Fortalecimento da Rede Nacional de Atenção Integral à Saúde do Trabalhador pela mobilização social: relato de experiência / Strengthening the National Network for Comprehensive Occupational Healthcare through social mobilization: an experience report

Resumo Introdução: a participação social é o pilar da implementação da Política Nacional de Saúde do Trabalhador e da Trabalhadora que estabelece as ações de atenção à Saúde do Trabalhador no Sistema Único de Saúde, a partir da Rede Nacional de Atenção Integral à Saúde do Trabalhador (Renast). Objetivo: descrever a parceria ensino-serviço para fortalecer a atenção à Saúde do Trabalhador em um município, em consonância com os princípios da Renast, a partir da formação e mobilização social em saúde. Métodos: trata-se de um relato do projeto de extensão desenvolvido por demanda da Comissão Intersetorial de Saúde do Trabalhador e da Trabalhadora municipal. Foram realizadas três oficinas de trabalho que utilizaram o diálogo em grupos de discussão como método para produção de conhecimento associado a estratégias de ensino-aprendizagem. Resultados: profissionais de saúde, estudantes, trabalhadores e representantes de entidades participaram das oficinas, que versavam sobre: organização da Renast; a epidemiologia e papel dos diversos atores para fortalecimento da Renast; a articulação intra e intersetorial da Renast, suas fragilidades e potencialidades; e a relevância de cada ator no sentido de mobilizá-los para mudança de suas realidades. Conclusão: as oficinas apresentaram-se como estratégia possível de formação e ponto de partida, visando à mobilização social para fortalecer a Renast.

Abstract Introduction: social participation is a cornerstone in implementing the National Policy for Occupational Heath, which establishes care actions for worker's health within the Unified Health System, based on the National Network for Comprehensive Occupational Healthcare (Renast). Objective: to describe the educational-service partnership aimed at strengthening occupational care in a municipality according to Renast principles by education and social mobilization in health. Methods: This experience report focuses on the outreach project developed to answer the demands of the municipal Intersectoral Commission on Occupational Health. Three workshops were conducted using discussion groups as a method for knowledge production associated with teaching and learning strategies. Results: health professionals, students, workers, and representatives of entities participated in the workshops, which addressed Renast organization; epidemiology and the role of various actors in strengthening Renast; Renast intra and intersectoral articulation, its weaknesses and potentialities; and the relevance of each actor in changing their realities. Conclusion: the workshops proved to be a feasible strategy for education and social mobilization aimed at strengthening Renast.

Instrumentos de gestão na pauta do Conselho de Saúde / Management instruments on the Health Council's agenda

Resumo Trata-se de um estudo de caráter analítico-descritivo, pautado em pesquisa documental sobre a apreciação de instrumentos orçamentários e de planejamento da saúde no Conselho Municipal de Saúde de um município de médio porte do interior do estado de São Paulo, entre março de 2018 e março de 2020. Os dados foram coletados a partir das atas das reuniões ordinárias e extraordinárias para, em seguida, realizar a análise temática na apreciação dos instrumentos e encaminhamentos, bem como a análise descritiva dos prazos previstos nos calendários de planejamento da saúde e orçamentário. A análise das apreciações reforça o caráter democrático nas apreciações do conselho, porém, com grandes limitações para o exercício do controle social, tendo em vista o atraso nos calendários orçamentário e de planejamento da saúde.

Abstract This analytical-descriptive study, based on documentary research regarding the assessment of budgeting and planning instruments in a Municipal Health Council of a medium-sized municipality in the interior of the state of São Paulo, in the period between March 2018 and March 2020. Data were collected from the official records of the ordinary and extraordinary meetings to, then carry out a thematic analysis assessing instruments and referrals, as well as the descriptive analysis of the deadlines predicted for the planning and budget calendars. The analysis of the assessments reinforces the democratic character of the council's assessments, but with major limitations for the exercise of social control, due to the delay in the health budget planning calendar.

Brazilian version of need for recovery scale: Assessment of structural validity, criterion validity, and internal consistency.

