Long working hours and self-rated health in the national Brazilian working population: gender and employment status differences, 2019.

BACKGROUND: The regulation of working hours is governed by legal standards in formal employment. While the association between long working hours and various health outcomes has been extensively studied, there is limited evidence regarding Brazil. The objective of this study was to investigate the association among working hours, employment status, and self-rated health (SRH), taking into account differences between men and women in a national representative sample of the working population in Brazil. METHODS: A cross-sectional study was conducted among a representative sample of 33,713 workers in Brazil to assess self-rated health (SRH). We examined the associations between working hours and employment status, categorizing working hours as standard (40-44 h per week) or long (> 44 h per week), and employment status as formal or informal. Logistic regression models were employed, adjusting for sociodemographic, occupational characteristics, and health behaviors. Probabilities of negative SRH were calculated for men and women in different exposure profiles. Results were stratified by gender, and 95% confidence intervals (CIs) were applied to the findings. RESULTS: The prevalence of long working hours was higher among informal workers for both men and women. Adjusted odds ratio (AOR) results revealed that informal employment (AORwomen = 1.53; 95% CI: 1.13-2.07 and AORmen = 1.55; 95% CI: 1.22-1.96) and long working hours (AORwomen = 1.23; 95% CI: 1.06-1.43 and AORmen = 1.14; 95% CI: 1.00-1.30) were independently associated with negative SRH. Significant interactions between long working hours and informal employment were observed. Among individuals with the same exposure profile, women who engaged in long working hours had a higher probability of reporting negative SRH compared to men. CONCLUSIONS: The results of this study are in line with the literature, as differences between men and women in the likelihood of negative self-rated health were observed. The adverse health effects underscore the importance of implementing intersectoral actions to inform the revision of regulations concerning weekly working hours and the expansion of informal employment in low- and middle-income countries.

Back pain occurred due to changes in routinary activities among Brazilian schoolteachers during the COVID-19 pandemic.

OBJECTIVE: This study's main objective was to investigate the emergence of back pain as a consequence to changes in usual activities due to the COVID-19 pandemic among teachers in public schools in the state of Minas Gerais, Brazil. METHODS: A cross-sectional study was conducted among 15,276 schoolteachers using an online questionnaire. The variables included sociodemographic and occupational data, health situation, habits and behaviors during the COVID-19 pandemic. Bivariate analyses using Pearson's chi-square test and multiple analyses using Poisson regression were performed to identify the associated factors. RESULTS: About 58% of schoolteachers reported back pain due to changes in routine activities during the pandemic. The adjusted model showed a correlation between back pain and female sex, longer working hours, overwork, difficulties concerning distance working, negative changes in health status and quality of sleep; frequent feeling of sadness, depression, or anxiety; use of medications to relax, sleep or against stress/anxiety/depression; physical inactivity or negative changes in the practice of physical activities; increased body weight; reduction of leisure time; increased time of use of computer or tablet and overload of housework. CONCLUSION: During the COVID-19 pandemic, schoolteachers reported a high prevalence of emergence of back pain, which delineates a contradiction in terms: on the one hand, distance education allows social distancing that contributes to the preservation of teachers' health by reducing the risk of contamination by COVID-19. On the other hand, it imposes new demands that-in disagreement with working conditions-can threaten the health of these workers.

Precarious working conditions and health of metropolitan bus drivers and conductors in Minas Gerais, Brazil.

BACKGROUND: To investigate the relationship between precarious working conditions and the health of bus drivers and conductors. METHODS: Data were gathered by means of a survey and interviews conducted in 2012 with 1607 employees of the public transport system of the metropolitan region of Belo Horizonte, Brazil. Nine proxy variables were used to create a precariousness score, ranging from 0 to 9, on a comparative scale: score 0 "less precarious" and 9 "more precarious." Negative self-evaluations of health, medical diagnoses of depression and sleep disorders, common mental disorders, musculoskeletal pain and medical leave were assessed. Poisson regression was used to assess associations between precariousness and health adjusted for age, sex, education, vibration, and noise. RESULTS: The sample was composed of 853 drivers and 754 conductors. Most were men (87%), with age below 40 years (67.4%) and medium educational level (64.5%). The maximum precariousness score observed was 7. Most individuals were in the groups of scores 3 (26.7%) and 4 (26.1%). The prevalences of the health situations were: common mental disorders, 26.3%; medical diagnosis of depression, 9.7%; medical diagnosis of sleep disorder, 14.6%; musculoskeletal pain, 43.0%; medical leave (absenteeism), 34.8%; and negative self-evaluation of health, 20.2%. The prevalences of health conditions, with the exception of negative self-evaluations of health, were significantly higher among workers with higher levels of precarious working conditions. CONCLUSIONS: Worse health, particularly common mental disorders, was associated with self-assessed work precariousness.

