Low levels of potentially toxic elements in workers are associated with self-reported health outcomes.

Occupational exposure to toxic elements can adversely affect health. The current study evaluated blood concentrations of potentially toxic elements (PTE) including As, Cd, Cr, Cu, Hg, Mn, Ni, Pb, Sb, Sn, and Zn in formal and informal workers. Additionally, the study investigated the associations between blood PTE concentrations and reported health outcomes in the study population. The exposed group included women engaged in informal jewelry welding within their homes in Limeira, São Paulo state, Brazil (n = 36) and men who worked at a steel company in Volta Redonda, Rio de Janeiro state, Brazil (n = 22). The control group comprised residents of the same neighborhoods as the workers but without occupational exposure to chemicals (n = 28 in Limeira; n = 27 in Volta Redonda). Triple Quadrupole Inductively Coupled Plasma Mass Spectrometry (TQ ICP-MS) was used to determine PTE concentrations in blood samples. Glycemia, insulin, and lipid profile tests were performed. All participants completed questionnaires on household risk and reported morbidity. The blood concentrations of Cd, As, and Pb, as well as glycemia, were higher in informal workers than in control subjects. No significant differences were observed between formal workers and control subjects. A robust Poisson regression model, adjusted for variables suggested by a Directed Acyclic Graph, disclosed associations of blood lead and arsenic concentrations with the prevalence of neurological manifestations in Limeira. Blood lead levels > 2.6 µg dL-1 were associated with 2.3 times the prevalence of self-reported neurological manifestations (95 % CI: 1.17-4.58; p = 0.02) than lower blood lead concentrations. Furthermore, a positive association between blood cadmium concentrations and glycemia was observed. Informal occupational exposure to these elements may indicate an increased risk of developing diseases. Monitoring exposure and implementing interventions to reduce PTE exposure in the work environment represent significant steps toward prevention.

A Spanish version of the Three-Dimensional Work Fatigue Inventory (3D-WFI): factor structure, internal consistency, and criterion validity.

BACKGROUND: In the working population, there are risks of overload due to physical, mental, and emotional demands. No instrument is available in Spanish to measure these three types of work fatigue (WF) separately. This paper adapts the Three-Dimensional Work Fatigue Inventory (3D-WFI) (2015), which is of American origin and measures and differentiates these three different types of WF. It has adequate psychometric properties at its root, as do the subsequent German (2018), Lebanese (2022), and Chinese (2023) adaptations. METHODS: A total of 1100 workers (average age = 40 years) from economic sectors such as security and transportation of valuables, secondary and university educational institutions, and healthcare centers participated. They responded to the 3D-WFI, the Health-Related Quality of Life Index, and the Individual Strength Checklist for concurrent validity effects, together with items with sociodemographic and lifestyle variables. RESULTS: A confirmatory factor analysis with the total sample 3D-WFI supports its three-dimensionality; Cronbach's alpha and Omega values are adequate by dimensions: for physical work fatigue (α = 0.92, Ω = 0.92), for mental work fatigue (α = 0.94. Ω = 0.94), and emotional work fatigue (α = 0.95, Ω = 0.95). The 3D-WFI correlates significantly with the Checklist Individual Strength (0.743), and a pattern of significant relationships is found between WF and antecedent variables (e.g., being exposed to heat and noise, emotional labor, concentration, and workwear), as well as some consequences of WF (for example, mental health, absenteeism, work satisfaction, and sleep quality). CONCLUSIONS: We contribute here to the cross-cultural validity of the 3D-WFI, which can be used reliably and validly in the Chilean and probably Latin American working population. Some WF predictor variables are confirmed, as well as WF impacts on the absenteeism, health, and quality of life among workers.

Mobile health technologies for workers' health and wellbeing: A systematic search of mHealth applications in Brazil.

BACKGROUND: Inadequate working conditions and sedentary work can exert a negative impact on workers' health and wellbeing, leading to musculoskeletal disorders and disability. Mobile health (mHealth) applications (apps) have high potential for the self-management of workers' health. OBJECTIVE: To identify mHealth apps aimed at promoting workers' health and wellbeing available in Brazilian online stores and assess these apps in terms of engagement, functionality, aesthetics and information quality. METHODS: A systematic search for apps was conducted in the Brazilian online App Store and Play Store in December 2022. Only smartphone apps in Brazilian Portuguese directed at workers' health were assessed. The appraisal of the quality of the applications was performed using the Mobile App Rating Scale (MARS). RESULTS: Among the 3449 mHealth apps found, ten were eligible for inclusion. The mean overall score was 3.15 ± 0.91 on a scale of 1-5. The lowest score was found for the "credibility" item. Exercises and breaks were the most frequent strategies. Most apps provided low-quality information from questionable sources and therefore received a mean score of 2.1 ± 1.5 on the MARS information subscale. CONCLUSION: Ten relevant mHealth apps were eligible for inclusion. The mHealth apps for the promotion of workers' health and wellbeing currently available in Brazil exhibited moderate quality and limited functionality.

Short-acting opioid prescriptions and Workers' Compensation using the National Ambulatory Medical Care Survey.

