types of WRA and describes diagnostic procedures, treatment, prevention, and approaches to patient management. It is not always easy to distinguish between OA and WEA. It is important to establish a diagnosis (of sensitizer-/irritant-induced OA or WEA) in order to prevent worsening of symptoms, as well as to prevent other workers from being exposed, by providing early treatment and counseling on social security and work-related issues.

RESUMO A asma relacionada ao trabalho (ART) é um acometimento com elevada prevalência na população adulta. A ART inclui a asma ocupacional (AO), desencadeada pela exposição a um agente presente em um determinado ambiente de trabalho, e a asma agravada ou exacerbada pelo trabalho (AA/ET), que acomete indivíduos com antecedentes de asma ou que iniciaram um quadro de asma concomitante, mas sem relação causal com o ambiente de trabalho. Estima-se que 16,0% e 21,5% da asma no adulto sejam AO e AA/ET, respectivamente. O elevado e crescente número de substâncias químicas usadas na produção industrial, no uso domiciliar ou em serviços é responsável pela incidência de asma associada à exposição a agentes químicos na vida adulta. Este artigo de revisão descreve os principais tipos de ART, os procedimentos para seu diagnóstico, tratamento e prevenção e as condutas frente ao diagnóstico. Nem sempre é fácil a distinção entre AO e AA/ET. A importância do diagnóstico (AO ou AA/ET e asma induzida por sensibilizantes ou irritantes) tem relação com a adoção de medidas de prevenção para evitar que novos indivíduos sejam expostos e que os acometidos apresentem agravamento da doença, utilizando tratamento precoce e fornecendo orientação sobre aspectos previdenciários e trabalhistas.

Occupational stressors and work accidents among health workers / Estressores ocupacionais e acidentes de trabalho entre trabalhadores da saúde

ABSTRACT OBJECTIVE To test the association between occupational stressors and work accidents due to exposure to biological material (ATbio) in health workers, considering the isolated and combined analysis of the dimensions of two models, the demand-control model (DCM) and the effort-reward imbalance model (ERI). METHODS Cross-sectional study in a representative sample of workers with higher, technical and secondary education, including health agents from primary and medium-complexity care units in five cities in Bahia. Random sampling was selected, stratified by geographic area, level of service complexity and occupation. The outcome variable was ATbio; The main exposure was occupational stressors, assessed by the DCM and ERI. Incidences and relative risks were estimated as a function of the acute, short-term nature of the outcome of interest. Associations between ATbio and isolated and combined DCM and ERI dimensions were tested. RESULTS A total of 3,084 workers participated in the study. The global incidence of ATbio was 3.4% and was associated with high psychological demand, high effort and high commitment to work, adjusted for sex, age, education and work shift. High-strain work and a situation of imbalance between efforts and rewards were associated with ATbio. With the combination of the models, an increase in the measure of association with the outcome was observed. Significant associations of greater magnitude were observed in the complete combined models. ATbio's risk was 5.23 times higher among those exposed in both complete models compared to the absence of exposure in both models. CONCLUSIONS Occupational stressors were associated with ATbio. Advantages in using the combined models were observed. The approach of different psychosocial dimensions has expanded the ability to identify exposed groups, offering a solid basis for interventions for ATbio's prevention in health.

RESUMO OBJETIVO Testar associação entre estressores ocupacionais e acidentes de trabalho por exposição a material biológico (ATbio) em trabalhadores da saúde, considerando a análise isolada e combinada das dimensões de dois modelos, o modelo demanda-controle (MDC) e o modelo de desequilíbrio esforço-recompensa (ERI). MÉTODOS Estudo de corte transversal em amostra representativa de trabalhadores de nível superior, técnico, médio, incluindo agentes de saúde de unidades da atenção básica e média complexidade em cinco cidades da Bahia. Selecionou-se amostragem aleatória, estratificada por área geográfica, nível de complexidade do serviço e ocupação. A variável desfecho foi ATbio; a exposição principal foram os estressores ocupacionais, avaliados pelo MDC e ERI. As incidências e os riscos relativos foram estimados em função do caráter agudo, de curta duração, do desfecho de interesse. Testaram-se associações entre ATbio e as dimensões do MDC e ERI isolados e combinados. RESULTADOS Participaram do estudo 3.084 trabalhadores. A incidência global de ATbio foi de 3,4% e mostrou-se associada a alta demanda psicológica, alto esforço e alto comprometimento com o trabalho, com ajuste por sexo, idade, escolaridade e turno de trabalho. Trabalho de alta exigência e situação de desequilíbrio entre esforços e recompensas estavam associados aos ATbio. Com a combinação dos modelos, observou-se incremento da medida de associação com o desfecho. As associações significantes e de maior magnitude foram observadas nos modelos combinados completos. O risco de ATbio foi 5,23 vezes maior entre os expostos em ambos os modelos completos em comparação com a ausência de exposição nos dois modelos. CONCLUSÕES Estressores ocupacionais mostraram-se associados aos ATbio. Observaram-se vantagens no uso dos modelos combinados. A abordagem de diferentes dimensões psicossociais ampliou a capacidade de identificação de grupos expostos, oferecendo base sólida para intervenções de prevenção dos ATbio em saúde.