BACKGROUND: The Need For Recovery scale (NFR) is a tool that allows early identification of work-related health risks. However, the structure of the Brazilian version of NFR scale (Br-NFR) which contains 11 items has not been evaluated. OBJECTIVES: To evaluate the structural validity, criterion validity, and internal consistency of the Br-NFR scale in workers. METHODS: 672 workers were included in this study. A split-half validation method was applied to the sample to create a development and validation sample. The structure of the Br-NFR was examined through Exploratory Factor Analysis (EFA) using the development sample. The validation sample was used to evaluate the structure with Confirmatory Factor Analysis (CFA). For the latter, several goodness-of-fit indices were considered to evaluate the model fit of the structures tested in this study. Criterion validity was assessed between the Brazilian structure and structures found in the literature compared with the original scale through intraclass correlation coefficient (ICC2,1). The internal consistency of the Br-NFR was assessed using Cronbach's alpha. Both analyses used the validation sample. RESULTS: The EFA showed that the scale has a one-factor structure and the CFA demonstrated that the Br-NFR structure with 7 items presented excellent to acceptable goodness-of-fit indices. Excellent values of ICC were found between the structures tested in the study and the original 11-item structure of the NFR. The Br-NFR scale presented good internal consistency. CONCLUSION: The Br-NFR is unidimensional. The final 7-item version presented to be equivalent to the original 11-item scale and also has good internal consistency.

Correlação entre a postura em pé durante o trabalho e dor na coluna lombar e nos membros inferiores em trabalhadoras da limpeza e cuidadoras de idosos / Correlación entre la postura de trabajo de pie y el dolor en la columna lumbar y los miembros inferiores en trabajadores de limpieza y cuidadores de ancianos / Correlation between standing posture during work and low back and lower limb pain among cleaners and caregivers of older adults

RESUMO A postura em pé durante o trabalho tem sido associada a sintomas musculoesqueléticos. Entretanto, há poucos estudos que avaliam o tempo em pé utilizando medidas objetivas. Assim, o objetivo deste estudo foi verificar se o tempo em pé no trabalho está associado com dor na coluna lombar e nos membros inferiores nos últimos sete dias e 12 meses em cuidadoras de idosos e trabalhadoras da limpeza. Trata-se de estudo transversal, em que o tempo em pé no trabalho foi quantificado por meio de inclinômetros fixados na coxa e na coluna vertebral, e os sintomas musculoesqueléticos foram avaliados por meio do Questionário Nórdico de Sintomas Osteomusculares. Os dados foram analisados por meio da correlação ponto bisserial (rpb) entre o tempo em pé no trabalho e a presença de sintomas musculoesqueléticos. As análises foram realizadas por meio do software SPSS e o nível de significância adotado foi de 5%. Verificou-se que as trabalhadoras passam a maior parte do tempo em pé paradas (41,3%) ou andando (39,3%). Houve correlação positiva entre a presença de sintoma na lombar e o tempo em pé (rpb=0,52; p<0,05) e correlação negativa entre o tempo andando e sintomas no quadril (rpb=−0,53; p<0,05) nos últimos 12 meses e o tempo correndo e sintomas no quadril (rpb=−0,43; p<0,05) e na coluna lombar (rpb=−0,43; p<0,05) nos últimos sete dias. O maior tempo em pé foi correlacionado com a presença de sintomas na lombar; enquanto o menor tempo andando e correndo foram correlacionados com a presença de sintomas no quadril e na coluna lombar.

