Cross-cultural adaptation of an environmental health measurement instrument: Brazilian version of the health-care waste management • rapid assessment tool.

BACKGROUND: Periodic assessment is one of the recommendations for improving health-care waste management worldwide. This study aimed at translating and adapting the Health-Care Waste Management - Rapid Assessment Tool (HCWM-RAT), proposed by the World Health Organization, to a Brazilian Portuguese version, and resolving its cultural and legal issues. The work focused on the evaluation of the concepts, items and semantic equivalence between the original tool and the Brazilian Portuguese version. METHODS: A cross-cultural adaptation methodology was used, including: initial translation to Brazilian Portuguese; back translation to English; syntheses of these translation versions; formation of an expert committee to achieve consensus about the preliminary version; and evaluation of the target audience's comprehension. RESULTS: Both the translated and the original versions' concepts, items and semantic equivalence are presented. The constructs in the original instrument were considered relevant and applicable to the Brazilian context. The Brazilian version of the tool has the potential to generate indicators, develop official database, feedback and subsidize political decisions at many geographical and organizational levels strengthening the Monitoring and evaluation (M&E) mechanism. Moreover, the cross-cultural translation expands the usefulness of the instrument to Portuguese-speaking countries in developing regions. CONCLUSION: The translated and original versions presented concept, item and semantic equivalence and can be applied to Brazil.

Overweight and Obesity in Brazilian Immigrants in Massachusetts, USA: A Time Series Analysis (2009-2020).

INTRODUCTION: Obesity is considered a growing public health problem by the Brazilian Ministry of Health and a global epidemic by the World Health Organization (WHO). In 2020, the Centers for Disease Control and Prevention (CDC) estimated the prevalence of adult obesity at 31.9% in the USA. The USA is one of the main destinations for Brazilian immigrants in search of better living conditions, and Massachusetts is one of the states with the highest presence of Brazilians. Changes in lifestyle and eating habits are often associated with increases in overweight and obesity in immigrants in the USA, especially Hispanics, an official classification that does not, however, include Brazilians. The aim of this study was to describe the temporal trend of overweight and obesity in Brazilian immigrants assisted by the Cambridge Health Alliance (CHA) healthcare network in Massachusetts. METHODS: This was an ecological time series study of 128,206 records of Brazilians aged between 18 and 60 years based on hospital data from 2009 to 2020. RESULTS: Mean age was 38.9 (SD = 10.6), and 61% of the sample were women. The prevalence of overweight and obesity was 38.4% and 25.4%, respectively. Obesity exhibited an increasing trend, while eutrophy and overweight decreased during the study period. CONCLUSION: As little is known about the health of Brazilian immigrants in the USA, this study contributes to the literature on the subject. The observed increasing trends agree with the worldwide increase in obesity and indicate the need for future research exploring individual factors associated with immigrant acculturation.

Systematic Review and Meta-Analysis of Metabolic Syndrome and Its Components in Latino Immigrants to the USA.

The Metabolic Syndrome (MetS) is an increasingly prevalent condition globally. Latino populations in the USA have shown an alarming increase in factors associated with MetS in recent years. The objective of the present systematic review was to determine the prevalence of MetS and its risk factors in immigrant Latinos in the USA and perform a meta-analysis of those prevalence. The review included cross-sectional, cohort, or case−control studies involving adult immigrant Latinos in the USA, published during the period 1980−2020 in any language. Studies involving individuals who were pregnant, aged <18 years, immigrant non-Latinos, published outside the 1980−2020 period, or with other design types were excluded. The Pubmed, Web of Science, Embase, Lilacs, Scielo, and Google Scholar databases were searched. The risk of bias was assessed using the checklists of the Joanna Briggs Institute. The review included 60 studies, and the meta-analysis encompassed 52 studies. The pooled prevalence found for hypertension, diabetes, general obesity, and abdominal obesity were 28% (95% Confidence Interval (CI): 23−33%), 17% (95% CI: 14−20%), 37% (95% CI: 33−40%), and 54% (95% CI: 48−59%), respectively. The quality of the evidence of the primary studies was classified as low or very low. Few studies including immigrants from South America were identified. Further studies of those immigrants are needed due to the cultural, dietary, and language disparities among Latin American countries. The research protocol was registered with the Open Science Framework (OSF).

Impacts of COVID-19 on the oil and gas industry in Brazil.

This study aimed to analyze the progression of COVID-19 cases on oil and gas workers in Brazil. This is a descriptive research based on secondary data available in the COVID-19 Monitoring Bulletins of the Ministry of Mines and Energy and news about outbreaks on digital media. The findings show that the numerous news reports published on digital media indicate unhealthy working conditions, and workers' representatives appear as the main source of these findings. Managers' failure in health surveillance of this working class were also observed as to the frequent omission of official data and compulsory notifications on the health and safety of oil and gas workers.

Este estudo teve como objetivo analisar a evolução dos casos de trabalhadores do setor de petróleo e gás afetados pela covid-19 no Brasil. Tratou-se de uma pesquisa descritiva, realizada a partir de dados secundários disponíveis nos boletins de monitoramento da covid-19 do Ministério de Minas e Energia e das notícias sobre surtos de covid-19 em petroleiros publicadas nas mídias digitais. Concluiu-se que as inúmeras notícias publicadas pelas mídias digitais refletem condições de trabalho insalubres, e os representantes dos trabalhadores surgem como a principal fonte desses achados. Foram observadas ainda falhas na vigilância em saúde por parte dos gestores dessa classe trabalhadora no que concerne à frequente omissão de dados oficiais e às notificações compulsórias sobre a saúde e a segurança dos petroleiros.

