Employment conditions and health inequities: a case study of Brazil / Condições de emprego e iniquidades em saúde: um estudo de caso no Brasil

This paper was prepared for the Employment Conditions and Health Inequalities Knowledge Network (EMCONET), part of the WHO Commission on the Social Determinants of Health. We describe the Brazilian context of employment conditions, labor conditions and health, their characteristics and causal relationships. The social, political and economic factors that influence these relationships are also presented with an emphasis on social inequalities, and how they are reproduced within the labor market and thereby affect the health and wellbeing of workers. A literature review was conducted in SciELO, LILACS, Google and Google Scholar, MEDLINE and the CAPES Brazilian thesis database. We observed that there are more workers operating in the informal sector than in the formal sector and these former have no social insurance or any other social benefits. Work conditions and health are poor in both informal and formal enterprises since health and safety labor norms are not effective. The involvement of social movements and labor unions in the elaboration and management of workers' health polices and programs with universal coverage, is a promising initiative that is underway nationwide.

Este trabalho descreve aspectos das condições de trabalho e emprego e suas relações com a saúde, no contexto brasileiro, enfatizando as desigualdades sociais relacionadas com a inserção no mercado de trabalho, tendo sido desenvolvido como contribuição ao documento da rede "Employment Conditions and Health Inequalities Knowledge Network (EMCONET) - WHO Commission on Social Determinants of Health". A pesquisa bibliográfica foi realizada no SciELO, LILACS, Google, Google Scholar, MEDLINE e no banco de teses da CAPES. No Brasil, o número de trabalhadores inseridos no setor informal supera o daqueles no setor formal. As informações sobre adoecimento e morte relacionados ao trabalho não estão disponíveis para o conjunto da população economicamente ativa. As condições de trabalho e saúde são ruins em ambos os grupos e, apesar do complexo arcabouço legal referente à proteção dos trabalhadores e de avanços setoriais, as políticas públicas permanecem fragmentadas, apresentam baixa cobertura e pouca eficácia. O crescente envolvimento do movimento social e de sindicatos de trabalhadores na elaboração e gestão de políticas e programas de saúde sinaliza um processo promissor em curso no país.

Employment conditions and health inequities: a case study of Brazil.

This paper was prepared for the Employment Conditions and Health Inequalities Knowledge Network (EMCONET), part of the WHO Commission on the Social Determinants of Health. We describe the Brazilian context of employment conditions, labor conditions and health, their characteristics and causal relationships. The social, political and economic factors that influence these relationships are also presented with an emphasis on social inequalities, and how they are reproduced within the labor market and thereby affect the health and wellbeing of workers. A literature review was conducted in SciELO, LILACS, Google and Google Scholar, MEDLINE and the CAPES Brazilian thesis database. We observed that there are more workers operating in the informal sector than in the formal sector and these former have no social insurance or any other social benefits. Work conditions and health are poor in both informal and formal enterprises since health and safety labor norms are not effective. The involvement of social movements and labor unions in the elaboration and management of workers' health polices and programs with universal coverage, is a promising initiative that is underway nationwide.

[Noise-induced hearing loss and high blood pressure among city bus drivers]. / Perda auditiva induzida por ruído e hipertensão em condutores de ônibus.

OBJECTIVE: To estimate the prevalence of occupational noise-induced hearing loss and arterial hypertension among city bus drivers. METHODS: A cross-sectional study was carried out on a probability random sample of 108 city bus drivers taken out of a total of 1,529 estimated professionals in the city of Campinas, Brazil, in 1991. Drivers were interviewed using questionnaires on job history, shift work and vacation schedules and underwent clinical and laboratory examinations including measures of blood pressure, pure-tone audiometry, speech audiometry, and anthropometric data analysis after an informed consent was obtained. RESULTS: The prevalence of noise-induced hearing loss was 32.7%. According to Merluzzi's classification, 91.2% (31 cases) were classified as first and second-degree losses and the most affected frequencies were 6 kHz in 61.3%, and 4 kHz in 38.7%. There were no differences in the laterality of the first affected ear. The prevalence of arterial hypertension was 13.2% (PAD > or =90 mmHg; PAS > or =140 mmHg). CONCLUSIONS: The risk of noise-induced hearing loss was greater for drivers in job for more than 6 years, after controlling for age-related hearing loss. An odds ratio of 19.25 was found for those aged 45 or more (1.59

Perda auditiva induzida por ruído e hipertensäo em condutores de ônibus / Noise-induced hearing loss and high blood pressure among city bus drivers

OBJETIVO: Estimar as prevalências de perda auditiva induzida por ruído e hipertensäo arterial em condutores de ônibus urbanos. MÉTODOS: Executou-se estudo transversal em amostra probabilística de 108 motoristas da cidade de Campinas, SP. Aplicou-se questionário sobre história profissional, jornadas de trabalho e repouso, e realizou-se exame físico e laboratorial incluindo medida da pressäo arterial, audiometria tonal limiar, logoaudiometria e dados antropométricos, após a obtençäo de consentimento. RESULTADOS: A prevalência de perda auditiva induzida por ruído foi de 32,7 por cento do total examinado. Segundo a classificaçäo de Merluzzi, nos 31 casos classificados em primeiro e segundo graus, observou-se que a freqüência audiométrica com perda auditiva mais acentuada foi a de 6 kHz (61,3 por cento), seguida pela de 4 kHz (38,7 por cento), sem diferenças significantes quanto à lateralidade. A prevalência de hipertensäo arterial diastólica (PADÝ90 mmHG; PASÝ140 mmHG) foi de 13,2 por cento dos examinados. CONCLUSÖES: O risco de disacusia induzida por ruído foi maior para os motoristas com mais de seis anos de trabalho, após ajuste para a perda relacionada com a idade, com um odds ratio de 19,25 (1,59

Acesso e qualidade da atencao a pessoa portadora de deficiencia fisica em servicos publicos de saude do municipio de Campinas / Access and quality of the assistance given to the disabled people in the public health services in Campinas county

Este trabalho tem como finalidade analisar a acessibilidade e a qualidade da assistencia a pessoa portadora de deficiencia fisica nos servicos publicos de saude do...