RESUMEN La postura de trabajo de pie está asociada con síntomas musculoesqueléticos. Sin embargo, hay pocos estudios que evalúan el tiempo prolongado en esta postura utilizando medidas objetivas. Por esto, el objetivo de este estudio fue verificar si el tiempo prolongado al trabajar de pie está asociado al dolor en la columna lumbar y en los miembros inferiores de los cuidadores de ancianos y los trabajadores de limpieza entre los últimos siete días y 12 meses de trabajo. Se trata de un estudio transversal, en el que se cuantificó el tiempo prolongado en el trabajo de pie por medio de inclinómetros fijados en el muslo y la columna vertebral, y los síntomas musculoesqueléticos fueron evaluados por el Cuestionario Nórdico de Síntomas Musculoesqueléticos. Para el análisis de datos se utilizó la correlación biserial puntual (rpb) entre el tiempo prolongado en el trabajo de pie y la presencia de síntomas musculoesqueléticos. Los análisis se realizaron con el software SPSS, y se adoptó el nivel de significación del 5%. Se constató que las trabajadoras pasaban la mayor parte del tiempo paradas (41,3%) o caminando (39,3%). Hubo una correlación positiva entre la presencia de síntomas en la región lumbar y el tiempo prolongado de pie (rpb=0,52; p<0,05) y una correlación negativa entre el tiempo al caminar y los síntomas en la cadera (rpb=−0,53; p<0,05) en los últimos 12 meses, y el tiempo al correr y los síntomas en la cadera (rpb=−0,43; p<0,05) y en la columna lumbar (rpb=−0,43; p<0,05) en los últimos siete días. El mayor tiempo prolongado de pie se correlacionó con la presencia de síntomas en la región lumbar, mientras que el menor tiempo al caminar y correr se correlacionó con la presencia de síntomas en la cadera y columna lumbar.

ABSTRACT Maintaining a standing posture during work has been associated with musculoskeletal symptoms. Few studies, however, assess the standing time using objective measures. Thus, this study aimed to verify whether standing time at work is associated with lower back and lower limb pain in the last seven days and last 12 months in caregivers of older adults and cleaners. This is a cross-sectional study. Standing time at work was quantified using inclinometers attached to the workers' thigh and spine. Musculoskeletal symptoms were assessed using the Nordic Musculoskeletal Questionnaire. Data were analyzed using the point-biserial correlation coefficient (rpb) between standing time at work and the presence of musculoskeletal symptoms. The analyses were performed using the SPSS software, adopting 5% significance level. Workers spend most of their time standing still (41.3%) or walking (39.3%). The presence of symptoms in the lower back was positively correlated with standing time (rpb=0.52; p<0.05). Walking time was negatively correlated with symptoms at the hip in the last 12 months (rpb=−0.53; p<0.05) and running time with symptoms at the hip, in the last seven days, (rpb=−0.43; p<0.05) and the lower back (rpb=−0.43; p<0.05). Longer standing time was correlated with the presence of symptoms in the lower back. Meanwhile, less time walking and running were correlated with the presence of musculoskeletal symptoms in the hips and lower back.

Usefulness of the Rapid Office Strain Assessment (ROSA) tool in detecting differences before and after an ergonomics intervention.

BACKGROUND: Most ergonomics studies on office workstations evaluate the effects of an intervention only by subjective measures such as musculoskeletal pain and discomfort. Limited evidence has been provided regarding risk factor reduction in office environments through standardized methods assessments. The Rapid Office Strain Assessment (ROSA) tool can provide an estimation of risk factor exposure for office workers as a means by which the outcome of interventions can be quantified. PURPOSE: The aim of the study was to evaluate if ROSA scores reflect changes in risk factors after an ergonomics intervention among office workers. METHODS: Office workers (n = 60) were divided into two groups. The experimental group received a workstation intervention and the control group received no intervention. Changes in ROSA scores were compared before and after the intervention in both groups. RESULTS: Statistically significant reductions in the ROSA final and section scores occurred after the intervention in the experimental group with (mean reduction of 2.9, 0.8 and 1.6 points for sections A, B and C, respectively). In contrast, no differences were detected in the control group (mean increase of 0.1 point for sections A and C and mean reduction of 0.1 point for Section B). CONCLUSIONS: These findings show that ROSA scores reflect changes in risk factors after an ergonomics intervention in an office environment. Consequently, this tool can be used for identifying and controlling risk factors among computer workers, before and after interventions.

Effects of workstation adjustment to reduce postural exposure and perceived discomfort among office workers - A cluster randomized controlled trial.

