The impact of remote work on worker's health O impacto do home office na saúde do trabalhador

Remote work was brought to the forefront with the arrival of the COVID-19 public health emergency. Although there is no evidence of a direct cause-and-effect relationship between venous disease and work, the current medical consensus is that work can severely intensify its progression. Here, we report the case of a worker at a financial institution, who had been working remotely for around one year and had stopped exercising regularly for the same period. In January 2021, he presented intense pain and marked edema in the soleus area of the right lower limb, which prompted a visit to the emergency department. Laboratory analyses showed slight increases in d-dimer (720 ng/mL) and C-reactive protein (5 mg/dL) levels. A venous Doppler ultrasound of the lower limbs revealed the presence of an occlusive thrombus in the right soleus veins, reaching the right popliteal vein with associated venous dilation. The diagnosis of right, popliteal-distal acute deep vein thrombosis was thus reached. It is clearly impossible to change some of the risk factors of chronic venous insufficiency;however, other aspects such as obesity and working conditions can be the object of preventive actions that generate changes. We thus highlight the importance and possibility of a multidisciplinary approach to this theme, which could evolve into the establishment of a protocol for the prevention and treatment of venous diseases according to each job position.

The impact of remote work on worker's health.

Remote work was brought to the forefront with the arrival of the COVID-19 public health emergency. Although there is no evidence of a direct cause-and-effect relationship between venous disease and work, the current medical consensus is that work can severely intensify its progression. Here, we report the case of a worker at a financial institution, who had been working remotely for around one year and had stopped exercising regularly for the same period. In January 2021, he presented intense pain and marked edema in the soleus area of the right lower limb, which prompted a visit to the emergency department. Laboratory analyses showed slight increases in d-dimer (720 ng/mL) and C-reactive protein (5 mg/dL) levels. A venous Doppler ultrasound of the lower limbs revealed the presence of an occlusive thrombus in the right soleus veins, reaching the right popliteal vein with associated venous dilation. The diagnosis of right, popliteal-distal acute deep vein thrombosis was thus reached. It is clearly impossible to change some of the risk factors of chronic venous insufficiency; however, other aspects such as obesity and working conditions can be the object of preventive actions that generate changes. We thus highlight the importance and possibility of a multidisciplinary approach to this theme, which could evolve into the establishment of a protocol for the prevention and treatment of venous diseases according to each job position.

O home office ganhou um papel de destaque com a chegada da emergência de saúde pública relativa à COVID-19. Embora não haja evidência da relação direta de causa e efeito de doença venosa com o trabalho, existe consenso atual, na opinião médica, de que o trabalho pode agravar seriamente o seu desenvolvimento. É relatado o caso de um profissional de instituição bancária, em teletrabalho há cerca de 1 ano, momento em que suspendeu também a prática de exercício físico. Em janeiro de 2021, iniciou quadro de dor intensa e edema acentuado na região solear do membro inferior direito, motivo pelo qual recorreu ao Serviço de Urgência. No estudo analítico, foram destacadas ligeiras elevações dos D-dímeros (720 ng/mL) e proteína C-reativa (5 mg/dL). A ecografia com estudo de Doppler venoso dos membros inferiores revelou presença de trombo oclusivo nas veias soleares direitas com extensão à veia poplítea direita com dilatação venosa associada. Admitiu-se, então, o diagnóstico de trombose venosa profunda poplíteo-distal direita de características agudas. É evidente que é impossível modificar alguns dos fatores de risco para a insuficiência venosa crônica; porém, outros fatores como obesidade e condições de trabalho podem ser alvo de ações preventivas que gerem modificações. Assim, ressaltam-se a importância e a possibilidade da abordagem multidisciplinar ao tema, o que poderia evoluir para o estabelecimento de um protocolo de prevenção e tratamento de doenças venosas em função do posto de trabalho executado.