Vigilância epidemiológica hospitalar de Goiás: 1ª coletânea de boletins dos núcleos hospitalares de epidemiologia / Hospital epidemiological surveillance in Goiás: 1st collection of bulletins from hospital epidemiology centers

Coletânea de 13 boletins publicados no site da Secretaria de Estado da Saúde de Goiás, que se destacaram por descrever o perfil de morbimortalidade da unidade e apresentar temas relevantes para a população do Estado de Goiás. Trata-se de um estudo descritivo, realizado com dados do período de janeiro a março de 2023, com informações provenientes das declarações de óbitos e prontuário eletrônico do paciente

Collection of 13 bulletins published on the Goiás State Department of Health website, which stood out for describing the unit's morbidity and mortality profile and presenting relevant themes for the population of the State of Goiás. This is a descriptive study, carried out with data from January to March 2023, with information from death certificates and the patient's electronic medical record

Estudio de las heridas por amoladora tratadas en el Hospital de Clínicas y Hospital Pasteur, Montevideo, Uruguay / Grinder injuries treated at the Clínicas and Pasteur Hospital of Montevideo, Uruguay / Estudo das lesões por esmerilhadeira tratadas no Hospital de Clínicas e Hospital Pasteur, Montevidéu, Uruguai

Resumen: Introducción: las heridas causadas por amoladora representan una consulta frecuente al cirujano plástico en nuestro país. Los objetivos del presente trabajo fueron conocer la epidemiología de los pacientes que consultaban con estas lesiones, conocer las circunstancias del accidente y estudiar si existía relación entre las condiciones de uso de la herramienta y la gravedad de las lesiones. Material y método: se realizó un estudio descriptivo, transversal, donde se recabaron los datos de los pacientes que consultaban por heridas por amoladora en las puertas de emergencia de Hospital Pasteur y Hospital de Clínicas en un período de 6 meses. Resultados: un total de 76 pacientes fueron incluidos en el estudio, la mayoría de sexo masculino, en edad laboral activa (39 a 58 años) dedicados a la realización de trabajos temporales o tareas de construcción, con bajo nivel de instrucción. El 84% de las heridas fueron graves. El 61% de los pacientes no utilizó los elementos de seguridad de la herramienta al momento del accidente. La mayoría de las lesiones se produjeron fuera del ambiente laboral. Conclusiones: en base a nuestro trabajo pudimos establecer el perfil epidemiológico de la población más susceptible de sufrir estas lesiones. Comprobamos que las heridas producidas por amoladora son en su mayoría graves y requieren procedimientos complejos para su resolución.

Summary: Introduction: grinder injuries represent a large number of consultations for plastic surgeons in our country. This study aims to learn about the epidemiological characteristics of patients who consulted for these lesions and the circumstances of the accidents, and to analyze whether there is a relationship between the conditions for tool use and the severity of lesions. Methodology: we conducted a retrospective, descriptive, transversal study where we collected data from the patients who consulted for grinder injuries at the emergency departments of Pasteur and Clínicas Hospital during a 6-month period. Results: seventy-six patients were included in the study, most of which were male working adults (between 39 and 58 years-old) who had temporary jobs or were performing construction works and had low levels of education. 84% of lesions were severe. 61% of patients did not respect safety regulations at the time of the accident. Most lesions occurred out of working hours. Conclusions: based on our study, we could identify the epidemiological profile of the most vulnerable population for this kind of lesions. We proved that most grinder lesions are severe and their management requires complex procedures.

Resumo: Introdução: as lesões causadas por esmerilhadeira são causa frequente de consulta ao cirurgião plástico no Uruguai. Os objetivos do presente trabalho foram conhecer as características dos pacientes que consultaram com essas lesões, conhecer as circunstâncias do acidente e analisar a possível relação entre as condições de uso da ferramenta e a gravidade das lesões. Metodologia: foi realizado um estudo descritivo, transversal, onde foram coletados dados de pacientes que consultaram por lesões de esmerilhadeira no pronto-socorro do Hospital Pasteur e Hospital de Clínicas durante um período de 6 meses. Resultados: foram incluídos no estudo 76 pacientes, a maioria do sexo masculino, em idade ativa para trabalhar (39 a 58 anos) dedicados à realização de trabalhos temporários ou trabalhos na construção civil, com baixo nível de escolaridade. 84% dos ferimentos foram graves. 61% dos pacientes não utilizaram os elementos de segurança da ferramenta no momento do acidente. A maioria das lesões ocorreu fora do ambiente de trabalho. Conclusões: com base em nosso trabalho conseguimos estabelecer o perfil da população mais suscetível a esses agravos. Constatamos que a maioria das lesões causadas por esmerilhadeiras são graves, exigindo procedimentos complexos para sua resolução.

Dynamics of severe accidents in the oil & gas energy sector derived from the authoritative ENergy-related severe accident database.

