Prevalence of occupational accidents and associated variables in the Brazilian workforce.

INTRODUCTION: Current estimates suggest that 317 million occupational accidents occur annually worldwide. OBJECTIVES: To estimate the prevalence of occupational accidents and associated variables in the Brazilian workforce. METHODS: A cross-sectional study was performed using data from adults aged 18 or older who participated in the National Health Survey (Pesquisa Nacional de Saúde) (2013). This study was based on participants' responses to questions regarding their history of occupational accidents in the previous 12 months. Socioeconomic, lifestyle and health-related variables were also examined. Prevalence rates and ratios were calculated using Poisson multivariate regression models (with 95% confidence intervals), followed by Wald's tests for robust variance estimation. RESULTS: The prevalence of occupational accidents was 2.79% (95% confidence interval, 2.53-3.08%). These incidents were associated with male gender (prevalence ratio = 1.42; 95% confidence interval, 1.14-1.77), living in rural areas (prevalence ratio = 1.27; 95% confidence interval, 1.06-1.62), age 18 to 24 (prevalence ratio = 2.02; 95% confidence interval, 1.20-3.40), illiteracy (prevalence ratio = 3.12; 95% confidence interval, 1.96-4.96) and having two or more chronic illnesses (prevalence ratio = 2.12; 95% confidence interval, 1.29-3.47). CONCLUSIONS: Though the prevalence of occupational accidents in the Brazilian workforce was low, these incidents were associated with multimorbidity, socioeconomic status and lifestyle variables.

Prevalence of multimorbidity and associated factors in the Brazilian working population.

INTRODUCTION: According to the World Health Organization (2018), recent changes in the epidemiological profile of working populations point to an increase in non-communicable chronic illnesses and a decrease in communicable chronic illnesses. OBJECTIVES: To estimate the prevalence of multimorbidity in the Brazilian working population (≥18 years) and identify associated factors based on data from the 2013 national health survey (Pesquisa Nacional de Saúde). METHODS: This was a cross sectional study based on data from the 2013 national health survey, which included n = 47,629 people aged 18 years or older. As part of the survey, participants were asked whether they had ever been diagnosed with any of several chronic diseases. The prevalence of multimorbidity in this population and its association with socioeconomic, lifestyle and occupational characteristics were examined. Bivariate analyses were used to calculate prevalence ratios and 95% confidence intervals. Multivariate analyses were conducted using Poisson regression and Wald's tests to estimate the coefficients of significant variables. RESULTS: The prevalence of multimorbidity was 19.98% (95% confidence interval: 19.29%-20.70%). Higher rates of multimorbidity were associated with female gender, age 60 years or older, living with a spouse, past history of smoking, low education levels (illiterate/primary), living in urban areas, having medical or dental insurance and a history of work accidents. CONCLUSIONS: The prevalence of multimorbidity in the Brazilian population is low. When present, multimorbidity is associated with specific occupational, socioeconomic and lifestyle characteristics.

Healthcare service utilization and work-related productivity in reflexology intervention for advanced breast cancer women.

PURPOSE: This project's purpose was to determine the effects of a home-based reflexology intervention on symptom-related use of health services and work-related productivity during the 11-week study. METHODS: A total of 256 patients were randomized to four weekly reflexology sessions (each lasting 30 min, delivered by lay caregivers who received two training sessions by a professional reflexologist) or attention control. The Conventional Health Service and Productivity Costs Form was used to collect information on health service utilization and out-of-pocket expenditure of symptom management. The Health and Work Performance Questionnaire was used to measure workplace performance for patients during the study period. We used weighted and unweighted logistic and linear regression analyses. RESULTS: Patients in the reflexology group were less likely to have hospital visits compared to the control group in the weighted unadjusted (odds ratio [OR] = 0.49; 95% confidence interval [CI] = [0.25, 0.97]), unweighted adjusted (OR = 0.35; 95% CI = [0.16, 0.75]), and weighted adjusted (OR = 0.30, 95% CI = [0.13, 0.66]) logistic regressions. Compared to attention control, patients in the reflexology group had lower relative absenteeism in the unweighted adjusted (- 0.32; 95% CI = [- 0.60, - 0.03]) linear regressions and less absolute presenteeism (15.42, 95% CI = [0.87, 29.98]) in the weighted unadjusted analysis. CONCLUSION: The reflexology intervention delivered by lay caregivers reduced hospital visits and increased workplace productivity in a short-term period, which has potential for cost saving for health care systems and employers. TRIAL REGISTRATION: NCT01582971.

