Valoraciones sobre el proceso de prevención de enfermedades profesionales, a propósito de dos novedades editoriales / Appraisals about the Process for Preventing Professional Diseases. A Propose of two Editorial Updates

En el volumen 37 del último número de la Revista Cubana de Medicina General Integral perteneciente al año 2021, se identifican entre las novedades editoriales dos valiosos trabajos1,2 que motivan una valoración sobre la significación del proceso de prevención de enfermedades profesionales (PPEP), en las condiciones actuales del desarrollo socioeconómico del país. La baja tasa de natalidad y el envejecimiento poblacional, unido a la generación de nuevas formas de gestión económica que incluyen a trabajadores por cuenta propia, usufructuarios de tierras, pequeñas y medianas empresas, en ocasiones carentes de los tradicionales sistemas de seguridad y salud en el trabajo, operados por profesionales especializados, elevan la significación del mandato previsto en el artículo 69 de la Carta Magna, en términos de adopción de medidas adecuadas para la prevención de accidentes y enfermedades profesionales.3 En ese sentido, López y otros2) revelan, mediante revisión científica, las implicaciones del especialista en Medicina General Integral que se desempeña como médico de familia, con el diseño y ejecución de las medidas preventivas referidas en la cita anterior. Estos autores realizan un análisis integrador del Programa del Médico y Enfermera de la Familia y el Programa Nacional de Salud de los Trabajadores, con énfasis en las actividades de salud ocupacional, cuyo resultado constituye, en opinión de la remitente, un referente para reflexionar de manera creadora sobre el mejoramiento del...(AU)

Una pequeña historia de la medicina del trabajo en Venezuela / A short history of occupational medicine in Venezuela

Se presenta una recopilación de hechos relacionados con la salud y seguridad en el trabajo, en forma de aproximación, sin intentar un análisis histórico, siguiendo un hilo transversal del rol de la medicina, en lo que ha significado a través del tiempo la salud física y mental del trabajador. Se discute la contradicción entre la salud y el trabajo, intentando dar una explicación de cómo los diferentes sistemas económicos han intentado mediar en esta contradicción. El artículo hace hincapié en las circunstancias, que en el caso venezolano, condujeron al desarrollo de hecho y de derecho de la atención de la salud de quien trabaja, primero de nuestros ancestros, los indios americanos, luego de los esclavos negros y con el pasar del tiempo, de los trabajadores de las minas en el siglo XIX y delos trabajadores petroleros en el siglo XX, siglo que a partir de 1950, con la graduación en Inglaterra del primer médico ocupacional venezolano, el Dr. Emigdio Cañizales Guédez, vio crecer exponencialmente los profesionales que se sumaron a este campo del ejercicio profesional, que incluyó servicios en las empresas, gremios, y finalmente, los postgrados. Se trae a la memoria a personas de todo el país, que, desde su lugar de acción, dieron su aporte para que la Medicina del Trabajo o Medicina Ocupacional ocupe hoy un lugar estratégico en lo que significa la empresa nacional, sea pública o privada(AU)

A compilation of facts related to health and safety at work is presented, in the form of an approximation, without attempting a historical analysis, following a transversal thread of the role of medicine in what physical and mental health has meant over time. Who works the contradiction between health and work is discussed, trying to explain how different economic systems have tried to mediate this contradiction. The article emphasizes the circumstances that in the Venezuelan case led to the de facto and legal development of health care, first of our ancestors, the American Indians, then of the black slaves and over time of the workers of the mines in the 19th century and of the oil workers in the 20th century, a century that from1950, with the graduation in England of the first Venezuelan occupational doctor, Dr. Emigdio Cañizales Guédez, will see the professionals who joined grow exponentially. To this field of professional practice, which will include services in companies, trade unions and finally postgraduate courses. The article brings to mind people from all over the country, who from their place of action, gave their contribution so that Occupational Medicine or Occupational Medicine now occupies a strategic place in what the national company means, whether public or private(AU)

Câncer nasal e dos seios paranasais relacionados à saúde ocupacional / Nasal and paranasal sinus cancer related to occupational health