BACKGROUND: Short-acting opioids have been utilized for pain management with little known about their use in patients on Workers' Compensation (WC) insurance. Our goal was to investigate this association in the ambulatory care setting. METHODS: Using the National Ambulatory Medical Care Survey, visits from patients aged 18-64 during the years 2010 until 2018 were evaluated (excluding 2017 due to data availability). Demographic and co-morbidity data from each visit was obtained along with the visit year. The first short-acting opioid medication prescribed in the database was considered. Survey-weighted frequencies were evaluated. Logistic regression estimated the crude and adjusted odds ratios (OR) with 95% confidence intervals for the use of short-acting opioid prescription. RESULTS: There were 155,947 included visits with 62.5% for female patients. Most patients were White with 11.7% identifying as Black, and 6% identifying as another race. Over 13% of the sample was of Hispanic descent. WC was the identified insurance type in 1.6% of the sample population. Of these patients, 25.6% were prescribed a short-acting opioid, compared with 10.1% of those with another identified insurance. On multivariable regression, Black patients had increased odds of being prescribed a short-acting opioid compared to white patients (OR: 1.22, 95% CI: 1.11-1.34). Those on WC had 1.7-fold higher odds of being prescribed short-acting opioids (95% CI: 1.46-2.06). CONCLUSION: Certain patient characteristics, including having WC insurance, increased the odds of a short-acting opioid prescription. Further work is needed to identify prescribing patterns in specific high-risk occupational groups, as well as to elicit potential associated health outcomes.

A Deep Learning-Based Platform for Workers' Stress Detection Using Minimally Intrusive Multisensory Devices.

The advent of Industry 4.0 necessitates substantial interaction between humans and machines, presenting new challenges when it comes to evaluating the stress levels of workers who operate in increasingly intricate work environments. Undoubtedly, work-related stress exerts a significant influence on individuals' overall stress levels, leading to enduring health issues and adverse impacts on their quality of life. Although psychological questionnaires have traditionally been employed to assess stress, they lack the capability to monitor stress levels in real-time or on an ongoing basis, thus making it arduous to identify the causes and demanding aspects of work. To surmount this limitation, an effective solution lies in the analysis of physiological signals that can be continuously measured through wearable or ambient sensors. Previous studies in this field have mainly focused on stress assessment through intrusive wearable systems susceptible to noise and artifacts that degrade performance. One of our recently published papers presented a wearable and ambient hardware-software platform that is minimally intrusive, able to detect human stress without hindering normal work activities, and slightly susceptible to artifacts due to movements. A limitation of this system is its not very high performance in terms of the accuracy of detecting multiple stress levels; therefore, in this work, the focus was on improving the software performance of the platform, using a deep learning approach. To this purpose, three neural networks were implemented, and the best performance was achieved by the 1D-convolutional neural network with an accuracy of 95.38% for the identification of two levels of stress, which is a significant improvement over those obtained previously.

Digital Innovations for Occupational Safety: Empowering Workers in Hazardous Environments.

BACKGROUND: The quest to increase safety awareness, make job sites safer, and promote decent work for all has led to the utilization of digital technologies in hazardous occupations. This study investigated the use of digital innovations for safety and health management in hazardous industries. The key challenges and recommendations associated with such use were also explored. METHOD: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, a total of 48 studies were reviewed to provide a framework for future pathways for the effective implementation of these innovations. FINDINGS: The results revealed four main categories of digital safety systems: wearable-based systems, augmented/virtual reality-based systems, artificial intelligence-based systems, and navigation-based systems. A wide range of technological, behavioral, and organizational challenges were identified in relation to the key themes. CONCLUSION: Outcomes from this review can inform policymakers and industrial decision-makers about the application of digital innovations for best safety practices in various hazardous work conditions.

Fatores associados à insegurança laboral em profissionais de saúde bucal do Sistema Único de Saúde durante a pandemia de COVID-19 / Factors associated with workplace insecurity in brazilian Unified Health System's oral health professionals during the COVID-19 pandemic

Resumo Objetivos: analisar os fatores associados à insegurança na realização das atividades laborais durante a pandemia de COVID-19 entre profissionais de saúde bucal do Sistema Único de Saúde do Ceará. Métodos: estudo transversal com dados secundários disponibilizados pela Coordenadoria de Atenção à Saúde do Ceará, coletados em maio de 2020. Foram construídos modelos de regressão logística. Resultados: participaram 801 profissionais, dos quais 72,8% eram cirurgiões-dentistas, 73,9% relataram não ter recebido todos os equipamentos de proteção individual (EPI) recomendados e 58,2% relataram não se sentirem seguros para realizar atividades laborais. Na análise ajustada, foram associados à insegurança laboral: maior tempo de formação (RC=1,90; IC95%: 1,12; 3,20), vínculo empregatício efetivo (RC=1,85; IC95%: 1,15; 2,99) e não recebimento de todos os EPI recomendados (RC=1,84; IC95%: 1,16; 2,91); enquanto a chance de insegurança foi menor entre os profissionais que atuavam no nível secundário de atenção à saúde (RC=0,52; IC95%: 0,28; 0,96). Conclusão: os profissionais relataram situação de insegurança laboral durante a primeira onda da pandemia. O estudo revelou a necessidade de melhorias nas condições de trabalho com distribuição de EPI de forma equitativa em todo o estado, garantindo um exercício laboral mais seguro.

Abstract Objectives: to analyze the factors associated with workplace insecurity during the COVID-19 pandemic among oral healthcare providers of the Unified Health System of the state of Ceará. Methods: cross-sectional study with secondary data made available by the Health Care Coordination, which were collected in May 2020. Logistic regression models were constructed. Results: in total, 801 professionals participated in this research, of whom 72.8% were dentists, 73.9% reported receiving only some of the recommended Personal Protective Equipment (PPE), and 58.2% reported feeling unsafe to carry out work activities. In the adjusted analysis, the following factors were associated with workplace insecurity: permanent employment (OR=1.85; 95%CI: 1.15; 2.99) and not receiving all the recommended PPE (OR=1.84; 95%CI: 1.16; 2.91); whereas the chance of feeling insecure was higher among dental assistants and technicians (OR=2.13; 95%CI 1.34; 3.40) than among dental surgeons. Conclusion: professionals reported workplace insecurity during the first wave of the pandemic. This study shows the need for improving working conditions with equal distribution of PPE throughout the state, ensuring safer working conditions.