Organized into a global network of critical infrastructures, the oil & gas industry remains to this day the main energy contributor to the world's economy. Severe accidents occasionally occur resulting in fatalities and disruption. We build an oil & gas accident graph based on more than a thousand severe accidents for the period 1970-2016 recorded for refineries, tankers, and gas networks in the authoritative ENergy-related Severe Accident Database (ENSAD). We explore the distribution of potential chains-of-events leading to severe accidents by combining graph theory, Markov analysis and catastrophe dynamics. Using centrality measures, we first verify that human error is consistently the main source of accidents and that explosion, fire, toxic release, and element rupture are the principal sinks, but also the main catalysts for accident amplification. Second, we quantify the space of possible chains-of-events using the concept of fundamental matrix and rank them by defining a likelihood-based importance measure γ. We find that chains of up to five events can play a significant role in severe accidents, consisting of feedback loops of the aforementioned events but also of secondary events not directly identifiable from graph topology and yet participating in the most likely chains-of-events.

Vigilância em Saúde do Trabalhador e articulações intersetoriais no enfrentamento do trabalho infantil em Diadema, SP, Brasil / Surveillance in Occupational Health and intersectorial articulations in the fight against child labour in Diadema, SP, Brazil

Este artigo visa apresentar uma intervenção desenvolvida no âmbito de atuação do Centro de Referência em Saúde do Trabalhador de Diadema, SP. Os objetivos foram analisar os acidentes de trabalho com adolescentes notificados pela rede municipal de saúde de 2009 a 2019 e relatar as estratégias intersetoriais e as ações de vigilância e prevenção implementadas. Foram analisados os dados do Sistema de Informação de Agravos de Notificação, relatórios técnicos das vigilâncias e registros de reuniões e eventos da equipe. Dos 5.179 acidentes de trabalho graves notificados, 7,5% atingiram jovens entre 14 e 17 anos, sendo 72% do sexo masculino e 28% do feminino. A compreensão do fenômeno de modo ampliado foi favorecida pela discussão intersetorial e pelo matriciamento na saúde. Foram constatadas as dificuldades dos profissionais de saúde em identificar o acidente de trabalho e a negação dos pais sobre as condições adversas de trabalho. Espera-se superar a invisibilidade e subnotificação das situações de trabalho infantil e contribuir para aplicação dos princípios da precaução e da prevenção para construir paradigmas protetivos sobre as crianças e suas famílias no enfrentamento do trabalho infantil

This study aims to show an intervention developed within the scope of the Worker's Health Reference Centre in Diadema. We analysed municipal health network reports of occupational accidents with adolescents from 2009 to 2019 to assess intersectoral strategies and the implemented surveillance and prevention actions. Notifiable Diseases Information System, technical reports from surveillance, and records of our team's meetings and events of were analyzed. Of the 5,179 reported serious work accidents, 7.5% affected young people aged between 14 and 17 years, 72% of which were boys and 28%, girls. Intersectoral discussion and a matrix health support favoured a broader understanding of the phenomenon. We found difficulties of healthcare providers in identifying work accidents and parents' denial about adverse working conditions. We expect to overcome the invisibility and underreporting of child labour and contribute to the application of principles of precaution and prevention to build protective paradigms for children and their working families to combat child labour

Lesiones traumáticas en la mano por el uso de amoladora. Un problema en nuestro medio / Traumatic injuries to the hand from the use of an angle grinder. A problem in our field

Introducción: Las lesiones en las manos causadas por amoladora son comunes y generalmente ocurren en adultos jóvenes. En países en desarrollo, el ámbito doméstico y el trabajo informal son los escenarios más frecuentes. El objetivo de este estudio fue describir factores asociados a las lesiones por amoladora, y cuantificar y clasificar las heridas, según la gravedad y la región anatómica de la mano involucrada. Materiales y Métodos: Se realizó un estudio epidemiológico, retrospectivo. Entre 2016 y 2020, estudiamos a los pacientes con heridas de mano causadas por amoladora. Se analizaron el nivel educativo, la experiencia con la herramienta, el material cortado, el uso de equipo de protección personal, la edad y el sexo. Para determinar el patrón de las lesiones se realizó un análisis clínico-anatómico y radiológico detallado e individualizado. La gravedad fue evaluada con el Hand Injury Severity Score. Resultados: Se evaluó a928 pacientes (920 hombres y 8 mujeres, edad promedio 42 años). Solo el 22,4% usaba equipo de protección personal en el momento del accidente. El 84,5% (776 casos) realizaba tareas inusuales para la que esta herramienta no fue diseñada. La mano más afectada fue la izquierda (62,06%). En 784 pacientes, las heridas involucraban los dedos, el patrón de asociación predominante fue entre el 2do y 3er dedo (54,44%). Las lesiones fueron leves (24,1%), moderadas (41,3%), graves (26%) y mayores (8,6%). Conclusiones: Las lesiones por amoladora pueden resultar devastadoras. Una actualización epidemiológica reforzaría la necesidad de desarrollar métodos preventivos con el fin de disminuir su alta incidencia. Nivel de Evidencia: IV