Resumo: Esta pesquisa, apresentada no formato de artigo, está inserida na linha de pesquisa Processo de Cuidar em Saúde e Enfermagem, do Programa de Pós-Graduação em Enfermagem, e integra o Grupo de Pesquisa Multiprofissional em Saúde do Adulto da Universidade Federal do Paraná. Introdução: o câncer nasal e dos seios paranasais corresponde a menos de 1% dos demais tipos de câncer, com fatores etiológicos decorrentes do meio ambiente, das atividades ocupacionais e dos hábitos de vida, com período de latência que pode variar até 20 anos para o aparecimento dos sintomas neoplásicos. Objetivos: caracterizar o perfil sociodemográfico, clínico e ocupacional dos brasileiros com câncer nasossinusal; traduzir, adaptar culturalmente e validar o Questionario Sulla Storia di Lavoro e Sulle Abitudini di Vita utilizado pelo Registro Tumori Seni Nasali e Paranasali da Lombardia, Itália, para o contexto cultural brasileiro; examinar o perfil sociodemográfico, clínico e ocupacional dos pacientes com câncer nasossinusal e relacionar a ocupação com a exposição ao pó de couro, lenha, cromo e níquel. Artigo 1: é um estudo observacional, descritivo e retrospectivo, utilizando os dados secundários do Integrador de Registro Hospitalar de Câncer no período de 2007 a 2019, com os CIDs: C30.0 e C31.0 a C31.9. Foram analisados 1.803 registros e destacou-se que 1.161 (64%) eram do sexo masculino, com faixa etária predominante entre 50 e 59 anos (26%; n=298), da raça/cor branca (46%; n=535), solteiros (55%; n=640) e com ensino fundamental incompleto (40%; n=461), que tinham incidência da neoplasia no seio maxilar (52%; n=943), com estadiamento clínico grau IV (32%; n=575). A ocupação foi registrada nos brasileiros com câncer nasossinusal no Grupo 6 (64,7%; n=701) - trabalhadores agropecuários, florestais e da pesca, e no Grupo 8 (26,7%; n=289) - trabalhadores da produção de bens e serviços industriais, principalmente no Estado da Bahia (11%; n=206) e Minas Gerais (18%; n=327). Artigo 2: descreve um estudo metodológico com as etapas de tradução, síntese, retrotradução, relatório de retrotradução, revisão, teste piloto e tradução final proposto pelo European Organisation for Research and Treatment of Cancer. O instrumento foi dividido em 11 domínios conforme a característica das perguntas do instrumento original. O pré-teste foi realizado num hospital de referência em oncologia do Estado do Paraná, Brasil, com 15 participantes que foram os pacientes com câncer nasal e dos seios paranasais e cinco familiares, entre julho e setembro de 2021. O instrumento obteve um índice de 94% de concordância entre os juízes, que fizeram sugestões de inclusão, manutenção semântica e substituição em 11 domínios. No pré-teste os participantes fizeram confirmação do entendimento sobre as perguntas e os domínios de 100% (n=15), entretanto, todos tiveram dificuldade de interpretação da palavra "popper", e 53% (n= 8) fizeram proposições de melhoria no questionário. Um participante solicitou a inclusão do narguilé nos hábitos de fumo. Artigo 3: consiste num relato de séries de casos de um hospital de oncologia do Estado do Paraná, no Sul do Brasil, no período de 2005 a 2021. Foram incluídos pacientes com idade acima de 18 anos, de ambos os sexos, com CID C30 e o grupo C31, que estavam em acompanhamento de saúde nos últimos 12 meses na instituição hospitalar, ou familiares (no caso de óbito do paciente) com idade superior ou igual a 18 anos. Os participantes foram entrevistados com o Questionário sobre o Histórico de Trabalho e os Hábitos de Vida, com os dados obtidos analisados por frequência simples e absoluta Resultados: O Artigo 3 teve 52 participantes eram do sexo masculino (56%; n= 29), casados (31%; n= 16), com ensino fundamental completo (23%; n= 12) e sem histórico de tabagismo (27%; n= 14), onde a localização prevalente foi C30.0 em homens (33%; n=17) com carcinoma de células escamosas (40,3%; n= 21). A exposição carcinogênica com poeira da madeira (29,8%; n=17), cromo e níquel (17,5%; n=10) e com couro e derivados (14%; n=8). Conclusão: a frequência do câncer nasal e dos seios paranasais foi maior no sexo masculino, com ensino fundamental, nos trabalhadores agropecuários e da indústria de transformação e tiveram exposição ao agente carcinogênico; o estudo poderá motivar as reflexões acerca do acometimento do câncer nasal e dos seios paranasais no contexto brasileiro, principalmente de origem ocupacional, conforme as monografias do International Agency for Research on Cancer, que enfatiza a importância de utilizar um instrumento de investigação com informações complexas e essenciais do histórico ocupacional e dos hábitos de vida direcionado para o câncer nasal e dos seios paranasais.

Abstract: This study, presented in the form of an article, is part of the Care Process in Health and Nursing research line of the Postgraduate Program in Nursing, and the Multiprofessional Research Group in Adult Health at the Universidade Federal do Paraná. Introduction: nasal and paranasal sinus cancer corresponds to less than 1% of other types of cancer, has etiological factors resulting from the environment, occupational activities and lifestyle, and a latency period varying up to 20 years for the onset of neoplastic symptoms. Objectives: to characterize the sociodemographic, clinical and occupational profile of Brazilians with sinonasal cancer; translate, culturally adapt and validate the Questionario Sulla Storia di Lavoro e Sulle Abitudini di Vita used by the Registro Tumori Seni Nasali e Paranasali from Lombardy, Italy, for the Brazilian cultural context; to examine the sociodemographic, clinical and occupational profile of patients with sinonasal cancer, and relate the occupation to exposure to leather dust,wood dust, chromium and nickel. Article 1: is an observational, descriptive, retrospective study using secondary data from the Hospital Cancer Registry Integrator from 2007 to 2019 with ICDs: C30.0 and C31.0 to C31.9. Analysis of 1,803 records was performed, highlighting that 1,161 (64%) were male, predominant age group of 50-59 years (26%; n=298), white race/color (46%; n=535) , single (55%; n=640), incomplete primary education (40%; n=461), with incidence of neoplasia in the maxillary sinus (52%; n=943), and clinical staging grade IV (32%; n=575). The occupations registered in Brazilians with sinonasal cancer were in Group 6 (64.7%; n=701) - agricultural, forestry and fishing workers, and in Group 8 (26.7%; n=289) - workers in the production of industrial goods and services, mainly in the states of Bahia (11%; n=206) and Minas Gerais (18%; n=327). Article 2: describes a methodological study with the steps of translation, synthesis, back-translation, back-translation report, review, pilot test and final translation proposed by the European Organization for Research and Treatment of Cancer. The instrument was divided into 11 domains according to characteristics of the questions in the original instrument. The pre-test was carried out between July and September 2021 in a reference hospital in oncology in the state of Paraná, Brazil, with 15 participants that were patients with nasal and paranasal sinus cancer, and five family members. The instrument obtained an index of 94% agreement among judges, who made suggestions for inclusion, semantic maintenance and replacement in 11 domains. In the pre-test, although participants confirmed their 100% (n=15) understanding of questions and domains, all had difficulty interpreting the word "popper", and 53% (n=8) made suggestions for improvements in the questionnaire. One participant requested the inclusion of hookah in smoking habits. Article 3: consists of a case series report from an oncology hospital in the state of Paraná, southern Brazil, from 2005 to 2021. Patients of both sexes aged over 18 years, with ICD C30 and group C31, under healthcare in the last 12 months at the hospital, or family members (in the case of patient's death) aged 18 years or older were included. Participants were interviewed using the Work History and Lifestyle Questionnaire. The data obtained were analyzed by simple and absolute frequency. Results: Article 3 had 52 participants that were male (56%; n= 29), married (31%; n= 16), with complete primary education (23%; n= 12) and no history of smoking (27 %; n=14), and the prevalent location was C30.0 in men (33%; n=17) with squamous cell carcinoma (40.3%; n=21). Carcinogenic exposure to wood dust (29.8%; n=17), chromium and nickel (17.5%; n=10), and leather and leather products (14%; n=8). Conclusion: the frequency of nasal and paranasal sinus cancer was higher in males with primary education, in agricultural workers and in the manufacturing industry who were exposed to the carcinogenic agent; the study may motivate reflections on the involvement of nasal and paranasal sinus cancer in the Brazilian context, mainly of occupational origin, according to monographs of the International Agency for Research on Cancer, which emphasizes the importance of using a research instrument with complex and essential information of occupational history and lifestyle habits directed to nasal and paranasal sinus cancer.

