Mottled Raynaud's phenomenon and hand-arm vibration syndrome: followed up for 10 years.

Vibration white finger is a form of secondary Raynaud's phenomenon (RP) caused by the use of handheld vibrating tools. RP usually appears on the extremities of the fingers, and its borders are well recognised. No reports have been published on 'mottled' RP in continuous observation from the onset to the disappearance of RP. A man in his 60s who had been using vibrating tools such as jackhammers and tampers for 30 years presented with sensations of coldness, burning and numbness. Whole-body cold exposure was performed outdoors in winter, and RP was photographed continuously. 'Mottled' RP can be defined as triphasic colour changes: white, blue and red. The patient was taken off work, kept warm and medicated. His symptoms improved slightly after 10 years of follow-up, but the RP did not disappear. 'Mottled' RP is rare and refractory and should be recognised as a form of RP.

Standardised 25-Step Traditional Thai Massage (TTM) Protocol for Treating Office Syndrome (OS).

Traditional Thai massage (TTM) is a unique form of whole body massage practiced to promote health and well-being in Thailand since ancient times. The goal of the present study was to create a standardised TTM protocol to treat office syndrome (OS) diagnosed based on the identification of the palpation of at least one so-called myofascial trigger point (MTrP) in the upper trapezius muscle. The new 90 min TTM protocol, which was developed following appropriate review of the literature and in consultation with relevant experts, has 25 distinct steps (20 pressing steps, 2 artery occlusion steps, and 3 stretching steps). Eleven TTM therapists treated three patients each using the new 90 min TTM protocol. All of the therapists reported scores greater than 80% in respect to their satisfaction and confidence to deliver the protocol, and all of the patients gave the treatment a satisfaction score of greater than 80%. The treatment produced a significant reduction in pain intensity measured on a Visual Analogue Scale (VAS), with minimum and maximum values of 0 and 10 cm, of 2.33 cm (95% CI (1.76, 2.89 cm), p < 0.001) and significant increase in pain pressure threshold (PPT) of 0.37 kg/cm2 (95% CI (0.10, 0.64 kg/cm2), p < 0.05). The protocol was revised based on the feedback and the results obtained, and the new standardised TTM protocol will be applied in a randomised control trial (RCT) to compare the efficacy of TTM and conventional physical therapy (PT) for treating OS.

COVID 19 - Possible interrelations with respiratory comorbidities caused by occupational exposure to various hazardous bioaerosols. Part II. Clinical course, diagnostics, treatment and prevention.

INTRODUCTION AND OBJECTIVE: The course of COVID-19 caused by the SARS-CoV-2 may be aggravated by bioaerosols containing other viruses, bacteria, and fungi, occurring mainly in the occupational environment. Hence, the diagnostics and treatment of COVID-19 should address such a possibility in the anamnesis, treatment and final recommendations for avoiding of adverse exposure. ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE: As SARS-CoV-2 attacks primarily the respiratory system and the severe manifestation of COVID-19 is interstitial pneumonia, diagnostics should include the following clinical and laboratory examinations: chest X-ray; high resolution computed tomography (HRCT); pulmonary function tests; arterial-blood gas test; genetic tests for the presence of SARS-CoV-2, in the future with the use of highly specific and sensitive nano-based biosensors; tests for the presence of specific immunity against the antigens of microorganisms causing other infectious or allergic pulmonary diseases (in the case of anamnestic indications). Because an universally accepted treatment for COVID-19 does not exist, the hitherto prescribed antiviral and immune-modulating drugs should be used be with caution. In many cases, a better alternative could be a safe supportive therapy, such as supplementation of the diet with probiotics, prebiotics, vitamins and microelements. SUMMARY: The most important preventive measures against COVID-19 should include: vaccination; the use of filter or surgical masks; disinfection and sterilization; maintaining of well-functioning ventilation and air conditioning systems; reduction of the community air pollution which has been identified as an important factor increasing the COVID-19 severity. In the choice of preventive measures, the above should be considered for their potential efficacy against other bioaerosols as potential disease-aggravating agents.

Occupational Lead Poisoning in a Patient with Acute Abdomen and Normocytic Anemia.

We herein report a 24-year-old male construction worker with occupational lead poisoning who presented with acute abdomen and normocytic anemia. The levels of urinary delta-aminolevulinic acid and free erythrocyte protoporphyrin were elevated without any increase in the level of urine porphobilinogen. Detection of an elevated blood lead level of 100 µg/dL confirmed a diagnosis of lead poisoning. Chelation therapy with calcium disodium ethylenediaminetetraacetate resulted in prompt improvement of the clinical symptoms and the blood lead level. Clinicians should be aware that lead poisoning caused by occupational exposure can still occur sporadically in construction workers in Japan.