Influence of Environmental Exposure to Steel Waste on Endocrine Dysregulation and PER3 Gene Polymorphisms.

OBJECTIVE: To evaluate the association between environmental exposure to the following chemical substances: cadmium (Cd), lead (Pb), nickel (Ni), manganese (Mn), benzene (BZN), and toluene (TLN), and Period Circadian Regulator 3 (PER3) gene variable number of tandem repeats (VNTR) polymorphisms, according to chronotype in a population living in a steel residue-contaminated area. METHODS: This assessment comprises a study conducted from 2017 to 2019 with 159 participants who completed health, work, and Pittsburgh sleep scale questionnaires. Cd, Pb, Ni, Mn, BZN, and TLN concentrations in blood and urine were determined by Graphite Furnace Atomic Absorption Spectrometry (GFAAS) and Headspace Gas Chromatography (GC), and genotyping was carried out using Polymerase Chain Reaction (PCR). RESULTS: A total of 47% of the participants were afternoon chronotype, 42% were indifferent, and 11% were morning chronotype. Insomnia and excessive sleepiness were associated with the indifferent chronotype, while higher urinary manganese levels were associated with the morning chronotype (Kruskal-Wallis chi-square = 9.16; p < 0.01). In turn, the evening chronotype was associated with poorer sleep quality, higher lead levels in blood, and BZN and TLN levels in urine (χ2 = 11.20; p < 0.01) in non-occupationally exposed individuals (χ2 = 6.98; p < 0.01) as well as the highest BZN (χ2 = 9.66; p < 0.01) and TLN (χ2 = 5.71; p < 0.01) levels detected in residents from the influence zone 2 (far from the slag). CONCLUSION: Mn, Pb, benzene, and toluene contaminants may have influenced the different chronotypes found in the steel residue-exposed population.

Nocturnal awakenings of Brazilian immigrants in Massachusetts.

OBJECTIVE: The purpose of this study was to assess the relationship between the quantity of jobs and nocturnal awakenings of Brazilians living in Massachusetts. MATERIAL AND METHODS: We sampled of 48 documented Brazilians around the age of 45.5 years old. 52.1% of them were women. Data gathering occurred for three weeks, using the Pittsburgh Sleep Quality Index. Participants also wore wrist actigraph and filled sleep/wake diary for a week. RESULTS: The sleep quality of immigrants with one job (mean=8.58, SD=4.16) is better when compared to immigrants with 2-3 jobs (mean=12.7, SD=3.57) according to the PSQI scores. Immigrants with 2-3 jobs reported dissatisfaction on three components of the scale: sleep duration, sleep efficiency and sleep quality. DISCUSSION: There is a positive relationship between the quantity of jobs and nocturnal awakenings and between nocturnal awakenings and complaints related to sleep apnea among Brazilians in Massachusetts. The assessment of systemic morbidities associated with sleep pattern changes should be considered in future research.

Teaching work social temporality in a public university and health. / A temporalidade social do trabalho docente em universidade pública e a saúde.

This study aimed to analyze teaching work's temporality aspects in their relationship with health. Qualitative research was conducted with the participation of ten professors from a public university. Six meetings called "Worker's Health workshops" were held, a research methodology that gathers workers and researchers to discuss topics related to work and health. The material was analyzed through the content analysis technique, in the thematic modality. The main themes were identified from the transcribed materials of the workshops' dialogues, namely: working time intensification and extension, teacher's health, working time and sleep deprivation, and health advocacy strategies and solutions. We noted that health advocacy strategies are located in individuals and the workgroup, through cooperation and social time. The theme of an intensive and extensive combination of working time associated with insecure work conditions was identified. We concluded that teaching work time is underpinned by rules and social values under the historical determination of new managerial standards within the public university.

[Quality analysis of self-reported information on sleep duration in schoolchildren in the Study of Cardiovascular Risk Factors in Adolescents (ERICA)]. / Análise da qualidade da informação autorreferida sobre duração do sono de escolares do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA).

The study aimed to assess sleep behavior in adolescents 12 to 17 years of age participating in ERICA (Study of Cardiovascular Risk Factors in Adolescents), based on sociodemographic characteristics, school shift, and type of school, and to describe the correction of inconsistent sleep times in a nationally representative study in Brazil. Data were collected in 2013 and 2014. Four questions were asked on habitual time for sleeping and waking on weekdays and weekends, with 24 possible answers, one for each hour of the day. Analysis of inconsistencies considered the distribution of frequencies of answers as to sleeping and waking times, in addition to compatibility with the school shift. Sleep duration during the week and on weekends was obtained by the difference between sleeping and waking times, and differences of ≤ 4 or ≥ 14 hours were excluded. Mean total sleep duration in seven days was calculated by the formula (weekday sleep duration x 5 + weekend sleep duration x 2)/7. The following groups were created: original data (answers that did not require correction), corrected data (inconsistent, but amenable to correction), and excluded data (inconsistent, and for which there was no criterion for correction). Correction recovered inconsistent information for 5,988 adolescents, 8% of the 74,589 participants. A total of 7,937 (10.6%) answers were excluded. Adolescents whose information was corrected or excluded were younger, predominantly males, from public schools, and from the North of Brazil. Correction minimized losses and lent greater consistency to the data treatment. The study contributes to the improvement of data collection tools in observational studies, lending transparency to the way of dealing with inherent limitations in the data collection method.

