Influencia da Qualidade do Sono na Qualidade de Vida no Trabalho de Policais Militares / Influencia de la Calidad del Sueño en la Calidad de Vida en el Trabajo de la Policía Militar / Influence of Sleep Quality on the Quality of Life and Work of Military Police Officers

Resumo Introdução: A profissão policial é considerada de alto risco e exige um vigor físico e mental do trabalhador diante do serviço realizado. De tal modo que uma boa qualidade do sono é importante, pois impacta diretamente em diversos aspectos na saúde desses trabalhadores. Ademais, a falta de uma boa qualidade do sono devido ao trabalho pode influenciar negativamente a qualidade de vida no trabalho. Objetivo: Analisar a influência da qualidade do sono na qualidade de vida no trabalho de policiais militares. Metodologia: Estudo quantitativo, correlacionalde corte transversal, realizado no primeiro semestre de 2019, com policiais de três municípios da Bahia, Brasil. Foram utilizados três instrumentos: sociodemográfico e características laborais; qualidade de vida de vida no trabalho; e qualidade do sono. Foi aplicado o teste do qui quadrado para as variáveis sociodemograficas e ocupacionais. Posteriormente, foi aplicado o teste de correlação de Spearman entre a qualidade do sono com as dimensões da qualidade de vida no trabalho. Resultados: Evidenciou-se entre os 298 policiais que a mediana da idade foi de 40 anos e tempo de serviço ≤ 7 anos, observou-se também que os policiais com pior qualidade do sono apresentaram qualidade de vida no trabalho insatisfatória em todas as dimensões (biológica/fisiológica; psicológica/comportamental; sociológica/relacional; econômica/política, ambiental/organizacional). Conclusão: Os policiais sofrem com a qualidade do sono e consequentemente influencia negativamente a qualidade de vida no trabalho. Assim, há uma necessidade de desenvolver ações no ambiente de trabalho que possam diminuir os afastamentos decorrentes dos problemas de saúde ocasionados pela qualidade do sono.

Resumen Introdución: La formación policial se considera de alto riesgo y requiere vigor físico y mental por parte de la persona trabajadora antes de realizar el servicio. Para esto, la buena calidad de sueño es importante, ya que impacta directamente en la salud de la población trabajadora en varios aspectos. Además, la falta de una buena calidad de sueño debido al trabajo puede influir negativamente en la calidad de vida fuera del trabajo. Objetivo: Analizar la influencia de la calidad del sueño en la calidad de vida en el trabajo de policías militares. Metodología: Estudio cuantitativo, correlacional transversal, realizado en el primer semestre de 2019, con policías de tres municipios de Bahía, Brasil. Se utilizaron tres instrumentos: características sociodemográficas y laborales, calidad de vida en el trabajo y calidad de sueño. Se aplicó la prueba chi cuadrado para las variables sociodemográficas y ocupacionales. Posteriormente, se aplicó la prueba de correlación de Spearman entre la calidad del sueño y las dimensiones de calidad de vida en el trabajo. Resultados: La muestra fue de 298 policías, la mediana de edad fue de 40 años y la antigüedad en el servicio fue ≤ 7 años. También, se observó quienes tuvieron peor calidad de sueño, también tuvieron una calidad de vida en el trabajo insatisfactoria en todos sus dimensiones (biológica/fisiológica; psicológica/conductual; sociológica/relacional; económica/política, ambiental/organizacional). Conclusión: Quienes son agentes de policía sufren de mala calidad de sueño y, en consecuencia, se influye negativamente su calidad de vida en el trabajo. Por lo tanto, existe la necesidad de desarrollar acciones en el lugar de trabajo que pueda reducir los riesgos de problemas de salud causados por la calidad del sueño.

Abstract Background: Police training is considered high risk and demands physical and mental vigor from the worker before preforming the service. Therefore, sleep quality is important as it directly impacts the health of these workers in several aspects. Furthermore, the lack of sleep quality due to work can negatively influence the quality of life outside of work. Aim: To analyze the influence of sleep quality on the quality of life and work of military police officers. Methods: A quantitative, cross-sectional correlational study, conducted in the first half of 2019 with police officers from three municipalities in Bahia, Brazil. Three instruments were used: sociodemographic and work characteristics; quality of life at work; and sleep quality. The chi-square test was applied for sociodemographic and occupational variations. Subsequently, the Spearman correlation test was applied between sleep quality and the quality of life and work dimensions. Results: Among the 298 police officers the median age was 40 years and the length of service was ≤ 7 years. It was also observed that police officers with poorer sleep quality had an unsatisfactory quality of life at work in all its dimensions (biological/physiological; psychological/behavioral; sociological/relational; economic/political, environmental/organizational). Conclusion: Police officers suffer from poor sleep quality and this negatively influence their quality of life and work. Therefore, there is a need to develop actions in the workplace that may reduce the risks of health problems caused by poor sleep quality.

[Investigation and analysis of acute poisoning of organic fluorine mixed gas in a fluorine polymerization plant].