This study aimed to evaluate the effects of workstation adjustment to reduce postural exposure and perceived discomfort among office workers in a cluster randomized controlled trial. Experimental (EG, n = 31) and control groups (CG, n = 30) were compared before (pre-intervention), immediately (post-intervention), and 3 months after (follow up) the intervention. EG received workstation adjustments and CG did not received the intervention. Postural exposure of head, upper back and upper arms was objectively measured by inclinometers. Overall level of perceived discomfort for the whole body was evaluated using a visual analogue scale (0-100 mm). EG showed a statistically significant reduction on the head (pre: 10.1°, SD 5.7°; post: 6.6°, SD 4.7°) and upper back flexion (pre: 15.4°, SD 10.7°; post: 10.4°, SD 8.4°) from pre to post-intervention. EG also showed a statistically significant reduction from pre (50.7°, SD 9.5°) to post-intervention (42.1°, SD 7.6°) and from pre to follow up (41.6°, SD 6.5°) on upper arm elevation. CG did not show any difference between evaluations. Perceived discomfort increased 7.2 (SD 2.0) mm in CG and decreased 22.1 (SD 2.2) mm in EG between pre and post intervention. The variation between pre intervention and follow up was 4.5 (SD 1.2) mm increase for the CG and 24.1 (SD 1.5) mm of reduction for the EG (P < 0.01). There was no significant difference for the post intervention and follow up for both groups (P > 0.05). The results show evidence of the workstation adjustment to reduce postural exposure and perceived discomfort among office workers.

Cross-cultural adaptation and psychometric properties of the short version of COPSOQ II-Brazil.

OBJECTIVES: Translate and culturally adapt the short version of Copenhagen Psychosocial Questionnaire II (COPSOQ II) into Brazilian Portuguese (COPSOQ II-Br) and evaluate its psychometric properties. METHODS: Translation and cultural adaptation followed the standardized guidelines. Structural validity was assessed using exploratory factorial analysis. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC3,1) and internal consistency by Cronbach's alpha. Floor and ceiling effect was considered acceptable if less than 15% of participants reported the lowest or highest scores. Measurement error was assessed by standard error of measurement (SEM), while construct validity was tested by correlating the COPSOQ II-Br, the Job Content Questionnaire and the Nordic Musculoskeletal Questionnaire. RESULTS: The study evaluated a total of 211 civil servants and service providers in the test and 157 in the retest. After cross-cultural adaptation, the COPSOQ II-Br structure comprised seven domains and 11 dimensions. Most dimensions showed acceptable floor and ceiling effects, excepting "Work family conflicts" (floor effect of 26.1%), and "Meaning and commitment" and "Job satisfaction," with ceiling floor of 27.5% and 22.3%, respectively. Cronbach's alpha values reached the recommended levels (varied between 0.70 and 0.87). Test-retest reliability indicated that all dimensions had ICC between 0.71 and 0.81. SEM ranged from 0.6 to 2.2 and the construct validity showed good results with the tested instruments (significant positive and negative correlations). CONCLUSIONS: All psychometric properties of the short version COPSOQ II-Br are suitable for use in Brazil. The instrument is thus validated and can be used by occupational health and human resources professionals to evaluate psychosocial working conditions.

Comparison of two methods of sorting recyclable materials on posture among trash sorters in Brazil: a cross-sectional study.

Objective. The aim of the present study was to compare postural exposure between two methods of sorting recyclable materials: manual sorting on a fixed work surface and the use of conveyor belts. Materials and methods. Postures and movements of the head, upper back and upper arms were recorded during 2 h among 40 workers using inclinometers. Sociodemographic variables were collected with the aid of a standardized questionnaire and musculoskeletal symptoms were evaluated using the Nordic musculoskeletal questionnaire. Results. The angular velocity of the head, upper back and upper arms was significantly higher when sorting on a fixed work surface compared to the conveyor belt method. Upper arm elevation was also higher on the fixed work surface. Conclusion. The conveyor belt method showed lower angular velocities during the manual sorting of recyclable materials compared to a fixed work surface.