Avaliação dos aspectos psicossociais do trabalho no Brasil no contexto da saúde do trabalhador: uma revisão de escopo / Assessment of psychosocial aspects of work in Brazil in the context of worker health: a scoping review

Resumo Objetivo: descrever dimensões da avaliação dos aspectos psicossociais do trabalho (APST) encontradas na literatura e em documentos normativos no Brasil. Métodos: revisão de escopo com busca de artigos nas bases Portal da Biblioteca Virtual em Saúde do Brasil, Web of Science e Medline, publicados de 2017 a 2021. Também incluíram-se documentos governamentais brasileiros com orientação ou indicação para avaliação dos APST. Resultados: foram selecionados 58 artigos e 22 documentos governamentais. Destes, 75,9% são estudos de delineamento quantitativo transversal. A área da saúde foi o principal campo de estudo, assim como a categoria dos profissionais de enfermagem. Dos documentos governamentais, 63,6% classificam-se como materiais de suporte técnico, a maioria voltada para saúde do trabalhador e vigilância. Discussão: a maior parte dos estudos compreende APST como aspectos relacionados ao estresse ocupacional, referenciando-se, sobretudo, no modelo demanda-controle. A associação com desfechos de saúde, principalmente burnout, se destacou entre os artigos. Mesmo apresentando fragilidade de delimitação conceitual e metodológica, os documentos governamentais têm na Ergonomia da Atividade e Psicodinâmica do Trabalho as principais referências teóricas. Conclusão: é preciso maior aproximação entre conhecimento acadêmico, normatização e suporte técnico sobre avaliação dos APST para fortalecimento da Vigilância em Saúde do Trabalhador e da Trabalhadora (Visatt).

Abstract Objective: to describe the dimensions of the assessment of psychosocial aspects of work (APST) in Brazil found in the literature and normative documents. Methods: this is a scoping review that included the of scientific papers in the Virtual Health Library of Brazil, Web of Science and Medline databases, published from 2017 to 2021. Gray literature was also included, being characterized by documents from the Brazilian government with guidance or indications to evaluate APST. Results: 58 articles and 22 government documents were included. Of these, 75.9% are cross-sectional quantitative studies. The health area stood out as the main field of study, as well as the category of nursing professionals. Regarding government documents, 63.6% were classified as technical support materials, most of which focused on worker's health and surveillance. Discussion: most of scientific studies understand APST as aspects related to occupational stress, mainly referring to the demand-control model. The association with health outcomes, especially burnout, stood out among the scientific papers. Despite presenting conceptual and methodological frailty regarding APST, government documents presented the Ergonomic Activity and Psychodynamics of Work as the main theoretical references. Conclusions: academic knowledge, legal standardization and technical support should be made closer on the evaluation of APST to strengthen VISATT.

Aprendizados e estratégias inventivas no cotidiano de catadoras(es) de material reciclável / Learnings and inventive strategies in the daily life of waste pickers

Resumo Introdução: o mundo do trabalho apresenta profundas transformações que impactam no cotidiano e nos processos de subjetivação de trabalhadores, inclusive os informais, como os catadores de material reciclável. Seu trabalho tem uma constante importância socioambiental, produz múltiplos sentidos e, ao mesmo tempo, é atrelado a interdições e riscos. Objetivo: compreender os processos de aprendizado e inventividade no trabalho de catadores de material reciclável da região da Grande Florianópolis. Métodos: trata-se de uma pesquisa exploratória-descritiva, com abordagem qualitativa, com entrevistas semiestruturadas e observações do ambiente de trabalho. Foram utilizados mapas de associação de ideias como estratégia de análise das práticas discursivas, com a análise conjunta dos discursos, extraindo as similaridades entre as narrativas dos catadores. Resultados: foram entrevistados 14 catadores. Identificou-se que o processo de aprendizado das atividades laborais ocorreu no próprio cotidiano, principalmente com pessoas mais experientes, além do desenvolvimento de conhecimentos e habilidades com base na experiência. Quanto ao caráter inventivo dos trabalhadores, observou-se a utilização de regras, normas e princípios para os seus fazeres, que são compartilhados e renovados cotidianamente. Conclusão: evidenciou-se a relevância dos vínculos estabelecidos nas relações cotidianas, tanto para o aprendizado como para o compartilhamento de estratégias inventivas.

Abstract Introduction: the labor market brings profound transformations that impact workers' daily lives and subjectivation processes, including informal ones such as waste pickers. Waste picking has a reiterated socio-environmental importance, producing multiple meanings while being linked to interdictions and risks. Objective: understand the work learning processes and inventiveness of waste pickers in the metropolitan region of Florianópolis. Methods: this qualitative, descriptive and exploratory study used semi-structured interviews and fieldwork observations to collect the information necessary to answer the defined objective. Discursive practices were analyzed via maps of association of ideas and joint discourse analysis by extracting the similarities between the pickers' narratives. Results: a total of 14 waste pickers were interviewed. Learning took place in everyday relations, especially with more experienced pickers, with knowledge and skills being developed based on experience. As for the inventive axis, workers use rules, norms, and principles for their activities, which are shared and reiterated daily. Conclusion: results highlight the bonds established by waste pickers in everyday relations, both for learning and sharing inventive strategies.