In January 2021, an acute chemical poisoning incident occurred at a fluorine polymerization plant. Through the analysis of the occupational health situation of the enterprise, combined with the clinical manifestations of the poisoned patients and the laboratory examination results, it was determined that the incident was an acute poisoning incident caused by the inhalation of organic fluorine mixed gas in the fluorine polymerization plant. Subsequently, it was clarified that the accident was caused by the illegal operation of the employees of the fluorine polymerization plant, which caused the discharge of the organic fluorine mixed gas containing high concentration of octafluoroisobutene, resulting in the poisoning of the on-site construction personnel. In order to avoid the occurrence of similar incidents, enterprises should implement the main responsibility of safety production, regularly organize supervision and inspection, eliminate illegal operations, conduct safety education and training for the staff of the unit and outsourced staff, and improve the emergency rescue ability of sudden poisoning incidents.

[Discussion on the application status and method improvement of gas chromatography in occupational health inspection standards in China].

As a rapid, accurate and efficient analytical technique, gas chromatography is widely used in the detection of volatile organic compounds and inorganic small molecule toxins, and it is the main analytical method in the national testing standards for occupational health. The existing effective national standards of gas chromatography for the detection of some substances have low column efficiency, high toxicity of reagents, poor correlation of the standard curve and low desorption efficiency and other problems, some of which can be solved through method improvement. At the same time, with the use of new materials and new processes, new types of toxic substances are emerging, and there are still many occupational disease hazards of limited value without supporting detection methods, gas chromatography can be applied to the detection of some toxic substances to better complement the vacancy of China's occupational health detection methods. This paper analyzes the current situation of the application of gas chromatography in occupational health testing standards, discusses the improvement of some of these methods, and helps to promote the application and development of gas chromatography in occupational health testing.

A systematic scoping review of health-promoting interventions for contact centre employees examined through a behaviour change wheel lens.

PURPOSE: Social determinants of health and poor working conditions contribute to excessive sickness absence and attrition in contact centre advisors. With no recent review conducted, the current scoping review is needed to investigate the volume, effectiveness, acceptability, and feasibility of health-promoting interventions for contact centre advisors. This will inform the adoption and implementation of evidence-based practice, and future research. METHODS: Searches conducted across four databases (MEDLINE, PsycInfo, CINAHL, Web of Science) and reference checking in February 2023 identified health-promoting interventions for contact centre advisors. Extracted and coded data from eligible interventions were systematically synthesised using the nine intervention functions of the Behaviour Change Wheel and behaviour change technique taxonomy. RESULTS: This scoping review identified a low number of high quality and peer-reviewed health-promoting intervention studies for contact centre advisors (28 studies since 2002). Most interventions were conducted in high-income countries with office-based advisors, predominantly using environmental restructuring and training strategies to improve health. Most interventions reported positive effectiveness results for the primary intended outcomes, which were broadly organised into: i) health behaviours (sedentary behaviour, physical activity, smoking); ii) physical health outcomes (musculoskeletal health, visual health, vocal health, sick building syndrome); iii) mental health outcomes (stress, job control, job satisfaction, wellbeing). Few interventions evaluated acceptability and feasibility. CONCLUSION: There is little evidence on the effectiveness, acceptability, and feasibility of health-promoting interventions for contact centre advisors. Evidence is especially needed in low-to-middle income countries, and for remote/hybrid, nightshift, older and disabled advisors.

Processo de trabalho das enfermeiras da atenção primária à saúde frente à pandemia por covid-19 / Nurses' work process of primary health care in the face of the covid-19 pandemic / Proceso de trabajo de las enfermeras de la atención primaria de salud ante la pandemia del covid-19

Objetivo: Analisar o processo de trabalho das enfermeiras da Atenção Primária à Saúde frente à pandemia de COVID-19. Métodos: Trata-se de uma pesquisa qualitativa, descritiva e exploratória. A coleta de dados ocorreu de abril a maio de 2021, por meio de entrevista semiestruturada com 09 enfermeiras. Os dados foram analisados por meio de análise temática, e interpretados à luz da literatura pertinente. Resultados: Evidenciou-se o medo de faltar Equipamentos de Proteção Individual e recusa de atendimentos na falta destes. Utilizou-se a teleconsulta como meio de assistência de enfermagem, que mostrou limitações, como: invasão de privacidade das enfermeiras, extensão da jornada de trabalho e sobrecarga. Priorizou-se o atendimento à saúde da mulher e da criança. E ainda, notou-se o esforço no acolhimento aos casos suspeitos e agudos de COVID-19. Verificou-se a sobrecarga de trabalho e acúmulo de funções. Entretanto, lições foram adquiridas como a valorização de medidas de proteção, como a higiene das mãos. Conclusão: Infere-se a necessidade de criação e validação de novos protocolos que fortaleçam a assistência de enfermagem, bem como a importância de estimular as políticas de saúde para controle das Infecções Relacionadas à Assistência à Saúde. (AU)

Objective: To analyze the work process of Primary Health Care nurses in the face of the COVID-19 pandemic. Methods: This is a qualitative, descriptive and exploratory research. Data were analyzed using thematic analysis and interpreted in light of the relevant literature. Results: The fear of lacking personal protective equipment was evidenced and the refusal of care in the absence of these. Teleconsultation was used as a means of nursing care, which showed limitations such as invasion of nurses' privacy, extension of the workday and overload. The health care of women and children was prioritized. Also, there was an effort to host suspected and acute cases of COVID-19. There was work overload and accumulation of functions. However, lessons were learned, such as valuing protective measures such as hand hygiene. Conclusion: The need to create and validate new protocols that strengthen nursing care is inferred, as well as the importance of stimulating health policies to control Health-Related Infections. (AU)