Introduction: Hand injuries caused by angle grinders are frequent and generally take place among young adults. In developing countries, the domestic and informal work environments are the most frequent places where this could happen. The present study is aimed at describing associated factors to these types of injuries. Lesions were quantified and classified according to the sever-ity and anatomic region of the hand involved. Methods: An epidemiologic, retrospective study was performed between 2016 and 2020. The patients' level of education, previous experience using the machine, use of personal protective equipment (PPE), sex, and age were analyzed. To determine the pattern of the injuries, a clinical-anatomical and a detailed and individualized radiological analysis were performed on each patient. The severity was measured using the "Hand Injury Severity Score" (HISS). Results: 928 patients were studied (920 men, 8 women, average age of 42 years [range 18-67]). Only 22.4% were wearing PPE at the time of the accident. 776 participants were performing tasks for which the tool was not intended (84.5%). The left hand was the most af-fected (60%). In 784 patients, the injuries involved their fingers (84.48%); the predominant pattern was the index and middle finger (55%). According to the HISS, 24.1% were minor injuries, 41.3% were moderate, 26% were serious, and 8.6% were severe. Con-clusions: Injuries caused by an angle grinder can be devastating. We believe that an epidemiological update is likely to increase the need to develop preventive methods to decrease its high incidence. Level of Evidence: IV

Enfermedades, lesiones y accidentes en trabajadores de la construcción en Uruguay, período 2014-2018 / Illnesses, injuries and accidents among construction workers in Uruguay, 2014-2018

El presente trabajo se realizó en el marco de las actividades de investigación y extensión del Departamento de Salud Ocupacional de la Facultad de Medicina Universidad de la República, por iniciativa de los trabajadores del sindicato único de la construcción y afines. El objetivo fue conocer el perfil de salud y enfermedad de los trabajadores del sector con el propósito de generar acciones que promuevan la salud laboral del colectivo involucrado. La investigación realizada es de carácter descriptivo a partir de fuentes secundarias. De los resultados se destacaron las enfermedades del aparato osteomioarticular, lesiones por traumatismos o envenenamiento y patologías del aparato respiratorio como principales causas de ausentismo de origen médico. La patología osteomioarticular fue la primera causa de incapacidad total y también es la primera causa de incapacidad para la tarea en el periodo estudiado. La tasa de incidencia acumulada de los accidentes en el año 2014 fue de 81,8 por 1.000 trabajadores cotizantes de la construcción, presentando una caída sostenida hasta el 2018 que alcanzó el valor de 60,2 por 1.000 trabajadores cotizantes. El tipo de accidente más frecuente observado en el periodo fueron las lesiones a esfuerzo excesivo. Con respecto a los accidentes mortales existe una caída marcada entre los años 2014 al 2016 con un ascenso progresivo en 2018. De la investigación surge como necesidad mejorar el reconocimiento de la patología profesional en el sector, profundizar las acciones en seguridad y salud con énfasis en aspectos ergonómicos de la carga física(AU)

This study was carried out under the framework of the research and outreach activities of the Department of Occupational Health of the School of Medicine of the University of the Republic, as an initiative of the workers of its single union of construction and related industries. The objective was to describe the health and disease profile of workers in the sector in order to generate actions to promote their occupational health. The study was descriptive and consisted of a secondary analysis of existing data. Musculoskeletal disorders, traumatic injuries, poisonings and respiratory illnesses were the main cause of sickness absence. Musculoskeletal disorders were the main cause of both work-related and total disability. The cumulative incidence rate of injuries in 2014 was 81.8 per 1000 dues-paying construction workers, and subsequently declined until 2018, to an incidence of 62.2 per 1000 dues-paying workers. Overexertion was the most common mechanism of injury. With respect to fatal accidents, there was a arked decline between 2014 and 2016, followed by a progressive increasein 2018. This study underscores the need to improve the recognition of occupational illness and injury in the construction and related industries sector, and to add depth to safety and health interventions, with an emphasis on ergonomic aspects of physical loads(AU)

Viral hepatitis caused by occupational accidents: distribution of cases in Brazil, 2007-2014 / Hepatites virais por acidentes de trabalho: distribuição dos casos no Brasil, 2007-2014 / Hepatitis viral por accidentes de trabajo: distribución de casos en Brasil, 2007-2014

Background and Objectives: to analyze the distribution of cases of viral hepatitis due to occupational accidents in Brazil from 2007 to 2014. Methods: this is an ecological study of a descriptive nature of notifications of viral hepatitis registered in the Information System for Notifiable Diseases. Results: they point out that the mean incidence of viral hepatitis due to occupational accidents in Brazil was 2 cases/1,000,000 of the economically active and employed population. There was an increasing trend in the Midwest region (p=0.02), among women (p=0.01) and those aged 38 to 49 years and 50 and older (p=0.01). The decreasing time trend was observed among those up to 37 years old and for non-black race/skin color (p=0.04). Conclusion: the temporal distribution was stationary in most regions and states in Brazil, increasing among female workers over 38 years old and decreasing among non-black women and under 37 years old.(AU)

Justificativa e Objetivos: analisar a distribuição dos casos de hepatites virais por acidentes de trabalho no Brasil de 2007 a 2014. Métodos: trata-se de um estudo ecológico de natureza descritiva das notificações de hepatites virais registradas no Sistema de Informação de Agravos de Notificação. Resultados: apontam que a incidência média de hepatites virais por acidentes de trabalho no Brasil foi de 2 casos/1.000.000 da população economicamente ativa e ocupada. Houve tendência de aumento na região Centro-Oeste (p=0,02), entre as mulheres (p=0,01) e entre 38 a 49 anos e 50 anos ou mais (p=0,01). A tendência temporal decrescente foi observada entre aqueles com até 37 anos e para raça/cor da pele não preta (p=0,04). Conclusão: a distribuição temporal foi estacionária na maioria das regiões e estados do Brasil, aumentando entre as trabalhadoras acima de 38 anos e diminuindo entre as mulheres não negras e com menos de 37 anos.(AU)