Common mental disorders and risk perception in nursing work at covid-19 hospital units / Trastornos mentales comunes y percepción del riesgo en el trabajo de enfermería en unidades hospitalarias exclusivas para covid-19 / Transtornos mentais comuns e percepção de risco no trabalho de enfermagem em unidades hospitalares covid-19

ABSTRACT Objective: to analyze the associations between suspected Common Mental Disorders and risk perception in Nursing work at Covid-19 hospital units and to understand the elements intertwined in these relationships, from the workers' perspective. Method: a parallel-convergent mixed-methods study, carried out with 327 Nursing workers from Covid-19 units in seven hospitals from the state of Rio Grande do Sul, Brazil. The quantitative data were collected through a sociodemographic, work-related and risk perception questionnaire, added to the Self-Reporting Questionnaire and subjected to inferential statistical analysis. The qualitative data were produced through semi-structured interviews and treated in the light of thematic content analysis. Results: in all, 76.4% of the participants reported that their performance during the Covid-19 pandemic considerably or greatly increased the risks in their job. Regarding the risk exposure intensity, the workers consider themselves very exposed to the following risks: Covid-19 infection (51.4%); contaminating their family (45.9%); a family member developing a severe form of Covid-19 (46.5%); suffering psychological harms (47.7%); experiencing sleep (45.9%) or dietary pattern (40.7%) disorders; and isolating themselves from friends and family (48%). All of these variables were associated with suspected Common Mental Disorders. Qualitatively, it was evident that fear was the feeling signaling the intersection between risk perception and mental illness. Conclusion: suspected Common Mental Disorders were associated with the perception of multiple risks, with fear as the main element intertwined in this relationship.

RESUMEN Objetivo: analizar las asociaciones entre sospecha de Trastornos Mentales Comunes y percepción del riesgo en el trabajo de Enfermería en unidades hospitalarias exclusivas para COVID-19 y conocer los elementos entrelazados en estas relaciones, desde la perspectiva de los trabajadores. Método: estudio de métodos mixtos paralelo-convergente, realizado con 327 trabajadores da Enfermería de unidades exclusivas para COVID-19 de siete hospitales del estado de Rio Grande do Sul, Brasil. Los datos cuantitativos se recolectaron por medio de un cuestionario sociodemográfico, laboral y de percepción de riesgos, además de utilizarse el Self-Reporting Questionnaire, y se los sometió a análisis estadístico inferencial. Los datos cualitativos se produjeron por medio de entrevistas semiestructuradas y se los procesó sobre la base de análisis temático de contenido. Resultados: el 76,4% indicó que desempeñarse en la atención a pacientes con Covid-19 aumentó considerablemente o en demasía los riesgos en el trabajo. Con respecto a la intensidad de exposición a los riesgos, los trabajadores consideran estar muy expuestos a los siguientes riesgos: infección por Covid-19 (51,4%); contaminar a su familia (45,9%); que algún familiar desarrolle la forma grave da Covid-19 (46,5%); padecer perjuicios psicológicos (47,7%); sufrir alteraciones en el sueño (45,9) o en los hábitos alimenticios (40,7); u aislarse de familiares y amigos (48%). Todas estas variables demostraron estar asociadas a la sospecha de Trastornos Mentales Comunes. Cualitativamente, se evidenció que el sentimiento que señalizó la intersección entre percepción de riesgo y padecimiento mental fue el miedo. Conclusión: la sospecha de Trastornos Mentales Comunes se asoció a la percepción de múltiples riesgos, donde el miedo fue el principal elemento entrelazado en esa relación.

RESUMO Objetivo: analisar as associações entre a suspeita de Transtornos Mentais Comuns e a percepção de risco no trabalho da enfermagem em unidades hospitalares Covid-19 e conhecer os elementos imbricados nestas relações, na perspectiva dos trabalhadores. Método: estudo de métodos mistos paralelo-convergente, realizado com 327 trabalhadores da enfermagem de unidades Covid-19 de sete hospitais do estado do Rio Grande do Sul, Brasil. Os dados quantitativos foram coletados por meio de um questionário sociodemográfico, laboral e de percepção de riscos, somado ao Self-Reporting Questionnaire e submetidos a analise estatística inferencial. Os dados qualitativos foram produzidos por meio de entrevistas semiestruturadas e tratados à luz da análise temática de conteúdo. Resultados: 76,4% referiram que a atuação na Covid-19 aumentou consideravelmente ou muito os riscos no seu trabalho. No que tange à intensidade de exposição dos riscos, trabalhadores se consideram muito expostos ao risco de infecção por Covid-19 (51,4%); risco de levar a contaminação para sua família (45,9%); risco de que alguém da família desenvolva a forma grave da Covid-19 (46,5%); risco de sofrer danos psicológicos (47,7%); risco de sofrer alterações do sono (45,9); do padrão alimentar (40,7); e de se isolar de amigos e familiares (48%). Todas estas variáveis se mostraram associadas a suspeita de Transtornos Mentais Comuns. Qualitativamente, evidenciou-se que o medo era o sentimento balizador da intersecção entre a percepção de risco e o adoecimento mental. Conclusão: a suspeita de Transtornos Mentais Comuns associou-se à percepção de múltiplos riscos, sendo que o medo foi o principal elemento imbricado nessa relação.

Software development for the assistance to be provided to workers after accidents involving biological material / Desarrollo de un programa de software para la asistencia provista a los trabajadores después de un accidente con material biológico / Desenvolvimento de software para a assistência ao trabalhador após-acidente com material biológico

ABSTRACT Objective: to develop a prototype web-based software program for managing the assistance to be provided to workers after accidents involving exposure to biological material. Method: a research study on technological production involving the development of web-based software using the Agile Scrum method. It was conceived based on data produced in convergent care research with professionals involved in welcoming and decision-making regarding injured workers. The web-based software prototype underwent evaluation by participant that use the tool and was documented. Results: the web-based software assists in recording diverse information about accidents involving biological material and provides access to information, easing prompt actions and ensuring safety in procedures, which favors decision-making and the assistance provided to the workers. Conclusion: workers' health requires technological and managerial investments, with a focus on qualified welcoming and educational management to prevent accidents.