[The application of holistic nursing in the rehabilitation of occupational pneumoconiosis complicated with chronic obstructive pulmonary disease].

Objective: To investigate the effect of holistic nursing on the rehabilitation of patients with occupational pneumoconiosis complicated with acute exacerbation of chronic obstructive pulmonary disease (COPD) . Methods: In October 2018, from September 2016 to September 2018, 120 pneumoconiosis patients with copd admitted to the occupational disease department of Laigang Hospital attached to Affilated to Shandong First Medical University were selected, according to random number table method is divided into experimental group (60 cases) and control group (60 cases) in the control group given conventional nursing, the experimental group to implement the holistic nursing, before and after the intervention were compared of two groups of patients with disease recognition grade self-management behavior of related parameters of blood gas analysis and lung function changes. Results: Comparison of disease recognition score between the two groups, the experimental group was higher than the control group (P<0.05) . Comparison of scores of self-management behaviors such as diseases medical management, daily life management. Emotion management and so on between the two groups showed that the experimental group was higher than the control group (P<0.05) . Comparison of blood gas analysis indicators between the two groups showed that PaO(2) in the experimental group was higher than that in the control group (P<0.05) . Comparison of pulmonary function indicators between the two groups showed that FEV(1) and FEV(1)/FVC in the experimental group were higher than that in the control group (P<0.05) . Conclusion: Holistic nursing can effectively improve the cognition of pneumoconiosis patients with copd in the acute exacerbation stage, regulate their self-management behavior, improve arterial oxygen content, improve pulmonary ventilation function. and promote the recovery of the disease.

The Global Spine Care Initiative: a narrative review of psychological and social issues in back pain in low- and middle-income communities.

PURPOSE: The purpose of this review was to describe psychological and social factors associated with low back pain that could be applied in spine care programs in medically underserved areas and low- and middle-income countries. METHODS: We performed a narrative review of cohort, cross-sectional, qualitative and mixed methods studies investigating adults with low back pain using Medline and PubMed were searched from January 2000 to June 2015. Eligible studies had at least one of the following outcomes: psychological, social, psychosocial, or cultural/ethnicity factors. Studies met the following criteria: (1) English language, (2) published in peer-reviewed journal, (3) adults with spinal disorders, (4) included treatment, symptom management or prevention. RESULTS: Out of 58 studies, 29 were included in this review. There are few studies that have evaluated psychological and social factors associated with back pain in low- and middle-income communities, therefore, adapting recommendations from other regions may be needed until further studies can be achieved. CONCLUSION: Psychological and social factors are important components to addressing low back pain and health care providers play an important role in empowering patients to take control of their spinal health outcomes. Patients should be included in negotiating their spinal treatment and establishing treatment goals through careful listening, reassurance, and information providing by the health care provider. Instruments need to be developed for people with low literacy in medically underserved areas and low- and middle-income countries, especially where psychological and social factors may be difficult to detect and are poorly addressed. These slides can be retrieved under Electronic Supplementary Material.

Anisocoria secondary to inadvertent contact with scopolamine patch.

A unilaterally fixed mydriasis, also known as a 'blown pupil,' is considered an ominous sign concerning for intracranial pathology. Causes of anisocoria can range from benign to immediately life-threatening. When a patient presents with anisocoria, the concern for a fatal diagnosis leads the clinician to obtain numerous tests, many of which may be unnecessary. The authors present a case of a healthy woman in her 30s who presented with an acute unilateral mydriasis likely secondary to inadvertent contact with a scopolamine patch. On examination, she had no other neurological deficits. Further investigation did not reveal any abnormality. In the event of a patient with an isolated mydriasis in an otherwise healthy and conversant patient with no other neurological deficits, it is essential to rule out other causes before pursuing aggressive and unnecessary testing and treatment.

[Music and Glaucoma]. / Musik und Glaukom.

