[A case of ataxic gait disturbance due to 1-bromopropane neurotoxicity].

A 55-year-old man presented a slowly progressive sensory disorder, predominantly in both lower limbs, and gait disturbance. Neurological examinations revealed abnormal sensation and spasticity in both lower limbs, and a wide-based gait. Although examination revealed mild hyperchloremia and decreased motor conduction velocity in the peroneal nerve, head and whole spine MRI, and spinal fluid examination were normal. His job history revealed he had been engaged in metal cleaning work using 1-bromopropane (1-BP) for three years. His serum bromide concentration was increased to 175.6 mg/l (standard value: 5 or less), so we diagnosed him as having 1-BP neurotoxicity. The serum bromide concentration decreased after avoidance of exposure to 1-BP, but the gait disturbance remained. It was considered that we should obtain a detailed job history and measure the serum bromide concentration in patients with a sensory disorder in the extremities and gait disturbance of unknown origin.

The use of diagnostic imaging of the lumbar spine to define fitness to work in asymptomatic workers exposed to weight manipulation. / O uso de exames de imagem da coluna lombar para definição de aptidão em trabalhadores assintomáticos expostos a manipulação de carga

The application of evidence based medicine in the practice of occupational medicine is essential to assess the accuracy, effectiveness and cost-effectiveness of any health technologies implemented by the occupational health program. In this opinion article, the authors reflect upon the use of imaging tests for early detection of workers at higher risk of illness due to low back pain associated with medical recommendations to not work in activities with higher biomechanical risk of back pain. The limitations of this practice are discussed through basic concepts of epidemiology and data gathered preferably by systematic reviews.

A aplicação da saúde baseada em evidências publicadas ou locais na prática da medicina do trabalho é essencial para avaliação da acurácia, efetividade e custo efetividade de quaisquer tecnologias de saúde implementadas no programa de saúde ocupacional. Neste artigo de opinião, os autores refletem sobre o uso de exames de imagem para detecção precoce de trabalhadores com maior risco de adoecimento por dor lombar associado a inaptidão de não atuar em atividades com maior risco ocupacional biomecânico de dorsalgia. As limitações dessa prática são discutidas através de conceitos básicos da epidemiologia e evidências publicadas preferencialmente em revisões sistemáticas. Não recomendamos a sua utilização para os objetivos ocupacionais citados neste artigo.

Características clínicas y epidemiológicas en trabajadores diagnosticados con COVID-19 en un servicio externo de seguridad y salud en el trabajo en Lima-Perú

Objetivo: Describir las características clínicas y epidemiológicas de los trabajadores que son parte de la vigilancia médica ocupacional de un servicio de seguridad y salud en el trabajo. Materiales y métodos: Estudio observacional, descriptivo, retrospectivo, longitudinal de un grupo de trabajadores diagnosticados con COVID-19 que estuvieron bajo vigilancia médico-ocupacional del 18 de marzo al 31 de julio del 2020. Se analizó la información con el software estadístico Stata(R) 15.0. Resultados: El género masculino fue el más afectado, con el 77,16 %, y comprendió al grupo etario de 20 a 39 años, con el 63,30 %. Por otro lado, la ausencia de comorbilidades fue del 81,11 %; sin embargo, el 18,9 % restante presentó una o más comorbilidades, y la más frecuente fue la obesidad, con el 61,95 %, seguida del asma, con un 11,09 %. El dolor de garganta y la tos fueron los síntomas más frecuentes, con un 20,67 % y un 19,78 %, respectivamente. Conclusiones: La población estudiada fue predominantemente adulta joven, del sexo masculino, sin comorbilidades, que no presentó ningún síntoma predominante ni necesitó hospitalización.

Objective: To describe the clinical and epidemiological characteristics of workers kept under occupational medical surveillance conducted by an occupational safety and health service. Materials and methods: An observational, descriptive, retrospective, longitudinal study of a group of workers diagnosed with COVID-19 kept under occupational medical surveillance from March 18 to July 31, 2020. The data was analyzed using the Stata Statistical Software: Release 15. Results: Males were more severely affected than females (77.16 %), among which the 20- to 39-year-old age group prevailed (63.30 %). On the other hand, study subjects with no comorbidities accounted for 81.11 %. However, the remaining 18.9 % presented one or more comorbidities, with obesity being the most frequent one (61.95 %), followed by asthma (11.09 %). Sore throat and cough were the most common symptoms with 20.67 % and 19.78 %, respectively. Conclusions: The study population mainly consisted of young male adults with no comorbidities, who neither showed predominant symptoms nor required hospitalization.