Objetivo: Analizar el proceso de trabajo de las enfermeras de Atención Primaria de Salud frente a la pandemia de COVID-19. Métodos: Se trata de una investigación cualitativa, descriptiva y exploratoria. Los datos se analizaron mediante un análisis temático y se interpretaron a la luz de la bibliografía pertinente. Resultados: Se evidenció el miedo a la falta de equipo de protección personal y la negativa de atención en ausencia de estos. La teleconsulta fue utilizada como medio de atención de enfermería, que mostró limitaciones como la invasión de la privacidad de los enfermeros, la duración de la jornada laboral y la sobrecarga. Se priorizó la atención de la salud de las mujeres y los niños. Además, hubo un esfuerzo para albergar casos sospechosos y agudos de COVID-19. Había sobrecarga de trabajo y acumulación de funciones. Sin embargo, se aprendieron lecciones, como la valoración de medidas de protección como la higiene de manos. Conclusión: Se infiere la necesidad de crear y validar nuevos protocolos que fortalezcan los cuidados de enfermería, así como la importancia de estimular políticas de salud para el control de las Infecciones Relacionadas con la Salud. (AU)

Asbestos and disease - a public health success story?

OBJECTIVE: This paper discusses the failure and success of society to decrease the adverse health effects of asbestos exposure on workers' health in relation to scientific knowledge. METHODS: The findings are based on a narrative literature review. RESULTS: Early warnings of the adverse health effects of workplace exposure to asbestos were published already in the 1930s. Serious health effects, such as malignancies and fibrosis due to occupational asbestos exposure, were highlighted in major medical journals and textbooks in late 1960s. New technologies could detect also asbestos fibers in the lung of non-occupational exposed persons in the 1970s. The first bans for using asbestos came in the early 1970s, and more general bans by authorities came in the 1980s and continue until today. CONCLUSIONS: The rather late recognition of adverse effects of asbestos exposure in the general population and measures to decrease the exposure through more general bans came rather late. However, the very strong measures such as general bans in many countries have been a success. A Swedish study showed that the general ban and other measures have decreased the risk of malignancies due to occupational exposure. The effect of the bans on adverse effects in the general population has yet to be studied. Analysis of fibers in the lungs of persons born after the bans could be an efficient method.

Risk factor analysis and risk prediction study of obesity in steelworkers: model development based on an occupational health examination cohort dataset.

BACKGROUND: Obesity is increasingly recognized as a grave public health concern globally. It is associated with prevalent diseases including coronary heart disease, fatty liver, type 2 diabetes, and dyslipidemia. Prior research has identified demographic, socioeconomic, lifestyle, and genetic factors as contributors to obesity. Nevertheless, the influence of occupational risk factors on obesity among workers remains under-explored. Investigating risk factors specific to steelworkers is crucial for early detection, prediction, and effective intervention, thereby safeguarding their health. METHODS: This research utilized a cohort study examining health impacts on workers in an iron and steel company in Hebei Province, China. The study involved 5469 participants. By univariate analysis, multifactor analysis, and review of relevant literature, predictor variables were found. Three predictive models-XG Boost, Support Vector Machine (SVM), and Random Forest (RF)-were employed. RESULTS: Univariate analysis and cox proportional hazard regression modeling identified age, gender, smoking and drinking habits, dietary score, physical activity, shift work, exposure to high temperatures, occupational stress, and carbon monoxide exposure as key factors in the development of obesity in steelworkers. Test results indicated accuracies of 0.819, 0.868, and 0.872 for XG Boost, SVM, and RF respectively. Precision rates were 0.571, 0.696, and 0.765, while recall rates were 0.333, 0.592, and 0.481. The models achieved AUCs of 0.849, 0.908, and 0.912, with Brier scores of 0.128, 0.105, and 0.104, log losses of 0.409, 0.349, and 0.345, and calibration-in-the-large of 0.058, 0.054, and 0.051, respectively. Among these, the Random Forest model demonstrated superior performance. CONCLUSIONS: The research indicates that obesity in steelworkers results from a combination of occupational and lifestyle factors. Of the models tested, the Random Forest model exhibited superior predictive ability, highlighting its significant practical application.

Fifty years of research in the Scandinavian Journal of Work, Environment & Health.

OBJECTIVE: The Scandinavian Journal of Work, Environment & Health was launched 50 years ago. In this paper we describe how research topics have changed over time. METHODS: A complete list of all 2899 articles in the past 50 years was compiled. Each article was coded for type of exposure, type of health outcome, research design, first author, and country of correspondence address. Count of citations was based on the Scopus database. RESULTS: Overall, the attention for chemical exposure in the first 30 years has shifted towards the psychosocial work environment, shift work, and physical work load. These shifts in exposure are mirrored by increased attention over time for mental disorders and musculoskeletal disorders. Cardiovascular disorders and cancer have been studied consistently over the past 50 years. Researchers from Scandinavian countries have been responsible for about 50% of the Journal's content, while authorship has broadened to about 30 countries in recent years. CONCLUSION: During the past 50 years, some research topics have consistently remained highly visible in the Journal, whereas other topics have gained or lost interest. In terms of authors' contribution, the Journal has its roots in research from the Nordic countries, but has evolved over time as a truly international periodical with a well-recognized position in research on occupational health.