Cross-cultural adaptation and psychometric properties of the short version of COPSOQ II-Brazil

ABSTRACT OBJECTIVES Translate and culturally adapt the short version of Copenhagen Psychosocial Questionnaire II (COPSOQ II) into Brazilian Portuguese (COPSOQ II-Br) and evaluate its psychometric properties. METHODS Translation and cultural adaptation followed the standardized guidelines. Structural validity was assessed using exploratory factorial analysis. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC3,1) and internal consistency by Cronbach's alpha. Floor and ceiling effect was considered acceptable if less than 15% of participants reported the lowest or highest scores. Measurement error was assessed by standard error of measurement (SEM), while construct validity was tested by correlating the COPSOQ II-Br, the Job Content Questionnaire and the Nordic Musculoskeletal Questionnaire. RESULTS The study evaluated a total of 211 civil servants and service providers in the test and 157 in the retest. After cross-cultural adaptation, the COPSOQ II-Br structure comprised seven domains and 11 dimensions. Most dimensions showed acceptable floor and ceiling effects, excepting "Work family conflicts" (floor effect of 26.1%), and "Meaning and commitment" and "Job satisfaction," with ceiling floor of 27.5% and 22.3%, respectively. Cronbach's alpha values reached the recommended levels (varied between 0.70 and 0.87). Test-retest reliability indicated that all dimensions had ICC between 0.71 and 0.81. SEM ranged from 0.6 to 2.2 and the construct validity showed good results with the tested instruments (significant positive and negative correlations). CONCLUSIONS All psychometric properties of the short version COPSOQ II-Br are suitable for use in Brazil. The instrument is thus validated and can be used by occupational health and human resources professionals to evaluate psychosocial working conditions.

Fisioterapia em cuidados paliativos no contexto da atenção primária à saúde: ensaio teórico / Physiotherapy palliative care in primary health care: theoretical essay

Resumo Introdução Com a revisão de diretrizes para a organização da Atenção Básica em 2017, os cuidados paliativos (CP) foram incluídos na relação de serviços a ser prestados pelas equipes de Atenção Primária à Saúde (APS). Objetivo Este artigo visa tecer reflexões acerca da atuação da Fisioterapia em CP no contexto da APS, a partir de fundamentos, princípios e diretrizes que sustentam esse cuidado. Método O percurso teórico reflexivo aqui delineado sobre a atuação da Fisioterapia em CP no contexto da APS pauta-se em revisão de literatura científica, diretrizes da APS e documentos nacionais e internacionais de CP. Resultados Verifica-se que tensionamentos práticos existentes estão vinculados à ausência da temática CP na grade curricular dos cursos de graduação em Fisioterapia e a aspectos organizacionais dos processos de trabalho na APS. Conclusão Para atuação qualificada, há necessidade de integração das perspectivas e da filosofia dos CP em sua totalidade e em consonância com as diretrizes de atuação na APS durante a formação profissional do fisioterapeuta, com a necessidade também de investimentos no desenvolvimento de pesquisas nesse cenário.

Abstract Background The revision version of the National Primary Care Policy in 2017 included the Palliative Care (PC) among the services provided by Primary Health Care (PHC). Objective To produce a theoretical-reflexive essay about Physical Therapy in Palliative Care in PHC, considering the barriers to this approach. Method The theoretical reflective course outlined in the present study, regarding the Physical Therapy practice in Palliative Care in the context of PHC, is based on a review of the scientific literature, guidelines of the PHC, and national and international palliative care documents. Results The existing practitioner tensions may be related to the absence of the Palliative Care theme in the curricular curriculum of undergraduate courses in Physical Therapy, and to the organizational aspects of the work process in PHC. Conclusion In order to offer PC by physical therapists in PHC, it might be considered: a) the totality of perspectives and philosophy of CP in accordance with the guidelines of action in PHC among undergraduate phase, and b) the development of researches in this field of action in order to adapt the work process to guarantee integral care.

Effects of work surface and task difficulty on neck-shoulder posture and trapezius activity during a simulated mouse task.