Impact of a hearing conservation programs on occupational noise-induced hearing loss

ABSTRACT Purpose: to analyze the impact of a Hearing Conservation Program on occupational noise-induced hearing loss in a metallurgical plant. Methods: a longitudinal case study (2003-2018) was carried out and a Hearing Conservation Program assessed with interviews and document verification. The assessment also included 2,350 audiometric examinations and occupational noise exposure of 152 Hearing Conservation Program - participating employees, collecting the data from the company's database. Results: high compliance indices regarding occupational noise -induced hearing loss - prevention Hearing Conservation Program practices were found between 2003 and 2018. The comparison between 2018 and 2003 showed a reduced number of workers exposed to noise at 85 dB(A) or above. The final prevalence of audiometric changes suggestive of occupational noise-induced hearing loss that remained in degree I differed from the initial one in the period. The high Hearing Conservation Program percentages and low occupational noise-induced hearing loss indicators point to an inverse relationship between them. Conclusion: the results suggest a positive impact of a Hearing Conservation Program on occupational noise-induced hearing loss in this metallurgical plant, in the period studied.

Control and Prevention of SARS-CoV-2 Outbreaks among Healthcare Workers from 129 Healthcare Facilities in Mexico.

Few reports have shared the workflows to reduce SARS-CoV-2 infections among risk groups, including healthcare workers (HCWs). This study describes an occupational health program implemented to reduce the incidence of COVID-19 and establishes a back-to-work algorithm in HCWs of 129 Salud Digna outpatient care clinics in Mexico. This program was composed of training plans, screening SARS-CoV-2 infections, the containment of infections, follow-up COVID-19 cases, and continuing supervision in addition to the steady supply and training for the correct use of PPE. From 16 April 2020 to 15 April 2021, 7376 individuals were enrolled, of which 423 were excluded because they did not meet the inclusion criteria or refused the follow-up. In the cohort studied, we found a COVID-19 incidence of 35.4% (2610 individuals), lower hospitalization (0.11%), ICU (0.04%) and lethality rate (0.04%). Additionally, 85.9% of COVID-19 cases tested negative for SARS-CoV-2 after 14 days of the first positive test with an average isolation time of 26-33 days. Finally, 99% of people received personal protective equipment and adequate training to use it. Our results show that the program implemented reduced the hospitalization ICU admission and lethality in HCWs; we consider this workflow to help other workplaces offer safe conditions for HCWs and patients.

Identificación y análisis de factores de riesgo psicosocial según la NOM-035-STPS-2018 en una universidad mexicana / Identification and analysis of psychosocial risk factors according to NOM-035-STPS-2018 in a Mexican university

Antecedentes: Las actividades laborales pueden implicar riesgos para la salud física y emocional, así como para la productividad y satisfacción laboral. En México recientemente se publicó la Norma Oficial Mexicana NOM-035-STPS-2018, que establece que la identificación, análisis y prevención de factores de riesgo psicosocial debe realizarse en todos los centros de trabajo, incluyendo las instituciones universitarias. Método: Esta investigación tuvo como objetivos: a) evaluar el nivel de riesgo psicosocial en un centro universitario y describir las acciones necesarias en el cumplimiento de la Norma y b) explorar el uso de la escala de clima social organizacional y la escala de riesgo psicosocial para profesores universitarios para la evaluación complementaria. Resultados: Participaron 50 trabajadores, el 32% con nivel de riesgo psicosocial medio-alto, los dominios con más trabajadores en riesgo fueron: jornada de trabajo (74%) y falta de control sobre el trabajo (42%). Se encontraron correlaciones entre la mayoría de los factores de los cuestionaros, pero no con el factor Ambiente de trabajo del cuestionario de la NOM-035. Conclusiones: En este estudio, la implementación de la Norma permitió determinar las estrategias de acción potencialmente efectivas para reducir el riesgo psicosocial según las necesidades del centro de trabajo. En general, los instrumentos muestran consistencia, pero algunos factores no se ajustan a lo esperado, por lo que se sugiere corroborar su factibilidad en poblaciones similares.(AU)