Objetivou-se avaliar o comportamento do sono de adolescentes de 12 a 17 anos, participantes do ERICA (Estudo de Riscos Cardiovasculares em Adolescentes), estudo de representatividade nacional, segundo características sociodemográficas, turno e tipo de escola, e descrever a correção das horas inconsistentes. A coleta de dados ocorreu em 2013 e 2014. Foram feitas quatro perguntas sobre horas habituais de dormir e de acordar durante a semana e no final de semana, com 24 opções de respostas, uma para cada hora do dia. A análise das inconsistências considerou a distribuição de frequências das respostas quanto às horas habituais de dormir e de acordar, além da compatibilidade com o turno. A duração do sono durante a semana e final de semana foi obtida pela diferença entre horas habituais de dormir e de acordar e foi excluída se ≤ 4 ou ≥ 14 horas. A média de sono total da semana foi calculada pela fórmula: (duração do sono durante a semana x 5 + duração do sono no final de semana x 2)/7. Foram criados três grupos: dados originais (respostas que não necessitaram correções), dados corrigidos (inconsistentes, mas passíveis de correção) e dados excluídos (inconsistentes, para os quais não se tinha critério para correção). A correção recuperou informação inconsistente de 5.988 adolescentes (8%) dos 74.589 participantes. Foram excluídas 7.937 (10,6%) respostas. Os adolescentes cujas informações foram corrigidas ou excluídas são mais novos, do sexo masculino, de escolas públicas e da Região Norte. A correção minimizou perdas e conferiu maior consistência ao tratamento dos dados. O estudo contribui para o aprimoramento da construção de instrumentos de coleta de dados em estudos observacionais, tornando transparente a forma de lidar com as limitações inerentes ao método de coleta de dados.

El objetivo fue evaluar el comportamiento del sueño en adolescentes de 12 a 17 años, participantes en el ERICA (Estudio de Riesgos Cardiovasculares en Adolescentes), según características sociodemográficas, turnos y tipos de escuela, donde además se describe la corrección de las horas incompatibles en un estudio de nivel nacional en Brasil. La recogida de datos se realizó en 2013 y 2014. Se hicieron cuatro preguntas sobre las horas habituales de sueño y de despertarse durante la semana y el fin de semana, con 24 opciones de respuesta, una para cada hora del día. El análisis de las incompatibilidades consideró la distribución de frecuencias en las respuestas, respecto a las horas habituales de sueño y de despertarse, además de la compatibilidad con el turno. La duración del sueño durante la semana y fin de semana se obtuvo mediante la diferencia entre horas habituales de sueño y de despertarse y fue excluida si ≤ 4 ó ≥ 14 horas. La media de sueño total de la semana se calculó mediante la fórmula: (duración del sueño durante la semana x 5 + duración del sueño durante el fin de semana x 2)/7. Se crearon tres grupos: datos originales (respuestas que no necesitaron correcciones), datos corregidos (inconsistentes, pero plausibles de corrección) y datos excluidos (inconsistentes en los que no había criterio para la corrección). La corrección recuperó información inconsistente de 5.988 adolescentes (8%) de los 74.589 participantes. Se excluyeron 7.937 (10,6%) respuestas. Los adolescentes cuya información fue corregida o excluida son más jóvenes, sexo masculino, procedentes de escuelas públicas y de la región Norte. La corrección minimizó pérdidas y otorgó una mayor consistencia al tratamiento de los datos. El estudio contribuye al perfeccionamiento de la creación de instrumentos de recogida de datos en estudios observacionales, haciendo transparente la forma de enfrentarse a las limitaciones inherentes del método de recogida de datos.

Profile of disability retirement among civil servants at Oswaldo Cruz Foundation, 2012-2016.

BACKGROUND: Disability retirement, an outcome of permanent incapacity for work, represents 14.5% of pensions granted by the Brazilian National Social Security Institute. However, there are no data available for civil servants. OBJECTIVE: To describe the epidemiological profile of disability retirement among employees of Oswaldo Cruz Foundation (FIOCRUZ) in the period from 2012 to 2016. METHODS: Cross-sectional study in which we analyzed the following variables: age, sex, total working time, years of work at FIOCRUZ, position and reason for retirement as per ICD-10 codes. The significance level was set to p=0.05 and all the data are presented with 95% confidence interval. RESULTS: The prevalence of disability retirement in the analyzed period was 113/10,000 employees. Employees granted disability retirement benefits worked about 9 years less. Odds for disability were higher for technicians (prevalence ratio-PR=6.83) and technical assistants (PR=7.67). Mental and behavioral disorders were the main reason for disability retirement (38.71%). CONCLUSION: Noncommunicable diseases are the main cause of disability retirement. We call the attention to the need to revise the legislation that establishes mandatory retirement after 24 months of sick leave. An interdisciplinary occupational health surveillance approach is necessary to obtain accurate knowledge of the actual situation in workplaces and of the impacts of work processes.