Justificación y Objetivos: analizar la distribución de los casos de hepatitis viral por accidentes de trabajo en Brasil de 2007 a 2014. Métodos: se trata de un estudio ecológico de carácter descriptivo de las notificaciones de hepatitis viral registradas en el Sistema de Información de Enfermedades de Declaración Obligatoria. Resultados: señalan que la incidencia media de hepatitis viral por accidente de trabajo en Brasil fue de 2 casos/1.000.000 de población económicamente activa y ocupada. Hubo una tendencia creciente en la región del Medio Oeste (p=0,02), entre las mujeres (p=0,01) y las de 38 a 49 años y 50 y más (p=0,01). La tendencia temporal decreciente se observó entre los de hasta 37 años y para raza/color de piel no negra (p=0,04). Conclusión: la distribución temporal fue estacionaria en la mayoría de las regiones y estados de Brasil, aumentando entre las trabajadoras mayores de 38 años y disminuyendo entre las mujeres no negras y menores de 37 años.(AU)

Assessment of ergonomic exposure, work-related occupational injuries, and prevention: Child work in the brickfield industry in India.

Child labor is an infraction of fundamental human rights, and it prevents the children's physical, psychosocial, and psychological development. In India, children have been working in different unorganized sectors as paid laborers. Children were found performing a fair amount of manual, rigorous tasks in the brickfield industry due to socioeconomic disadvantages. Child brickfield workers suffered from musculoskeletal pain and injuries due to working with a heavy physical workload, which hampers the overall quality of life. A study had been conducted among these child brickfield laborers from India during 2011-2017. The study found laceration (38.7% male and 36.9% female) as the primary injury followed by sprain and strain, scratches, avulsion, and fractures among child brickfield workers. The study shows that child workers are highly prone to injuries, mainly toe (23.9% male and 28.1% female), hands (22.0% male and 23.4% female), wrists, feet, ankles, and fingers. The injury rate among male and female child brickfield laborers was 7.64 and 9.52 per 1000 workers. The primary source of injuries in brickfields was due to falling from height. Several risk factors, including biomechanical, work stress, may play a key role in work-related injuries among child brickfield laborers.

Hand injuries during COVID-19: Lessons from lockdown.

The two-month nationwide lockdown implemented in Australia in response to COVID-19 involved restrictions on social gatherings and non-essential services, resulting in marked changes to the distribution of time spent at home and in the workplace. Given the likelihood of future lockdowns, this study aimed to investigate whether the lockdown was associated with an alteration in the pattern of acute hand injuries admitted to Sydney Hospital Hand Unit relative to the same period in 2019, and whether target areas for preventative strategies could be identified. During the lockdown period in 2020, 332 acute presentations were noted, and in the same period in 2019, 310 cases were noted. The mean patient age was higher in 2020, largely due to a 327% increase in do-it-yourself (DIY) injuries. Workplace injuries increased in 2020 despite a 9.5% reduction in hours-worked, reflecting a redistribution of workers into manual labour jobs with a higher risk for hand injuries. Patients who suffered low-energy injuries at work were also significantly younger in 2020, suggesting this effect was most pronounced in younger age-groups, probably due to the shutdown of hospitality-based industries. Domestic violence-related injuries increased in 2020, highlighting the need to maintain resources to provide support in such cases at subspecialty hand units, which are often largely outpatient-centred. This study, therefore, identified a number of key areas that could be targeted in the event of future lockdowns, including messages regarding safe DIY activities, and more stringent requirements regarding worksite briefing and safety for people commencing labour-based jobs, especially if transferring from another industry.

Injuries outside of horseracing: is it time to focus on injury prevention of jockeys outside of races?

Objectives: Falls and injuries are frequent in professional horseracing. However, professional jockeys spend a large part of their week in horse-related activities outside of racing such as schooling, exercise riding, and yard-related activities. The injury risk related to these activities remains largely unknown internationally. This study aimed to identify the injury prevalence and injury profile of flat and jump jockeys during non-racing activities. Methods: In total 45.6% and 38.5% of all licensed Irish professional flat and jump jockeys completed a cross-sectional self-recall questionnaire examining injuries that occurred outside of racing during 2018. Injury proportion, repeat incidence proportion, and descriptive statistics were calculated. Results: Fifteen percent of professional jockeys sustained an injury outside of a race, half of those injured receiving at least another injury in 2018 and 66.52 injuries per 1,000 falls were noted. Injuries frequently occurred to the upper limb (36.67%), with fractures common (32.00%). Most injuries occurred due to a fall (60.00%) and 77.27% occurred in the gallops. Half of injuries resulted in the jockey missing racing, with 31.00 ± 47.18 (4-180) days lost on average. Twenty-three percent of jockeys attended hospital and 16.67% required surgery due to injury. Interestingly, just under a third did not report their injury to anyone. Conclusion: Injuries to professional jockeys, whilst not as frequent outside of racing, tend to be serious and can affect jockeys financially and impact their availability to ride. Prioritizing injury prevention strategies to maximize availability of jockeys to race is important. Education on the importance of reporting all injuries regardless of where they occur is important to ensure their management and rehabilitation.