Background: The work activities can involve risks to physical and emotional health, as well as productivity and job satisfaction. In México, the Official Mexican Standard NOM-035-STSPS-2018 was recently published, which establishes that the identification, analysis and prevention of psychosocial risk factors must be carried out in all work centers, including the university centers. Method: The objectives of this research were: a) evaluate the level of psychosocial risk in a university center and describe the necessary actions to be taken in complying with the Standard and b) explore the use of the organizational social climate scale and the psychosocial risk scale for university professors for the complementary evaluation. Results: Fifty workers participated, 32% with medium-high psychosocial risk level, the domains with the most workers at risk were: working hours (74%) and lack of control over work (42%). Correlations were found between most of the factors of the questionnaires but none with the work environment factor of the NOM-035 questionnaire. Conclusions: In this study, the implementation of the Standard allowed to determinate the potentially effective action strategies to reduce psychosocial risk according the needs of the workplace. In general, the instruments show consistency, but some factors do not match what is expected, so it is suggested to corroborate their feasibility in similar populations.(AU)

Recursos relacionados ao bem-estar na aposentadoria de trabalhadores de instituição pública / Resources related to welfare in retirement of employees of a public university institution

Aim:Analyze the resources related to welfare in retirement of employees of a public university institution. Methods:This was a cross-sectional, analytical-descriptive study conducted at a public university institution in the South ofBrazil, with 295 employees. Data was collected in the months between August and October 2017. The mean values of responses of each domain of the Inventory of Resources for Retirement were calculated. Bivariate analysis was performed to identify the correlations between the domains of the instrument by means of the Spearman correlation coefficient. Results: The majority of the participants belonged to the technical-administrative or operational category (56.9%), professors (43.1%), and post-graduate students (67.2%). The employees presented the highest deficits related to financial resources. Analysis among the constructs of the instrument demonstrated weak to moderate correlations among all the domains (R2 ranged from 0.175 ­0.566 / p-value=0.000). Conclusion: The resources related to welfare in retirement, which were approached in this study, showed correlation among them, indicating the need to implement interdisciplinary strategies with regard to preparation for retirement, with the purpose of promoting a successful post-career for employees.

Objetivo: Analisar a correlação dos recursos relacionados ao bem-estar na aposentadoria de trabalhadores de instituição universitária pública. Métodos: Estudo transversal, analítico-descritivo, desenvolvido em uma instituição universitária pública do sul do Brasil, com 295 trabalhadores. A coleta de dados ocorreu entre os meses de agosto a outubro de 2017. Foram calculadas as médias das respostas de cada domínio do Inventário de Recursos para a Aposentadoria. Realizou-se a análise bivariada para identificar as correlações entre os domínios do instrumento por meio do coeficiente de correlação de Spearman. Resultados: A maioria dos participantes pertencia à categoria técnico-administrativa ou operacional (56,9%) e docentes (43,1%), pós-graduados (67,2%). Os trabalhadores apresentaram maiores déficits relacionados ao recurso financeiro. A análise entre os constructos do instrumento demonstrou correlações de fraca à moderada entre todos os domínios (R2 variou de 0,175 ­ 0,566 / p-valor=0,000). Conclusão: Os recursos relacionados ao bem-estar na aposentadoria, abordados neste estudo, possuem correlação entre si, indicando a necessidade de implementar estratégias interdisciplinares de preparação para a aposentadoria, a fim de promover ao trabalhador uma pós-carreira bem-sucedida.

