Network Analysis of Biomarkers Associated with Occupational Exposure to Benzene and Malathion.

Complex diseases are associated with the effects of multiple genes, proteins, and biological pathways. In this context, the tools of Network Medicine are compatible as a platform to systematically explore not only the molecular complexity of a specific disease but may also lead to the identification of disease modules and pathways. Such an approach enables us to gain a better understanding of how environmental chemical exposures affect the function of human cells, providing better perceptions about the mechanisms involved and helping to monitor/prevent exposure and disease to chemicals such as benzene and malathion. We selected differentially expressed genes for exposure to benzene and malathion. The construction of interaction networks was carried out using GeneMANIA and STRING. Topological properties were calculated using MCODE, BiNGO, and CentiScaPe, and a Benzene network composed of 114 genes and 2415 interactions was obtained. After topological analysis, five networks were identified. In these subnets, the most interconnected nodes were identified as: IL-8, KLF6, KLF4, JUN, SERTAD1, and MT1H. In the Malathion network, composed of 67 proteins and 134 interactions, HRAS and STAT3 were the most interconnected nodes. Path analysis, combined with various types of high-throughput data, reflects biological processes more clearly and comprehensively than analyses involving the evaluation of individual genes. We emphasize the central roles played by several important hub genes obtained by exposure to benzene and malathion.

Assessor burden, inter-rater agreement and user experience of the RoB-SPEO tool for assessing risk of bias in studies estimating prevalence of exposure to occupational risk factors: An analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.

BACKGROUND: As part of the development of the World Health Organization (WHO)/International Labour Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury, WHO and ILO carried out several systematic reviews to determine the prevalence of exposure to selected occupational risk factors. Risk of bias assessment for individual studies is a critical step of a systematic review. No tool existed for assessing the risk of bias in prevalence studies of exposure to occupational risk factors, so WHO and ILO developed and pilot tested the RoB-SPEO tool for this purpose. Here, we investigate the assessor burden, inter-rater agreement, and user experience of this new instrument, based on the abovementioned WHO/ILO systematic reviews. METHODS: Twenty-seven individual experts applied RoB-SPEO to assess risk of bias. Four systematic reviews provided a total of 283 individual assessments, carried out for 137 studies. For each study, two or more assessors independently assessed risk of bias across the eight RoB-SPEO domains selecting one of RoB-SPEO's six ratings (i.e., "low", "probably low", "probably high", "high", "unclear" or "cannot be determined"). Assessors were asked to report time taken (i.e. indicator of assessor burden) to complete each assessment and describe their user experience. To gauge assessor burden, we calculated the median and inter-quartile range of times taken per individual risk of bias assessment. To assess inter-rater reliability, we calculated a raw measure of inter-rater agreement (Pi) for each RoB-SPEO domain, between Pi = 0.00, indicating no agreement and Pi = 1.00, indicating perfect agreement. As subgroup analyses, Pi was also disaggregated by systematic review, assessor experience with RoB-SPEO (≤10 assessments versus > 10 assessments), and assessment time (tertiles: ≤25 min versus 26-66 min versus ≥ 67 min). To describe user experience, we synthesised the assessors' comments and recommendations. RESULTS: Assessors reported a median of 40 min to complete one assessment (interquartile range 21-120 min). For all domains, raw inter-rater agreement ranged from 0.54 to 0.82. Agreement varied by systematic review and assessor experience with RoB-SPEO between domains, and increased with increasing assessment time. A small number of users recommended further development of instructions for selected RoB-SPEO domains, especially bias in selection of participants into the study (domain 1) and bias due to differences in numerator and denominator (domain 7). DISCUSSION: Overall, our results indicated good agreement across the eight domains of the RoB-SPEO tool. The median assessment time was comparable to that of other risk of bias tools, indicating comparable assessor burden. However, there was considerable variation in time taken to complete assessments. Additional time spent on assessments may improve inter-rater agreement. Further development of the RoB-SPEO tool could focus on refining instructions for selected RoB-SPEO domains and additional testing to assess agreement for different topic areas and with a wider range of assessors from different research backgrounds.