Acidentes de trabalho com exposição a materiais biológicos entre trabalhadores no norte de Minas Gerais / Work accidents with exposure to biological materials betweenworkers in the north of Minas Gerais / Accidentes de trabajo con exposición a materiales biológicos entre trabajadores en el norte de Minas Gerais

Objetivo: Descrever o perfil dos acidentes com exposição a material biológico ocorridos em Minas Gerais. Métodos: estudo epidemiológico, descritivo e transversal realizado por meio da consulta do Sistema de Informação de Agravos de Notificação dos municípios do norte de Minas Gerais, no período de 2008-2012. Resultados: dentre os 56 municípios investigados 28 notificaram 1025 acidentes, 46,1% ocorreram entre técnicos e auxiliares de enfermagem, 14,7% por estudantes e pelos médicos com 11,6% das ocorrências. Houve predomínio dos acidentes com profissionais de 30 a 39 anos, em procedimentos cirúrgicos, descarte inadequado de materiais perfuro cortantes e administração de medicamentos. Verificou-se que a exposição percutânea, o sangue como material orgânico e agulhas como agente. Conclusão: as causas dos acidentes mais comumente estão diretamente relacionadas com a maneira em executar as atividades no decorrer do trabalho, desencadeadas por ineficiência dos equipamentos de proteção individuais ou coletivos, percebe-se a fragilidade no cumprimento da norma regulamentadora

Objective:To describe the profile of accidents with exposure to biological material that occurred in Minas Gerais. Methods: an epidemiological, descriptive and cross-sectional study carried out by consulting the Notification Disease Information System of the municipalities of northern Minas Gerais, from 2008-2012. Results: among the 56 municipalities investigated 28 reported 1025 accidents, 46.1% occurred among technicians and nursing assistants, 14.7% by students and doctors with 11.6% of occurrences. There was a predominance of accidents with professionals aged 30 to 39 years, in surgical procedures, improper disposal of sharps and administration of medication. Percutaneous exposure, blood as organic material and needles as agent were found. Conclusion: the causes of accidents most commonly are directly related to the way to perform activities during work, triggered by inefficiency of individual or collective protective equipment, it is perceived the weakness in compliance with the regulatory standard

Objetivo: Describir el perfil de accidentes con exposición a material biológico ocurridos en Minas Gerais. Métodos: un estudio epidemiológico, descriptivo y transversal realizado mediante la consulta del Sistema de Información de Enfermedades de Notificación de los municipios del norte de Minas Gerais, de 2008 a 2012. Resultados: entre los 56 municipios investigados, 28 reportaron 1025 accidentes, 46.1% ocurrieron entre técnicos y auxiliares de enfermería, 14.7% por estudiantes y médicos con 11.6% de incidentes. Predominaron los accidentes con profesionales de 30 a 39 años, en procedimientos quirúrgicos, eliminación inadecuada de objetos punzantes y administración de medicamentos. Se encontraron exposición percutánea, sangre como material orgánico y agujas como agente. Conclusión: las causas de accidentes más comúnmente están directamente relacionadas con la forma de realizar actividades durante el trabajo, desencadenadas por la ineficiencia de los equipos de protección individuales o colectivos, se percibe la debilidad en el cumplimiento de la norma reguladora

Incidência e tendência temporal de acidentes de trabalho na indústria têxtil e de confecção: análise de Santa Catarina, Brasil, entre 2008 e 2017 / Incidence and time trend of occupational accidents in the textile and clothing industry: analysis of Santa Catarina, Brazil, between 2008 and 2017

RESUMO: Objetivo: Estimar a incidência e a tendência temporal dos acidentes de trabalho típicos na indústria têxtil e de confecção de Santa Catarina no período de 2008 a 2017. Métodos: Trata-se de um estudo epidemiológico retrospectivo baseado nos dados da Relação Anual de Informações Sociais (RAIS). A tendência temporal foi analisada por meio do cálculo da mudança média anual e da regressão logística. Resultados: Houve tendência de queda na incidência de acidentes de trabalho em Santa Catarina no período estudado (8,8%). Observaram-se as maiores taxas de acidentes no ano de 2008 entre homens (12,6%), trabalhadores com faixa de idade entre 40 e 49 anos (6,7%), negros (7,4%), pessoas com menos de 12 anos de estudo (5,0%), com remuneração média de 3 a 7 salários mínimos (7,0%), com até quatro anos de tempo de emprego (6,9%), trabalhadores da fabricação de produtos têxteis (10,3%), estabelecimentos de médio porte (100 a 499 trabalhadores) (7,9%) e nas regiões da Grande Florianópolis (7,0%) e Vale do Itajaí (6,8%). Conclusões: O risco de acidente de trabalho típico caiu significativamente ao longo do período. Contudo futuros estudos são necessários para analisar novas relações que possam apontar outros fatores associados. Espera-se que este estudo possa contribuir para subsidiar ações de prevenção, promoção, proteção e reabilitação da saúde dos trabalhadores desse setor produtivo.

