RESUMO
Introduction: Low back pain and work-related musculoskeletal disorders are two of the leading causes of absenteeism worldwide. Objectives: To determine the prevalence and predictive factors of low back pain and work-related musculoskeletal disorders in Brazilian domestics and cleaners. Methods: This population-based cross-sectional study used data from the 2013 and 2019 National Health Survey (Pesquisa Nacional de Saúde), involving a total of 8,160 workers. The prevalence of low back pain and work-related musculoskeletal disorders was calculated based on adjusted prevalence ratio by Poisson regression and 95%CI. Results: The prevalence of lowback pain was 19.1% in 2013 and 20.6% in 2019, while the prevalence of musculoskeletal disorders was 2.2% in 2013 and 2.4% in 2019. Low back pain was associated with older age (prevalence ratio: 1.74; 95%CI 1.44-2.09), poor or very poor self-rated health (prevalence ratio: 2.10; 95%CI 1.76-2.50), holding a prepaid health plan (prevalence ratio: 1.27; 95%CI 1.09-1.47), and moderately severe (prevalence ratio: 2.27; 95%CI 1.84-2.80) or severe (prevalence ratio: 2.32; 95%CI 1.77-3.04) depressive symptoms. Musculoskeletal disorders affected domestics less frequently (prevalence ratio: 0.53; 95%CI 0.40-0.72) and were associated with women (prevalence ratio: 2.50; 95%CI 1.34-4.66), adults (40-59 years) (prevalence ratio: 1.79; 95%CI 1.26-2.55), holding a prepaid health plan (prevalence ratio: 2.31; 95%CI 1.63-3.26), and the presence of moderately severe (prevalence ratio: 4.00; 95%CI 2.34-6.86) or severe (prevalence ratio: 3.63; 95%CI 1.77-7.46) depressive symptoms. Conclusions: Brazilian domestics and cleaners need interventions and improvements in health care given the prevalence of low back pain and musculoskeletal disorders as well as their association with depression.
Introdução: Lombalgia e distúrbios osteomusculares relacionadas ao trabalho são duas das principais causas de absenteísmo no mundo. Objetivos: Determinar a prevalência e fatores preditivos da lombalgia e distúrbios osteomusculares relacionados ao trabalho em trabalhadores domésticos e faxineiros brasileiros. Métodos: Este estudo transversal populacional coletou dados da Pesquisa Nacional de Saúde, realizada nos anos de 2013 e 2019, totalizando uma amostra de 8.160 trabalhadores. A prevalência da lombalgia e distúrbios osteomusculares relacionados ao trabalho autorreferidos foi calculada pela razão de prevalência ajustada pelo modelo de regressão de Poisson e IC95%. Resultados: A prevalência de lombalgia foi de 19,1% em 2013 e 20,6% em 2019; e de distúrbios osteomusculares foi de 2,2% em 2013 e 2,4% em 2019. A lombalgia esteve associada aos indivíduos idosos (razão de prevalência: 1,74; IC95% 1,44-2,09), com percepção baixa ou muito baixa a respeito da sua saúde (razão de prevalência: 2,10; IC95% 1,76-2,50), com plano de saúde (razão de prevalência: 1,27; IC95% 1,09-1,47) e com sintomas depressivos moderadamente graves (razão de prevalência: 2,27; IC95% 1,84-2,80) ou graves (razão de prevalência: 2,32; IC95% 1,77-3,04). A presença de distúrbios osteomusculares foi menor nos trabalhadores domésticos (razão de prevalência: 0,53; IC95% 0,40-0,72); e esteve associada ao sexo feminino (razão de prevalência: 2,50; IC95% 1,34-4,66), adultos (40-59 anos) (razão de prevalência: 1,79; IC95% 1,26-2,55), ter plano de saúde (razão de prevalência: 2,31; IC95% 1,63-3,26) e presença de sintomas depressivos moderadamente graves (razão de prevalência: 4,00; IC95% 2,34-6,86) ou graves (razão de prevalência: 3,63; IC95% 1,77-7,46). Conclusões: Trabalhadores domésticos e faxineiros necessitam de intervenções, melhorias na saúde e adaptação dos ambientes de trabalho dada a prevalência de lombalgia e distúrbios osteomusculares e associações com a depressão.
RESUMO
INTRODUCTION: Antiretroviral therapy (ART) for HIV/AIDS is associated with adverse events (AEs). However, little is known about the differences in the risk of AEs between women and men living with HIV/AIDS. This study aims to determine (1) whether there are sex differences in the risk of AEs in people with HIV/AIDS treated with ART and (2) the prevalence of AEs to the reproductive system and bone mineral density in women. METHODS AND ANALYSIS: This systematic review (SR) will include randomised trials evaluating ART in people living with HIV/AIDS with at least 12 weeks of duration follow-up. Searches will be conducted in Medline, Embase, Cochrane Library, Epistemonikos, Lilacs, trial registries and grey literature databases, without restriction on publication status, year of publication and language. The primary outcome will be the risk of ART discontinuation or drop-outs/withdrawals of ART due to AEs and the number of any treatment-emergent AE. The secondary outcomes are the incidence of serious clinic or laboratory (grade 3 and/or 4) treatment-emergent AEs, hospitalisation, death and AEs specific to the reproductive system and bone mineral density (osteoporosis, osteopenia and fractures) of women. Selection, data extraction and quality assessment will be performed by pairs of reviewers. Cochrane collaboration tools will be used to assess the risk of bias. If appropriate, a meta-analysis will be conducted to synthesise results. The overall quality of the evidence for each outcome will be determined by the Grades of Recommendation, Assessment, Development and Evaluation. ETHICS AND DISSEMINATION: The results of this SR will assist the formulation of public policies aimed at the management and monitoring of AEs of ART in people living with HIV/AIDS. A deliberative dialogue will be scheduled with the Department of Chronic Conditions and Sexually Transmitted Infections of Brazil's Ministry of Health to align the project with policymakers' interests. PROSPERO REGISTRATION NUMBER: CRD42021251051.