The prevalence of occupational exposure to noise: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.

BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of individual experts. Evidence from mechanistic and human data suggests that occupational exposure to noise may cause cardiovascular disease. In this paper, we present a systematic review and meta-analysis of the prevalence of occupational exposure to noise for estimating (if feasible) the number of deaths and disability-adjusted life years from cardiovascular disease that are attributable to exposure to this risk factor, for the development of the WHO/ILO Joint Estimates. OBJECTIVES: We aimed to systematically review and meta-analyse estimates of the prevalence of occupational exposure to noise. DATA SOURCES: We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines, and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA: We included working-age (≥15 years) workers in the formal and informal economies in any WHO Member and/or ILO member State, but excluded children (<15 years) and unpaid domestic workers. We included all study types with an estimate of the prevalence of occupational exposure to noise, categorized into two levels: no (low) occupational exposure to noise (<85dBA) and any (high) occupational exposure to noise (≥85dBA). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We combined prevalence estimates using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using the RoB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates. RESULTS: Sixty-five studies (56 cross-sectional studies and nine cohort studies) met the inclusion criteria, comprising 157,370 participants (15,369 females) across 28 countries and all six WHO regions (Africa, Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific). For the main analyses, we prioritized the four included studies that surveyed national probability samples of general populations of workers over the 58 studies of workers in industrial sectors and/or occupations with relatively high occupational exposure to noise. The exposure was generally assessed with dosimetry, sound level meter, or official or company records; in the population-based studies, it was assessed with validated questions. Estimates of the prevalence of occupational exposure to noise are presented for all 65 included studies, by country, sex, 5-year age group, industrial sector, and occupation where feasible. The pooled prevalence of any (high) occupational exposure to noise (≥85dBA) among the general population of workers was 0.17 (95% confidence interval 0.16 to 0.19, 4 studies, 108,256 participants, 38 countries, two WHO regions, I2 98%, low quality of evidence). Subgroup analyses showed that pooled prevalence differed substantially by WHO region, sex, industrial sector, and occupation. CONCLUSIONS: Our systematic review and meta-analysis found that occupational exposure to noise is prevalent among general populations of workers. The current body of evidence is, however, of low quality, due to serious concerns for risk of bias and indirectness. Producing estimates of occupational exposure to noise nevertheless appears evidence-based, and the pooled effect estimates presented in this systematic review are suitable as input data for the WHO/ILO Joint Estimates (if feasible). Protocol identifier: 10.1016/j.envint.2018.09.040 PROSPERO registration number: CRD42018092272.

The effect of occupational exposure to noise on ischaemic heart disease, stroke and hypertension: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury.

BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large number of individual experts. Evidence from mechanistic data suggests that occupational exposure to noise may cause cardiovascular disease (CVD). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from CVD that are attributable to occupational exposure to noise, for the development of the WHO/ILO Joint Estimates. OBJECTIVES: We aimed to systematically review and meta-analyse estimates of the effect of any (high) occupational exposure to noise (≥85 dBA), compared with no (low) occupational exposure to noise (<85 dBA), on the prevalence, incidence and mortality of ischaemic heart disease (IHD), stroke, and hypertension. DATA SOURCES: A protocol was developed and published, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic academic databases for potentially relevant records from published and unpublished studies up to 1 April 2019, including International Trials Register, Ovid MEDLINE, PubMed, Embase, Lilacs, Scopus, Web of Science, and CISDOC. The MEDLINE and Pubmed searches were updated on 31 January 2020. We also searched grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA: We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to noise on CVD prevalence, incidence or mortality, compared with the theoretical minimum risk exposure level (<85 dBA). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We prioritized evidence from cohort studies and combined relative risk estimates using random-effect meta-analysis. To assess the robustness of findings, we conducted sensitivity analyses (leave-one-out meta-analysis and used as alternative fixed effects and inverse-variance heterogeneity estimators). At least two review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide tools and approaches adapted to this project. RESULTS: Seventeen studies (11 cohort studies, six case-control studies) met the inclusion criteria, comprising a total of 534,688 participants (39,947 or 7.47% females) in 11 countries in three WHO regions (the Americas, Europe, and the Western Pacific). The exposure was generally assessed with dosimetry, sound level meter and/or official or company records. The outcome was most commonly assessed using health records. We are very uncertain (low quality of evidence) about the effect of occupational exposure to noise (≥85 dBA), compared with no occupational exposure to noise (<85 dBA), on: having IHD (0 studies); acquiring IHD (relative risk (RR) 1.29, 95% confidence interval (95% CI) 1.15 to 1.43, two studies, 11,758 participants, I2 0%); dying from IHD (RR 1.03, 95% CI 0.93-1.14, four studies, 198,926 participants, I2 26%); having stroke (0 studies); acquiring stroke (RR 1.11, 95% CI 0.82-1.65, two studies, 170,000 participants, I2 0%); dying from stroke (RR 1.02, 95% CI 0.93-1.12, three studies, 195,539 participants, I2 0%); having hypertension (0 studies); acquiring hypertension (RR 1.07, 95% CI 0.90-1.28, three studies, four estimates, 147,820 participants, I2 52%); and dying from hypertension (0 studies). Data for subgroup analyses were missing. Sensitivity analyses supported the main analyses. CONCLUSIONS: For acquiring IHD, we judged the existing body of evidence from human data to provide "limited evidence of harmfulness"; a positive relationship is observed between exposure and outcome where chance, bias, and confounding cannot be ruled out with reasonable confidence. For all other included outcomes, the bodies of evidence were judged as "inadequate evidence of harmfulness". Producing estimates for the burden of CVD attributable to occupational exposure to noise appears to not be evidence-based at this time. PROTOCOL IDENTIFIER: 10.1016/j.envint.2018.09.040. PROSPERO REGISTRATION NUMBER: CRD42018092272.

Environmental Assessment and Evaluation of Oxidative Stress and Genotoxicity Biomarkers Related to Chronic Occupational Exposure to Benzene.

Environmental and occupational exposure to benzene from fuels is a major cause for concern for national and international authorities, as benzene is a known carcinogen in humans and there is no safe limit for exposure to carcinogens. The objective of this study was to evaluate the genotoxic effects of chronic occupational exposure to benzene among two groups of workers: filling station workers (Group I) and security guards working at vehicles entrances (Group II), both on the same busy highway in Rio de Janeiro, Brazil. Sociodemographic data on the workers were evaluated; the concentration of benzene/toluene (B/T) in atmospheric air and individual trans,trans-muconic acid (ttMA) and S-phenylmercapturic acid (S-PMA) were measured; oxidative stress was analyzed by catalase (CAT), glutathione S-transferase (GST), superoxide dismutase (SOD), thiol groups (THIOL) and malondialdehyde (MDA); genotoxicity was measured by metaphases with chromosomal abnormalities (MCA) and nuclear abnormalities, comet assay using the enzyme formamidopyrimidine DNA glycosylase (C-FPG), and methylation of repetitive element LINE-1, CDKN2B and KLF6 genes. Eighty-six workers participated: 51 from Group I and 35 from Group II. The B/T ratio was similar for both groups, but Group I had greater oscillation of benzene concentrations because of their work activities. No differences in ttMA and S-PMA, and no clinical changes were found between both groups, but linearity was observed between leukocyte count and ttMA; and 15% of workers had leukocyte counts less than 4.5 × 109 cells L-1, demanding close worker's attention. No differences were observed between the two groups for THIOL, MDA, MCA, or nuclear abnormalities. A multiple linear relationship was obtained for the biomarkers MCA and C-FPG. A significant correlation was found between length of time in current job and the biomarkers C-FPG, MCA, GST, and MDA. Although both populations had chronic exposure to benzene, the filling station workers were exposed to higher concentrations of benzene during their work activities, indicating an increased risk of DNA damage.

WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational noise and of the effect of exposure to occupational noise on cardiovascular disease.

BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from cardiovascular disease attributable to exposure to occupational noise, to inform the development of the WHO/ILO joint methodology. OBJECTIVES: We aim to systematically review studies on exposure to occupational noise (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational noise on cardiovascular diseases (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. The eligible risk factor will be occupational noise. Eligible outcomes will be hypertensive heart disease, ischaemic heart disease, stroke, cardiomyopathy, myocarditis, endocarditis and other circulatory diseases. For Systematic Review 1, we will include quantitative prevalence studies of exposure to occupational noise (i.e., low: <85 dB(A) and high: ≥85 dB(A)) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of high exposure to occupational noise on the prevalence of, incidence of or mortality due to cardiovascular disease, compared with the theoretical minimum risk exposure level (i.e., low exposure). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018092272.

Conhecimentos e práticas de adolescentes na prevenção de acidentes de trabalho: estudo qualitativo / Knowledge and practices by adolescents in preventing occupational injuries: a qualitative study

OBJETIVO: Descrever conhecimentos e práticas adotados por estudantes do ensino médio na prevenção de acidentes de trabalho. DELINEAMENTO DO ESTUDO: O estudo foi realizado em uma escola pública, localizada no Município de São Paulo, em 2003. Participaram 53 estudantes do período noturno, com idades entre 14 e 21 anos, divididos em dois grupos: com e sem experiência de trabalho (32 e 21 adolescentes, respectivamente). Eles responderam a duas questões: "Por quê os acidentes de trabalho ocorrem?" e "O que você faz para evitar que ocorram acidentes de trabalho?". As análises dos dados foram feitas no programa Quali-quanti, para a elaboração do discurso de sujeito coletivo. ANALISE DOS DISCURSOS: Para os adolescentes com experiência de trabalho, acidentes ocorrem devido ao descuido ou má sorte do funcionário, irresponsabilidade do patrão, falta de treinamento no trabalho e ambiente de trabalho inseguro. Os adolescentes sem experiência relataram que acidentes de trabalho ocorrem devido ao descuido do funcionário e irresponsabilidade do patrão. Sobre as formas de proteção dos acidentes de trabalho os adolescentes de ambos grupos relataram que: prestam (prestariam) atenção no trabalho e usam (usariam) equipamentos de segurança. CONCLUSÕES: Os adolescentes dos dois grupos mostraram conhecimento limitado sobre acidentes de trabalho e formas de prevenção. Os adolescentes apontaram como "culpa da vítima" as ocorrências dos acidentes de trabalho e a melhor forma de proteção "prestar atenção no trabalho". A cultura de culpar a vítima está presente desde a adolescência e provavelmente é resultado de um processo de aprendizado na sociedade.

OBJECTIVE: To describe knowledge and practices adopted by high school students to prevent occupational injuries. STUDY DESIGN: The study was carried out in a public school located in São Paulo, in 2003. Fifty-three evening students aged 14 to 21 years old participated the study, they were divided into two groups with and without job experience (32 and 21 students, respectively). The students answered two questions: "Why do occupational injuries occur?" and "How do you avoid occupational injuries?" Analyses were performed using the software "Quali-quanti" to structure collective discourses. ANALYSIS OF DISCOURSES: Adolescents with work experience reported that occupational injuries occur due to carelessness of the employee, bad luck of the employee, employer's negligence, lack of training, and unsafe workplace. Adolescents without work experience reported that the main causes of work injuries were carelessness of the employee and employer's negligence. Regarding the ways to protect themselves against occupational injuries, both groups reported that: they pay attention (would pay attention) and wear safety equipment (would wear) safety equipment. CONCLUSIONS: Adolescents from both groups showed limited knowledge about occupational injuries and prevention methods. Students "blamed the victim" to explain the injuries and considered "paying attention to work" as the best way to protect themselves. These facts showed that the culture of blaming the victim is present since adolescence and probably it is an outcome of a learning process of the society.

[Knowledge and practices by adolescents in preventing occupational injuries: a qualitative study]. / Conhecimentos e práticas de adolescentes na prevenção de acidentes de trabalho: estudo qualitativo.

