Sleep patterns in Amazon rubber tappers with and without electric light at home.

Today's modern society is exposed to artificial electric lighting in addition to the natural light-dark cycle. Studies assessing the impact of electric light exposure on sleep and its relation to work hours are rare due to the ubiquitous presence of electricity. Here we report a unique study conducted in two phases in a homogenous group of rubber tappers living and working in a remote area of the Amazon forest, comparing those living without electric light (n = 243 in first phase; n = 25 in second phase) to those with electric light at home (n = 97 in first phase; n = 17 in second phase). Questionnaire data (Phase 1) revealed that rubber tappers with availability of electric light had significantly shorter sleep on work days (30 min/day less) than those without electric light. Analysis of the data from the Phase 2 sample showed a significant delay in the timing of melatonin onset in workers with electric light compared to those without electric light (p < 0.01). Electric lighting delayed sleep onset and reduced sleep duration during the work week and appears to interfere with alignment of the circadian timing system to the natural light/dark cycle.

Morbidity among nursing personnel and its association with working conditions and work organization.

INTRODUCTION: Work organization patterns and working conditions experienced by nursing personnel in the hospital settings may be associated to increased morbidity among these health workers. AIM: To estimate the prevalence and factors associated with self-reported diseases among nursing personnel at the emergency hospital in Rio Branco/State of Acre, Brazil. METHODS: A cross-sectional study was conducted involving 272 participants who answered a questionnaire including sociodemographic characteristics, working conditions, lifestyles, work ability, and a fatigue perception scale. The self-reported diseases in the 12 months prior to data collection were considered the dependent variable. RESULTS: A total of 85.7% of the participants reported one or more diseases in the past 12 months. Most prevalent diseases were: musculoskeletal diseases (37.1%), digestive diseases (28.7%), mental disorders (28.3%), work injuries (27.9%), and respiratory diseases (26.8%). The following significant variables remained in the final model: high work demands (OR 2.69), reported fatigue (OR 3.59), night work (OR 6.55) and being a technician or nursing assistant (OR 4.23). CONCLUSIONS: Variables related to working conditions and work organization were associated with the occurrence of reported diseases among nursing professionals. Health promotion measures at work require a comprehensive approach including the working conditions and the work organization.

Factors associated with depression symptoms in high school students in São Paulo, Brazil

OBJECTIVE: To assess factors associated with depression symptoms in high school students. METHODS: A cross-sectional study involving high school students was conducted in the city of São Paulo, Brazil, 2001. A total of 724 students aged 14-18 years answered questionnaires on life and health conditions. Another questionnaire was applied to working (44.8 percent) and unemployed (22.9 percent) students to collect information on working conditions. Factors associated to depressive disorders were analyzed using multiple logistic regression controlled for occupational status. RESULTS: Overall prevalence rate of depression was 7.5 percent. Rates according to gender were 39 (10.3 percent) in females and 15 (4.3 percent) in males. The multiple logistic regression analysis showed that factors associated with depressive disorders were: poor self-perception of health (OR=5.78), being female (OR = 2.45), and alcohol consumption (OR=2.35). CONCLUSIONS: The study results showed that sociodemographic, lifestyle and health variables were associated with symptoms of depression in this population. These ndings suggest that it is important to have mental health professionals available in high schools for early detection of mental conditions and student counseling.

OBJETIVO: Investigar os fatores associados a sintomas depressivos em estudantes do ensino médio. MÉTODOS: Foi realizado estudo transversal com estudantes residentes no Município de São Paulo, Brasil, em 2001. O total de 724 estudantes com idades entre 14 e 18 anos preencheram questionários de condições de vida e saúde. Dentre eles, os estudantes trabalhadores (44,8 por cento) e desempregados (22,9 por cento) também responderam a um outro questionário de condições de trabalho. A regressão logística foi utilizada para determinar os fatores associados para apresentar distúrbios depressivos, utilizando-se a "situação ocupacional" para ajustar o modelo. RESULTADOS: A prevalência dos sintomas depressivos na população estudada foi de 7,5 por cento; as taxas de acordo com o sexo foram de 39 (10,3 por cento) e 15 (4,3 por cento) nos adolescentes dos sexos feminino e masculino, respectivamente. A regressão logística mostrou que os fatores associados aos distúrbios depressivos são: baixo escore na auto-avaliação da saúde (OR=5,78), ser do sexo feminino (OR=2,45) e consumo de bebidas alcoólicas (OR=2,35). CONCLUSÕES: Os resultados mostraram que variáveis sociodemográficas, de estilo de vida e de saúde estavam associadas aos distúrbios depressivos. Esses achados sugerem a importância de que profissionais de saúde mental em escolas de ensino médio efetuem rastreio para reconhecer precocemente problemas mentais e fornecer aconselhamento aos estudantes.