ABSTRACT: Objective: To estimate the incidence and time trend of typical work accidents in the textile and clothing industry in Santa Catarina from 2008 to 2017. Methods: This was a retrospective epidemiological study based on data from the Annual Social Information Report (RAIS). The time trend was analyzed by calculating the average annual change and logistic regression. Results: There was a downward trend in the incidence of occupational accidents in Santa Catarina during the period studied (8.8%). The highest incidence occurred in 2008 among men (12.6%), workers aged between 40 and 49 years (6.7%), black people (7.4%), people with less than 12 years of education (5.0%), with an average income of 3 to 7 minimum wages (7.0%), with up to 4 years of employment (6.9%), workers in the manufacture of textile products (10, 3%), medium-sized establishments (that is, between 100 and 499 workers; 7.9%) and in the regions of Greater Florianópolis (7.0%) and Vale do Itajaí (6.8%). Conclusions: The risk for typical occupational accidents dropped significantly over the period studied. However, future studies are needed to analyze new relationships that may point to other associated factors. It is hoped that this study can contribute to support measures for the prevention, promotion, protection and rehabilitation of the health of workers in this production sector.

[Using Trigger Tool to detect incidents and adverse events in a mutual insurance company that collaborate with the Social Security system]. / Uso del Trigger Tool para la Detección de Incidentes y Eventos Adversos en una Mutua Colaboradora con la Seguridad Social.

OBJECTIVE: To evaluate differences between the detection of incidents or adverse events (I/AE) using a Trigger Tool (TT) and voluntary notification platform (SNEA). METHODS: The study population is the working population attended on an outpatient basis in an Insurance Company ("mutua") from January to September 2016. The cases declared as Incident or Adverse Event (I / AE) were selected through the SNEA (21 cases), according to whether the event has not affected the patient or on the contrary has affected him. On the other hand, 20 clinical histories per month were randomly selected where the TT was applied(180 cases). The 201 clinical histories were reviewed looking for the existence of triggers. The agreement between the SNEA system and the TT was evaluated using proportion of positive agreement (I/EA), proportion of negative agreement (not I/EA) and Kappa index. RESULTS: TT detected I/EA cases in 41.3% of the revisions while the SNEA was 10.3% (p<0.001). The Kappa index showed a low concordance value (Kappa = 0.12), which indicates the small coincidence of I/EA detected by both systems. The proportion of negative agreement was greater than that of positive agreement (74.5% versus 26.9%). The SNEA system detected less I/ EA and above all it deals with fewer incidents. On the contrary, the TT system detected a greater number of I EA and especially EA. CONCLUSIONS: Trigger Tool is a recommended tool for the detection of incidents or adverse events that can complement the one obtained through voluntary notification platform in the reality of a "mutua".

OBJETIVO. Evaluar diferencias entre la detección de incidentes o eventos adversos (I/EA) en una mutua laboral, mediante una herramienta tipo Trigger Tool (TT) y una plataforma de notificación voluntaria (SNEA). MÉTODOS. La población de estudio es la población trabajadora atendida ambulatoriamente en una mutua laboral de Enero a Septiembre del 2016. Se seleccionaron los casos declarados como I/EA según si el evento no ha afectado al paciente o por el contrario le ha afectado, a través del SNEA (n=21 casos). Por otro lado, se seleccionaron aleatoriamente 20 historias clínicas por mes donde se aplicó la herramienta TT (180 casos). Se adaptaron 11 triggers para detectar I/EA. Se revisaron las 201 historias clínicas buscando la existencia de triggers. Se obtuvo la concordancia entre el sistema SNEA y el TT utilizando la proporción de concordancia positiva (I/EA), proporción de concordancia negativa (no I/EA) e índice Kappa. RESULTADOS. TT detectó casos de I/EA en el 41,3% de las revisiones mientras que el SNEA 10,3% (p<0,001). El índice Kappa ofreció un valor de concordancia baja (Kappa=0,12) lo que denota la pequeña coincidencia de sucesos adversos detectados por ambos sistemas. La proporción de concordancia negativa fue mayor que la de concordancia positiva (74,5% frente a un 26,9%). El sistema SNEA detectó menos I/EA y sobre todo se trata de menos incidentes. Por el contrario, el sistema TT detectó mayor número de I/EA y especialmente EA. CONCLUSIONES. Trigger Tool es una herramienta recomendable para la detección de incidentes o eventos adversos que puede complementar la obtenida mediante una plataforma de notificación voluntaria en la realidad de una Mutua laboral.

Upper extremity replantation and revascularization in Finland between 1998 and 2016.

Emergency replantation and revascularization operations of upper extremity injuries demand considerable resources, but their actual occurrence is unknown. This study evaluated all emergency replantations and revascularizations in the upper extremity in Finland from 1998 to 2016. A total of 2,434 operations were identified within the study period. The average number of operations per year was 128 which corresponds with 2.4 operations per 100,000 person years. Operations were most common in persons aged 20 to 59 years and the rate of operations ranged from 1.4 to 5.0 per 100,000 person years. Thirteen percent of the patients were women and 87% were men. This study shows rates of emergency replantation and revascularization operations in upper extremity injuries and proves that the rates have been constant over the past 19 years in Finland.