RESUMEN Objetivo: desarrollar un prototipo de software web para gestionar la asistencia provista a los trabajadores después de un accidente con exposición a material biológico. Método: investigación de producción tecnológica con desarrollo de un programa de software web empleando el método Ágil Scrum. El trabajo fue concebido a partir de datos producidos en una investigación convergente asistencial con profesionales que participan en la recepción y el proceso de toma de decisiones con respecto a los trabajadores accidentados. Además de ser registrado, el prototipo de programa de software web fue sometido a la evaluación de los participantes, que utilizan la herramienta. Resultados: el programa de software web contribuye a registrar diversa información sobre cada accidente con material biológico y proporciona acceso a los datos, aportando agilidad en las derivaciones y seguridad en las acciones, lo que favorece el proceso de toma de decisiones y la asistencia provista a los trabajadores. Conclusión: la salud de los trabajadores requiere inversiones tecnológicas y gerenciales, enfocadas en una recepción de calidad y en una buena gestión educativa para prevenir accidentes.

RESUMO Objetivo: desenvolver um protótipo de web software para o gerenciamento da assistência ao trabalhador após acidente com exposição a material biológico. Método: pesquisa de produção tecnológica com o desenvolvimento de um web software com utilização do método Ágil Scrum. Idealizado a partir de dados produzidos na pesquisa convergente assistencial com profissionais envolvidos no acolhimento e na tomada de decisões frente ao trabalhador acidentado. O protótipo de web software passou pela avaliação dos participantes usuários da ferramenta e foi registrado. Resultados: o web software auxilia no registro de informações sobre o acidente com material biológico e proporciona acesso à informação, trazendo agilidade nos encaminhamentos e segurança nas condutas, o que favorece a tomada de decisão e a assistência ao trabalhador. Conclusão: a saúde do trabalhador requer investimentos tecnológicos e gerenciais, com foco no qualificado acolhimento e gestão educativa para a prevenção dos acidentes.

Como a pandemia de COVID-19 afetou a notificação de acidentes do trabalho em diferentes atividades econômicas e ocupações no Brasil? Um estudo ecológico usando o p-score / How did the COVID-19 pandemic affect occupational accident notification in different economic activities and occupations in Brazil? An ecological study using p-score

Resumo Objetivo: mensurar o impacto da pandemia de COVID-19 nas notificações de acidentes do trabalho (AT) no Brasil, por atividade econômica e ocupação. Métodos: estudo ecológico que utilizou os casos de AT registrados entre 2015 e 2020 no Anuário Estatístico da Previdência Social. Os AT foram analisados por setor de atividade econômica, ocupação e códigos da 10ª revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10). Uma adaptação do p-score foi aplicada para comparar os casos de AT pré-pandemia com os do primeiro ano da pandemia. Resultados: os p-scores variaram de -60,2%, para AT por nexo técnico epidemiológico, a -13,9%, para AT típico. As doenças do trabalho apresentaram p-score de 151,1%. Houve aumento notável nos casos de doenças ocupacionais dos capítulos I e X da CID-10. As notificações de AT diminuíram em todas as categorias de atividades econômicas, exceto nas de saúde humana e serviços sociais (p-score = 8,0%). Na maioria das categorias, os valores foram negativos, exceto nos subgrupos forças de segurança e profissionais de saúde de nível superior, técnico e gestores. Conclusão: houve redução geral na notificação de AT durante a pandemia de COVID-19 no Brasil, que evidenciou desigualdades entre diferentes setores de atividades e ocupações, além de mudança no perfil de adoecimento dos trabalhadores.

Abstract Objective: to assess the COVID-19 pandemic impact on Occupational Accident (OA) notifications in Brazil by economic activity and occupation. Methods: an ecological study was conducted using OA cases recorded in the Statistical Yearbook of Social Security from 2015 to 2020. Accidents were analyzed by sector of economic activity, occupation, and ICD-10 codes. Pre-pandemic cases were compared with the first year of the public health emergency scenario caused by Sars-Cov-2 using an adapted p-score. Results: p-scores ranged from -60.2% for technical-epidemiological Occupational Accidents to -13.9% for typical OA. Occupational diseases had a p-score of 151.1%. Cases of occupational diseases from ICD-10 chapters I and X showed a significant increase. OA notifications decreased in all CNAE sections, except for human health and social services activities (p-score = 8.0%). P-score values were negative in most CBO categories, except in subgroups such as security forces and high-level health professionals, technicians, and managers. Conclusion: Brazil registered a general reduction in OA notifications due to the pandemic, which evinced inequalities in different sectors and occupations, as well as changes in the illness profile of workers.

Risk of Dysphonia in Legal Professionals: Proposal for a Screening Protocol

Introduction: Due to the communicative requirements inherent to the profession, the legal professional benefits from speech therapy monitoring for the proper use of the voice and to avoid the occurrence of vocal disorders. The development of specific instruments will contribute with more relevant data to guide this monitoring. Objective: To verify the applicability of the General Dysphonia Risk Screening Protocol (DRSP-G) and the Specific Dysphonia Risk Screening Protocol for Legal Professionals (DRSP-LP) and to correlate the average scores of both with vocal deviation, sex, age, professional performance time, vocal signs and symptoms, and vocal self-assessment. Methods: Fifty legal professionals participated. All participants completed the DRSP-G and DRSP-LP and recorded their voices for detection of the presence of altered vocal quality. Results: Most participants presented a high risk of dysphonia, which was higher in men. Altered vocal quality was observed in 34% of the participants. The items with the highest scores in the DRSP-G were talking a lot (76%), excessive daily coffee intake (70%), contact with smokers (60%), and insufficient hydration and sleep (48%); in the DRSP-LP, alcohol consumption (68%) and exposure to air conditioning (64%). There was no correlation between risk scores and the degree of dysphonia, or with age or length of professional experience. The DRSP-G score correlated with vocal signs and symptoms and vocal self-perception. Conclusions: The joint application of the DRSP-G and the DRSP-LP enabled a quantitative and qualitative analysis of risk factors for dysphonia in legal professionals.