Factors associated with depression symptoms in high school students in São Paulo, Brazil.

OBJECTIVE: To assess factors associated with depression symptoms in high school students. METHODS: A cross-sectional study involving high school students was conducted in the city of São Paulo, Brazil, 2001. A total of 724 students aged 14-18 years answered questionnaires on life and health conditions. Another questionnaire was applied to working (44.8%) and unemployed (22.9%) students to collect information on working conditions. Factors associated to depressive disorders were analyzed using multiple logistic regression controlled for occupational status. RESULTS: Overall prevalence rate of depression was 7.5%. Rates according to gender were 39 (10.3%) in females and 15 (4.3%) in males. The multiple logistic regression analysis showed that factors associated with depressive disorders were: poor self-perception of health (OR=5.78), being female (OR = 2.45), and alcohol consumption (OR=2.35). CONCLUSIONS: The study results showed that sociodemographic, lifestyle and health variables were associated with symptoms of depression in this population. These findings suggest that it is important to have mental health professionals available in high schools for early detection of mental conditions and student counseling.

Effects of environmental and organizational factors on the health of shiftworkers of a printing company.

This study explored the effects of environmental and organizational stressors on the health of shiftworkers in a printing company (n = 124). A questionnaire was used to gather data on work history, organizational factors, psychosocial characteristics, medical history, present health, occupational and non-occupational exposures, and lifestyle factors. The perception of environmental and organizational conditions was associated (P < 0.05) with chronic back pain (odds ratio [OR], 1.29), varicose veins (OR, 1.35), allergic rhinitis (OR, 1.27), depression (OR, 1.45), and gastritis (OR, 1.15). Anxiety scores were associated with allergic rhinitis (OR, 1.14) and skin allergy (OR, 1.09). Shiftwork was a significantly risk factor for conjunctivitis (OR, 3.68), depression (OR, 0.23), cardiac arrhythmia (OR, 7.13), and gastritis (OR, 4.38). Other associations included tenure and chronic back pain (OR, 4.89), toluene exposure and skin allergy (OR, 3.76), worksite and conjunctivitis (OR, 7.0), and worksite and dermatitis (OR, 1.24 to 4.95). The number of hours of exercise per week was associated with varicose veins (OR, 4.33), and alcohol intake was associated with cardiac arrhythmia (OR, 6.74).

Work activities of practical nurses and risk factors for the development of musculoskeletal disorders.

Musculoskeletal and emotional disorders are important causes of reported diseases, causing medical absences, and eventually earlier decrease of work ability. This paper reports the results of a study carried out among practical nurses working at the Orthopedics and Trauma Institute. The objectives of the study were: (a) to describe the routine activities performed during day and night shifts, and (b) to compare the work activities performed in different wards during these shifts. A Brazilian version of the Work Ability Index--WAI (TUOMI et al., 1994) was answered by 83 practical nurses. Forty-three of them (52%) reported pains or musculoskeletal diseases, either based on their own opinion or diagnosed by a physician. These nurses were invited to join the second phase of the study and twenty-nine accepted it. All work activities performed in 29 shifts were observed and recorded. The results showed that day shifts were far more demanding in terms of the number of activities related to patients' care than afternoon and night shifts. Also, body postures associated with day work activities demanded important physical efforts. The number of nurses in charge during night shifts was substantially lower than during day shifts. This could lead to an overload and affect the health of the nurses.

[Fatigue and workability in twelve-hour fixed shifts]. / Fadiga e capacidade para o trabalho em turnos fixos de doze horas.