OBJECTIVES: The purpose of this study is to evaluate the influence of the work surface and task difficulty on the head, upper back and upper arm postures and activity of the descending trapezius during a simulated mouse task. METHODS: Healthy female university students (N = 15) were evaluated. The work surface was positioned at elbow height (EH) and above elbow height (AEH) and the task difficulty was set at low (LD) and high (HD) levels. The postures were recorded by inclinometers. Trapezius activity was normalized by the maximum voluntary isometric contraction (MVIC). RESULTS: Significantly higher head flexion was found at EH compared to the AEH condition, with an average difference of 2°-5° at the same difficulty level. The HD task significantly increased head (3°-6°) and upper back flexion (6°-7°) at the same table height. For upper arm elevation and trapezius activation, the AEH condition presented higher upper arm elevation (about 6°-8°) and trapezius activity (0.8-1.4% of MVIC), regardless of the difficulty level of the task. CONCLUSIONS: Head posture was influenced by the table height and task difficulty; the upper back posture by high difficulty; and upper arm posture and trapezius activity were only influenced by table height.

Can a self-administered questionnaire identify workers with chronic or recurring low back pain?

To verify if the Nordic Musculoskeletal Questionnaire (NMQ), Visual Analogue Scale (VAS), Roland-Morris Disability Questionnaire (RDQ) and physical examination of the lumbar spine can identify workers with chronic or recurring low back pain, using health history for reference. Fifty office workers of both sexes, aged between 19 and 55 yr, were evaluated using a standardized physical examination and the NMQ, VAS and RDQ. Discriminant analysis was performed to determine the discriminant properties of these instruments. A higher success rate (94%) was observed in the model including only the NMQ and in the model including the NMQ and the physical examination. The lowest success rate (82%) was observed in the model including the NMQ, RDQ and VAS. The NMQ was able to detect subjects with chronic or recurring low back pain with 100% sensitivity and 88% specificity. The NMQ appears to be the best instrument for identifying subjects with chronic or recurring low back pain. Thus, this self-reported questionnaire is suitable for screening workers for chronic or recurring low back pain in occupational settings.

Avaliação de diferentes parâmetros para interpretar a necessidade de descanso em ergonomia / Assessment of parameters to interpret the need for recovery in ergonomics: the need for recovery scale

INTRODUÇÃO: A Escala de Necessidade de Descanso (Enede) tem sido amplamente utilizada na ergonomia. No entanto, não há ponto de corte validado na literatura que permita identificar de forma consensual altos níveis de necessidade de descanso. OBJETIVO: Comparar a utilização de diferentes parâmetros matemáticos para interpretação dos dados da Enede, sendo eles tercil, quartil e média, assim como pontos de corte já sugeridos pela literatura, no sentido de investigar o comportamento desses parâmetros na identificação de altos níveis de necessidade de descanso. MATERIAIS E MÉTODOS: Participaram do estudo 679 trabalhadores, sendo 192 trabalhadores da indústria, 128 profissionais de enfermagem e 359 operadores de teleatendimento. A coleta de dados foi realizada pela aplicação de questionários. RESULTADOS: A distribuição dos resultados variou consideravelmente entre os grupos. As separatrizes definidas com base na distribuição dos dados (tercil e quartil) apresentaram valores semelhantes a alguns pontos de corte descritos na literatura. Os diferentes pontos de corte propostos pela literatura não identificaram quantidades similares de trabalhadores com altos níveis de necessidade de descanso. A distribuição não normal de duas das populações mostrou que a média pode não ser um parâmetro adequado. DISCUSSÃO E CONCLUSÕES: Os diferentes parâmetros matemáticos utilizados para identificar altos níveis de necessidade de descanso não conduziram a resultados equivalentes, sugerindo cautela na sua seleção. Até que estudos com maiores populações estejam disponíveis, a utilização da própria distribuição dos dados de um grupo é mais recomendada que a utilização de pontos fixos para identificar altos níveis de necessidade de descanso.