Factors associated with alcohol abuse and dependence among public transport workers in the metropolitan region of Belo Horizonte.

PURPOSE: Alcohol use may be associated with occupational factors. The objective of this study was to describe the prevalence and identify factors independently associated with alcohol abuse and dependence among urban public workers. METHODS: In this cross-sectional study, a proportional sample of 1607 bus drivers and conductors in three municipalities within the metropolitan region of Belo Horizonte was analyzed (total population: 17,740). Face-to-face interviews were conducted using a digital questionnaire that investigated working conditions and health. Affirmative responses to at least two questions in the CAGE questionnaire were considered to represent situations of abuse and dependence. The magnitude of the associations was estimated by means of logistic regression in univariable and multivariable models. RESULTS: The prevalence of alcohol abuse and dependence was 13.5 %. Positive associations with the following were identified: lower schooling level (incomplete high school: OR 1.77; 95 % CI 1.14-2.74; and elementary education: OR 1.57; 95 % CI 1.10-2.26); current smoking (OR 2.12; 95 % CI 1.47-3.07); non-participation in social activities (OR 1.74; 95 % CI 1.21-2.48); medical diagnosis of three of more diseases (OR 1.57; 95 % CI 1.01-2.42); aggression at work (OR 1.39; 95 % CI 1.01-1.93); and work-related distress (OR 1.85; 95 % CI 1.27-2.71). Workers who did not have children presented a lower chance of alcohol abuse and dependence than did those with children (OR 0.67; 95 % CI 0.45-0.99). CONCLUSIONS: Results of this study point that the urban public transport workers, users of public transport and also pedestrians could be on increased risk of accidents. So considering the importance of this service for all society and the risk involved in this activity, prospective studies are needed to clarify the relationships observed.

Depression among physicians working in public healthcare in Belo Horizonte, Brazil.

PURPOSE: Prevalence of depressive disorders has been reported among physicians in a number of different settings. The aim of the present study is to assess the prevalence of self-reported depression and its associated factors among physicians working in the public healthcare system of Belo Horizonte, Minas Gerais state, Brazil. METHODS: A cross-sectional survey was carried out in 2009 to investigate individual and occupational dimensions of depressive disorders in a group of physicians working at several municipal healthcare units. The percentage of physicians that self-reported a confirmed diagnosis of depression by another physician was used as the prevalence proportion; the Poisson regression univariate and multivariate models were applied to study factors associated with depression. RESULTS: The response rate was 81.2 %, of which 12.0 % reported depression confirmed by another physician. Reports of RSI/WMSD (p < 0.001) and passive work (p < 0.05) were positively and independently associated with the outcome. CONCLUSIONS: Our data bring valuable information that may help guide interventions and health-promoting activities for physicians by indicating concrete measures to change working conditions that affect mental health.

Factors associated with job satisfaction among public-sector physicians in Belo Horizonte, Brazil.

Evidence indicates an association between job satisfaction and illness among physicians. There are also negative consequences of physician dissatisfaction on the quality of medical services. With this in view, a cross-sectional study of a stratified random sample of physicians (n = 266) was conducted in the municipal public health care system in Belo Horizonte, Brazil. Participants answered a questionnaire about job satisfaction, sociodemographic and lifestyle characteristics, work and employment conditions, and health status. Of the 232 respondents, 150 (64.94%) declared themselves satisfied with the work, with no significant difference between male and female physicians (66.4% vs. 64.2%; p = 0.74). The number of physicians satisfied with their work was significantly higher among those who experienced a high level of social support at work (p < 0.01) and was significantly lower among those working under high-strain conditions (p = 0.01) and those who screened positive for the presence of common mental disorders (p < 0.01). These findings suggest that policies to promote social support and mental health in the workplace, as well as the implementation of strategies to increase physicians' control over their work activities, can have a positive effect on the job satisfaction of these professionals.

Occupational inequalities and gender differences: work accidents, Brazil, 2019.