Factores psicosociales y rendimiento laboral en colaboradores de una institución educativa privada, Lima, 2021 / Psychosocial Factors and Work Performance of Collaborators at a Private Educational Institution, Lima, 2021

Introducción: La actividad laboral de las personas siempre ha transformado al mundo, sin embargo, ha generado muchos riesgos y enfermedades. Asimismo, el trabajo ha sido afectado por la globalización, la tecnología y la crisis sanitaria por la COVID-19. Generando, transformaciones en las estructuras del empleo y en las condiciones del trabajo, tornándose más exigente en el área laboral, estas condiciones han predispuesto factores psicosociales negativos que amenaza la salud; ocasionando enfermedades y accidentes laborales, y como consecuencia un deficiente rendimiento laboral. Objetivo: Determinar la relación entre los factores psicosociales y el rendimiento laboral en colaboradores de una institución educativa privada de Lima. Metodología: Enfoque cuantitativo, de diseño no experimental, corte transversal y de tipo correlacional. En el estudio participaron 120 colaboradores de la institución educativa privada, según el muestreo no probabilístico; como instrumento se aplicó el Cuestionario de "Factores Psicosociales en el Trabajo" y el "El cuestionario de Rendimiento Laboral Individual" compartido digitalmente través del correo electrónico. Resultados: del total de los encuestados, el 52,50% manifestaron tener una buena percepción de los factores psicosociales; sin embargo, se obtuvo una mala percepción en las dimensiones exigencia laboral con el 63,30% y satisfacción con la remuneración del rendimiento con el 52,50%; con respecto a la variable rendimiento laboral, el 75,00% demostró un nivel alto. Conclusión: Los trabajadores que indicaron una alta exigencia laboral tuvieron 11 veces mayor probabilidad de presentar un alto rendimiento en su trabajo (OR:11,03; IC 95%: 1,71-17,95).

Introduction: People's work has always transformed the world; however, it has also posed many risks and diseases. Likewise, work has been affected by globalization, technology, and the COVID-19 health crisis. There have been transformations in employment structures and working conditions, which have become more demanding. These conditions have predisposed negative psychosocial factors that threaten health, causing occupational illnesses and accidents and, consequently, poor work performance. Objective: To determine the relationship between psychosocial factors and work performance in employees of a private educational institution in Lima. Methods: Quantitative approach, non-experimental, cross-sectional, and correlational design. A total of 120 employees of the private educational institution participated in the study, according to a non-probabilistic sampling method. The Psychosocial Factors at Work Questionnaire and the "Individual Work Performance Questionnaire," shared digitally via e-mail, were used. Results: Of the total respondents, 52.50% had a good perception of psychosocial factors; however, a poor perception was identified in the dimensions "work demands" (63.30%) and "satisfaction with performance compensation" (52.50%). Conclusion: Workers who indicated high work demands were 11 times more likely to have high work performance (OR: 11.03; 95% CI: 1.71­17.95).

Introdução: A atividade de trabalho das pessoas sempre transformou o mundo, no entanto, gerou muitos riscos e doenças. Da mesma forma, o trabalho tem sido afetado pela globalização, pela tecnologia e pela crise sanitária da COVID-19. Estas condições predispuseram fatores psicossociais negativos que ameaçam a saúde, causando doenças e acidentes no trabalho e, como consequência, um mau desempenho no trabalho. Objetivo: Determinar a relação entre fatores psicossociais e o desempenho no trabalho dos funcionários de uma instituição de ensino privada em Lima. Metodologia: Abordagem quantitativa, projeto não-experimental, transversal e correlacional. O estudo envolveu 120 funcionários da instituição privada de ensino, de acordo com amostragem não-probabilística; o questionário "Fatores Psicossociais no Trabalho" e o "Questionário de Desempenho Individual do Trabalho", compartilhado digitalmente por e-mail, foram utilizados como instrumentos. Resultados: Do número total de entrevistados, 52,50% afirmaram que tinham uma boa percepção dos fatores psicossociais; no entanto, foi obtida uma má percepção nas dimensões das demandas do trabalho com 63,30% e satisfação com a remuneração por desempenho com 52,50%; com relação ao desempenho variável do trabalho, 75,00% mostraram um alto nível. Conclusão: Os trabalhadores que indicaram altas exigências de trabalho tinham 11 vezes mais probabilidade de ter alto desempenho no trabalho (OR: 11,03; 95% CI: 1,71-17,95).

Futuros cirurgiões-dentistas canhotos graduandos da Universidade Federal de Uberlândia: perfil, dificuldades e dores osteomusculares / Future left-handed dentists graduating from the Federal University of Uberlândia: profile, difficulties and musculoskeletal pain

Os indivíduos canhotos necessitam de utensílios para concretização de suas atividades diárias, bem como, para o exercício da prática odontológica onde a escassez de equipamentos específicos pode refletir em desgaste corporal, com isso, o presente trabalho tem por objetivo identificar os estudantes canhotos do curso de Odontologia da Universidade Federal de Uberlândia além de identificar suas dificuldades, queixas e locais de dores osteomusculares nas atividades laboratoriais e clínicas. Métodos: Foram incluídos todos os alunos canhotos matriculados no ano de 2021. Foram aplicados questionários on line para coletar os dados dos alunos. Resultados: Foram tabulados e como resultados, encontrou-se que os canhotos representam 5,6% do total de alunos do curso de Odontologia, a maioria são mulheres (66,7%), com média de idade de 21 anos. O segundo período foi o que apresentou maior número de canhotos (25%). As atividades práticas do curso, estas foram cursadas por 91,7% dos entrevistados, que relataram com maior frequência usar a mão esquerda (62,5%), sentar na posição de 1 hora (20,8%) e ter maior dificuldade ao tratar o quadrante superior direito (45,8%). Os locais mais citados de dores osteomusculares após realizar essas atividades, foram: punhos e mãos (62,5%), parte inferior das costas (62,5%) e pescoço (58,3%). Conclusão: Os canhotos representam a minoria dos alunos e suas dificuldades são, a falta de estrutura física adequada e a incompreensão das pessoas ao redor. Em relação a queixa de dor ou desconforto, mãos, punhos, parte inferior das costas e pescoço foram os membros mais citados no estudo(AU)