INTRODUCTION: The Need for Recovery Scale (NFR) has been widely used in Ergonomic studies. However, there is no consensual cutoff point in the literature to identify high levels of need for recovery. OBJECTIVE: To compare the results from different mathematical parameters used to interpret the levels of need for recovery, among them, tertile, quartile and mean, as well as the cutoff values already suggested in the available literature in order to investigate how these parameters will identify high levels of need for recovery. MATERIALS AND METHODS: A total sample of 679 workers participated in this study. Of this total, N = 192 were industrial workers, N = 128 nursing professionals and N = 359 call-center operators. Data collection was performed by means of questionnaires. RESULTS: The data distribution varied widely between groups. The cutoff points determined considering data distribution (tertile and quartile) presented similar values to few of cutoff points proposed by the literature. Divergent number of workers with high levels of need for recovery was identified using the different values of cutoff points proposed by the literature. The non-normal distribution of two worker groups indicated that the mean may not be an adequate parameter for all populations. DISCUSSION AND CONCLUSIONS: The mathematical parameters used to identify high levels of need for recovery led to different results, suggesting caution when selecting a method of evaluation. Inasmuch results from larger studies are not available, the use of the own data distribution parameters for each group is recommended instead of cutoff points already available in the literature.

Occupational posture exposure among construction electricians.

The aim of this study is to record, objectively describe and compare working postures of Brazilian and Norwegian construction electricians. Postures of the upper arms, head, and neck during work and breaks were quantified by means of inclinometry for a representative sample of 12 Brazilian and 12 Norwegian electricians in the construction industry during a full work-shift. Despite that differences were found between specific work-related factors, Brazilian and Norwegian workers revealed a high and very similar level and pattern of postures for all evaluated body regions, suggesting that results could be extrapolated to other electricians. Upper arm elevation was high and similar for both groups and head flexion and extension was pronounced compared to other occupations. Thus, extreme postures were identified for construction electricians in both countries, with similar exposure pattern also for defined tasks (planning, support and wiredraw), suggesting that this job is risky regardless organizational differences.

Are posture data from simulated tasks representative of field conditions? Case study for overhead electric utility workers.

Many ergonomics studies are conducted in laboratory-simulated work environments to assess risks for the development of musculoskeletal disorders under more controlled conditions. However, the simulated conditions could be of questionable validity with respect to reproduction of field conditions involving risk factors. The objective of this study was to verify whether the postures recorded for neck extension/flexion and upper arm elevation of overhead electric utility workers in a simulated environment were similar to those recorded in a field environment. Of the three frequently performed tasks analysed, two presented similar exposure in both conditions. However, differences were identified for a more complex task (relay replacement). These results suggest that simulated tasks may be more representative for more standardised tasks. This may indicate that researchers investigating risks should avoid simplifying complex tasks when reproducing field posture exposure in laboratories, since omitting extra subtasks may lead to an inaccurate reproduction of field exposure. Practitioner Summary: Studies comparing results from field and simulated environments are necessary to evaluate to what degree postural exposure reproduced in laboratory is representative of the exposure occurring in real work situations. This is particularly relevant for tasks involving training in simulated environment due to safety constraints.

Furniture dimensions and postural overload for schoolchildren's head, upper back and upper limbs.

The aim of this study was to evaluate how the fixed furniture dimensions match with students' anthropometry and to describe head, upper back and upper limbs postures and movements. Evaluation was performed in 48 students from a Brazilian state school. Furniture dimensions were measured with metric tape, movements and postures by inclinometers (Logger Tecknologi, Åkarp, Sweden). Seat height was high for 21% and low for 36% of the students; seat length was short for 45% and long for 9% and table height was high for 53% and low for 28%. Regression analysis showed that seat/popliteal height quotient is explained by 90th percentile of upper back inclination (ß=0.410) and 90th percentile of right upper arm elevation (ß=-0.293). For seat/thigh length quotient the significant variables were 90th percentile of upper back velocity (ß=-0.282) and 90th percentile of right upper arm elevation (ß=0.410). This study showed a relationship between furniture mismatch and postural overload. When the seat height is low students increase upper back left inclination and right upper arm elevation; when the seat is short students decrease the upper back flexion velocity and increase right upper arm elevation.

Need for recovery assessment among nursing professionals and call center operators.