Health Hazard Evaluations of occupational cancer cluster concerns: the USA, January 2001-December 2020.

OBJECTIVES: To describe recent investigations of potential workplace cancer clusters. METHODS: We identified Health Hazard Evaluations (HHEs) of cancer concerns during 2001-2020. We described information about industry, requestors, cancer characteristics, investigative procedures, and determinations about the presence of a cluster (ie, presence of excess cases, unusual case distribution or exposure). RESULTS: Of 5754 HHEs, 174 included cancer concerns, comprising 1%-5% of HHEs per year. In 123 HHEs, the cancer cluster concerns involved different cancer primary sites. Investigation procedures varied but included record review (n=63, 36%) and site visits (n=22, 13%). Of 158 HHEs with a cluster determination by investigator(s), 151 (96%) were not considered cancer clusters. In seven HHEs, investigators found evidence of a cluster, but occupational exposure to a carcinogen was not identified. CONCLUSIONS: The proportion of HHEs on workplace cancer cluster concerns remained steady over time; most did not meet the definition of a cluster or uncover an occupational cause. Public health practitioners can use this information to provide updated context when addressing workplace cancer cluster concerns and as motivation to refine investigative approaches. More broadly, this review highlights an opportunity to identify best practices on how to apply community cluster investigation methods to the workplace.

Development of an intervention program to reduce whole-body vibration exposure based on occupational and individual determinants among dumper operators.

Objectives. Studies related to a systematic approach for intervention design to reduce whole-body vibration (WBV) exposure are scarce. This study presents a systematic approach to identifying, selecting and prioritizing safety interventions to fulfill that research gap. Methods. A total of 130 vibration readings for dumper operators were taken from two surface iron ore mines to identify significant determinants of WBV exposure. Initially, age, weight, seat design, awkward posture, machine's age, load tonnage, dumper speed and haul road condition were hypothesized as determinants. Data were collected through standardized questionnaires and field-based observation. A multivariate statistical approach was applied for the practical use of the intervention program. Results. As some of the hypothesized factors were correlated, exploratory factor analysis (EFA) followed by multiple linear regression (MLR) was used to investigate their association with WBV exposure. As per EFA results, hypothesized factors were clubbed under individual, ergonomics and occupational factors. Occupational and ergonomics factors were found to be significantly associated with WBV exposure through MLR and used to form safety interventions to reduce WBV exposure. Conclusions. Our methodological approach is original in the occupational health research area and can be helpful to tailor the safety interventions for the unit level with minimum effort.

Risk factors for heat-related illness resulting in death or hospitalization in the oil and gas extraction industry.

Many oil and gas extraction (OGE) activities occur in high-heat environments, resulting in a significant risk of heat-related illness among outdoor workers in this industry. This report highlights cases of occupational heat-related illness that resulted in death and identifies common risk factors for heat-related fatalities and hospitalizations among OGE workers. Two databases maintained by the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) were reviewed to identify heat-related fatalities, hospitalizations, and associated risk factors among OGE workers. Nine fatalities and associated risk factors were identified during 2014-2019 from NIOSH's Fatalities in Oil and Gas Extraction (FOG) Database. Risk factors identified included those commonly associated with heat-related fatalities: new workers not acclimatized to heat, inadequate heat stress training, and underlying hypertension or cardiovascular disease. Of particular note, substance use was identified as a significant risk factor as more than half of the fatalities included a positive postmortem test for amphetamines or methamphetamines. Fifty heat-related hospitalizations were identified from OSHA's Severe Injury Report Database during January 2015-May 2021. Heat stress has been and will continue to be an important cause of fatality and adverse health effects in OGE as hot outdoor working conditions become more common and extreme. More emphasis on heat stress training, acclimatization regimens, medical screening, and implementation of workplace-supportive recovery programs may reduce heat-related fatalities and injuries in this industry.

An updated job-exposure matrix for occupational noise: development and validation.

OBJECTIVES: The aim of this study was to create a quantitative job-exposure matrix (JEM) for noise including a large set of measurements for the Swedish workforce, a detailed exposure-level assessment, spanning over an extensive time period from 1970 to 2014. METHODS: The JEM was developed by 2 teams, each with an experienced occupational hygienist and an occupational safety engineer. Each pair assessed the exposure using measurements performed and reported by occupational hygienists, occupational safety engineers, or similar, from 1970 to 2014. The measurements included either the original LAeq(8h) measurements or an LAeq(8h) levels calculated from partial measurements of the working day, provided that the measurement targeted a regular task usually performed during a full workday. The collection of measurement reports was done in 2008 and 2012 by contacting clinics working in the area of occupational health or occupational safety engineers and their submitted reports were added to our own material. Noise exposure assessments were inserted at the appropriate time period for the relevant job family. The final matrix was developed in a consensus procedure and the validity was investigated by comparison of the 2 team's individual results. RESULTS: The noise JEM contains 321 job families with information regarding occupational noise from 1970 to 2014. The time-period label has a 5-yr scale starting in 1970. The estimated average 8 h (TWA) noise level in decibels [dB(A)] for every job family and 5-yr period was coded as 1: <70 dB(A), 2: 70 to 74 dB(A), 3: 75 to 79 dB(A), 4: 80 to 84 dB(A) or 5: 85(+) dB(A). The validation showed no systematic difference in relative position and very high agreement in the ordering of paired ordinal classifications. The JEM has also successfully been applied in several epidemiological studies. CONCLUSIONS: We present a JEM for occupational noise using Swedish data from 1970 to 2014 with a higher degree of sensitivity in assessed noise exposure compared with the previously existing version. Repeated application of the JEM, in epidemiological studies, has shown consistent results and contributed to yielding important findings.