OBJECTIVE: To describe knowledge and practices adopted by high school students to prevent occupational injuries. STUDY DESIGN: The study was carried out in a public school located in São Paulo, in 2003. Fifty-three evening students aged 14 to 21 years old participated the study, they were divided into two groups with and without job experience (32 and 21 students, respectively). The students answered two questions: "Why do occupational injuries occur?" and "How do you avoid occupational injuries?" Analyses were performed using the software "Quali-quanti" to structure collective discourses. ANALYSIS OF DISCOURSES: Adolescents with work experience reported that occupational injuries occur due to carelessness of the employee, bad luck of the employee, employer's negligence, lack of training, and unsafe workplace. Adolescents without work experience reported that the main causes of work injuries were carelessness of the employee and employer's negligence. Regarding the ways to protect themselves against occupational injuries, both groups reported that: they pay attention (would pay attention) and wear safety equipment (would wear) safety equipment. CONCLUSIONS: Adolescents from both groups showed limited knowledge about occupational injuries and prevention methods. Students "blamed the victim" to explain the injuries and considered "paying attention to work" as the best way to protect themselves. These facts showed that the culture of blaming the victim is present since adolescence and probably it is an outcome of a learning process of the society.

Sleep deprivation of working adolescents--a hidden work hazard.

This manuscript discusses the sleep deprivation of adolescents and young workers and its impact on their work and learning. Several studies have shown that working adolescents wake up earlier, have a shorter nocturnal sleep duration and a higher level of sleepiness during wake time during the week than nonworking students do. These studies indicate that working students may have their learning ability negatively affected by being tired and sleepy. Therefore, on the basis of these results, the authors recommend that educational programs geared to sleep hygiene should be one of the priorities of the curriculum. At the same time, the workhours of teenagers should be shortened in order to allow them to work and study during daytime and to have enough time at night for leisure and rest. These recommendations would improve the quality of life of the population that already is or will soon be participating in the job market.

[Job control, job demands, social support at work and health among adolescent workers]. / Controle, exigências, apoio social no trabalho e efeitos na saúde de trabalhadores adolescentes.

OBJECTIVE: To evaluate physical and psychological dimensions of adolescent labor (such as job demands, job control, and social support in the work environment), and their relation to reported body pain, work injuries, sleep duration and daily working hours. METHODS: A total of 354 adolescents attending evening classes at a public school in Sao Paulo, Brazil, answered questionnaires regarding their living and working conditions (Karasek's Job Content Questionnaire, 1998), and their health status. Data collection took place in April and May 2001. Multiple logistic regression analysis was used to determine relations among variables. RESULTS: Psychological job demands were related to body pain (OR=3.3), higher risk of work injuries (OR=3.0) and reduced sleep duration in weekdays (Monday to Thursday) (p<0.01). Lower decision authority in the workplace (p=0.03) and higher job security (p=0.02) were related to longer daily working hours. CONCLUSIONS: It was concluded that besides physical stressors, psychological factors are to be taken into account when studying adolescent working conditions, as they may be associated with negative job conditions and health effects.

Job control, job demands, social support at work and health among adolescent workers

OBJETIVO: Avaliar as dimensões físicas e psicológicas do trabalho de adolescentes (demanda de trabalho, controle no trabalho e apoio social e ambiental), relacionando-os a relatos de: dores no corpo, acidentes de trabalho, duração de sono e duração diária da jornada de trabalho. MÉTODOS: Participaram do estudo 354 estudantes do período noturno de escola pública no Município de São Paulo, entre abril e maio de 2001. Esses, responderam a questionário sobre condições de vida, trabalho (escalas Karasek de controle no trabalho) e estado de saúde. Foram feitas análises de regressão logística múltipla a fim de determinar a relação entre variáveis. RESULTADOS: As exigências psicológicas mostraram-se associadas aos relatos de dores no corpo (OR=3,3), maiores riscos de ocorrência de acidentes de trabalho (OR=3,0) e redução da duração do sono durante os dias de semana (segunda a quinta-feira) (p<0,01). Baixa autoridade de decisão (p=0,03) e maior segurança no emprego (p=0,02) estão relacionadas à maior duração da jornada diária de trabalho. CONCLUSÕES: Concluiu-se que não somente os estressores físicos, mas também os psicológicos devem ser levados em consideração quando avaliadas as condições de trabalho de adolescentes, já que esses podem ser associados às más condições de trabalho e efeitos negativos na saúde.