INTRODUÇÃO: A aposentadoria por invalidez decorre da incapacidade laboral permanente. Estima-se que essas representem 14,5% do total de aposentadorias do Instituto Nacional do Seguro Social, não havendo dados disponíveis no setor público federal. OBJETIVO: Descrever o perfil epidemiológico das aposentadorias por invalidez entre os servidores da Fundação Oswaldo Cruz (FIOCRUZ), no período de 2012 e 2016. MÉTODOS: Realizou-se um estudo transversal, utilizando-se como variáveis idade, sexo, tempo de trabalho total, tempo de trabalho na Fiocruz, cargo exercido e motivo da aposentadoria segundo capítulo da Classificação Estatística Internacional de Doenças e Problemas Relacionados com a Saúde - 10ª edição (CID-10). Nas análises, um valor de p=0,05 e o intervalo de confiança de 95% (IC95%) foram sempre considerados. RESULTADOS: A prevalência para aposentadoria por invalidez no período de 2012 a 2016 foi de 113/10.000 servidores. Se aposentar por invalidez representou cerca de 9 anos a menos de trabalho. Trabalhar como técnico (razão das prevalências - RP=6,83) e assistente técnico (RP=7,67) foi ter mais chance de se aposentar por invalidez. Os transtornos mentais e comportamentais foram os que mais motivaram o desfecho, representando 38,71% dos casos. CONCLUSÃO: As doenças crônicas não transmissíveis são as principais causas de aposentadoria por invalidez. Sugere-se reavaliar o dispositivo legal de aposentadoria compulsória aos 24 meses de afastamento. Faz-se necessária uma abordagem interdisciplinar de vigilância em saúde do trabalhador para conhecimento da realidade nos ambientes e o impacto dos processos de trabalho.

Epidemiological profile of sickness absenteeism at Oswaldo Cruz Foundation from 2012 through 2016.

BACKGROUND: Accurate knowledge of the prevalence and profile of sickness absenteeism enables direct analysis of work environments and the health-disease process. OBJECTIVE: To establish the prevalence and profile of sick leaves granted to Oswaldo Cruz Foundation (FIOCRUZ) employees from 2012 through 2016. METHOD: Cross-sectional study with analysis of variables sex, age range, age at onset of sick leave, job position, FIOCRUZ unit, leave type, ICD code, leave duration, number of leave extensions, and outcomes; p=0.05 and 95% confidence interval were considered in all the analyses. RESULTS: Work accidents accounted for 2.30% of sick leaves; the absenteeism rate was 2.89%. Musculoskeletal diseases (21.2%), mental and behavioral disorders (13.1%) and consequences of external causes (11.3%) were the main reasons for sick leave. Mental and behavioral disorders exhibited the longest median leave duration (30 days). The odds of requiring a sick leave were highest among women (OR=4.08), employees with technical positions (OR=2.86), aged 25 to 34 years old (OR=2.68) or allocated to production units (OR=176.30) and hospitals (OR=34.05). CONCLUSIONS: We corroborate the relevance of accurate knowledge of aspects related to absenteeism for the planning of strategies to promote the functional capacity of workers, and reduce its consequences on the health-work-disease relationship.

INTRODUÇÃO: Conhecer a prevalência e o perfil do absenteísmo por doença permite a análise indireta dos ambientes de trabalho e do processo saúde-doença. OBJETIVO: Estabelecer a prevalência e o perfil de licenças médicas na Fundação Oswaldo Cruz (FIOCRUZ), entre 2012 e 2016. MÉTODO: Realizou-se um estudo transversal, utilizando-se como variáveis sexo, faixa etária, idade no início do afastamento, cargo, unidade de trabalho, tipo de licença, CID, número de dias de afastamento, número de prorrogações e desfecho. Nas análises, um valor de p=0,05 e o intervalo de confiança de 95% (IC95%) foram sempre considerados. RESULTADOS: A taxa de acidentes de trabalho foi de 2,30% do total de licenças e a de absenteísmo, de 2,89%. As desordens musculoesqueléticas (21,2%), os transtornos mentais e comportamentais (13,1%) e as causas externas (11,3%) foram as principais causas de afastamento, e os transtornos mentais apresentaram a maior mediana de dias de afastamento (30,00). As mulheres (OR=4,08), os que ocupam cargos técnicos (OR=2,86), os trabalhadores na faixa etária de 25 a 34 anos (OR=2,68) e as unidades de produção (OR=176,30) e hospitalares (OR=34,05) apresentaram as maiores chances de licença. CONCLUSÕES: Ratifica-se a importância do conhecimento sobre as questões relacionadas ao absenteísmo, de modo que estratégias de manutenção da funcionalidade dos trabalhadores e redução das consequências nas relações saúde-trabalho-doença possam ser encontradas.

Lead and mercury levels in an environmentally exposed population in the Central Brazil. / Avaliação dos níveis de chumbo e mercúrio em população exposta ambientalmente na Região Centro-oeste do Brasil.

The objective was to assess the level of exposure to lead and mercury in a population in the Pantanal region in Mato Grosso State, Brazil. Blood lead (PbB) (n = 119) and urinary mercury (HgU) (n = 109) in local residents were measured by atomic absorption spectrometry. Comparison of means and correlations between variables used analysis of variance (ANOVA) and linear regression, respectively, with 95% confidence intervals. Mean PbB was 2.82 ± 1.53µg dL-1. The comparison of PbB stratified by collection site (p ≤ 0.01), work activity (p ≤ 0.01), and consumption of locally produced cow's milk (p ≤ 0.05) showed statistically significant differences. There were also positive associations between PbB and collection site (p ≤ 0.01), participants' profession (p ≤ 0.05), local milk (p ≤ 0.01), and source of drinking water (p ≤ 0.01). Mean HgU was 1.41 ± 0.98µg L-1. The levels only showed significant differences for participants' profession (p ≤ 0.01), and positive associations emerged between HgU and work activity (p ≤ 0.01) and body mass index (p ≤ 0.01). The samples showed low lead and mercury levels, similar to those found in other environmentally exposed populations. Despite these low concentrations, current knowledge on the toxicity of these metals shows that health effects can already be felt at levels that were previously considered safe, thus characterizing a health hazard.