The present study descriptively compares the need for recovery (NFR) among 128 nursing professionals (nurses) and 223 call center operators according cutoff points in the literature (45 and 50) and by means of statistical tests, and verifies the association between NFR scores and the presence of musculoskeletal symptoms. NFR was evaluated with the Need for Recovery Scale and musculoskeletal symptoms were evaluated with the Nordic Musculoskeletal Questionnaire. At a 45 point cutoff, 22% of the call-center workers and 33% of the nurses were classified as fatigued; at a 50 point cutoff, 13% of the call center operators and 27% of the nurses were classified as fatigued. The nurses had higher fatigue levels than the call center workers (p=0.015). Significant correlations were found between NFR scores and musculoskeletal symptoms reported during the previous 12 months (r=0.299, p<0.001) and 7 days (r=0.314, p<0.001). Regarding cutoff points and statistical tests, the NFR scale identified higher fatigue levels among the nurses and was demonstrated to be a useful tool for evaluating worker well-being.

Biomechanical analysis of loading/unloading a ladder on a truck.

Loading/unloading a ladder on vehicles are frequent tasks and involve overhead handling that may expose workers to risk factors of shoulder musculoskeletal disorders. The objective of the present study was to evaluate posture, forces required and perceived exertion when loading and unloading the ladder on a utility truck. Thirteen male overhead line workers from an electric utility in Brazil participated in this study. Shoulder elevation angle was measured using inclinometers. The required force to load/unload the ladder was measured by dynamometer. Subjective assessment of the perceived exertion was recorded to compare the exertion reported during the test conditions to the field conditions. The task of loading/unloading the ladder presented risks of shoulder musculoskeletal disorders (MSDs) to workers because it requires high levels of force (approximately 60% of the maximal force) combined with overhead posture of the shoulders (more than 100° from the neutral posture). Age and height presented to interfere in biomechanical risks presented in load/unload task. There was no significant difference between the subjective exertion during the test conditions and handling the ladder in the field. Ergonomic intervention is recommended to reduce these risks for shoulder MSDs.

Postures and movements in the most common tasks of power line workers.

The repair and maintenance of electrical power lines involves awkward postures, which are known risk factors for developing musculoskeletal disorders. The aim of the present study was to quantify postures and movements of upper arm, head, upper back and neck in the main tasks performed by line workers. Posture of twelve right-handed line workers was recorded by inclinometry and presented as percentiles of angular and angular velocity distributions. All tasks involved considerable upper-arm elevation, ranging from 73° to 115° for the 90th percentile. Upper-arm elevation showed significant differences between tasks, but no consistent differences between right and left sides. Regarding velocity, the right arm presented higher levels than the left arm. All tasks required significant extension of head, upper back and neck, ranging from 7° to 67° for head (10th percentile). All tasks, except the one performed with a continuous extension, also involved pronounced flexion, ranging from 33° to 60° for the head (90th percentile). Work which required highly elevated arms also required significant head extension (r(2)=0.56). Awkward postures of upper arms, head, upper back and neck were identified by inclinometry, demonstrating the need for preventative interventions to reduce musculoskeletal disorders among line workers.

Cultural adaptation and psychometric properties of Brazilian Need for Recovery Scale.

OBJECTIVE: To translate the Need for Recovery Scale (NFR) into Brazilian Portuguese and culturally adapt it and assess the stability, internal consistency and convergent validity of the Brazilian scale among industrial workers. METHODS: The translation process followed the guidelines for cultural adaptation of questionnaires including the steps of translation, synthesis, back translation, expert committee review, and pre-testing. The Brazilian Portuguese NFR, final version (Br-NFR) was assessed for stability (n=52) and internal consistency (n=192) and for convergent validity through simultaneous assessment with other instruments: the Borg Scale (n=59); the Chalder Fatigue Questionnaire (n=57) and 3 subscales of the SF-36 (n=56). RESULTS: Stability and internal consistency met the criterion for a reliable measure (ICC=0.80 and Cronbach's alpha =0.87, respectively). The convergent validity between Br-NFR and other instruments also showed good results: Borg Scale (r= 0.64); Chalder Questionnaire (r= 0.67); SF-36 subscales: vitality (r= -0.84), physical functioning (r= -0.54), and role-physical (r= -0.47). CONCLUSIONS: The Br-NFR proved to be a reliable instrument to evaluate work-related fatigue symptoms in industrial workers. Furthermore, it showed significant and good correlations with well-established instruments such as the Borg Scale, the Chalder Questionnaire and SF-36 vitality subscale, supporting the validity of the Br-NFR.