OBJECTIVE: To analyze the variables associated with fatigue perception and workability on workers working 12-hour fixed night and day shifts. METHODS: A cross-sectional study was carried out. Forty-three workers, working 12-hour fixednight and day shifts in a textile factory, filled out questionnaires about fatigue, workability index, individual characteristics, life style and working conditions. A univariate linear regression analysis was performed. RESULTS: Fatigue-related factors are associated to the workers' life style (physical activities is a protection factor), and sleep difficulties, with may increase fatigue perception. Workability-related factors are associated to longevity on job and working night shifts - workability index decreases as job longevity increases. Working night shifts showed a higher workability index. The 12-hour shifts may cause a considerably higher workload, influencing worker's perception of fatigue and workability index and sleep disturbances. CONCLUSIONS: The results indicate that night shifts may not always be translated a health problem. However, this was a cross-sectional study with a small population sample and selection bias is not excluded. Since the workability index reduces while job longevity increases, there is a need for further longitudinal studies with larger population samples.

Shiftworkers in developing countries: health and well-being and supporting measures.

Developing countries currently represent approximately 79% of the world population. Living and working conditions in middle and low income countries are harder and worse than for workers in industrialized countries. In developing countries, workers usually face more dangerous workplaces and unhealthy environmental and occupational conditions than those of industrial countries. Shiftworkers can face even more difficulties, due to constraints caused by their working time and consequences on health. Occupational health actions oriented by health policies were implemented during the 1990s in several Asian countries and in Brazil. these actions are important to promote workers' health. The general aims of this report are: a) to discuss topics related to equity and health; b) to present the main items of international and Brazilian legislation for shiftworkers; and c) to review general and specific measures of occupational health for shiftworkers in developing countries. In order to have equity on health and well-being, supporting measures should encompass micro and macro improvements at local, regional and national levels. Governmental and non-governmental organizations, professional bodies, labor unions, research institutes, universities, technical schools and syndicates, would play important roles to achieve these goals.

Shift work at a modern offshore drilling rig.

The oil and gas exploration and production offshore units are classified as hazardous installations. Work in these facilities is complex, confined and associated with a wide range of risks. The continuous operation is secured by various shift work patterns. The objective of this study was to evaluate how offshore drilling workers perceived shift work at high seas and its impacts on their life and working conditions. The main features of the studied offshore shift work schedules are: long time on board (14 to 28 days), extended shifts (12 hours or more per day), slow rotation (7 to 14 days in the same shift), long sequence of days on the night shift (7 to 14 days in a row) and the extra-long extended journey (18 hours) on shift change and landing days. Interviews revealed a wide range of stressors caused by the offshore shift work, as well as difficulties to conciliate work with family life. It was observed that changes of the family model, leading to role conflicts and social isolation, work in a hazardous environment, perceiving poor sleep when working at night shifts and the imbalance between the expected and actual rewards are the major stressors for the offshore drilling workers.

Implementation of 12-hour shifts in a Brazilian petrochemical plant: impact on sleep and alertness.