Music may have multiple influences on the human organism. A possible therapeutic effect for patients with glaucoma has been postulated, aside from the known impact of music on the cardiovascular system, psychogenic effects and a short-term improvement in mental performance (Mozart effect). The higher level of mental stress in patients with glaucoma and type-A personality behaviour may be related to higher intraocular pressure in patients with glaucoma. Relaxing music may have a positive impact in these patients, related to a reduction in intraocular pressure or its fluctuations. However, only limited data exist on the effects of music on intraocular pressure. No clinical studies have yet been performed to investigate the effect of music or music therapy on glaucoma progression. The music of Mozart may influence visual field examinations, possibly due to a positive short term effect on mental performance. This factor needs to be addressed in studies dealing with the effect of music in glaucoma. The relevance of intraocular pressure increases in professional wind instrument players is controversial. An increased level of care might be advisable in patients with advanced glaucoma. The influences of music on humans, altered personality profiles in patients with glaucoma and the studies showing some effect of stress on intraocular pressure stress the relevance of psychological support for glaucoma patients, who are confronted with a disease with a high longterm risk of blindness.

[Conservative treatment of tendinopathies of upper limbs in occupational health: a literature review]. / Trattamenti conservative nelle tendinopatie agli arti superiori in ambito occupazioinale: revision narrative.

BACKGROUND: In the last few years, the incidence of upper limbs tendon injuries has seen a dramatic increase among workers. Conservative treatment is the first choice to relieve symptoms, allowing a safe return to work. However, the scientific evidence of its  efficacy is widely debated. OBJECTIVE AND METHODS: Research and literature review on the efficacy of conservative treatment of upper limbs tendon injuries in occupational settings. RESULTS: A total of 271 references were found on Medline and Embase up to May 2015. 116 papers were excluded, 155 articles were included and the full text read. CONCLUSIONS: After a timely diagnosis, a prompt start of the rehabilitation programme and a limitation of complete rest are useful to relieve pain, increase functionality and reduce work absenteeism in the long term. Conservative treatment combinations, such as manual therapy, specific exercises focused on increasing flexibility and muscle strength and specific-gesture training, achieves more significant results than a single isolated treatments. Currently, there is no strong scientific evidence to support prolotherapy and Platelet-Rich Plasma (PRP). However, current promising results will encourage further studies. Awareness among both employers and employees about prevention and risk factors should be enhanced.

Misleading Gastrointestinal Symptoms: The Ongoing Story of Chronic Lead Intoxication.

Inorganic lead intoxication has emerged as an important and challenging clinical problem owing to increased awareness of lead and enhanced surveillance of exposed individuals. However, recognition may not be very difficult when there is an obvious history of exposure. Our interest began a few years ago when we could trace an outbreak, following a patient who was admitted with colickly abdominal pain, convulsions, and coma. After that, 16 more cases were identified and characterized. All patients recovered completely after adequate chelation therapy. Although the clinical picture of lead intoxication is pleomorphic, the increased awareness of gastroenterologists in this subject may possibly bring chronically complaining difficult patients to an earlier, unexpected, and fairly treatable disease.

Relation between voice disorders and work in a group of Community Health Workers / Relacao entre disturbio de voz e trabalho em um grupo de Agentes Comunitarios de Saude

Purpose: To analyze the relationship between voice disorders and work in a group of Community Health Agents (CHA). Methods: The subjects of this study were 65 CHA working in the city of São Paulo. Thefiinstrument used for data collection was an adaptation of the questionnaire named Conditions of Vocal Production – Teachers (CPV-P). The results were keyed in twice and submitted to statistical analysis, in order to verify: the self-reported frequency of voice disorder frequency of present vocal symptoms, the association among the three most frequently reported present symptoms, and environmental and organizational aspects of work. Results: Of the 65 (100%) CHA in the study, 37 (56.9%) self-reported having present or past vocal disorders. The most frequently reported present symptoms were: dry throat, tiredness when speaking, and burning sensation in the throat. There was significant association between: taking work to home, having personal items stolen, police intervention, violence against employees and vocal symptom dry throat, not having enough time to complete all tasks, difficulty in leaving work, inadequate furniture, intense physical strain, objects stolen from the health unit, racism and vocal symptom tiredness when speaking, dust, job dissatisfaction, work stress, building destruction, drug issues, and vocal symptom burning in throat. Conclusion: Based on the obtained results, the initial hypothesis of association between the development of vocal disorders among the subjects and the adversities present in their work environment and organization was confirmed. .