Left-handed individuals need tools to carry out their daily activities, as well as for the exercise of dental practice where the scarcity of specific equipment can reflect on body wear, with this, the present work aims to identify left-handed students of the course of Dentistry at the Federal University of Uberlândia, in addition to identifying their difficulties, complaints and sites of musculoskeletal pain in laboratory and clinical activities. Methods: All left-handed students enrolled in the year 2021 were included, and three questionnaires were applied online to identify the profile of students and the difficulties encountered in laboratory and clinical practice. Results: They were tabulated and as a result, it was found that left-handers represent 5.6% of the total number of students in the Dentistry course, most of them are women (66.7%), with a mean age of 21 years. The second period was the one with the highest number of left-handers (25%). The practical activities of the course were carried out by 91.7% of the interviewees, who reported more frequently using their left hand (62.5%), sitting in the 1 o'clock position (20.8%) and having greater difficulty when treat the upper right quadrant (45.8%). The most cited sites of musculoskeletal pain after performing these activities were: wrists and hands (62.5%), lower back (62.5%) and neck (58.3%). Conclusion: Lefthanded people represent the minority of students, and their difficulties are the lack of adequate physical structure and the misunderstanding of the people around them. In relation to complaints of pain or discomfort, hands, wrists, lower back and neck were the most cited members in the study(AU)

Ambiente de trabalho seguro e sustentável: como a ergonomia de conscientização e participativa se aplica aos servidores públicos? / Safe, sustainable work environment: how awareness and participatory ergonomics can be applied to public servers? / Un entorno de trabajo seguro y sostenible: ¿cómo aplicar la sensibilización y la ergonomía participativa a los servidores públicos?

Introdução: As práticas ergonômicas de conscientização e de participação assumem importante papel na prevenção das doenças ocupacionais. Entretanto, os métodos utilizados pelos programas de prevenção das instituições e empresas visam a correção dos riscos ergonômicos, não observando o fator humano detentor da execução da tarefa. Objetivo: Analisar a utilização das Ergonomia de Conscientização e Participa- ção como programa de educação visando a prevenção primária e a conscientização dos riscos ergonômicos das lesões por esforço repetitivo (LER) e distúrbios osteomusculares relacionadas ao trabalho (DORT). Metodologia: Revisão crítica de literatura, sintetizando o embasamento teórico pertinente ao tema, com documentação técnica, normas, decretos, portarias e dados estatísticos atualizados de afastamento; formando, assim, à análise documental. Resultados e Discussão: Os dados estatísticos mostram a importância de uma mudança nos hábitos, nos programas e nas intervenções ergonômicas no ambiente laboral do trabalhador, visando minimizar os impactos socioeconômicos dos altos índices de afastamento para organizações, empresas privadas e, principalmente, serviços públicos de ensino superior devido a maior precariedade dos ambientes de trabalho. Práticas ergo- nômicas de conscientização e participação dos trabalhadores podem proporcionar uma melhora nos desconfortos do ambiente laboral. Ressalta-se a escassez de pesquisas que priorizem a relação custo-benefício e a eficácia a longo prazo na área de Ergonomia. Conclusões: Novas análises devem ser observadas para promover melhora da qualidade de vida do trabalhador, diminuição das perdas econômicas, contribuindo para um trabalho seguro, decente e sustentável como preconiza principalmente o Objetivo 8 da Agenda 2030 da Organização das Nações Unidas.

Introduction: Ergonomic awareness and participation practices play an im- portant role in the prevention of occupational diseases. However, the methods used by institutions and companies' prevention programs aim to correct ergonomic risks and do not observe the human factor responsible for carrying out the task. Purpose: To analyze the use of Participation and Awareness Ergonomics as an education program aimed at raising awareness of ergonomic risks for the prevention of repetitive strain injuries (RSI) and work-related musculoskeletal disorders (WRMD). Methodology: Critical literature review, summarizing the theoretical basis relevant to the topic, with technical documen- tation, norms, decrees, ordinances, and updated statistical data on leave; thus forming the documental analysis. Results and discussion: Statistical data show the importance of changing habits, programs, and ergonomic interventions in the work environment of the worker, in order to minimize the socioeconomic impacts of the high removal rates of organizations, private companies, and, mainly, public higher education due to more pre- carious work environments. Ergonomic practices of awareness and participation of work- ers can improve the work environment's discomfort. The lack of research that prioritizes the cost-benefit ratio and long-term effectiveness in Ergonomics is highlighted. Conclu- sions: New studies must promote a significant improvement of the quality of life of work- ers, reduction of economic losses and, thus contribute to a safe environment, decent and sustainable, as advocated by Objective 8 of the United Nations 2030 Agenda.

Introducción: Las prácticas de sensibilización y participación ergonómicas desempeñan un papel importante en la prevención de las enfermedades profesionales. Sin embargo, los métodos utilizados por los programas de prevención de instituciones y em- presas tienen como objetivo corregir los riesgos ergonómicos y no observan el factor hu- mano responsable de la realización de la tarea. Propósito: Analizar el uso de la Ergonomía de Participación y Concienciación como programa educativo dirigido a la concienciación de los riesgos ergonómicos para la prevención de las lesiones por esfuerzos repetitivos (LER) y los trastornos musculoesqueléticos de origen laboral (TME). Metodología: Re- visión lit-eratura crítica, resumiendo la base teórica relevante al tema, con documentación técnica, normas, decretos, ordenanzas, y datos estadísticos actualizados sobre bajas la- borales; conformando así el análisis documental. Resultados y discusión: Los datos es- tadísticos demuestran la importancia del cambio de hábitos, programas e intervenciones ergonómicas en el ambiente de trabajo del trabajador, para minimizar los impactos soci- oeconómicos de los altos índices de desvinculación de organizaciones, empresas privadas y, principalmente, de la enseñanza superior pública, debido a la mayor precariedad de los ambientes de trabajo. Práticas ergonómicas de conscientização e par-ticipação dos tra- balhadores podem melhorar a incomodidade do ambiente de trabalho. Se destaca la falta de re-investigación que priorice la relación costo-beneficio y la eficacia a largo plazo en Ergonomía. Conclusiones: Nuevos estudios deben promover una mejora significativa de la calidad de vida de los trabajadores, la reducción de las pérdidas económicas y, así contribuir a un entorno seguro, digno y sostenible, como propugna el Objetivo 8 de la Agenda 2030 de las Na-ciones Unidas.