A recent worldwide trend in chemical and petrochemical industries is to extend the duration of shifts. Optimization of the labor force to reduce costs is one reason to increase the length of working time in a shift. Implementation of 12h shifts is a controversial decision for managers and scientists. Literature reviews show alertness is lower during the nighttime hours, and sleep duration is reduced and worse during the daytime. The main objective of this study was to evaluate the impacts of 12h shifts on alertness and sleep. To evaluate the duration and quality of sleep and alertness during work, 22 male shift workers on a continuous rotating schedule at a petrochemical plant completed activity logs and estimated alertness using analog 10-cm scales for 30 consecutive days, three times (at 2h, 6h, and 10h of the shift) every work shift. Statistical tests (analysis of variance [ANOVA] and Tukey) were performed to detect differences between workdays and off days. The shift schedule was 2 days/3 nights/4 off days, followed by 3 days/2 nights/5 off days, followed by 2 days/2 nights/5 off days. Sleep duration varied significantly (p < .001) among the work shifts and off days. Comparing work nights, the shortest mean sleep occurred after the second night (mean = 311.4 minutes, SD = 101.7 minutes), followed by the third night (mean = 335.3 minutes, SD = 151.2 minutes). All but one shift (sleep after the first work night) were significantly different from sleep after the first 2 workdays (p < .002). Tukey tests showed no significant differences in sleep quality between workdays and nights, with the exception of sleep after the third day compared to sleep after night shifts. However, significant differences were detected between off days and work nights (p < .01). ANOVA analysis showed borderline differences among perceived alertness during day shifts (p = .073) and significant differences among the hours of the shifts (p = .0005), especially when comparing the 2nd hour of the first day with the 10th hour of all the day shifts. There were no significant differences in perceived alertness during night work among the first, second, and third nights (p = .573), but there were significant differences comparing the times (2nd, 6th, 10th hour) of the night shifts (p < .001). The evaluation of sleep (duration and quality) and level of alertness have been extensively used in the literature as indicators of possible performance decrements at work. The results of this study show poorer sleep after and significantly decreased alertness during night work. Shifts of 12h are usually implemented for technical and economic reasons. These results point out the necessity of a careful trade-off between the financial and technical gains longer shifts might bring and the possible losses due to incidents or accidents from performance decrements during work.

Blaming the victim: aspects of the Brazilian case.

This report describes the consequences and some aspects of the origin and development of victim blaming in accident analysis, and some methods for investigating such events, with particular emphasis on the situation in Brazil. In Brazil, the spread of this practice seems to have been helped by several factors. (1) The idea that occupational accidents are simple phenomena with a limited number of causal factors linked to unsafe actions and/or conditions. In the past, the theory of accident proneness had less influence than in other countries. (2) Government regulations that stipulate the hiring of health and safety officers, production of "educational" material, and "preventive" campaigns that emphasize the role of the victim's "faulty" behavior in the origin of an accident. (3) Mandatory implementation of standardized models for accident investigation directed toward searching for a single "cause." Usually one conclusion, expressed in terms of unsafe acts or conditions, is formulated so that whoever performs an unsafe act is responsible for the accident. (4) Lack of knowledge, as shown in Brazilian publications on occupational accidents and in the evolution of studies on the nature of accident phenomena and of strategies adopted for their prevention.

[Functional aging and work conditions in forensic workers]. / Envelhecimento funcional e condições de trabalho em servidores forenses.

OBJECTIVE: The objective of this study was to evaluate aging associated to work conditions. METHOD: Eight hundred and seven forensic workers answered the questionnaire "Work Ability Index - WAI". The ergonomic conditions were analysed using a job analysis method - AET (Rohmert & Landau). RESULTS: The largest number of employees were mainly submitted to cognitive demands at work. The most reported diagnosed diseases were: musculoskeletal diseases (and lesions), neurological (including emotional disturbances), respiratory, digestive, skin and cardiovascular diseases. The analysis of the logistic regression models showed that: female workers, those with longer time on the job and job title of operational helper, increase the odds ratio to present low or moderate WAI. DISCUSSION: The results point out the need to improve the working conditions. It is suggested the implementation of Specialized Safety Engineering and Occupational Medicine Service, as it is demanded by the Federal Law 6,514 of 1977.

Toluene-induced hearing loss among rotogravure printing workers.

OBJECTIVES: This study explored the effects of occupational exposure to solvents and noise on the hearing of rotogravure printing workers from São Paulo, Brazil. METHODS: The study group comprised 124 workers exposed to various levels of noise and an organic solvent mixture of toluene, ethyl acetate, and ethanol. Data on work history, psychosocial aspects of the job, medical history, present health, stress, occupational and nonoccupational exposures to noise or chemicals, and life-style factors were collected through an interview. The participants underwent pure-tone audiometry and immittance audiometry testing. Their exposures to noise and solvents were assessed. RESULTS: Forty-nine percent of the workers had hearing loss. From the numerous variables that were analyzed for their contribution to the development of hearing loss (age, tenure, noise dose, solvent concentrations in air, biological marker for toluene, job category, work and medical history items, smoking, alcohol consumption, work perception scores, nonoccupational exposures), age and hippuric acid (the biologic marker for toluene in urine) were the only variables that met the significance level criterion in the final multiple logistic regression model. The odds ratio estimates for hearing loss were 1.07 times greater for each increment of 1 year of age [95% confidence interval (95% CI) 1.03-1.11] and 1.76 times greater for each gram of hippuric acid per gram of creatinine (95% CI 1.00-2.98). CONCLUSIONS: The findings suggest that exposure to toluene has a toxic effect on the auditory system. Further research is needed on the mechanisms underlying the effects of toluene and on the adequacy of current recommended exposure limits.