Introducción: Debido a las exigencias comunicativas inherentes a la profesión, el profesional del derecho se beneficia del seguimiento logopédico para el correcto uso de la voz y para evitar la aparición de trastornos vocales. El desarrollo de instrumentos específicos contribuirá con datos más relevantes para guiar este seguimiento. Objetivo: Verificar la aplicabilidad del Protocolo General de Detección de Riesgo de Disfonía (DRSP-G) y el Protocolo de Detección de Riesgo Específico para Profesionales del Derecho (DRSP-LP) y correlacionar las puntuaciones de ambos con varias variables de interés. Metodología: Participaron 50 profesionales del derecho. Todos completaron el DRSP-G y DRSP-LP y grabaron sus voces para detectar la presencia de alteraciones en la calidad de la voz. Resultados: La mayoría presentó un alto riesgo de disfonía, que fue mayor en los hombres. Se observó alteración en la calidad de la voz en el 34% de los participantes. Los ítems con puntajes más altos en el DRSP-G fueron hablar mucho (76%), ingesta diaria excesiva de café (70%), contacto con fumadores (60%) e hidratación y sueño insuficientes (48%); y en el DRSP-LP, consumo de alcohol (68%) y exposición al aire acondicionado (64%). No hubo correlación entre las puntuaciones de riesgo y el grado de disfonía, ni con la edad o la antigüedad profesional. La puntuación DRSP-G se correlacionó con los signos y síntomas vocales y la autopercepción vocal. Conclusiones: La aplicación conjunta del DRSP-G y el DRSP-LP permitió un análisis cuantitativo y cualitativo de los factores de riesgo de disfonía en profesionales del derecho.

Avaliação do sistema de vigilância em saúde do trabalhador relacionada aos acidentes de trabalho, antes e após a implantação do software de linkage Sentinela, em Porto Alegre, 2018-2021 / Evaluation of the occupational health surveillance system before and after the implementation of the Sentinela linkage software, in Porto Alegre, 2018-2021 / Evaluación del sistema de vigilancia de la salud del trabajador relacionada con los accidentes de trabajo, antes y después de la implementación del software de enlace Sentinela, en Porto Alegre, 2018-2021

O objetivo deste artigo é avaliar, segundo alguns atributos, o sistema de vigilância dos acidentes de trabalho antes e após a implantação do software Sentinela (2018-2021), com base em uma pesquisa descritiva de dados secundários, e efetuar recomendações. Foram analisadas variáveis da ficha de investigação, de acordo com os atributos qualidade dos dados (completitude e consistência), oportunidade e representatividade. Os resultados mostraram que, após o Sentinela, houve aumento da notificação de acidentes (66,16%), maior completitude das variáveis, com importante alteração na 'atividade econômica' (98,9%) e 'evolução' (96,3%), diminuição dos campos ignorados/em branco, com destaque para o campo 'evolução' (3,7%), e melhora na oportunidade de controle dos acidentes fatais (79 dias). Concluímos que a vigilância dos acidentes de trabalho tem excelente qualidade dos dados, é representativa, mas inoportuna. O Sentinela melhorou o sistema, tornando-o mais sensível na captação dos acidentes e permitindo-lhe ter informações de melhor qualidade. É necessária a avaliação rotineira dos atributos, para aprimoramento constante do sistema, assim como rever as rotinas das equipes de saúde, melhorando a oportunidade de controle por meio de suas ações

This article aims to evaluate the occupational health surveillance system before and after the implementa-tion of the Sentinela software (2018-2021), according to some attributes and based on descriptive research using secondary data, and to make recommendations. Variables of the accident investigation report were analysed, according to the attributes of data quality (completeness and consistency), opportunity and rep-resentativeness. The results have revealed that after Sentinela, there was an increase in the notification of accidents (66.16%), greater completeness of the variables, with an important change in 'economic activity' (98.9%) and 'evolution' (96.3%), a decreased in blank fields/information missing, with emphasis on the 'evolution' field (3.7%), and an improvement in the opportunity to control fatal accidents (79 days). We have concluded that the surveillance of the occupational accidents has excellent data quality, is representative, but inopportune. The Sentinela has improved the system, making it more sensitive in capturing accidents, allowing it to provide better quality of information. An evaluation of the attributes is routinely necessary to constantly improve the system, as well as reviewing the routines of health professionals, improving the opportunity to control by their actions

El objetivo de este artículo es evaluar, según algunos atributos, el sistema de vigilancia de los accidentes de trabajo antes y después de la implementación del software Sentinela (2018-2021), por medio de una investigación descriptiva de datos secundarios, y hacer recomendaciones. Fueron analizadas variables de la ficha de investigación de accidentes, de acuerdo con los atributos de calidad de los datos (completitud y consistencia), oportunidad y representatividad. Los resultados demostraron que, después del Sentinela, ha habido un aumento de la notificación de accidentes (66,16 %), una mayor completitud de las variables, con un cambio importante en 'actividad económica' (98,9 %) y 'evolución' (96,3 %), una disminución de campos ignorados/en blanco, con énfasis en el campo 'evolución' (3,7%), y mejora en la probabilidad de control de los accidentes mortales (79 días). Concluimos que la vigilancia de los accidentes de trabajo tiene excelente calidad de datos, es representativa, pero inoportuna. El Sentinela ha mejorado el sistema, haciéndolo más sensible en la captación de los accidentes y permitiéndole tener informaciones de mejor calidad. La evaluación de los atributos con regularidad es necesaria para el perfeccionamiento constante del sistema, así como la revisión de las rutinas de los equipos de salud, mejorando la oportunidad de control a través de sus acciones