Factors Associated with Primary and Secondary Amputation following Limb-Threatening Upper Extremity Trauma.

BACKGROUND: The aim of this study was to assess the factors associated with primary and secondary amputation in patients with limb-threatening trauma to the upper extremity, describe the incidence of these injuries, and describe the procedures involved in the treatment of these difficult injuries. METHODS: A retrospective study of 49 cases (in 47 patients) with acute limb-threatening trauma of the upper extremity proximal to the carpometacarpal joint level treated with either amputation or limb salvage was performed in two urban level I trauma centers between January of 2001 and January of 2018. RESULTS: Bivariate analysis demonstrated that cases of primary amputation more frequently had a higher Injury Severity Score, higher Abbreviated Injury Scale score, more proximal fractures, more severe muscle injuries, and a larger number of major nerve injuries. Secondary amputation, compared with limb salvage, was more frequently performed in patients who were younger, in cases with a higher Injury Severity Score, where there was more proximal soft-tissue injury, in case of nonsharp mechanism of injury, and in cases that required local flap procedures for wound closure. The authors found a yearly incidence of 62 cases of acute limb-threatening upper extremity trauma per 100,000 trauma admissions. CONCLUSIONS: Multiple factors influence the surgical decision to perform primary amputation or to attempt a salvage procedure following limb-threatening upper extremity trauma. Knowing which patients will have the most favorable outcomes of a salvage procedure is important, because salvage procedures impose a greater burden on the health care system and the patient, even more so in the case of secondary amputation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

Prevalence study on self-declared work accidents in areas covered by family health strategies: a cross-sectional study

ABSTRACT BACKGROUND: Occupational accidents are a complex phenomenon and a major public health problem. Occupational health surveillance actions are essential for prevention of injuries of this nature. OBJECTIVE: To ascertain the prevalence of and the variables associated with occupational accidents in the city of Itajubá (MG). DESIGN AND SETTING: A cross-sectional study with a quantitative approach, based on a household survey with random sampling, was conducted in areas covered by the Family Health Strategy (FHS) in Itajubá (MG). METHODS: Questionnaires were applied to 292 people. The data were analyzed by means of logistic regression. RESULTS: The prevalence of occupational accidents was 8.6%. The underreporting rate was 60.0%. The scenario for these accidents, according to the model established through the regression analysis, was most likely to involve males who declared their skin color as white and who did not have a formal employment contract. CONCLUSION: This study makes a contribution towards unveiling the relationship between healthcare and work, and thus serve as support for the development of strategies to prevent underreporting. Lastly, the results provide the basis for future public health intervention actions and for future studies.

[Pathologist occupational hazards: Results of a survey for the French case]. / Risques professionnels chez les pathologistes : résultats d'une enquête française.

INTRODUCTION: The profession of pathologist exposes to various risks, notably infectious, physical and chemical. The objective of this study was to make an inventory of these occupational risks to which pathologists are subjected and to evaluate the pathologies that they presented. A particular attention was given to microscopic and screen work as they can induce musculoskeletal or ophthalmic disorders, and stress-related psychological disorders. METHOD: An anonymous online questionnaire containing 54 questions had been sent by mail to pathologists via the French Society of Pathology and the Syndicate of French Pathologists. RESULTS: Five hundred and twelve pathologists responded to the survey. Thirty-eight percent reported musculoskeletal disorders in the last 6 months. Visual disturbances concerned 73.4% of respondents. In the last 12 months, 33.3% of pathologists had been injured or had had mucosal projections during macroscopic or autopsy specimens. The frequency of infectious diseases was low (6.2%) as well as that of cancers (3.9%). Psychological disorders such as depression or burnout were reported by 16.7% of respondents. Pathologists seemed happy at work and had a good overall lifestyle. Few doctors had medical follow-up and few had benefited from ergonomic advice and training on the risks of chemicals. CONCLUSION: The results of this study showed the interest of a medical surveillance adapted to the pathologies presented by the pathologists. Educational and preventive measures should be introduced early in the career, focusing on ergonomics and learning about chemical and biological hazards.

Impacto da quarentena pela COVID-19 no perfil epidemiológico de queimados em Minas Gerais, Brasil / Impact of quarantine due to COVID-19 on the epidemiological profile of burns in Minas Gerais, Brazil