Using a severity threshold to improve occupational injury surveillance: Assessment of a severe traumatic injury-based occupational health indicator across the International Classification of Diseases lexicon transition.

BACKGROUND: Traumatic injury is a leading cause of death and disability among US workers. Severe injuries are less subject to systematic ascertainment bias related to factors such as reporting barriers, inpatient admission criteria, and workers' compensation coverage. A state-based occupational health indicator (OHI #22) was initiated in 2012 to track work-related severe traumatic injury hospitalizations. After 2015, OHI #22 was reformulated to account for the transition from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) to ICD-10-CM. This study describes rates and trends in OHI #22, alongside corresponding metrics for all work-related hospitalizations. METHODS: Seventeen states used hospital discharge data to calculate estimates for calendar years 2012-2019. State-panel fixed-effects regression was used to model linear trends in annual work-related hospitalization rates, OHI #22 rates, and the proportion of work-related hospitalizations resulting from severe injuries. Models included calendar year and pre- to post-ICD-10-CM transition. RESULTS: Work-related hospitalization rates showed a decreasing monotonic trend, with no significant change associated with the ICD-10-CM transition. In contrast, OHI #22 rates showed a monotonic increasing trend from 2012 to 2014, then a significant 50% drop, returning to a near-monotonic increasing trend from 2016 to 2019. On average, OHI #22 accounted for 12.9% of work-related hospitalizations before the ICD-10-CM transition, versus 9.1% post-transition. CONCLUSIONS: Although hospital discharge data suggest decreasing work-related hospitalizations over time, work-related severe traumatic injury hospitalizations are apparently increasing. OHI #22 contributes meaningfully to state occupational health surveillance efforts by reducing the impact of factors that differentially obscure minor injuries; however, OHI #22 trend estimates must account for the ICD-10-CM transition-associated structural break in 2015.

Factors Affecting Clinical Performance among Pakistani Dental Students: A Cross-Sectional Study

Abstract Objective: To identify the factors affecting clinical performance among dental students and to help addressing these problems. Material and Methods: A cross-sectional study in which students of third and final year of dentistry participated. Data was collected from June 2022 till September 2022. Data was collected from the third and final year dental students of both public and private dental colleges within the Pakistan using a purposive sampling technique. Results: A total of 372 dental students participated in this study. Thirty eight (31.9%) students belonged to third year while 81 (68.1%) were final year students from government college. For the private dental college, 121 (47.8%) were third year students while 132 (52.2%) were final year students. Majority of the participants were males from both the colleges. 42.9% of government dental students and 26.5% of private dental students agreed on well-preparedness of clinical instructors. 5.5% from private and 21.0% from government dental colleges agreed that adequate personal protective equipment were present in clinical departments. Conclusion: From this study, it is concluded that there should be focus more focus on the factors to enhance clinical skills, supervision of students in clinical practice to help addressing the problems faced during learning and performance in a clinical environment, to produce self-confident, motivated, knowledgeable, skillful and a professional dental graduates.

Factors related to Nursing workload in the Oncology assistance provided to hospitalized women / Factores relacionados con la carga de trabajo de enfermería en la atención oncológica de mujeres hospitalizadas / Fatores relacionados à carga de trabalho da enfermagem na assistência oncológica de mulheres hospitalizadas

Objective: to evaluate the Nursing workload and its related factors in the assistance provided to hospitalized women with gynecological and breast cancers, according to the Nursing Activities Scores adapted for cancer patients. Method: a cross-sectional and epidemiological study. The participants were women with gynecological and/or breast cancer, over 18 years of age, and hospitalized for a minimum period of 24 hours. The following was collected from the medical records: sociodemographic and clinical data, Karnofsky Performance Status and workload, according to the adapted Nursing Activities Score. The factors related to workload were analyzed by means of multiple linear regression. Results: the mean Nursing Activities Scores was 29.3%, denoting seven hours of daily care per patient. The factors related to workload differed according to the breast or gynecological cancer diagnosis (β=-0.01; p<0.001), clinical or surgical treatment (β=-0.03; p<0.001) and functional capacity at admission (β=0.07; p<0.001), as per the Karnofsky Performance Status. Conclusion: there was greater workload for the care of women with gynecological cancer undergoing clinical treatment and with lower functional capacity at admission. The findings reveal directions for optimization of resources and improvements in work processes and flows, in order to promote a favorable work environment and good quality assistance.