Estudio preliminar para la validación de la versión chilena del Vocal Tract Discomfort-VTD en población docente / Validation of the chilean version of the Vocal Tract Discomfort-VTD on teachers: a preliminary study

Debido a la carga vocal a la que están expuestos los profesionales de la voz, como los profesores, son frecuentes los trastornos de voz y mal uso vocal en este grupo, lo que hace necesario poder contar con instrumentos de pesquisa rápidos y sencillos para un diagnóstico precoz de sintomatología vocal. El objetivo del presente estudio es realizar una adaptación y validación preliminar de la pauta "Vocal Tract Discomfort Scale (VTD)" al idioma español chileno en profesores. Se comenzó con la traducción al español del instrumento original por parte de dos expertos nativos y luego la retro-traducción por dos expertos en idioma inglés para determinar concordancias y discrepancias. Luego se continuó con la validación de apariencia y contenido realizada por valoración de grupo de expertos compuesto por dos metodólogos y cinco fonoaudiólogos con experiencia en el área vocal. La validez de criterio se obtuvo mediante la correlación entre la escala en estudio y el Voice Handicap Index en su versión validada al español como prueba gold-standard, para lo cual se aplicó en una muestra de 31 docentes. La validación de la escala VTD es fiable y deja a disposición de los fonoaudiólogos una herramienta sencilla y comprensible para el entendimiento del impacto generado en personas con disfonía, particularmente, en profesionales de la voz como los profesores.

Due to the vocal load to which voice professionals such as teachers are exposed, voice disorders and vocal misuse are frequently found in this group. This makes it necessary to have quick and simple assessment instruments that allow early detection of vocal symptoms. The objective of this study was to adapt the "Vocal Tract Discomfort Scale (VTD)" to Chilean Spanish and carry out a preliminary validation of this protocol on teachers. First, the original instrument was translated toSpanish by two native speakers, and then back-translated by two English experts, in order to determine the presence of agreements and discrepancies. Subsequently, a group of experts made up of two methodologists and five speech therapists with experience in the voice field performed an appearance and content validation. Criterion validity was obtained through the correlation between the Vocal Tract Discomfort Scale and the Spanish-validated version of the Voice Handicap Index as a gold-standard test, for which the first was appliedto a sample of 31 teachers. The validation of the VTD scale is reliable and provides speech therapists with a simple and understandable tool that allows them to comprehend the impact of dysphonia on people, particularly on voice professionals such as teachers.

Trabalho da equipe de enfermagem do bloco cirúrgico: riscos de danos à saúde / Work of the nursing team in the surgical center: risks to health / Trabajo del equipo de enfermería en el bloque quirúrgico: riesgos de daños a la salud

Objetivo: Analisar os riscos de danos à saúde relacionados ao trabalho da equipe de enfermagem no bloco cirúrgico de um hospital universitário do Sul do Brasil. Métodos: Estudo transversal com abordagem quantitativa. Os dados foram coletados entre os meses de novembro de 2017 e janeiro de 2018, por meio da aplicação de um instrumento de pesquisa com os trabalhadores da equipe de enfermagem do bloco cirúrgico de um hospital univer-sitário. Os dados foram submetidos à análise estatística. Resultados: Constatou-se que 85,4% eram mulheres, com idade média de 47,7 anos. Referente aos danos psicológicos relacionados ao trabalho, 91,5% apresentaram baixo risco e 8,5% apresentaram risco médio. Quanto aos danos sociais, 87,5% apresentaram baixo risco e 10,4% apresentaram risco médio. Quanto aos danos físicos, 29,2% apresentaram alto risco, 35,4% apresentaram risco médio e 33,3% apresentaram baixo risco. Conclusões: Observou-se risco alto e médio para danos físicos relacionados ao trabalho, evidenciando a necessidade de intervenções que visem à prevenção do adoecimento dos trabalhadores.

Objective: To analyze the risks to health related to the work of the nursing team in the operating room of a university hospital in southern Brazil. Methods: Cross-sectional study with a quantitative approach. Data were collected between November 2017 and January 2018, through a survey with workers of the nursing team in the surgical center of a university hospital. Data were submitted to statistical analysis. Results: It was found that 85.4% were women, with a mean age of 47.7 years. Regarding work-related psychological compromise, 91.5% were at low risk and 8.5% were at medium risk. As for social harm, 87.5% were at low risk and 10.4% were at medium risk. As for physical risk, 29.2% were at high risk, 35.4% at medium risk, and 33.3% at low risk. Conclusions: There was a high and medium risk for physical injuries related to work, highlighting the need for interventions aimed at preventing illness among workers.

Objetivo: Analizar los riesgos de daños a la salud relacionados con el trabajo del equipo de enfermería en el quirófano de un hospital uni-versitario del sur de Brasil. Métodos: Estudio transversal con enfoque cuantitativo. Los datos fueron recolectados entre noviembre de 2017 y enero de 2018, mediante la aplicación de un instrumento de investigación con trabajadores del equipo de enfermería en el bloque quirúrgico de un hospital uni-versitario. Los datos fueron sometidos a análisis estadístico. Resultados: Se encontró que el 85,4% eran mujeres, con una edad promedio de 47,7 años. En cuanto al daño psicológico relacionado con el trabajo, el 91,5% tenía riesgo bajo y el 8,5% riesgo medio. En cuanto al daño social, el 87,5% tuvo riesgo bajo y el 10,4% riesgo medio. En cuanto al daño físico, el 29,2% se encontraba en riesgo alto, el 35,4% en riesgo medio y el 33,3% en riesgo bajo. Conclusiones: Hubo alto y medio riesgo de lesiones físicas relacionadas con el trabajo, destacando la necesidad de intervenciones dirigidas a la preven-ción de enfermedades entre los trabajadores.