O objetivo foi avaliar o nível de exposição ao chumbo e mercúrio em população do Pantanal Mato-grossense, Brasil. Chumbo no sangue (Pb-S) (n = 119) e mercúrio na urina (Hg-U) (n = 109) de moradores da região foram determinados por espectrometria de absorção atômica. A comparação de médias e correlação entre as variáveis utilizaram o teste ANOVA e a regressão linear, respectivamente, com 95% de confiança. Pb-S médio foi 2,82 ± 1,53µg dL-1. A comparação de Pb-S estratificado por local de coleta (p ≤ 0,01), atividade laboral (p ≤ 0,01) e consumo de leite produzido na região (p ≤ 0,05) mostrou diferenças estatisticamente significativas. Também houve associações positivas entre Pb-S e local de coleta (p ≤ 0,01), profissão dos participantes (p ≤ 0,05), consumo de leite da região (p ≤ 0,01) e origem da água de consumo (p ≤ 0,01). A média de Hg-U foi 1,41 ± 0,98µg L-1. Os teores mostraram diferenças significativas apenas quanto à profissão dos participantes (p ≤ 0,01), e associações positivas surgiram entre Hg-U e atividade profissional (p ≤ 0,01) assim como índice de massa corporal dos sujeitos de estudo (p ≤ 0,01). As amostras apresentaram baixos níveis de chumbo e mercúrio, semelhantes àqueles encontrados em populações também expostas ambientalmente. Apesar dessas baixas concentrações, o conhecimento atual sobre toxicidade desses metais mostra que efeitos à saúde já podem ser sentidos em níveis antes considerados seguros, o que caracteriza o perigo.

El objetivo fue evaluar el nivel de exposición al plomo y mercurio en una población del Pantanal Mato-grossense, Brasil. El plomo en sangre (Pb-S) (n = 119) y mercurio en la orina (Hg-U) (n = 109) de los habitantes de esa región se determinó por espectrometría de absorción atómica. La comparación de medias y la correlación entre las variables utilizaron el test ANOVA y la regresión lineal, respectivamente, con un 95% de confianza. Pb-S medio fue 2,82 ± 1,53µg dL-1. La comparación de Pb-S estratificado por lugar de recogida (p ≤ 0,01), actividad laboral (p ≤ 0,01) y consumo de leche que se produjo en la región (p ≤ 0,05) mostró diferencias estadísticamente significativas. También hubo asociaciones positivas entre Pb-S y el lugar de recogida (p ≤ 0,01), profesión de los participantes (p ≤ 0,05), consumo de leche de la región (p ≤ 0,01) y origen del agua de consumo (p ≤ 0,01). La media de Hg-U fue 1,41 ± 0,98µg L-1. Los porcentajes mostraron diferencias significativas sólo respecto a la profesión de los participantes (p ≤ 0,01), y las asociaciones positivas surgieron entre Hg-U y la actividad profesional (p ≤ 0,01), así como índice de masa corporal de los sujetos de estudio (p ≤ 0,01). Las muestras presentaron bajos niveles de plomo y mercurio, semejantes a aquellos encontrados en poblaciones también expuestas ambientalmente. A pesar de esas bajas concentraciones, el conocimiento actual sobre toxicidad de estos metales muestra que los efectos sobre la salud, ya pueden ser apreciados en niveles antes considerados seguros, lo que caracteriza el peligro.

Exposição ocupacional ao Sars-CoV-2: investigação das condições de saúde/segurança dos trabalhadores essenciais para subsidiar ações de mitigação de risco da Covid-19 / Occupational exposure to SARS-CoV-2: investigation of the health/safety conditions of essential workers to support COVID-19 risk mitigation actions

RESUMO Em janeiro de 2020, a Organização Mundial da Saúde declarou a Covid-19 como emergência de saúde pública no mundo. Diante da ausência de medidas farmacológicas, a única prevenção adotada foi o distanciamento físico. Porém, trabalhadores essenciais ficaram submetidos às políticas de gestão de saúde e segurança das empresas. O objetivo deste artigo é investigar as condições de saúde e segurança dos trabalhadores expostos ao Sars-CoV-2, por meio da aplicação de ferramentas de inovação tecnológica, para dar suporte e subsidiar ações de mitigação de risco da doença. Trata-se de estudo transversal, conduzido na plataforma REDCap, por instrumento autoaplicável de comunicação de risco de trabalhadores em atividade presencial e remota, no Brasil. Participaram 2.476 trabalhadores, dos quais, 723 foram aceitos por análise de consistência das respostas. A idade média foi de 43,5 anos, sexo feminino (53,3%), cor branca (62%), carga de 21-40 horas semanais (60%) e Covid-19 em 27,4% da amostra. A maioria (75,2%) considerou que a transmissão ocorreu no trabalho e que medidas de proteção coletiva foram insuficientes. Os achados apontam deficiências nos planos de contingência das empresas, que repercutem em insegurança e risco de exposição ao Sars-CoV-2, reduzindo a eficácia das medidas sanitárias e transformando o trabalho em lócus de disseminação do vírus.