Objetivo: evaluar la carga de trabajo de enfermería y los factores relacionados con la atención de mujeres hospitalizadas con cáncer ginecológico y de mama, según el Nursing Activities Scores adaptado para pacientes oncológicos. Método: estudio epidemiológico y transversal. Participaron mujeres con cáncer ginecológico y/o de mama, mayores de 18 años, hospitalizadas por un período mínimo de 24 horas. De las historias clínicas se recolectaron datos sociodemográficos y clínicos, Karnofsky Performance Status y carga de trabajo, según el Nursing Activity Score adaptado. Los factores relacionados con la carga de trabajo se analizaron mediante regresión lineal múltiple. Resultados: el puntaje promedio del Nursing Activity Scores fue del 29,3%, lo que indica que se brindan siete horas diarias de atención por paciente. Los factores relacionados con la carga de trabajo difirieron según diagnóstico de cáncer de mama o ginecológico (β=-0,01; p<0,001), tratamiento clínico o quirúrgico (β=-0,03; p<0,001) y capacidad funcional al momento del ingreso (β=0,07; p< 0,001), conforme a la escala Karnofsky Performance Status . Conclusión: hubo una mayor carga de trabajo en la atención a mujeres con cáncer ginecológico en tratamiento clínico y con menor capacidad funcional al momento del ingreso. Los hallazgos revelan información útil para optimizar recursos, mejorar procesos y flujos de trabajo, con el fin de promover un ambiente de trabajo favorable y una atención de calidad.

Objetivo: avaliar a carga de trabalho da enfermagem e seus fatores relacionados na assistência às mulheres hospitalizadas com cânceres ginecológicos e mamários, segundo o Nursing Activities Scores , adaptado a pacientes oncológicos. Método: estudo epidemiológico de corte transversal. Participaram mulheres com câncer ginecológico e/ou mamário, maiores de 18 anos, hospitalizadas por período mínimo de 24 horas. Coletados, do prontuário, dados sociodemográficos, clínicos, Karnofsky Performance Status e carga de trabalho, segundo Nursing Activities Score adaptado. Os fatores relacionados à carga de trabalho foram analisados por regressão linear múltipla. Resultados: pontuação média do Nursing Activities Scores foi 29,3%, denotando sete horas de assistência diária por paciente. Os fatores relacionados à carga de trabalho diferiram conforme diagnóstico de câncer de mama ou ginecológico (β= - 0,01; p<0,001), tratamento clínico ou cirúrgico (β= - 0,03; p<0,001) e capacidade funcional na admissão (β= 0,07; p<0,001), pelo Karnofsky Performance Status . Conclusão: evidenciou-se maior carga de trabalho para atendimento de mulheres com câncer ginecológico sob tratamento clínico e com menor capacidade funcional na admissão. Os achados revelam direcionamentos para otimização de recursos, melhorias em processos e fluxos de trabalho, a fim de promover ambiente laboral favorável e assistência de qualidade.

Nexo causal entre trabalho e saúde/doença e o problema das perícias / Causal nexus between work and health/illness and the issue of expert testimonies

Resumo A esfera das perícias comumente reduz a questão do estabelecimento do nexo de causalidade entre trabalho e saúde/doença apenas ao binômio trabalho/vida pessoal. Partindo dos pressupostos dos campos Saúde do Trabalhador (ST) e Saúde Mental Relacionada ao Trabalho (SMRT), este ensaio visa problematizar o resultado da questão, que reside na existência de dificuldades enfrentadas por trabalhadores na obtenção do nexo causal entre seus agravos/adoecimentos, cuja causalidade mais complexa se explica a partir de várias mediações pouco consideradas nos atos periciais circunscritos apenas às anamneses clínicas de cunho biomédicas pautadas nos pressupostos da Medicina do Trabalho, Higiene e Saúde Ocupacional. As formas de superação à ideia de causa-efeito passam pelo entendimento de que o processo de adoecimento é social e histórico e de que é preciso buscar mediações entre trabalho e adoecimento para elucidar sintomatologias singulares a partir da experiência do desgaste coletivo. Tal averiguação deve, ao mesmo tempo, problematizar os próprios processos de trabalho dos atores sociais envolvidos nas investigações periciais e partir das prioridades definidas pelos próprios trabalhadores que atuam como sujeitos da análise da nocividade do trabalho para a saúde.

Abstract Expert testimonies commonly reduce the establishment of causal links between work and health/illness solely to the dichotomy of work/personal life. Based on the assumptions from the fields of Workers Health and Work-Related Mental Health, this essay problematizes the results of this issue, namely the difficulties faced by workers in establishing the causal link between their ailments/illnesses, whose more complex causality is explained through several mediations that are often overlooked by the limited expert acts restricted only to clinical anamneses based on Occupational Medicine, Hygiene, and Occupational Health. Overcoming the idea of cause and effect involves understanding that the process of falling ill is social and historical, and requires exploring the mediations between work and illness to elucidate singular symptomatology based on the collective wear and tear experience. Such an investigation should simultaneously problematize the very work processes of the social actors involved in the expert investigations, starting from the priorities defined by the workers themselves who act as subjects in the analysis of work-related harm to health.