A covid-19 como um analisador do sofrimento de enfermeiras: um ensaio teórico / Covid-19 as a suffering analyzer for female nurses: a theoretical essay / El covid-19 como analizador de sufrimiento de enfermeras: un ensayo teórico

Este ensaio propõe que a Covid-19 pode operar como um analisador, dentro da perspectiva da análise institucional, iluminando um determinado modo de organização social que promove profundas desigualdades e ameaça a vida em diversos níveis e revelando as condições sociais, institucionais e políticas de produção de sofrimento no corpo profissional de Enfermagem. A pandemia desvelou um conjunto de marcas relacionadas à profissão, agravadas pela crise sanitária, reforçando a naturalização das relações de cuidado atribuídas ao feminino, bem como um conjunto de clivagens e hierarquias internas à profissão a partir da sinergia de marcadores da diferença, como gênero, cor/raça, classe e geração. Além disso, este trabalho mostra a presença de uma necropolítica nas respostas à pandemia que banaliza a vida e permite morrer determinados grupos sociais. A ideia de "profissionais de linha de frente" é criticada em suas metáforas bélicas, mas tomada como figura de linguagem em sua potência para afirmar que existem corpos que, pelas marcas sociais e históricas e pela interdependência do cuidado, são mais presentes e exigidos e, portanto, mais vulneráveis à doença e ao sofrimento dela decorrente.(AU)

The essay proposes that Covid-19 can operate as an analyzer, within the perspective of institutional analysis, illuminating a certain mode of social organization that promotes profound inequalities and threatens life at various levels, revealing the social, institutional and political conditions for the production of suffering in the professional nursing body. The pandemic would unveil a set of marks related to the profession, aggravated by the sanitary crisis, reinforcing the naturalization of the care relations attributed to the feminine, as well as a set of cleavages and internal hierarchies to the profession from the synergy of markers of difference as gender, color/race, class and generation. The work shows the presence of necropolitics in responses to the pandemic, which trivializes life and allows certain social groups to die. The idea of "front-line professionals" is criticized in its war metaphors, but taken as a figure of speech in its potency to affirm that there are bodies that by social and historical marks, and by the interdependence of care, are more present and demanded, and therefore more vulnerable to disease and the resulting suffering.(AU)

El ensayo propone que el Covid-19 puede funcionar como analizador, desde la perspectiva del análisis institucional, revelando las condiciones sociales, institucionales y políticas de producción de sufrimiento de enfermeras. La pandemia revela algunas marcas relacionadas con la profesión, agravadas por la crisis de salud, reforzando la naturalización de la atribución del cuidado a lo femenino y un conjunto de jerarquías internas de la profesión. El trabajo también muestra la presencia de una necropolítica en las respuestas a la pandemia. La idea de "profesionales de primera línea" es criticada, pero tomada como una figura del lenguaje en su potencia para afirmar que hay cuerpos que, por las marcas sociales e históricas y por la interdependencia del cuidado, están más presentes y demandados, y por lo tanto más vulnerables a la enfermedad.(AU)

Engajamento com o trabalho e exaustão emocional de profissionais da socioeducação / Engagement with work and emotional exhaustion of socio-education professionals / Comprometimiento con el trabajo y agotamiento emocional de profesionales de la socioeducación

Buscou-se compreender a percepção dos profissionais das medidas socioeducativas acerca do seu engajamento e exaustão com o trabalho. Para isso, realizou-se um estudo qualitativo, descritivo e exploratório, por meio de uma entrevista semiestruturada a três integrantes da equipe técnica e dois coordenadores de segurança (idades entre 28 e 57 anos). A análise dos dados foi conduzida com o auxílio do software Iramuteq, que gerou cinco classes temáticas: a) rotina das unidades socioeducativas e as demandas do trabalho dos profissionais; b) gestão de conflitos nas unidades, da mediação à polícia; c) recursos pessoais e institucionais relacionados ao exercício da profissão; d) aspectos relacionados ao contexto de trabalho; e, por último, e) indicadores de esgotamento laboral, adversidades e adoecimento profissional. Os participantes descreveram diversas demandas relacionadas à exaustão física e psicológica (e.g. equipe reduzida, insalubridade, baixo salário e fragilidade do vínculo empregatício), mas também ressaltaram a relevância social de sua prática profissional junto aos adolescentes e o relacionamento positivo entre os profissionais como fatores que justificam o seu engajamento e permanência nas instituições socioeducativas. Conclui-se evidenciando que os contextos têm influência direta na saúde desses profissionais, o que sublinha a importância de se olhar para suas condições de trabalho e para aspectos ligados à saúde mental, promovendo, desse modo, avanços na realidade socioeducativa.(AU)

The aim was to understand the perception of professionals of socio-educational measures about their engagement and exhaustion with work. To that end, a qualitative, descriptive, and exploratory study was carried out by means of a semi-structured interview with three members of the technical team and two safety coordinators (ages between 28 and 57 years). Data analysis was conducted with the help of the IRAMUTEQ software, which generated five thematic classes: a) routine of socio-educational units and work demands of professionals; b) conflict management in the units, from mediation to the police; c) personal and institutional resources related to the exercise of the profession; d) aspects related to the work context; and, lastly, e) indicators of labor exhaustion, adversity, and occupational illness. Participants described several demands related to physical and psychological exhaustion (e.g. reduced team, insalubrity, low salary, and fragility of the employment relationship), but also emphasized the social relevance of their professional practice with adolescents and the positive relationship among professionals as factors that justify their engagement and permanence in socio- educational institutions. It is concluded that the contexts have a direct influence on the health of these professionals, which highlights the importance of looking at their working conditions and aspects related to mental health, thus promoting advances in the socio-educational reality.(AU)

Se procuró comprender la percepción de los profesionales que trabajan con medidas socioeducativas sobre su comprometimiento y el agotamiento en el trabajo. Para esto, se realizó un estudio cualitativo, descriptivo y exploratorio, por medio de una entrevista semiestructurada a tres integrantes del equipo técnico y dos coordinadores de seguridad (edades entre 28 y 57 años). El análisis de los datos fue conducido en el software IRAMUTEQ, que generó cinco clases temáticas: a) rutina de las unidades socioeducativas: demandas del trabajo de los profesionales; b) manejo de conflictos en las unidades: desde la mediación hasta la policía; c) recursos personales e institucionales relacionados al ejercicio de la profesión; d) aspectos relacionados al contexto del trabajo; e) indicadores de agotamiento laboral, adversidades y enfermedad del profesional. Los participantes describieron diversas demandas relacionadas al agotamiento físico y psicológico (por ej.: equipo reducido, insalubridad, bajos sueldos y fragilidad del vínculo laboral), pero también destacaron la importancia social de su práctica profesional junto a los adolescentes y el vínculo positivo entre los profesionales como factores que justifican su comprometimiento y permanencia en las instituciones socioeducativas. Se concluye que los contextos influyen directamente en la salud de estos profesionales, lo que rescata la importancia de verificar sus condiciones de trabajo y los aspectos relacionados a la salud mental, promoviendo, de este modo, avances en la realidad socioeducativa.(AU)