OBJETIVO: Analisar a relação entre distúrbio de voz e trabalho em um grupo de Agentes Comunitários de Saúde (ACS). MÉTODOS: Participaram 65 ACS atuantes no município de São Paulo. Para a coleta de dados, elegeu-se a adaptação do questionário Condições de Produção Vocal - Professor (CPV-P). Foram verificados: frequência autorreferida de distúrbio de voz; frequência de sintomas vocais; associação entre os três sintomas vocais mais citados e aspectos do ambiente e da organização do trabalho. RESULTADOS: Dos 65 (100%) ACS pesquisados, 37 (56,9%) autorreferiram apresentar distúrbio de voz. Os sintomas vocais mais citados foram: garganta seca, cansaço ao falar e ardor na garganta. Houve associação significativa entre: levar trabalho para casa, roubo de objetos pessoais, intervenção da polícia, violência contra os funcionários e o sintoma vocal garganta seca, não ter tempo para desenvolver todas as atividades, dificuldade para sair do trabalho, móveis inadequados, esforço físico intenso, roubo de material da UBS, manifestação de racismo e o sintoma vocal cansaço ao falar, poeira, insatisfação no trabalho, estresse no trabalho, depredações, problemas com drogas e o sintoma vocal ardor na garganta. CONCLUSÃO: Com base nos resultados obtidos, a hipótese inicial de associação entre o desenvolvimento do distúrbio de voz entre os pesquisados e as adversidades presentes no ambiente e na organização do seu trabalho foi confirmada. .

RADS and its variants: asthma by another name.

This article describes the different clinical variants of irritant-induced asthma, specifically focusing on high-dose irritant-induced asthma and irritant-induced work-exacerbated asthma, as well as reviews known causes, addresses the often adverse medical and socioeconomic outcomes of this complex condition, and considers issues of causation from an occupational and environmental medicine perspective.

Relation between voice disorders and work in a group of Community Health Workers.

PURPOSE: To analyze the relationship between voice disorders and work in a group of Community Health Agents (CHA). METHODS: The subjects of this study were 65 CHA working in the city of São Paulo. Thefiinstrument used for data collection was an adaptation of the questionnaire named Conditions of Vocal Production - Teachers (CPV-P). The results were keyed in twice and submitted to statistical analysis, in order to verify: the self-reported frequency of voice disorder frequency of present vocal symptoms, the association among the three most frequently reported present symptoms, and environmental and organizational aspects of work. RESULTS: Of the 65 (100%) CHA in the study, 37 (56.9%) self-reported having present or past vocal disorders. The most frequently reported present symptoms were: dry throat, tiredness when speaking, and burning sensation in the throat. There was significant association between: taking work to home, having personal items stolen, police intervention, violence against employees and vocal symptom dry throat, not having enough time to complete all tasks, difficulty in leaving work, inadequate furniture, intense physical strain, objects stolen from the health unit, racism and vocal symptom tiredness when speaking, dust, job dissatisfaction, work stress, building destruction, drug issues, and vocal symptom burning in throat. CONCLUSION: Based on the obtained results, the initial hypothesis of association between the development of vocal disorders among the subjects and the adversities present in their work environment and organization was confirmed.

Cervical syndrome - the effectiveness of physical therapy interventions.

INTRODUCTION: The cervical syndrome refers to a set of disorders caused by the changes in the cervical spine and the soft-tissue surrounding it, with pain as the predominant symptom. Sore neck has been a common problem among a large section of today`s population. The factors contributing to this issue include the modern lifestyle, prolonged sitting and incorrect, fixed or constrained working postures. The root of these difficulties is found in the mechanical disorders of the cervical spine structures, poor body posture and jerky body movements. In the Scandinavian countries neck pain is considered to be a public health problem. METHODS: The study evaluated 25 patients with an established diagnosis of cervical syndrome. The research was conducted at the PI Institute of Occupational and Sports Medicine of Zenica-Doboj Canton. Each patient received twenty physical therapy treatment sessions. RESULTS AND CONCLUSIONS: The study included 25 patients suffering from the cervical syndrome. The statistical analysis of gender distribution indicated that 36% of the patients were male, while 64% were female. The mean age of study participants was 46.76±4,23. The patients ranged in age from 39 to 54 years, with no statistically significant difference in the mean age of male and female patients, p=0.691. Analysing the types of occupational activities performed by the patients, the study found a positive relation between neck pain and prolonged sitting at work. The patients who performed office work made up 76% of the total number. Each method of physical therapy applied in the treatment of neck pain patients proved useful. However, the combination of electrotherapy, kinesiotherapy and manual massage proved to be most effective. CONCLUSION: The cervical syndrome is a common medical condition primarily affecting adult population, with prevalence being higher among women and office workers. The condition places a considerable socioeconomic burden on the afflicted. Cervical pain ranges greatly in severity - from moderate to unbearable, thus leading to high levels of work absence as well as to a decrease in the quality of life. Proper physical therapy program can help the patients with neck pain return to their normal everyday activities, improve their quality of life, as well as reduce the absence from work.