Como a pandemia de COVID-19 afetou a notificação de acidentes do trabalho em diferentes atividades econômicas e ocupações no Brasil? Um estudo ecológico usando o p-score / How did the COVID-19 pandemic affect occupational accident notification in different economic activities and occupations in Brazil? An ecological study using p-score

Resumo Objetivo: mensurar o impacto da pandemia de COVID-19 nas notificações de acidentes do trabalho (AT) no Brasil, por atividade econômica e ocupação. Métodos: estudo ecológico que utilizou os casos de AT registrados entre 2015 e 2020 no Anuário Estatístico da Previdência Social. Os AT foram analisados por setor de atividade econômica, ocupação e códigos da 10ª revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10). Uma adaptação do p-score foi aplicada para comparar os casos de AT pré-pandemia com os do primeiro ano da pandemia. Resultados: os p-scores variaram de -60,2%, para AT por nexo técnico epidemiológico, a -13,9%, para AT típico. As doenças do trabalho apresentaram p-score de 151,1%. Houve aumento notável nos casos de doenças ocupacionais dos capítulos I e X da CID-10. As notificações de AT diminuíram em todas as categorias de atividades econômicas, exceto nas de saúde humana e serviços sociais (p-score = 8,0%). Na maioria das categorias, os valores foram negativos, exceto nos subgrupos forças de segurança e profissionais de saúde de nível superior, técnico e gestores. Conclusão: houve redução geral na notificação de AT durante a pandemia de COVID-19 no Brasil, que evidenciou desigualdades entre diferentes setores de atividades e ocupações, além de mudança no perfil de adoecimento dos trabalhadores.

Abstract Objective: to assess the COVID-19 pandemic impact on Occupational Accident (OA) notifications in Brazil by economic activity and occupation. Methods: an ecological study was conducted using OA cases recorded in the Statistical Yearbook of Social Security from 2015 to 2020. Accidents were analyzed by sector of economic activity, occupation, and ICD-10 codes. Pre-pandemic cases were compared with the first year of the public health emergency scenario caused by Sars-Cov-2 using an adapted p-score. Results: p-scores ranged from -60.2% for technical-epidemiological Occupational Accidents to -13.9% for typical OA. Occupational diseases had a p-score of 151.1%. Cases of occupational diseases from ICD-10 chapters I and X showed a significant increase. OA notifications decreased in all CNAE sections, except for human health and social services activities (p-score = 8.0%). P-score values were negative in most CBO categories, except in subgroups such as security forces and high-level health professionals, technicians, and managers. Conclusion: Brazil registered a general reduction in OA notifications due to the pandemic, which evinced inequalities in different sectors and occupations, as well as changes in the illness profile of workers.

Distúrbio de voz e fatores de risco em profissionais da voz falada: uma revisão integrativa / Voice disorder and risk factors in spoken voice professionals: an integrative review

RESUMO Objetivo Identificar evidências científicas sobre o distúrbio de voz relacionado ao trabalho e fatores de risco, além de apontar os sintomas vocais, instrumentos e métodos de avaliação em profissionais da voz falada. Estratégia de pesquisa Revisão integrativa da literatura, realizada nas bases de dados LILACS, SciELO, MEDLINE/PubMed e Scopus. Critérios de seleção Artigos com profissionais da voz falada, que abordassem os fatores de riscos individuais, organizacionais e/ou ambientais vinculados aos sintomas e/ou distúrbios de voz, estudos observacionais, disponíveis na íntegra, sem restrição ao idioma e ano de publicação. Resultados Foram incluídos 58 estudos, maior publicação entre os anos de 2014 e 2022, predominantemente no Brasil, em destaque, o professor. O método de avaliação mais utilizado foi autoavaliação com o uso dos protocolos, seguido da avaliação perceptivo-auditiva e do exame laringológico. Os fatores de risco mais identificados foram os individuais, seguidos dos organizacionais e ambientais, além de terem sido relatados os sintomas vocais sensoriais e auditivos. Conclusão Os fatores mais autorreferidos são ruído, uso intenso da voz, alterações respiratórias, ser do gênero feminino e práticas vocais inadequadas. Quanto aos sintomas vocais sensoriais, destacam-se garganta seca, pigarro e fadiga vocal, e quanto aos auditivos, rouquidão.

ABSTRACT Purpose To identify scientific evidence about (Work-Related Voice Disorder) and risk factors, as well as to point out vocal symptoms, instruments and evaluation methods in spoken voice professionals. Research strategy Integrative literature review carried out in LILACS, SciELO, MEDLINE/PubMed and Scopus databases. Selection criteria Articles with spoken voice professionals, which addressed individual, organizational and/or environmental risk factors linked to symptoms and/or voice disorders, observational studies, fully available, without restriction to language and year of publication. Results 58 papers were included, the largest publication between the years 2014 and 2022, predominantly in Brazil, with emphasis on the teacher. The most used evaluation method was vocal assessment using self-assessment protocols, followed by auditory-perceptual assessment and laryngological examination. The mostly identified risk factors were individual ones, followed by organizational and environmental ones, in addition to sensory and auditory vocal symptoms having been reported. Conclusion The most often self-reported factors were noise, intense voice use, respiratory changes, being female and inappropriate vocal practices. For sensory vocal symptoms, dry throat, throat clearing and vocal fatigue stand out, and for auditory symptoms, hoarseness.