Uso de técnicas de aprendizado de máquina para classificação de fatores que influenciam a ocorrência de dermatites ocupacionais / Using machine learning techniques to classify factors that influence the occurrence of occupational dermatitis

Resumo Introdução: realizar a predição de doenças relacionadas ao trabalho é um desafio às organizações e ao poder público. Com as técnicas de aprendizado de máquina (AM), é possível identificar fatores determinantes para a ocorrência de uma doença ocupacional, visando direcionar ações mais efetivas à proteção dos trabalhadores. Objetivo: predizer, a partir da comparação de técnicas de AM, os fatores com maior influência para a ocorrência de dermatite ocupacional. Métodos: desenvolveu-se um código em linguagem R e uma análise descritiva dos dados e identificaram-se os fatores de influência de acordo com a técnica de AM que demonstrou melhor desempenho. O banco de dados foi disponibilizado pelo Serviço de Dermatologia Ocupacional da Fundação Oswaldo Cruz e contém informações de trabalhadores que apresentaram alterações cutâneas sugestivas de dermatite ocupacional no período de 2000-2014. Resultados: as técnicas com melhor desempenho foram: neural network, random forest, support vector machine e naive Bayes. As variáveis sexo, escolaridade e profissão foram as mais adequadas para os modelos de previsão de dermatite ocupacional. Conclusão: as técnicas de AM possibilitam predizer os fatores que influenciam a segurança e a saúde dos trabalhadores, os parâmetros que subsidiam a implantação de procedimentos e as políticas mais efetivas para prevenir a dermatite ocupacional.

Abstract Introduction: to predict work related diseases is a challenge for organizations and the governmental authorities. By means of machine learning (ML) techniques it is possible to identify factors that determine the occurrence of an occupational disease, aiming at taking more effective actions to protect workers. Objective: to predict, by comparing ML techniques, the factors which highly influence the occurrence of occupational dermatitis. Methods: we developed a code in R language and a descriptive analysis of the data and identified the influence factors according to the ML technique that presented the best performance. The database was made available by the Occupational Dermatology Service of Oswaldo Cruz Foundation and assembles information of the workers who experienced cutaneous alterations suggestive of occupational dermatitis between 2000-2014. Results: the techniques which presented the best performance were: neural network, random forest, support vector machine, and naive Bayes. Sex, schooling, and profession were the most adequate variables for the occupational dermatitis prediction models. Conclusion: ML techniques allowed to predict the factors that influence the workers' safety and health, as well as the parameters that subsidize the procedures implementation, and the most effective policies to prevent occupational dermatitis.

Research progress of occupational hazards in plywood manufacturing / 中华劳动卫生职业病杂志

Occupational disease hazards in plywood manufacturing mainly include wood dust, formaldehyde, phenol, ammonia, noise, terpene, microorganisms, etc. The exposure is complex with multiple factors accompanied or coexisted. In the production process, these factors are exceeded, and mass occupational disease hazard events occurred among workers. Exposure to wood dust, formaldehyde, terpene, etc., put workers at increased risk of cancer. This article provides a review of this issue in order to provide a scientific basis for the prevention and control of occupational disease hazards in plywood manufacturing.

A case of dimethylformamide poisoning caused by skin contact / 中华劳动卫生职业病杂志

In this paper, the clinical data of a case of accidental poisoning of dimethylformamide in a traffic accident was analyzed. The patient was trapped in the driving room, his limbs were soaked in dimethylformamide for a long time, and dimethylformamide was inhaled at the same time. After 4 days of treatment in a local hospital, he was transferred to the Department of Poisoning & Occupational Diseases, Emergency Medicine of Qilu Hospital of Shandong University for treatment. The main clinical manifestation of the patient was liver damage and intractable abdominal pain, which was cured by active treatment.

41 cases of chronic obstructive pulmonary disease caused by occupational irritating chemicals / 中华劳动卫生职业病杂志

Objective: To analyze the case characteristics of Chronic obstructive pulmonary disease caused by occupational irritant chemicals (OI-COPD). To provide basis for revising its diagnostic criteria. Methods: From June to December 2021, we investigated the information of OI-COPD patients confirmed by Shandong Institute of Occupational Health and Prevention of Occupational Diseases, Guangxi Zhuang Autonomous Region Institute of Occupational Disease Prevention and Control, Qingdao Central Hospital affiliated to Qingdao University and other diagnostic institutions in the past five years, a total of 41 cases. The basic information of OI-COPD cases, occupational risk factors exposure information, medical history, smoking history and clinical symptoms were analyzed retrospectively. The measurement data were tested for normal distribution, which was described by x±s, and compared between groups by t test; Those who do not conform to the normal distribution are described by the median [M (Q(1), Q(3)) ] and analyzed by nonparametric test; The counting data were expressed in frequency and rate (% ), and the comparison between groups was tested. Results: Of the 41 cases, 33 were male and 8 were female. The age of the patient diagnosed with OI-COPD was (49.5±10.3) years old, and the minimum age was 30 years old; Among them, 8 patients had a definite long-term smoking history (more than 5 years) ; The exposure duration of occupational risk factors was (18.6±10.3) years, of which 3 patients had exposure duration of less than 5 years; The occupational risk factors leading to OI-COPD include acids and acid-forming compounds, bases, aldehydes, nitrogen oxides, chlorine and its compounds, etc. The exposure level of occupational risk factors is related to the degree of COPD airflow restriction (χ(2)=6.17, P <0.05). 18 patients with diagnosis age <50 years old were diagnosed as early-onset COPD. The incidence of respiratory symptoms in the early diagnosis COPD group was lower than that in the non-early diagnosis COPD group, and the FEV1% pred was significantly higher than that in the non-early diagnosis COPD group. The difference was statistically significant (P<0.01 ) . Conclusion: The exposure level of occupational risk factors may be the risk factor affecting the degree of COPD airflow restriction. With the increase of the exposure level of COPD patients, the proportion of respiratory symptoms will also increase accordingly.

A summary on surveillance system of occupational disease under the framework of National Health Insurance Informatization Project / 中华劳动卫生职业病杂志

The surveillance of occupational disease has entered a new stage ofdevelopment, with the implementation of the national health informatization project. To improve the efficiency and quality of occupational disease monitoring information reporting in this paper, the system architecture and related management regulations, as long as the major changes and achievement of "surveillance system of occupational disease and health hazards information" under the framework of National Health Insurance Informatization Project were elaborated. The deficiencies existing in the system were analyzed, and expectation for the construction of the occupational disease surveillance system was addressed.