ABSTRACT In January 2020, the World Health Organization declared COVID-19 a public health emergency worldwide. Given the absence of pharmacological measures, the only prevention adopted was physical distancing. However, essential workers were subject to the health and safety management policies of companies. The aim of this article is to investigate the health and safety conditions of workers exposed to SARS-CoV-2, using the application of technological innovation tools, to support and subsidize disease risk mitigation actions. This is a cross-sectional study, conducted in the Redcap platform, by a self-administered instrument of risk communication of workers in face-to-face and remote activities, in Brazil. A total of2,476 workers took part, 723 of whom were accepted by analysis of consistency of responses. The average age was 43.5 years, female (53.3%), white (62%), working 21-40 hours a week (60%) and Covid-19 in 27.4% of the sample. Most (75.2%) considered that the transmission occurred at work and the collective protection measures were insufficient. The findings point to deficiencies in the contingency plans of the companies, which have repercussions on the insecurity and risk of exposure to SARS-CoV-2, reducing the effectiveness of sanitary measures and transforming the work into locus of dissemination of the virus.

[Notebooks on health and work: diaries of public university professors]. / Cadernetas de saúde e trabalho: diários de professores de universidade pública.

The main objective of this article is to present and analyze the research instrument called "health and work notebooks", focusing on the production of knowledge concerning professors' work at a public university. The notebooks serve as a qualitative and participant research technique that is appropriate for the in-depth study of relations between health and work, viewing workplaces as privileged spaces for exercising effective action in the defense of health and the work experience as the principal material for analysis. The notebooks' special quality as a research technique lies in worker's role as protagonist in the research, as the diary's author and co-participant in the study. Eight professors participated, all from the same institute in a federal university (IFES) in Rio de Janeiro, Brazil. As for analysis of the empirical materials from the notebooks and consistent with the workers, the thematic analysis technique was adopted, producing four main discussion categories: time on the job and professors' multiple work activities; precarization of working conditions at universities; faculty health at limits; and the notebooks viewed from the authors' perspective. As for the results, the theme that stood out was work overload and time pressure to meet targets. Finally, the health and work notebooks proved to be a potential research tool for generating knowledge from a collective perspective.

Este artigo tem como objetivo principal apresentar e analisar o instrumento de pesquisa designado como "cadernetas de saúde e trabalho", com foco na produção de conhecimento sobre o trabalho de docentes de universidade pública. Trata-se de uma técnica de investigação de caráter qualitativo e participativo, adequada ao aprofundamento do estudo das relações entre a saúde e o trabalho, reavendo os locais de trabalho como lugares privilegiados de observações para o exercício de uma efetiva ação de defesa da saúde e a experiência do trabalho como matéria principal de análise. A qualidade especial das cadernetas como técnica de investigação refere-se ao papel protagonista atribuído ao trabalhador no processo de pesquisa, autor do diário e coparticipante do estudo. Participaram oito docentes pertencentes ao mesmo instituto de uma universidade federal de ensino superior (IFES), localizada no Rio de Janeiro, Brasil. Quanto à análise dos materiais empíricos, procedentes das anotações das cadernetas e de encontro com os trabalhadores, adotou-se a técnica de análise temática, chegando-se a quatro categorias principais de discussão, a saber: o tempo de trabalho e as múltiplas atividades de trabalho do professor; precarização das condições de trabalho em universidades; saúde docente entre limites e cadernetas sob o olhar dos seus autores. No que concerne aos resultados, sobressaiu o tema alusivo à sobrecarga de trabalho e pressão do tempo para cumprimento de metas. Ao fim, considerou-se que as cadernetas de saúde e trabalho mostraram-se como ferramenta de pesquisa com potencial para se gerar conhecimento em perspectiva coletiva.

El objetivo principal de este artículo es presentar y analizar el instrumento de investigación denominado "cartillas de salud y trabajo", centrándose en la producción de conocimiento sobre el trabajo de docentes de universidad pública. Se trata de una técnica de investigación de carácter cualitativo y participativo, adecuada a la profundización del estudio de las relaciones entre la salud y el trabajo, reincorporando los lugares de trabajo como lugares privilegiados de observación para el ejercicio de una efectiva acción de defensa de la salud, y la experiencia laboral como materia principal de análisis. La cualidad especial de las cartillas como técnica de investigación se refiere al papel protagonista, atribuido al trabajador en el proceso de investigación, autor del diario y coparticipante del estudio. Participaron ocho docentes pertenecientes al mismo instituto de una universidad federal de enseñanza superior (IFES), localizada en Río de Janeiro, Brasil. En cuanto al análisis de los materiales empíricos, procedentes de las anotaciones de las cartillas y de encuentros con los trabajadores, se adoptó la técnica de análisis temático, llegándose a cuatro categorías principales de discusión, a saber: el tiempo de trabajo y las múltiples actividades de trabajo del profesor; precarización de las condiciones de trabajo en universidades; salud docente entre límites y cartillas bajo la atenta mirada de sus autores. En lo que concierne a los resultados, se resaltó el tema alusivo a la sobrecarga de trabajo y presión de tiempo para el cumplimiento de metas. Al final, se consideró que las cartillas de salud y trabajo se mostraron como herramientas de investigación con potencial para generar conocimiento desde una perspectiva colectiva.

Sleep and sleepiness among working and non-working high school evening students.