Efecto de un programa de pausa activa más folletos informativos en la disminución de molestias musculoesqueléticas en trabajadores administrativos / Effect of Rest Pauses Combined with Information Leaflets on the Decrease in Musculoskeletal Pain in Administrative Workers

RESUMEN Objetivos Comprobar el efecto de un programa de pausa activa más folletos informativos, en la disminución de molestias musculoesqueléticas en trabajadores administrativos de una institución pública de Lima, Perú. Materiales y métodos Se realizó un estudio cuasiexperimental con grupo control, no aleatorizado, en dos sedes en una institución pública. El grupo intervención (n=135) recibió folletos informativos una vez por semana, adicionalmente realizó el programa de pausas activas supervisadas, las cuales consistían en ejercicios de respiración, estiramiento y calentamiento. El grupo control (n=127) solo recibió folletos informativos una vez por semana. Se midió la frecuencia e intensidad de molestias musculoesqueléticas en los últimos siete días. Resultados La edad promedio fue 38 años. Los segmentos más afectados fueron el cuello y dorso lumbar. El grupo intervención redujo 20% la frecuencia de molestias musculoesqueléticas en cuello en los últimos siete días (p<0,001) y 17% en la zona dorso lumbar (p<0,001), el grupo control solo redujo la frecuencia en la zona dorso lumbar (p=0,029). Respecto a intensidad del dolor, el grupo de intervención tuvo mayor disminución en todos los segmentos evaluados (p<0,05). Conclusiones Las pausas activas supervisadas más folletos informativos lograron disminuir las molestias musculoesqueléticas en trabajadores administrativos. Por ello, puede ser implementado en otras instituciones públicas o privadas.

ABSTRACT Objectives To assess the effect of work pauses combined with information leaflets on the reduction of musculoskeletal pain in administrative workers of a public institution in Lima, Peru. Materials and methods This quasi-experimental study was conducted in two offices of a public institution and included an intervention group and a non-randomized control group. The intervention group (n = 135) was provided with information leaflets once a week, in addition to a program of rest pauses consisting of breathing exercises, stretching, and encouragement. The control group (n = 127) received information leaflets once a week. To assess outcomes, the rate and intensity of musculoskeletal pain over the previous 7 days were measured. Results The mean age of participants was 38 years. The most affected body regions were the neck and lumbar spine. In the intervention group, the rate of musculoskeletal pain was reduced by 20% in the neck (p<0.001) and 17% in the lumbar spine (p<0.001) over the previous 7 days. In the control group, the rate of musculoskeletal pain was decreased only in the lumbar spine (p=0.029). The intervention group reported less pain in all evaluated body regions (p<0.05). Conclusions Rest pauses combined with information leaflets resulted in decreased musculoskeletal pain in administrative workers, indicating that this strategy can be implemented in public and private institutions.

Condiciones de trabajo psicosociales y desgaste psíquico en trabajadores de diversos sectores empresariales de Centro-Oriente, Suroccidente y región Caribe en Colombia / Psychosocial working conditions and psychological exhaustion in workers of various business sectors in Center Orient, South Occidental and Caribbean Region in Colombia

Objetivo:Determinar la percepción de trabajadores de distintos sectores empresariales de Colombia sobre los factores psicosociales presentes en su entorno laboral y la relación entre los factores psicosociales nocivos y los síntomas subjetivos y alteraciones de la salud. Materiales y métodos: Estudio no experimental, transversal y cuantitativo. Participaron 370 trabajadores, de diferentes sectores empresariales de Colombia (Centro-Oriente, Suroc-cidente y región Caribe). Instrumento: batería para el estudio de las condiciones de trabajo de carácter psicosocial(CTCPS-MAC), validada para población iberoamericana, permite evaluar cuatro dimensiones: Contexto de trabajo, Contenido de trabajo, Factores individuales y Desgaste psíquico e incluye catorce factores psicosociales. Los datos se analizaron con IBM SPSS statistics 21. Se realizó análisis bivariado y regresión logística multivariante de factores psicosociales nocivos y desgaste psíquico. Resultados:Los factores formación, baja médica, contexto de trabajo, contenido de trabajo y factores individuales están asociados en este estudio con desgaste psíquico. El contexto de trabajo es la variable que infiere mayor riesgo (p=0.000; Exp (B)= 5.355) para provocar desgaste psíquico, seguida de la formación técnica o superior y del contenido del trabajo. Conclusiones: Si bien aquellos trabajadores cuya percepción nociva del contexto de trabajo (interrelación trabajo-vida familiar/personal, cultura de la organización, gestión de la empresa, etc.), del contenido de trabajo (concepción tareas, carga y ritmo de trabajo, etc.) y los que tienen formación técnica o superior tienen mayor probabilidad de padecer desgaste psíquico, se observan aspectos positivos de las condiciones de trabajo psicosocial y su influencia en los trabajadores y en las organizaciones.