Occupational accidents among middle and high school students of the state of São Paulo, Brazil.

OBJECTIVES: To estimate the prevalence of occupational injuries and identify their risk factors among students in two municipalities. METHODS: A cross-sectional survey was conducted in public schools of the municipalities of Santo Antonio do Pinhal and Monteiro Lobato, Brazil. A stratified probabilistic sample was drawn from public middle and high schools of the study municipalities. A total of 781 students aged 11 to 19 years participated in the study. Students attending middle and high school answered a comprehensive questionnaire on living and working conditions, as well as aspects of work injuries, and health conditions. Multiple logistic regression models were fitted to estimate risk factors of previous and present occupational injuries. RESULTS: Of 781 students, 604 previously had or currently have jobs and 47% reported previous injuries. Among current workers (n=555), 38% reported injuries on their current job. Risk factors for work injuries with statistically significant odds ratio >2.0 included attending evening school, working as a housekeeper, waiter or brickmaker, and with potentially dangerous machines. CONCLUSIONS: The study results reinforce the need of restricting adolescent work and support communities to implement social promotion programs.

Occupational accidents among middle and high school students of the state of Säo Paulo, Brazil

OBJETIVOS: Estimar a prevalência de acidentes de trabalho entre estudantes adolescentes em área urbana e identificar os fatores de risco de ocorrência dos acidentes de trabalho. MÉTODOS: Um estudo transversal foi conduzido nas escolas públicas de ensino fundamental e médio, das cidades de Santo Antonio do Pinhal e Monteiro Lobato, Estado de Säo Paulo. Foi realizada uma amostra probabilística estratificada em duas escolas públicas de ensino médio de cada uma das duas cidades pesquisadas. O total da populaçäo pesquisada foi de 781 estudantes, de 11 a 19 anos de idade. Os estudantes responderam um questionário sobre condiçöes de vida e trabalho, incluindo as características dos acidentes de trabalho ocorridos e problemas de saúde. Foram estimados os fatores de riscos para a ocorrência de acidentes no trabalho, do passado e do presente, usando modelos de regressäo logística múltipla. RESULTADOS: Dos 781 estudantes que participaram da pesquisa, 604 relataram ter experiência de trabalho. Destes, 47por cento relataram já ter sofrido acidentes. Entre aqueles que, no período de coleta de dados, estavam trabalhando (n=555), 38por cento afirmaram ter sofrido acidentes no posto que ocupavam naquele momento. Os fatores de risco para a ocorrência de acidentes de trabalho, que apresentaram razäo de chances acima de 2,0, foram: estudar no período vespertino, exercer funçöes de empregado(a) doméstico(a), garçom ou oleiro, e trabalhar com objetos e máquinas perigosas. CONCLUSOES: Os resultados mostram a necessidade de restringir o trabalho de adolescentes, dando apoio às comunidades na implementaçäo de programas de desenvolvimento social

Unveiling factors that contribute to functional aging among health care shiftworkers in São Paulo, Brazil.

The aims of this study were to evaluate aging factors associated with work stressors, work ability, and the quality of living conditions, among health care personnel. A cross-sectional study was conducted among 176 health care shiftworkers. Two health survey questionnaires (Tuomi et al., 1997, Scandinavian Journal of Work, Environment and Health, 17(Suppl 1), 67-74; and Tepas, 1996, unpublished instrument) were completed and ergonomic work analyses (Rohmert & Landau, 1983, A new technique for job analysis, London and New York: Taylor & Francis) were carried out at the emergency wards. Main concerns about exposure at the workplace were changes in equipment and technology, transportation, and changes in employer policies. Main concerns about off-the-job conditions were personal safety, increases in the cost of living, food safety, and water and air quality. 81.7% scored adequate (> 36.5 points) in the Work Ability Index, and considered themselves having adequate current work ability to cope with physical, mental, and social demands. The most frequently reported diseases were musculoskeletal disorders and minor emotional problems.