The aim of this study was to evaluate patterns of sleepiness, comparing working and non-working students. The study was conducted on high school students attending evening classes (19:00-22:30 h) at a public school in São Paulo, Brazil. The study group consisted of working (n=51) and non-working (n=41) students, aged 14-21 yrs. The students answered a questionnaire about working and living conditions and reported health symptoms and diseases. For seven consecutive days, actigraphy measurements were recorded, and the students also filled in a sleep diary. Sleepiness ratings were given six times per day, including upon waking and at bedtime, using the Karolinska Sleepiness Scale. Statistical analyses included three-way ANOVA and t-test. The mean sleep duration during weekdays was shorter among workers (7.2 h) than non-workers (8.8 h) (t=4.34; p<.01). The mean duration of night awakenings was longer among workers on Tuesdays and Wednesdays (28.2 min) and shorter on Mondays (24.2 min) (t=2.57; p=.03). Among workers, mean napping duration was longer on Mondays and Tuesdays (89.9 min) (t=2.27; p=.03) but shorter on Fridays and Sundays (31.4 min) (t=3.13; p=.03). Sleep efficiency was lower on Fridays among non-workers. Working students were moderately sleepier than non-workers during the week and also during class on specific days: Mondays (13:00-15:00 h), Wednesdays (19:00-22:00 h), and Fridays (22:00-00:59 h). The study found that daytime sleepiness of workers is moderately higher in the evening. This might be due to a work effect, reducing the available time for sleep and shortening the sleep duration. Sleepiness and shorter sleep duration can have a negative impact on the quality of life and school development of high school students.

Perfil demográfico e clínico de casos ocupacionais de sensibilização a metilisotiazolinona e Kathon CG: estudo seccional / Demographic and clinical profile of occupational cases of sensitization to methylisothiazolinone and Kathon CG: a cross-sectional study

Resumo Introdução: a metilisotiazolinona isolada ou associada à metilcloroisotiazolinona (Kathon CG) é um conservante relacionado à dermatite de contato alérgica ocupacional. Objetivos: avaliar o perfil demográfico e clínico dos casos ocupacionais de sensibilização a isotiazolinonas no município do Rio de Janeiro e descrever a presença desses preservativos em tintas nacionais. Métodos: estudo transversal baseado em informações de prontuários de trabalhadores submetidos a testes de contato entre 2013-2017. Descreveu-se a prevalência de características clínicas, demográficas e ocupacionais e utilizou-se um modelo não-ajustado para investigar a associação entre variáveis. Buscou-se a presença e a concentração de isotiazolinonas nas fichas de composição química de tintas nacionais. Resultados: dentre os 768 trabalhadores submetidos aos testes, 68 apresentavam dermatose ocupacional com resultado positivo para sensibilização à metilisotiazolinona/Kathon CG. As profissões mais acometidas foram as relacionadas a atividades domésticas e limpeza. Houve maior chance de sensibilização às isotiazolinonas nas mulheres e naqueles com acometimento das mãos e das pernas. Entre as 61 tintas avaliadas, 26 possuíam alguma isotiazolinona, sendo a metilcloroisotiazolinona a mais comum. Conclusões: a sensibilização às isotiazolinonas pode impactar a saúde do trabalhador e demanda maior vigilância com materiais de limpeza e cosméticos, assim como a discussão da regulação da composição de tintas comercializadas no país.

Abstract Introduction: methylisothiazolinone alone or associated with methylchloroisothiazolinone (Kathon CG) is a preservative related to occupational allergic contact dermatitis. Objectives: to evaluate the demographic and clinical profile of occupational cases of sensitization to isothiazolinones in the city of Rio de Janeiro and to describe the presence of these preservatives in national paints. Methods: cross-sectional study based on information from medical records of workers who underwent patch testing between 2013-2017. The prevalence of clinical, demographic and occupational characteristics was described and an unadjusted model was used to investigate the association between variables. We sought the presence and concentration of isothiazolinones in the chemical composition sheets of national paints. Results: among the 768 workers submitted to the tests, 68 had occupational dermatosis with a positive result for sensitization to methylisothiazolinone/Kathon CG. The most affected occupations were those related to domestic activities and cleaning. There was a greater likelihood of sensitization to isothiazolinones in women and in those with involvement of the hands and legs. Among the 61 paints evaluated, 26 had some isothiazolinone, with methylchloroisothiazolinone being the most common. Conclusions: sensitization to isothiazolinones can impact workers' health and demands greater vigilance on cleaning materials and cosmetics, as well as discussing the composition regulation of the paints sold in Brazil.

[The new organization of labor at public universities: collective consequences of job instability on the health of teachers]. / A nova organização do trabalho na universidade pública: consequências coletivas da precarização na saúde dos docentes.

The main objective of this article is to analyze the new organization of labor of university teachers, seeking to investigate the potential relationship with the health status of these workers. It is based on the assumption that job instability in public universities has had repercussions on the health of higher education teachers. A qualitative exploratory study was conducted by means of bibliographic research in indexed databases. As a method of analysis, thematic analysis was used, focusing on four empirical categories, namely: job instability in the teaching profession; intensification of labor; aspects of the organization of teaching work in universities; and data on the health of university teachers. It was revealed in the literature that the use of strong organizational pressures prevails in the university scenario and consequently the intensification of labor is prevalent, with emphasis on the issue of increasing the demand for academic productivity. It was also observed that the topic of excess workload of teachers is recurrent and the concept of availability of less leisure time prevails. In addition, the need for organized collective resistance was confirmed in order to modify the job instability of teaching work.