Objective: Determine the perception of workers in different business sectors in Colombia, on psychosocial factors that are present in their work environment and the relationship between negative psychosocial factors and subjective symptoms and health disorders. Materials and methods: Non-experimental, cross-sectional and quantitative study. 370 employees participated from different business sectors in Colombia (Central East, Southwestern, and Caribbean Region). Instruments: battery for the study of working conditions of psychosocial character (CTCPS-MAC) validated in Latin American population, which allows evaluating four dimensions: work context, work content, individual factors and psychological exhaustion and includes fourteen psychosocial factors. Data was analyzed with IBM SPSS statistics 21. It was performed a bivariate analysis and multivariate logistic regression of adverse psychosocial factors and psychological exhaustion. Results: Factors formation, sick leave, work context, work content and individual factors are associated in this study with psychological exhaustion. The work context is the variable that infers increased risk (p = 0.000, Exp (B) = 5.355) to cause psychological exhaustion, followed by technical or higher education and work content. Conclusions: Although those workers with a noxious perception of work context (interrelation between work and family and personal life, organizational culture, company management, etc.), content of work (tasks content, load and work rate, etc.), and those with technical or higher education, have more probability to suffer psychological exhaustion, positive aspects of psychosocial work conditions and their impact on workers and organizations are observed.

Pre-employment exam analysis of a military company and its relation to oral health

Absenteeism is determined as an absence from work, resulting in the decrease of the company's production and, consequentially, causing profit reduction. The employer must follow closely the employees' quality of life, assuring that they perform all their tasks effectively. Dental health is directly connected to the employee's general health status and cannot be put aside when trying to assure complete physical and mental well being of an individual. AIM: To analyze pre-employment exams of a military company in order to identify, among all the reasons for exclusion, dental problems that ultimately resulted prevented hiring of job applicants. METHODS: Information was collected in 2008 from the dental files of the Health Department archives, which contained data referring to the candidates applying for a specific position and permitted and analytical study of the reasons for exclusion, based on the International Classification of Diseases (ICD-10). RESULTS: 10.24% (720) of the candidates, from a total of 7,029, were excluded for dental reasons, namely dental cavitation, 2.8% (197), and pulpal and periapical diseases, 3.14% (221). CONCLUSIONS: Aside from being limited, the results of this study suggest that dental problems influence a great deal on the quality of life of employees that are able for work, and, that being said, should be managed closely to reduce absenteeism in the workplace.

The Experience of Occupational Health Care Providers in the Government-funded Subsidized Occupational Health Program for Small Scale Industries: Use of Focus Group Interview / 대한산업의학회지

OBJECTIVE:This study was conducted to provide the fundamental information to prepare better strategies based on the experiences of occupational health care providers who are involved in the Government-funded subsidized occupational health programs for small scale industries. METHODS:The focus group methodology was used in this study.The data was collected using focus group interviews and analyzed in the framework of the Grounded theory method as mapped by Strauss and Corbin(1990). The subjects enrolled in this study included 20 occupational health care providers in the Government-funded subsidized occupational health program for the SSI;6 doctors and 14 nurses. RESULTS: We identified 69 concepts,28 sub-categories and 5 categories(Table 2).The categories were the Program's Goals, Various Services,Difficulties in Implement Services, Program Evaluation,and Suggestions for Alternative Plans. CONCLUSIONS: This program showed that autonomous health management ability has not changed although the possibility for small scale industries to start the health management arose by acknowledging the importance of the health management in the work-place. A successful program should provided a practical service that is planned by the characteristics and the requirements of the workers,a better service than the standard, more visiting times,and a trusting relationship among workers. The occupational health agency's quality and the health manager's specialty needs to be improved and the health manager's authority should be consolidated. An actively cooperative triangular relation among the Labor Department/KOSHA, service organizations, and the workplace is required.In addition,alternative plans were suggested.These included various programs for planning an autonomous service suitable for the quality of the workplaces,a model set-up suitable for the quality of the workplaces,and a role model set-up for the health manager.