Estilo de vida y síndrome metabólico en el personal de salud de un hospital, 2022 / Lifestyle and metabolic syndrome in hospital health personnel, 2022

Fundamentos: El síndrome metabólico es un conjunto de factores de riesgo cardiovascular que junto con unestilo de vida inadecuado puede generar una importante morbimortalidad en la población adulta, afectandosu salud y productividad. El objetivo fue determinar la relación entre el estilo de vida y el síndromemetabólico (SM) en el personal de la salud durante la pandemia por COVID-19 en un hospital en el distrito deAte, 2022.Métodos: Diseño no experimental, descriptivo, correlacional y transversal. Los participantes fueron 416trabajadores de un hospital en el distrito de Ate. El SM fue valorado según la definición la FederaciónInternacional de Diabetes (FID) y el estilo de vida mediante el cuestionario Fantástico. Para la asociación devariables se aplicó prueba de chi-cuadrado.Resultados: Participaron 304 (73,1%) mujeres y 112 (26,9%) hombres, con edades entre 30-59 años (n=395,94,9%) y mayores de 60 años (n=21, 5,1%). La prevalencia del SM fue del 52,2%. Se observó una relaciónentre estilos de vida y el SM. Al identificarse las características clínicas del personal de salud se encontrósegún los componentes del SM diferenciado por género, en mujeres y varones que además de presentarObesidad central, HTA, triglicéridos elevados y glicemia alterada.Conclusiones: La prevalencia de SM se presentó en más de la mitad de los participantes, siendo superior enlas mujeres; se encontró asociación entre la presencia de SM y los estilos de vida.(AU)

Background: The metabolic syndrome is a set of cardiovascular risk factors that together with an inadequatelifestyle can generate significant morbidity and mortality in the adult population, affecting their health andproductivity. The objective was to determine the relationship between lifestyle and metabolic syndrome (MS)in health personnel during the COVID-19 pandemic in a hospital in Ate district, 2022.Methods: Non-experimental, descriptive, correlational and cross-sectional design. The participants were 416workers from a hospital in Ate district. MS was assessed according to the definition of the InternationalDiabetes Federation (IDF) and lifestyle using the Fantastic questionnaire. For the association of variables, achi-square test was applied.Results: 304 (73.1%) women and 112 (26.9%) men participated, aged between 30-59 years (n=395, 94.9%)and over 60 years old (n=21, 5.1%). The prevalence of MS was 52.2%. A relationship was observed betweenlifestyles and MS. When the clinical characteristics of the health personnel were identified, it was foundaccording to the components of the MS differentiated by gender, in women and men who, in addition topresenting central obesity, HBP, elevated triglycerides and altered glycemia.Conclusions: The prevalence of MS was present in more than half of the participants, being higher in women;an association was found between the presence of MS and lifestyles.(AU)

The Work, Play, and Worship Environments as Social Determinants of Health.

Consideration of the definition of the social determinants of health (SDOHs) requires health care to include work, play, and worship environments because they are important to the health of patients and communities. This article attempts to discuss the issues with limited focus on these areas and the importance of using multidisciplinary health-care teams during primary care visits. The expectation from this information is to advance the ability for primary care providers to support patients and the communities they work in to effect change toward decreasing health disparities and enhancing overall health outcomes.

Qualidade de vida e engajamento no trabalho em profissionais de enfermagem no início da pandemia de COVID-19 / Quality of life and work engagement among nursing staff at the start of the COVID-19 pandemic

Resumo O artigo investiga a correlação entre engajamento e qualidade de vida no trabalho dos profissionais de enfermagem de um hospital público do interior do estado de São Paulo, no início da pandemia de COVID-19. Estudo transversal, descritivo e correlacional, com profissionais de enfermagem, realizado entre dezembro de 2020 e janeiro de 2021. Foram utilizadas as versões brasileiras da Utrecht Work Engagement Scale (UWES) e da Escala de Avaliação da Qualidade de Vida no Trabalho (QVT), segundo modelo de Walton. Os profissionais de enfermagem apresentaram correlação forte e positiva (r≥0.70) entre o domínio integração social da QVT e a dimensão vigor da UWES (r=0,88; p=<0,001); correlação positiva moderada (r≥0.40≤0.69) entre as condições de trabalho (QVT) e as dimensões vigor (r=0,40; p=<0,001), dedicação (r=0,40; p=<0,001) e escore geral (r=0,41; p=<0,001) da UWES. As correlações foram positivas e fracas (r≤0.39) para os demais domínios da QVT e as dimensões da UWES. Concluiu-se que os profissionais com níveis satisfatórios de qualidade de vida tendem a ter níveis mais altos de engajamento no trabalho. No início da pandemia de COVID-19, os profissionais de enfermagem estavam fortemente engajados e satisfeitos com sua qualidade de vida no trabalho.