Traumas oculares no serviço de urgência da Fundação Banco de Olhos de Goiás / Ocular trauma in the emergency department of Goiás Eye Bank Foundation

OBJETIVO: Estudar e analisar os tipos de trauma ocular no serviço de urgência da Fundação Banco de Olhos de Goiás e orientar médicos generalistas quanto ao seu primeiro atendimento. MÉTODOS: Foram analisados 351 atendimentos no período de dezembro de 2010 a fevereiro de 2011, sendo que apenas nos casos de trauma ocular foram avaliados o sexo, idade, procedência, tipo de trauma e o tratamento realizado. RESULTADOS: Foi realizada uma análise de 351 atendimentos de urgência deste serviço, onde foi encontrado um total de 153 traumas oculares (43,6%), com predominância em 131 casos (85,6%) do sexo masculino. A faixa etária mais acometida foi a de adultos jovens de 20 a 39 anos, em 90 casos (58,8%). Goiânia foi a procedência mais frequente em 89 casos (58,2%). O trauma mecânico fechado por corpo estranho superficial foi o tipo de trauma mais comum com 95 casos (66,4%). O tratamento clínico foi amplamente mais predominante em 149 casos (97%). CONCLUSÃO: Em relação aos traumas oftalmológicos predominaram os pacientes com corpos estranhos superficiais do sexo masculino, na faixa etária economicamente ativa procedente de Goiânia, com tratamento clínico, e direta relação com acidentes ocupacionais, merecendo atenção especial quanto à prevenção.

PURPOSE: To study and analyze the types of ocular trauma in the emergency department of Goiás Eye Bank Foundation, Goiânia – Brazil and guide general physicians about the first medical contact. METHODS: An analysis was done in 351 visits between december, 2010 and february, 2011. The ocular trauma cases were evaluated by gender, age, origin, trauma type and treatment performed. RESULTS: Three hundred fifty-one emergency medical visits were analyzed and were found 153 ocular traumas (43.6%), showing predominance of 131 cases (85.6%) of men. The most frequent age was 20 to 39 year-old young male in 90 cases (58.8%). Goiânia was the most frequent origin with 89 (58.2%). The superficial foreign body mechanical trauma was the most common trauma type with 95 cases (66.4%). Clinical treatment was performed in 149 cases (97%). CONCLUSION: Concerning the ocular trauma, superficial foreign bodies predominated in males in working age coming from Goiânia treated clinically. There is a strong relationship with occupational accidents requiring special attention to prevention.

Influence of health education on cognition and behavior of occupational protection for nurses in op-eration room / 中国实用护理杂志

Objective To explore the influence of health education on the cognition and behavior of oc-cupational protection for nurses in operation room. Methods 85 nurses in operation rooms from 2 compre-hensive hospitals were selected with random clustering methods, baseline surveys and health education about the cognition and behavior of occupational protection were carded out in them. Results The awareness rate of occupational protection knowledge after health education was higher than that before it. The behavior of occupa-tional protection was better than that of before health education. Conclusions Health education can advance cognition and ability of occupational protection, then can prevent occupational risks effectively.

Investigation and analysis for occupational prevention status of clinical nurses / 中国实用护理杂志

Objective To understand the occupational prevention status of clinical nurses in Guangdong province.Methods We investigated 500 nurses in 15 class-three-grade-one hospitals in Guangdong province on occupational prevention status by questionnaires.Results The incidence of pricking wound and incised wound by ampule was frequent.The percent of everyday incidence reached 44.2% and 49.0%.There were 68.2% of nurses wore gloves when contacting the body fluid and blood of patients,55.3% of nurses wore gloves when contacting chemotherapeutic drugs,53.1% of nurses wore gloves during hemospasia,57.2% of them wore gloves when handling urine.There were 52.1% of nurses did not use gauze for protection when handling ampule.There were 61.3% nurses knew related protection law,18.2% of nurses knew the coping process after the incidence of occupational injury.58.2% of nurses established related preventive measure and instructions,43.1% of nurses thought it was necessry for hospitals to produce more comprehensive and systemic occupational prevention instructions.Conclusions The cognition of occupational prevention of nurses was weak and they lacked occupational prevention knowledge.It is necessary to strengthen the occupational prevention education and training.

Knowledge and Behavior among Nurses about AIDS:An Investigation and Intervention / 中华医院感染学杂志

85.0%),but they were lack of knowledge of special knowledge,41.1% of them knew AIDS diagnostic criteria,18.4% of them knew "window phase";the differences of nurse mastery of AIDS occupational prevention knowledge before and after the intervention were significant(P