Do weekly and fast-rotating shiftwork schedules differentially affect duration and quality of sleep?

Characteristics of shiftwork schedules can have distinct impacts on workers' sleep. This report presents comparisons of the effects of two different shiftwork schedules on duration and quality of the main sleep episodes in comparable worker populations at two different petrochemical plants. No significant differences were found for sleep duration in comparing the two plants. However, within each plant's shift cycles, morning and night shifts showed shorter sleep durations than all other workdays and days off. Quality of sleep was perceived as lowest for night shifts of both plant schedules, and of lesser quality for weekly than for fast-rotating shifts. These results support recommendations for reducing the number of consecutive nights of shiftwork. However, before recommending any optimal shift schedule, interactions of sleep duration and quality with shift schedules need much further evaluation.

[Diastolic blood pressure associated with accumulated work time among drivers and collectors]. / Associação da pressão arterial diastólica com o tempo acumulado de trabalho entre motoristas e cobradores.

The relationship between diastolic blood pressure and the variables "total cumulative working time" and "age" was examined by regression analysis. The study was carried out among 839 bus drivers and conductors, users of an occupational health center in Campinas, S. Paulo State, Brazil. The main results were a positive association between diastolic blood pressure and cumulative working time, as well as an interaction between this variable and the bus worker's age.

[Occupation and hypertension]. / Ocupação e hipertensão.

Scientific reports on Arterial Blood Hypertension for the period from 1970 to 1989 are reviewed, with special reference to its epidemiological focusing among workers. The knowledge gained and the theoretical and methodological advances associated with it are assessed.

Individual differences in night and continuously-rotating shiftwork: seeking anticipatory rather than compensatory strategy.

Individual differences in adaptation to night or continuously-rotating shiftwork may reflect distinct strategies of coping with temporal challenges of the environment. Rather than studying compensatory mechanisms, we have chosen the anticipatory response of the sleep onset time preceding work in order to reveal the strategy used by workers submitted to those shift systems including night work. Comprehensive interviews, taking into account several aspects of the workers' lives, allowed for a classification of the subjects in terms of adaptation to their working schedules. Night workers go to bed once a day, whereas shiftworkers prefer to allocate their sleep onsets to two different periods of the day. For both cases, the more well-adapted an individual is, according to the classification obtained by the interviews, the more regular will be the choice of sleep onset times.

Day- and shiftworkers' leisure time.

Cross-sectional studies of working and living conditions were conducted in two Brazilian petrochemical plants between 1988-1989. This paper presents analyses of reported activities undertaken during day- and shiftworkers' leisure time. One hundred and sixteen workers (67 continuous shiftworkers) daily logged standard protocols of all leisure activities, for three consecutive weeks. Workers logged 11,957 instances grouped in 27 different activities. The 14 most commonly mentioned leisure activities were analysed. Those most reported were meals with the family (breakfast, lunch, and dinner) and home TV viewing. Using chi 2 statistics, the results showed that the two factors studied--activities and work schedules (day and shift)--were not related. Analysing estimated coefficients of a second order log linear model, only a very few of the 14 activities most mentioned, did not differ in their frequencies between day and shiftworkers of the same plant. The same happened with the 12 activities most-mentioned of both plants: shiftworkers and dayworkers showed significant differences (p < 0.0001) on almost all frequencies of those activities mentioned. Hypotheses are made to explain some of the results. Home placement, and types of shiftwork schedules (weekly or swiftly rotating shifts) can be responsible for some of the activities performed during the workers' leisure time. Further investigation of those activities which are disturbed or cannot be performed due to work schedules is suggested.