Abstract This article investigates the correlation between work engagement and work-related quality of life among nursing staff at a public hospital in São Paulo State, at the onset of the COVID-19 pandemic. A descriptive, correlational, cross-sectional study of nursing personnel was conducted from December 2020 to January 2021, using the Brazilian versions of the Work & Well-being Survey (Utrecht Work Engagement Scale - UWES) and the Work-related Quality of Life (WRQoL) scale, following Walton's model. Nursing staffs returned a strong positive correlation (r≥0.70) between the social integration domain of the WRQoL and the vigour dimension of the UWES (r=0.88; p=<0.001); a moderate positive correlation (r≥0.40≤0.69) between working conditions (WRQOL) and the vigour (r=0.40; p<0.001), dedication (r=0.40; p<0.001) and overall score (r=0.41; p<0.001) dimensions of the UWES. Correlations were positive and weak (r≤0.39) for the other WRQoL domains and the UWES dimensions. It was concluded that personnel with satisfactory levels of quality of life tend to show higher levels of engagement at work. At the onset of the COVID-19 pandemic, nursing professionals were strongly engaged and satisfied with their work-related quality of life.

Associação entre intoxicação exógena e exposição ocupacional e ambiental de pacientes com câncer em Mato Grosso / Association between exogenous intoxication and occupational and environmental exposure of cancer patients in Mato Grosso

RESUMO O objetivo deste estudo foi investigar a associação entre características sociodemográficas relacionadas à exposição ambiental e ocupacional e o autorrelato de intoxicação de pacientes com diagnóstico de câncer em Mato Grosso, Brasil. Trata-se de um estudo transversal, com 998 pacientes com câncer atendidos em hospitais de referência do estado. A variável dependente foi obtida a partir do autorrelato de algum sintoma de intoxicação nos últimos 5 anos e se a intoxicação foi decorrente ou não do trabalho/ocupação. A associação entre características sociodemográficas relacionadas à intoxicação e à exposição ambiental e ocupacional e o autorrelato de intoxicação foi avaliada pelo teste exato de Fisher. Do total de entrevistados, 7,4% (IC95%: 6,0; 9,2) referiram intoxicação, sendo 2,3% dos casos (IC95%: 1,5; 3,4) decorrentes do trabalho. Os fatores associados ao autorrelato de intoxicação decorrente do trabalho foram ser do sexo masculino, ter escolaridade menor que 4 anos, sintoma de dor de cabeça, intoxicação por agrotóxico agrícola, por via respiratória e ter trabalhado com agrotóxicos, amianto, metais pesados e poeira industrial. Conclui-se que os indivíduos com maior exposição ocupacional aos agrotóxicos e a outros produtos químicos referiram maior ocorrência de intoxicações decorrentes do trabalho.

ABSTRACT The aim of this study was to investigate the association between sociodemographic characteristics, related to environmental and occupational exposure and self-report of intoxication in patients diagnosed with cancer in Mato Grosso, Brazil. This is a cross-sectional study, with 998 cancer patients seen at referral hospitals in the state. The dependent variable was obtained from the self-report of some intoxication symptom in the last 5 years and whether or not the intoxication was caused by work/occupation. The association between sociodemographic characteristics, related to intoxication and environmental and occupational exposure and self-report of intoxication was assessed by Fisher's exact test. Of all respondents, 7.4% (95%CI: 6.0; 9.2) reported intoxication, and 2.3% (95%CI: 1.5; 3.4) were work-related. Factors associated with self-reported work-related intoxication were being male, having less than 4 years of education, headache, intoxication by agricultural pesticides, by respiratory route and having worked with pesticides, asbestos, heavy metals and industrial dust. It was concluded that individuals with higher occupational exposure to pesticides and other chemicals reported higher occurrence of poisoning due to work.

Diagnostics and Prevention of Occupational Allergy in Hairdressers.

PURPOSE OF REVIEW: This study aims to provide an overview on current knowledge on occupational allergic diseases in hairdressers and up-to-date perspectives of prevention. RECENT FINDINGS: Hand eczema (dermatitis) is common in hairdressers, often caused by contact allergy to one or multiple small molecules (haptens) used, e.g., for dyeing, bleaching, and waving/relaxing or by ancillary substances such as preservatives. Hairdressers, compared to other patch-tested patients, have an up to fivefold increased risk to be found sensitized, e.g., against p-phenylenediamine, ammonium persulfate, and glyceryl thioglycolate. Some of these small molecules may induce respiratory sensitization causing allergic rhinitis and/or asthma, notably persulfate salts. Occupational hazards in hairdressing are well described. This knowledge needs to be put into use for risk reduction, mainly by substitution of allergenic ingredients by less allergenic ones, education, and use of ventilation and suitable single-use gloves.

Optimized menu formulation to enhance nutritional goals: design of a mixed integer programming model for the workers' food program in Brazil.

BACKGROUND: In Brazil, institutional foodservices are required to meet the recommendations of the Workers? Food Program (WFP), a national public policy used to plan collective menus. The current study aimed to propose a mathematical model to generate a one-month menu that meets the nutritional recommendations of the WFP, with low cost and good quality. METHODS: We considered aspects related to the eating habits of the Brazilian population, spacing of repetitions between the dishes, texture combination, and monotonicity of colors of the dishes served. A mixed integer programming model was built to formulate daily menus for an institutional foodservice for one month. The menu consisted of a base dish, a base dish option, salads (2 options), a protein dish, a protein dish option, a side dish, and a dessert. RESULTS: The model ensured compliance with the recommendations proposed by the WFP and the provision of healthy and nutritionally balanced meals. The menu generated met the recommendations of the WFP, with an average of 716.97 kcal/meal, including on average 58.28% carbohydrates, 17.89% proteins, and 24.88% total fats/meal. CONCLUSION: The model used can help in the menu elaboration dynamics of institutional foodservices, optimizing the work of the nutritionist in charge.