An historical overview of radon and its progeny: applications and health effects.

Since its discovery by Dorn in 1900, studies of radon and its progeny have contributed to such diverse scientific fields as meteorology, geophysics, mineral exploration and radiation health effects. In addition to terrestrial scientific studies of radon, NASA missions in recent decades have yielded data on the behaviour of radon and its progeny on the Moon and on Mars. Radon has been used therapeutically for ∼100 y in the form of radon seeds for the irradiation of malignant tumours. It is, however, for its negative health effects that radon is better and more justifiably known. The causal role of radon and, in particular, its progeny in the elevated incidence of lung cancer in underground uranium miners was established in the 1950s. It is of historical interest to note that the fatal lung disease of silver miners in Saxony and Bohemia in the 16th century, was undoubtedly lung cancer caused by the high levels of radon in the mines. In recent decades there has been an ever-growing interest in the public health effects of exposure to radon in homes. Extensive radon epidemiological studies both of underground miners and of the general public in recent decades have quantified the lung cancer risks from radon exposure. Radon was classified in 1988 by International Agency for Research on Cancer as a human carcinogen and in 2009 the World Health Organization identified radon as the second cause of lung cancer globally after smoking. Radon control strategies are used by many governments to control and reduce the risk to public health from radon.

[Psychosomatic aspects in the treatment of the singing voice]. / Psychosomatische Aspekte bei der Behandlung der Sängerstimme.

Voice and person form a unity and consequently, psychological factors always play a role in the treatment of voice disorders, especially in the area of the arts. This fact has to be taken into account in musician's medicine and it leads to integrating psychosomatic principles within the medical consultation, such as sufficient time, open structured communication, as well as empathy in the doctor-patient relationship. Furthermore, another important aspect of the treatment of singers is the understanding, based on musical expertise, towards the emotional requirements of the profession. If there is a distinct psychological component in the voice disorder it has to be included as a cofactor in the diagnostics. In such a case, the decision of the otorhinolaryngologist should be to include the treatment of the psychological factors within the voice therapy or to initiate parallel treatment in close cooperation with a specialist in psychosomatic medicine or a clinical psychologist specialized in musician's medicine. For singers, performance anxiety represents the additional frequent diagnosis and it should also be treated in this cooperation.

A combination of constraint-induced therapy and motor control retraining in the treatment of focal hand dystonia in musicians.

UNLABELLED: Focal hand dystonia (FHD) in musicians is a painless task-specific motor disorder characterized by an involuntary loss of control of individual finger movements. The aim of this study was to investigate the effects of an innovative behavioural therapy intervention, aimed at normalising movement patterns, in musicians affected by FHD. METHODS: Eight musicians volunteered to take part in this retraining protocol. Intensive constraint-induced therapy and motor control retraining at slow speed were the interventions. Video recordings of the subjects playing two pieces were used for data analysis. The Frequency of Abnormal Movements scale (FAM), the change in metronome speed achieved during motor control retraining, and two ordinal dystonia evaluation scales were chosen as outcome measures. It was hypothesised that there would be significant differences in the FAM scores and metronome speeds over a 12-month period. RESULTS: For the main outcome measure, the FAM scale scores, the two-factor repeated measures ANOVA revealed a very significant decrease in the number of abnormal movements per second of instrumental playing over the 12-month period (F = 6.32, df = 7, p < 0.001). Tukey's post-hoc tests carried out for the FAM scores revealed that significant changes occurred after 8 months of therapy. DISCUSSION: These results suggest that a combination of constraint-induced therapy and specific motor control retraining may be a successful strategy for the treatment of musicians' FHD. Furthermore, the results suggest that retraining strategies may need to be carried out for at least 8 months before statistically significant changes are noted.

Evaluation and treatment of wrist drop in a patient due to lead poisoning: case report.

Lead (Pb) is widely used because of its useful properties and it is ubiquitous in human environment. There are various lead based industries and several workers who are working in these industries without the knowledge of the ill effects of lead and hence not taking proper precautions while handling lead. Many a times, these workers who have accumulated lead in their blood and body organs, are not properly diagnosed and might receive only symptomatic treatment. We describe a thirty-two-year old male, who was working in an unorganized lead based industry for 3 yr, developed severe lead poisoning leading to wrist drop. Since one year the patient received only symptomatic treatment for abdominal pain. His laboratory investigation showed elevated blood lead levels. The chelation therapy using D-Penicillamine brought down his blood lead levels and is on follow up presently. It is required to take proper history about the occupation of the patient, exposed to potentially hazardous levels of lead in the workplace and medically evaluate them.