Prevalência de multimorbidade e fatores associados na população trabalhadora brasileira / Prevalence of multimorbidity and associated factors in the Brazilian working population

A rápida transição no perfil demográfico e epidemiológico tem registrado o aumento da longevidade, do adoecimento crônico e a precocidade da incapacidade, tornando o sistema de saúde menos preparado para atender a demanda crescente de pessoas com doenças crônicas não-transmissíveis, especialmente aquelas com duas ou mais, conhecido por multimorbidade. Este estudo objetiva estimar a prevalência de multimorbidade na população trabalhadora brasileira (≥18 anos) e conhecer seus fatores associados, considerando os dados da Pesquisa Nacional de Saúde (PNS), 2013. A princípio, foi realizada uma revisão sistemática de literatura baseada no protocolo PRISMA, com o intuito de identificar o impacto da multimorbidade na saúde do trabalhador. Após a revisão, foram desenvolvidos dois estudos de cunho transversal a partir dos dados da PNS, 2013, com n= 47.629 pessoas acima de 18 anos. Foram utilizadas questões do inquérito que respondiam, no segundo estudo, se o indivíduo já havia recebido o diagnóstico de alguma das doenças crônicas incluídas no inquérito e, no terceiro estudo, se já havia se envolvido em algum acidente de trabalho nos últimos 12 meses. Realizamos análise das prevalências da multimorbidade em relação às características socioeconômicas, estilo de vida e do trabalho; análise bivariada com obtenção da razão de prevalência (RP), intervalos de confiança a um nível de 95% (IC 95%); e modelo multivariado por meio da Regressão de Poisson, com teste de Wald para estimação robusta, para variáveis significativas na análise. A prevalência de multimorbidade foi de 19,98% (IC95%: 19,29% - 20,70%) e esteve associada ao sexo feminino, à faixa etária de 60+, conviver com o cônjuge, ser exfumante, ser analfabeto, morar na zona urbana, ter plano de saúde e já ter sofrido algum acidente de trabalho. A prevalência de acidente de trabalho foi de 2,79% (IC95%: 2,53% - 3,08%) e esteve associada ao sexo masculino, à faixa etária de 18 ­ 24, ser analfabeto, ter quatro doenças crônicas associadas e morar na zona rural. Estimou-se uma baixa prevalência de multimorbidade e acidente de trabalho na população trabalhadora brasileira e, esteve associada às características relacionadas ao trabalho, socioeconômicas e de estilo de vida (AU).

The fast transition in the demographic and epidemiological profile has recorded the increase in longevity, chronic illness and the prococity of disability, making the health system less prepared to meet the growinf demando of people with non communicable chronic diseases, especially those with two or more, known as multimorbidity. This study aims to estimate the prevalence of multimorbidity in the brazilian workers population (≥18 years old) and to know its associated factors considering he data from the National Health Survey (PNS), 2013. At first, a systematic literature review was conducted based on the PRISMA protocol, in order to identify the impact of the multimorbidity on workers' health. After the review, two crosses sectional studies were developed based on the data from the PNS, 2013, with n= 47,629 people over 18 years old. Survey questions were used to answer, to second study, whether the individual had alread received the diagnosis of some of the chronic diseases included in the questions and, to third study, whether the individual already involved in some work accident around the last 12 months. We analyze the prevalences of multimorbidity in relation to socioeconomic characteristics, lifestyle and work; bivariate analysis with obtaining the prevalence ratio (RP), confidence intervals at a level of 95% (CI 95%); and multivariate model through Poisson regression, with Wald test robust estimation, for significant variables in the analysis. The prevalence of multimorbidity was 19.98% (95%CI: 19.29% - 20.70%) and was associated with the female gender, to the age range of 60+, to live with the spouse, to be former smoker, to be illiterate, to live the urban area, have health insurance and have already suffered some work accident. The prevalence of work accident of 2.79% (CI95%: 2,53% - 3,08%) and was associated with the male gender, to the age range 18 ­ 24, to be illiterate, to have four chronic diseases and to live the rural área. A low prevalence of multimorbidity and work accident were estimated in the brazilian workers population and was associated with labor, socioeconomic and lifestyle characteristics (AU).