OBJETIVO: Analisar o impacto da quarentena pela COVID-19 no número e no perfil epidemiológico de queimados no estado de Minas Gerais, Brasil. MÉTODO: Estudo retrospectivo por meio da análise de dados quantitativos e qualitativos de acidentes por queimaduras registrados pelo Corpo de Bombeiros Militar de Minas Gerais entre janeiro de 2019 e abril de 2020. RESULTADOS: Foram analisados 285 registros de queimaduras entre janeiro de 2019 e abril de 2020, com redução de 22,25% nos atendimentos, quando comparados os primeiros quatro meses dos dois anos. O tipo de queimadura mais frequente foi a térmica (86,67%) e a água quente representou o agente etiológico mais comum (19,57%), seguido do álcool (18,84%). Pacientes do gênero masculino foram mais acometidos, 60% de janeiro a abril de 2019 e 53% em 2020, e a maioria classificados como pardos (31,93%). A faixa etária com maior incidência foi entre 18 e 64 anos (77,19%) e 61,40% das lesões foram classificadas como leves. O grau de queimadura mais prevalente foi de segundo grau (17,19%) e em 32,28% dos pacientes a superfície corporal total queimada foi menor que 10%. O número de queimaduras provindas de acidente de trabalho reduziu 25% se comparados os primeiros quadrimestres de 2019 e 2020. CONCLUSÕES: Pode-se sugerir que a quarentena pela COVID-19 levou à diminuição do número de pacientes atendidos por queimaduras em Minas Gerais e teve impacto no perfil epidemiológico desses pacientes, como a queda no número de ocorrências no local de trabalho e na faixa etária economicamente ativa. (AU)

OBJECTIVE: To analyze the impact of quarantine by COVID-19 on the number and epidemiological profile of burnings in the state of Minas Gerais, Brazil. METHODS: Retrospective study through the analysis of quantitative and qualitative data of burn injuries recorded by the Military Fire Department of Minas Gerais between January 2019 and April 2020. RESULTS: 285 burn records were analyzed between January 2019 and April 2020, with a 22.25% reduction in the number of attendances, when compared to the first four months of the two years. The most frequent type of burn was thermal (86.67%) and hot water represented the most common etiologic agent (19.57%), followed by alcohol (18.84%). Male patients were more affected, 60% from January to April 2019 and 53% in 2020, and the majority classified as brown (31.93%). The age group with the highest incidence was between 18 and 64 years of age (77.19%), and 61.40% of the lesions were classified as mild. The most prevalent burn degree was second degree (17.19%) and in 32.28% of the patients the total body surface burned was less than 10%. The number of burns from accidents at work reduced 25% compared to the first four months of 2019 and 2020. CONCLUSIONS: It can be suggested that the quarantine by COVID-19 led to a decrease in the number of burn patients in Minas Gerais and had an impact on the epidemiological profile of these patients, such as the decrease in the number of occurrences in the workplace and the economically active age group. (AU)

Queimaduras ocupacionais no Distrito Federal, Brasil: Estudo retrospectivo de 17 anos / Work-related burns in the Federal District, Brazil: A 17-year retrospective study

OBJETIVO: Avaliar a epidemiologia das queimaduras ocupacionais e as características sociodemográficas das vítimas de queimaduras internadas em um hospital público no período de 17 anos. MÉTODO: Estudo longitudinal, retrospectivo de abordagem quantitativa realizado na unidade de queimados de um hospital público no Brasil de janeiro de 2002 a dezembro de 2018. Entre 4201 queimados internados nesse período, 497 foram vítimas de queimaduras no ambiente de trabalho e tiveram seus prontuários médicos e de alta hospitalar avaliados retrospectivamente. RESULTADOS: A maioria dos pacientes era do sexo masculino (88,5%) e a média de idade foi de 35 anos (intervalo, 18-74). As causas mais frequentes de queimaduras foram eletricidade (41,1%), líquidos inflamáveis (27,5%) e chamas (11,7%). As ocupações mais comuns foram: eletricista (25,3%), cozinheiro (10,9%) e mecânico (8,2%). A superfície corporal queimada média foi de 15,4% e a taxa de mortalidade foi de 2,6%. Variações anuais foram observadas na frequência mensal de acidentes de trabalho, com aumento do número de queimaduras em maio e novembro, que são meses que precedem festividades culturais no Brasil. CONCLUSÃO: Poucas mudanças na epidemiologia e gravidade das queimaduras ocupacionais foram observadas no período de 17 anos de estudo, sugerindo que os programas de prevenção não foram eficazes na redução de queimaduras no ambiente de trabalho. Assim, novas iniciativas dos setores público e privado são necessárias, visando a prevenção de queimaduras de trabalho.

OBJECTIVE: To evaluate the epidemiology of work-related burns and sociodemographic characteristics of burn victims admitted to a public hospital over a period of 17 years. METHODS: This longitudinal, retrospective, quantitative study was conducted in the burn unit of a public hospital in Brazil from January 2002 to December 2018. Of the 4201 burn patients admitted to the hospital during the study period, 497 of them were victims of work-related burns, and therefore their hospital discharge summary and medical records were retrospectively reviewed. RESULTS: Most patients were men (88.5%) and the mean age was 35 years (range, 18-74). Electricity was the most frequent cause of burns (41.1%), followed by flammable liquids (27.5%) and flames (11.7%). The most common occupations were electricians (25.3%), cooks (10.9%), and mechanics (8.2%). The mean total body surface area involved was 15.4% and the mortality rate was 2.6%. Annual periodic variations were observed in the monthly frequency of work-related burns, with an increased number of burn accidents occurring in May and November, which are months that precede cultural festivities in Brazil. CONCLUSIONS: Few changes in the epidemiology and severity of work-related burns were observed during the 17-year study period, suggesting that prevention programs have not been effective in reducing burn accidents in the workplace. Thus, new initiatives from the public and private sectors aiming at preventing work-related burn injuries are necessary.