Experiência do programa de saúde do trabalhador de Piracicaba: desafios da vigilância em acidentes do trabalho / Experience of the Piracicaba Worker Health Program: challenges for the surveillance of work-related accidents

Apresenta-se neste estudo a descrição da experiência de saúde do trabalhador no Município de Piracicaba-SP e as propostas de vigilância com ênfase nos acidentes do trabalho graves. O texto representa o esforço coletivo da equipe em sua atuação. Ele mostra a importância de ações interinstitucionais, a parceria entre o Programa de Saúde do Trabalhador - SUS, com membros do Ministério do Trabalho e Emprego (MTE), a integração do serviço com as universidades e com representantes da sociedade civil, na proteção e promoção da saúde. Os dados das Comunicações de Acidentes do Trabalho (CAT) processados em 1997 serviram de base para o planejamento das atividades e mostram que o município possui uma proporção de incidência anual de 5,43 acidentes e doenças do trabalho para 100 trabalhadores expostos (regidos pela Consolidação das Leis do Trabalho - CLT), bem acima da média nacional de 1,62 por 100, ano base de 1996. A rede local de prontos-socorros atende a cerca de 60% dos Acidentes e Doenças Profissionais, o que mostra a importância das ações preventivas do setor público, neste contexto. Propõe-se um sistema de vigilância aos acidentes graves e fatais, nos moldes de eventos sentinela, que inclui um sistema de comunicação, a busca ativa de casos e o registro das ocorrências na rede de pronto atendimento e ações ou negociações coletivas setoriais para prevenção dos riscos mais relevantes.

This study describes a worker's health experience in Piracicaba city and proposes surveillance actions with an emphasis on severe work-related accidents. This text represents our collective work as a team. It reveals the importance of interinstitutional actions in prevention and health promotion, such as: the partnership among the Worker's Health Program of the Unified Health System - SUS, with members of the Ministry of Labour, and the integration of health services with the universities and representatives of the community. Data of the Work Related Accident Register (CAT) of 1997, served as the basis for planning the activities and showed an annual incidence of 5,43 work-related accidents and occupational diseases per 100 exposed workers, much more than the National average (1,62 per 100) registered in 1996. The local emergency services assist about 60% of work-related accidents and professional diseases, showing the importance of these health problems and the potential impact of local preventive actions and workers' health promotion. A sentinel surveillance system for severe occupational accidents is proposed, which would include an information system, active search and reporting of the cases at the local emergency services. Another aspect proposed is the actions or collective negotiations for risk prevention.

Study of repuirements and conditions to be improved for voluntary occupational health program in worksite / 예방의학회지

To perform voluntary occupational health program in worksites, regulational supports are necessary. The regulational supports include assessment of current occupational health program and appropriate incentives. The purpose of this study is to find out the requirements of voluntary occupational health program and conditions to be improved. Study population was industrial health managers of both industries with less than 300 workers and over 300 workers, and the member of labor union who is responsible for safety and health in worksite. Two different questionnaire were used to find out the requirements and conditions to be improved respectively. The results were; 1. The category which prevalence rate of occupational injuries and occupational disease should be lower than national average was most important in health managers employed in industries over 300 workers and followed by reporting system, education, worksite policy, work environment assessment, protective equipment, consequently. But those employed in industries less than 300 workers showed high importance in prevalence rate of occupational injuries and disease, reporting system, worksite policy, work environment assessment, protective equipment, education, consequently. 2. The members of labor union thought that worksite policy was most important and the next is education, reporting system, work environment assessment, protective equipment, prevalence rate of occupational injuries and disease. 3. There were difference in importance of education and worksite policy according to the size of industries. Reporting system, prevalence rate of occupational injuries and disease, and worksite policy had different importance between members of labor union and health managers. 4. In the results of questionnaire for conditions to be improved, the most important condition was top manager's willingness except personal protective equipments, and followed by financial support, legal support. The limitations of this study were the problems of representativeness of study population. but voluntary health program should be performed in worksites which have relatively good occupational health system. So, this selection bias could not disrupt our results.