Why presumptions are important in occupational health: The example of COVID-19 infection as an occupational disease.

Workers who become ill or injured on the job while undertaking extraordinary risks on behalf of the public are, at times, granted facilitated access to workers' compensation (WC) benefits through the application of presumptions in the compensation process. Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, a broad range of occupational groups faced an elevated risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure at work to perform vital services to maintain our food supply, sustain needed transportation, provide health care, assure energy supply and others. Some states or jurisdictions in the United States recognized both the risk and the service of these workers by enacting COVID-19 presumption laws to streamline selected essential workers' eligibility for WC benefits. Other states did not. Results of these contrasting public approaches permit an examination of the impact of presumptions in compensation by examining the frequency and outcomes of COVID-19 claims in "COVID-19 presumption" and "nonpresumption" states. Despite state-level variations in economic response to the pandemic, industry mix, and presumption eligibility criteria, the use of COVID-19 presumptions appears to have substantially increased claim filing rates and improved access to benefits. Lastly, the additional costs of COVID-19 claims to employers and insurers were lower than initially predicted. In response to future airborne infectious disease outbreaks, workers' compensation presumption laws should be universally implemented to permit a broad range of high-risk workers to work on the public's behalf without fear of losing wages and incurring medical expenses associated with a work-related viral exposure.

COVID-19 entre profissionais fisioterapeutas: uma análise segundo prevalência e fatores associados / Covid-19 among brazilian physiotherapists: analysis of prevalence and associated factors / Covid-19 entre los fisioterapeutas brasileños: análisis de prevalencia y factores asociados

Objetivo: analisar a prevalência da COVID-19 entre os fisioterapeutas brasileiros e os fatores associados segundo características demográficas e ocupacionais. Método: estudo transversal, analítico, segundo inquérito on-line, com a participação de 670 fisioterapeutas de todas as regiões do Brasil. Utilizou-se uma adaptação do método respondent driven sampling ao ambiente virtual para a coleta de dados. Análises bivariadas e de regressão logística múltipla foram utilizadas para identificar associação entre o diagnóstico da COVID-19 e variáveis demográficas e ocupacionais. Considerou-se variáveis estatisticamente significativas com base em um p<0,05. Resultados: a prevalência da COVID-19 foi de 30% (IC95%: 27,8-32,3). Fisioterapeutas da região Sudeste tiveram menores chances de ter diagnóstico da COVID-19. Fisioterapeutas que prestaram assistência em hospital de campanha, que ficaram isolados da família e que tem crianças menores de 12 em casa tiveram chances aumentadas para o diagnóstico da infecção. Conclusão: questões sociodemográficas e ocupacionais impactam no aumento do diagnóstico de Covid-19 entre profissionais fisioterapeutas, o que enfatiza a necessidade de um sistema de saúde de qualidade, igualitário nas diferentes regiões brasileiras.(AU)

Objective: to estimate the prevalence of COVID-19 among Brazilian physiotherapists and its associated factors. Method: cross-sectional study, according to an online survey, with the participation of 670 physiotherapists from all regions of Brazil. An adaptation of the respondent driven sampling method to the virtual environment was used to collect data. Bivariate and multiple logistic regression analyzes were used to identify associations between the diagnosis of COVID-19 and demographic and occupational variables. Variables were considered statistically significant based on p<0.05. Results: the prevalence of COVID-19 was 30% (95%CI: 27.8-32.3). In the Southeast region, physiotherapists were less likely to be diagnosed with COVID-19. Physiotherapists who provided care in a field hospital, who were isolated from their families and who have children under 12 years of age at home had an increased chance of being diagnosed with the infection.Conclusion: sociodemographic and occupational issues impact the increase in COVID-19 diagnoses among physiotherapists, which emphasizes the need for a quality and egalitarian health system in different Brazilian regions.(AU)

Objetivo: evaluar la tasa de prevalencia del COVID-19 en fisioterapeutas de Brasil y analizar sus factores asociados. Método: realizamos un estudio transversal mediante una encuesta on-line, en la que participaron 670 fisioterapeutas de todas las áreas de Brasil. Para la recogida de datos se utilizó una adaptación del método respondent driven sampling al entorno virtual. Se utilizaron análisis bivariados y de regresión logística múltiple para identificar la asociación entre el diagnóstico COVID-19 y variables demográficas y ocupacionales. Las variables se consideraron estadísticamente significativas en función de una p<0,05. Resultados: la prevalencia de COVID-19 fue del 30% (IC 95%: 27,8-32,3). Los fisioterapeutas del sudeste tenían menos probabilidades de ser diagnosticados de COVID-19. Los fisioterapeutas que prestaban asistencia en un hospital de campaña, que estaban aislados de sus familias y que tenían hijos menores de 12 años en casa tenían más probabilidades de que se les diagnosticara la infección. Conclusiones: aspectos sociodemográficos y ocupacionales inciden en el aumento del diagnóstico de COVID-19 entre los fisioterapeutas profesionales, lo que enfatiza la necesidad de un sistema de salud de calidad e igualitario en las diferentes regiones brasileñas.(AU)