Meta analysis of the prevalence and influencing factors of WMSDs among dentists in China / 中华劳动卫生职业病杂志

Objective: To explore the relevant factors of work-related musculoskeletal disorders (WMSDs) among dentists through Meta analysis, providing a basis for the prevention and control of WMSDs among dentists. Methods: In April 2022, cross-sectional research literatures on the prevalence correlation of WMSDs among Chinese dentists were searched in databases such as China National Knowledge Infrastructure, Wanfang, VIP, PubMed, Web of Science, and Em Base database. The search was conducted from the establishment of the database until April 2022, literatures were selected using keywords such as musculoskeletal disorders and dentists. To extract gender, age, length of service, disease classification and other related influencing factors as indicator, and prevalence was selected as the outcome indicator. After evaluating the quality of the literatures, RevMan 5.3 software was used to calculate the combined RD (95%CI) values of the included literatures. Results: A total of 15 articles were included, with a total sample size of 3646 people. Meta analysis results showed that the prevalence of WMSDs among dentists in China was 80%, and the top three parts of the incidence rates were 65% of the waist, 58% of the neck, and 50% of the back. Gender, age, length of service, region and disease classification all increased the risk of WMSDs, and the combined effect size were 75%, 78%, 71%, 77% and 82% respectively (P<0.05) . Conclusion: The occurrence of WMSDs among dentists in China is related to multiple factors such as gender, age, length of service and disease classification. The above risk factors should be taken into account in the workplace and preventive measures should be actively implemented to prolong the working life of dentists.

Investigation and analysis of late reporting and under-reporting of occupational diseases from 2018 to 2020 in China / 中华劳动卫生职业病杂志

Objective: To understand the late reporting and the under-reporting of occupational disease from 2018 to 2020 in China and analyze the causes, so as to provide scientific evidence for improving the quality of occupational disease reports in China, timely acquiring the incidence of occupational disease, and assessing the occupational hazards. Methods: From May to December 2021, A total of 320 occupational disease diagnostic institutions were selected for investigation. The original documents of occupational disease diagnosis cases from 2018 to 2020 were compared with the online reported cases, and late reported and under-reported cases of occupational disease were analyzed. Results: A total of 32207 diagnosed cases from 2018 to 2020 were investigated, including 28934 confirmed cases and 3273 cases without occupational disease. The overall late reported rate and under-reported rate of confirmed cases were 20.2% and 2.1%, respectively. There were significant differences in the rate of late reporting and under-reporting of occupational diseases in different regions and different types of diagnostic institutions (P<0.001). The southwest region had the highest rates of late reporting and under-reporting, 61.6% and 7.9% respectively. The late reported rate of all kinds of occupational diseases was about 15.0%, and the under-reported rate was from 1.5.0% to 5.0%. Conclusion: At present, the phenomenon of late reporting and under-reporting occupational diseases is still obvious. It is necessary to strengthen the inspection of occupational disease reporting, improve the quality of occupational disease reporting, and provide scientific basis for the formulation of occupational disease prevention and control policies.

Analysis of the status of occupational disease prevention and control of enterprises in mining and manufacturing industries in China in 2019 / 中华劳动卫生职业病杂志

Objective: To analyze the status of prevention and treatment of occupational diseases among mining and manufacturing industries in China in 2019, provide the scientific basis for the formulation and revision of policies and standards of prevention and treatment of occupational diseases. Methods: In May 2022, Collecting data of a project named Surveillance of Occupational Hazards in the Workplace in 2019 through the National Surveillance System for Occupational Hazards in the workplace. Compare the status of prevention and treatment of occupational diseases in 63 563 enterprises of mining and manufacturing industries among different dimensions. Results: The training rate of managers was 76.17% and that of occupational health managers was 76.97%. The rate of reporting of occupational diseases hazardous items was 67.58%, the rate of launching of the detection of occupational hazards was 57.16%, and the rate of launching of occupational health examination was 62.42%. Excluding the distribution rate of dust mask, the installation rate of various occupational prevention facilities and the distribution rate of gas mask and hearing protector were less than 80%. The differences in all the indicators among different areas, enterprise scales, economic types were statistically significant (P<0.05) . Conclusion: There are still some enterprises which are relatively weak in the ability of the prevention and treatment of occupational diseases in China. Measures such as special support, guidance and strengthen supervision should be taken towards those enterprises toimprove the awareness of prevention and treatment of occupational diseases and the level of that.

Two cases of airway dysfunction related to diacetyl exposure / 中华劳动卫生职业病杂志

Occupational exposure to diacetyl can lead to bronchiolitis obliterans. In this paper, two patients with severe obstructive ventilation disorder who were exposed to diacetyl at a fragrance and flavours factory were analyzed. The clinical manifestations were cough and shortness of breath. One of them showed Mosaic shadows and uneven perfusion in both lungs on CT, while the other was normal. Field investigation found that 4 of the 8 workers in the factory were found to have obstructive ventilation disorder, and 2 had small airway dysfunction. This paper summarizes the diagnostic process of patients in order to improve the understanding of airway dysfunction caused by occupational exposure to diacetyl and promote the development of relevant standards.

Research progress on the disease burden of pneumoconiosis in China / 中华劳动卫生职业病杂志

Pneumoconiosis is the largest and most serious disease among the legal occupational diseases in China, which causes long-term heavy disease burden to individuals, enterprises and society. How to scientifically and reasonably measure and reduce the health impact and economic loss caused by pneumoconiosis has become a key and difficult research topic. In recent years, with the development of global burden of disease (GBD) research, some scholars have adopted disease burden index to evaluate the disease burden of pneumoconiosis, but the research results and data are relatively independent, and there is a lack of systematic evaluation system and framework. This paper summarized the application of disease burden assessment index for pneumoconiosis, epidemiological and economic burden of pneumoconiosis, and the cost-effectiveness of reducing the burden. This paper aims to understand the present situation of pneumoconiosis disease burden in our country, discover the problems and challenges of pneumoconiosis disease burden research in our country now. It provides scientific basis for the research and application of pneumoconiosis and other occupational disease burden in China, as well as the formulation of comprehensive intervention measures, optimization of health resources allocation and reduction of disease burden.