Incapacidade, cotidiano e subjetividade: a narrativa de trabalhadores com LER/DORT / Incapacidad, cotidiano y subjetividad: la narrativa de trabajadores con LER/DORT / Disability, everyday life and subjectivity: the narrative of workers with RSI/WMSD

Objetivou-se conhecer a experiência de adoecimento de trabalhadores com Ler/Dort, apoiando-se nos pressupostos da "experiência de enfermidade" e nas "narrativas da doença". Foram utilizadas a técnica de entrevista narrativa e a análise temática para se apreenderem as categorias que emergiram do discurso dos oito sujeitos participantes desta pesquisa. Os resultados apontam que a "ineficiência do corpo" para o trabalho foi evidenciada pelo descompasso entre a produção exigida pelo trabalho e a produzida pelo corpo do trabalhador. O corpo funciona como um "suporte de signos" das mudanças no comportamento e nas estruturas do corpo, ajudando a consolidar o imaginário de incapacidade. "As metáforas" representam o atestado público de declínio profissional e o descrédito quanto à condição de enfermo. Conclui-se que a incapacidade se manifesta precocemente na percepção de ineficiência do trabalhador no processo produtivo, porém sua legitimação parece ser tardia, custando o preço da cronificação e da invalidez para o trabalhador.

The aim was to examine how workers with repetitive strain injuries (RSIs)/ work-related musculoskeletal disorders (WMSDs) experience sickness, by drawing upon the notions of "experience of illness" and "disease narratives". The narrative interview technique and thematic analysis were used to understand the categories emerging from the discourse of the eight participants in this study. The results indicated that "body inefficiency" for work was shown by the mismatch between the production required for the work and what the workers' bodies produced. The body played a sign-supporting role regarding changes in behavior and body structure, thereby helping to consolidate the imagery of disability. Thus, metaphors publicly attested to professional decline and discredited the condition of illness. It was concluded that although the disability was expressed early among the perceptions of the workers' inefficiency within the productive process, it seemed to be legitimated later, at the cost of the workers' chronic disease and disability.

Se ha objetivado conocer la experiencia de enfermar en trabajadores con LER/DORT con apoyo en los presupuestos de la "experiencia de enfermedad" y en las "narrativas de la enfermedad. Se utilizaron la técnica de entrevista narrativa y el análisis temático para aprehender las categorías que emergieron del discurso de los ocho sujetos participantes de esta investigación. Los resultados indican que la "ineficiencia del cuerpo" para el trabajo se evidenció por el descompás entre la producción exigida por el trabajo y la producida por el cuerpo del trabajador. El cuerpo funciona como un"soport e de signos" de los cambios en el comportamiento y en las estruoturas del cuerpo ayudando a consolidar lo imaginario de Incapacidad, "Las metáforas" representan el certificado público de declinio profesional y el descrédito en cuanto a la condición de enfermo. Se concluye que la incapacidad se manifiesta precozmente en la percepción de ineficiencia del trabajador en el proceso productivo pero su legitimación parece tardía, costando el precio de cronicidad y de la invalidez para el trabajador.

Work-related musculoskeletal disorders among Brazilian dental students.

The aim of this analytical cross-sectional study was to evaluate the presence of work-related musculoskeletal disorders (WMSD) among dental students in two Brazilian dental schools. The sample included 227 randomized subjects from fifth to ninth semesters who were developing clinical activities. Each student signed an informed consent form. A self-reporting questionnaire was used to obtain data on the practice of physical exercise, the presence of pain during or soon after treating patients, and the adoption of preventive measures related to clinical activities. Results were analyzed using the Statistical Package for Social Sciences 13.0. The chi(2) test was used to identify associations between variables. The presence of pain during or after clinical work was reported by 173 participants (76.2 percent). Statistically significant differences were found between gender and the occurrence of pain. Pain was present during clinical activities (p=0.006) and imposed limitations on the work routine (p=0.011). Among those who practiced physical exercise, eighty-eight (74.6 percent) reported pain. The high percentage of pain reported by dental students suggests the value of reviewing work conditions in dental practices in order to minimize the exposure of all workers to WMSD.