Este artigo tem como principal objetivo analisar a nova organização do trabalho dos professores universitários, estabelecendo uma relação com o panorama de saúde desses trabalhadores. Parte-se do pressuposto segundo o qual a precarização do trabalho nas universidades públicas vem gerando repercussões na saúde dos docentes da educação superior. Realizou-se um estudo qualitativo de caráter exploratório por meio de pesquisa bibliográfica em bases de dados indexadas. Como método de análise, lançou-se mão da analise temática, chegando a quatro categorias empíricas, sendo elas: precarização do trabalho docente; intensificação laboral; aspectos da organização do trabalho docente em universidade; e dados sobre a saúde dos docentes universitários. Verificou-se, na literatura, que prepondera no cenário das universidades o uso de fortes pressões organizacionais e como consequência produz-se a intensificação do trabalho, com destaque para a questão do aumento da exigência de produtividade acadêmica. Constatou-se, ainda, que o tema da sobrecarga de trabalho do professor é recorrente e prevalece a ideia de menor disponibilidade de tempo para o lazer. Além disso, confirmou-se o imperativo da resistência coletiva organizada de maneira a se modificar o quadro de precarização do trabalho do professor.

Work ability of health care shift workers: What matters?

This paper aims at identifying variables associated with inadequate work ability among nursing personnel at a public hospital, considering factors related to socio-demographic, lifestyles, working conditions, and health outcomes. A cross-sectional study was conducted in a university hospital in São Paulo, Brazil, as part of a larger research study on tolerance to 12 h night work. Nursing staff included registered nurses, nurse technicians, and nurse aides; in total, there were 996 healthcare workers (878 female; 118 male) at the time of the study. Some 696 workers (69.9%) of the population agreed to participate. Data collection (October 2004-July 2005) was based on a comprehensive questionnaire about living and working conditions (including incivility at work, work demands, work control, and support), mental and physical health symptoms (fatigue and sleep problems), and work ability. This report presents analyses of the adapted Brazilian version of the Work Ability Index (WAI) and associated variables. The study population worked one of the following shift schedules at this hospital: 12 h nights followed by 36 h off or 9 h or 6 h day (morning or afternoon) shifts. The mean age of the respondents was 34.9 (S.D.+/-10.4) years of age; 31.5% of the participants held two jobs. Statistical analyses using a hierarchical multiple logistic regression model were performed to evaluate the factors associated with inadequate (moderate and low scores) of the WAI. The significantly associated factors were socio-demographic (income responsibility, sole breadwinner, raising kids, age group), working conditions (thermal discomfort, organization of the workplace, and verbal abuse), and health outcomes (high body mass index, obesity, sleep problems, and fatigue). In spite of limitations of the study design, results indicate that the nursing profession is associated with stressful working conditions, contributing to inadequate WAI. This is in addition to bad living conditions and precarious work. Intervention measures, either at the workplace or at individual levels, are necessary to prevent a decrease in work ability, even in this quite young working population.

Work ability and health of security guards at a public University: a cross-sectional study.

OBJECTIVE: to evaluate the work ability and health status of security guards at a public University. METHODS: a cross-sectional, descriptive, and analytical study was carried with 119 security guards. The following instruments were used: Work Ability Index (WAI), Patient Health Questionnaire (PHQ-9), International Physical Activity Questionnaire (IPAQ, short), Alcohol Use Disorders Identification Test (AUDIT), Medical Outcomes Study (MOS), and Demand-Control-Support (DCS). Descriptive statistics were used to describe the study samples and the Spearman's coefficient correlation was performed to assess the WAI. Significance level was set at 5%. RESULTS: samples were composed by men; the mean age was 54.9 years (SD=5.7); 80% had partners, and 75% had basic education. The majority (95%) had only one job, the average length of service was 24.8 years (SD=11), ranging from 3 to 43 years. 88.9% worked ≤40 hours and 75% did not work at night shift or rotating shifts. The average score given to work ability was good (40.7 points), with significant correlation to social support at work (p-value=0.002), health conditions (p-value=0.094), and depression symptoms (p-value=0.054). CONCLUSION: this study showed that many characteristics might affect the work ability scores. Considering the results, we note that healthy life habits and a reorganization of work environments should be encouraged.

Work ability and associated factors of Brazilian technical-administrative workers in education.

BACKGROUND: Studies about work ability have grown in importance owing to the worldwide aging of active populations. Research has shown that measuring work ability has a predictive value in cases of long-term sickness absence and early retirement. Our goal was to analyze the work ability and associated factors of civil servants from a higher education institution in Brazil. The participants in this cross-sectional study were 600 technical-administrative workers at a public university. Work ability was measured using the work ability index. RESULTS: The participants were as follows: 51.8% male; mean age of 45 years (SD = ±11); married or in a stable union (61.5%); holding a graduate degree (56.7%); having only one job (83.3%), working 40 h a week or less (78.6%); not working evenings (79.8%); and having direct contact with the public (58.3%). The prevalence of reduced work ability was 13.9%. The following factors were found to be associated with reduced work ability: age 50 years old or above (PR = 2.58; 95% CI 1.25-5.09); female (PR = 2.77; 95% CI 1.25-3.60); education up to secondary school (PR = 2.37; 95% CI 1.13-3.59); overall poor self-assessed health (PR = 2.96; 95% CI 1.32-3.93); signs and symptoms of depression (PR = 4.86; 95% CI 2.23-6.55); sedentariness (PR = 3.00; 95% CI 1.38-4.68) and poor social support at work (PR = 4.01; 95% CI 1.66-4.37). CONCLUSIONS: Most of the participants showed good work ability, but some subjects had reduced work ability. This study makes a contribution to expanding the discussion about the factors associated with work ability toward proposing actions for maintaining that ability or helping recovery in the case of diminished ability. Such actions can help reduce work absenteeism and early retirement, both of which have a social and economic impact in Brazil. Studying the determinants of work ability and recommendations to address those determinants will help efforts to improve the quality of life of individuals, both at work and personally, and promote healthy aging.