OBJECTIVE: To analyze the distribution and association of sociodemographic and occupational factors with self-reported work accidents (WA) in a representative sample of the Brazilian population, with emphasis on occupational class, and to examine gender differences in this distribution. METHODS: A population-based cross-sectional study, using data from the 2019 National Health Survey (PNS), analyzed the responses of a sample of adults aged 18 or over. Factors associated with WA were investigated using binary logistic regression and hierarchical analysis using blocks (sociodemographic and occupational variables). The final model was adjusted by variables from all blocks, adopting a significance level of 5%. The values of odds ratios (OR) and respective confidence intervals were obtained. RESULTS: Among the participants, 2.69% reported having suffered a WA, with a higher prevalence in men (3.37%; 95%CI 2.97-3.82%) than in women (1.86%; 95%CI 1.55-2.23%). The analysis identified that age group, night work, working hours, and exposure to occupational risks were associated with WA, with emphasis on gender differences. The class of manual workers, both qualified (ORwomen = 2.87; 95%CI 1.33-6.21 and ORmen = 2.46; 95%CI 1.37-4.40) and unskilled (ORwomen = 2.55; 95%CI 1.44-4.50 and ORmen = 3.70; 95%CI 1.95-7.03), had a higher chance of WA than the class of managers/professionals. CONCLUSION: Occupational factors contributed significantly to the increase in the probability of WA for men and women, with greater magnitude among those positioned in the lower strata of the occupational structure. The results obtained are clues for working out WA prevention actions.

Musculoskeletal pain among healthcare workers: an exploratory study on gender differences.

BACKGROUND: Musculoskeletal disorder rates among healthcare workers are high compared to other occupational groups. Studies indicate a higher prevalence of musculoskeletal pain in women as compared to men in most productive sectors. The objectives of our study were to assess the prevalence of upper-limb musculoskeletal pain in male and female employees of the Belo Horizonte municipal Health Department, and to identify associated factors, considering individual and occupational characteristics, by gender. METHODS: This cross-sectional study of a proportional sample of 1,721 subjects from a universe of 13,602 workers in the municipal health system evaluated the prevalence of self-reported upper-limb musculoskeletal pain. The magnitude of the associations was estimated by Poisson regression. RESULTS: The prevalence of upper-limb musculoskeletal pain was 24.1% among women and 11.0% among men. Women who had high domestic workloads, and performed tasks under high strain showed high prevalence of musculoskeletal pain. For women and men, a high prevalence of upper-limb pain was reported by those who performed highly physically demanding tasks, and those exposed to poor environmental conditions. CONCLUSIONS: The findings suggest gender differences in the distribution of upper-limb musculoskeletal pain across occupational groups. It also support initiatives that focus on the need to give visibility to the different effects of working conditions on the health of occupational groups and suggest the importance of developing specific measures to promote women's health. The higher prevalence of pain observed among women with high domestic workloads suggests the importance of these activities when evaluating workload in occupational studies.

Teleconsultations by primary care physicians of Belo Horizonte: challenges in the diffusion of innovation.

INTRODUCTION: Telemedicine is the provision of health services by professionals who use information and communications technology in the exchange of information for the diagnosis, treatment, and prevention of diseases. Since 2004, the Municipal Department of Health of Belo Horizonte, MG, Brazil, has been implementing telehealth initiatives with the goal of increasing the ability of primary care providers to resolve problems by providing them with clinical support and with continuing education using information and communications technologies. This study characterized the primary care physicians who used the Belo Horizonte telehealth store-and-forward teleconsultation. MATERIALS AND METHODS: A descriptive study was conducted of the frequency of use of store-and-forward teleconsultation and characteristics of physician users. RESULTS: We analyzed 737 store-and-forward teleconsultations in the period 2006-2010. The number of store-and-forward teleconsultations grew from 2006 to 2009, and 85 physicians used the tool. The physician users were predominantly women, specialists in family and community medicine, those employed under a stable contract, and older and with more time in the profession and in public service. The adoption rate was 6.0%, 4.8%, and 1.2% in 2008, 2009, and 2010, respectively. CONCLUSIONS: Context variables and individual variables may be influencing the adoption of store-and-forward teleconsultation in Belo Horizonte. It would be useful to further study the factors that constitute barriers to using teleconsultations and to improve the training in use of the tool.

[Self-rated health and factors related to the work of basic education's teachers in Brazil]. / Autoavaliação de saúde e fatores relacionados ao trabalho dos professores da educação básica no Brasil.

The scope of this article is to analyze the association between teachers' self-rated health and the conditions in which they work in Basic Education schools in Brazil. It involved a cross-sectional study, carried out between 2015 and 2016, representative of Basic Education teachers in the country, the outcome variable of which was self-rated health (SRH). The explanatory variables were the work-related characteristics. To assess the factors associated with SRH, the Proportional Odds Logistic Regression Model was used. The prevalence of poor SRH was 27%. The probability of poor SRH was significantly higher for the group that reported episodes of verbal violence (OR=1.26; 95%CI 1.09-1.44), work pressure (OR=1.18; 95%CI 1, 04-1.33), and a commute to school of more than 50 minutes (OR=1.19; 95%CI 1.03-1.38). The probability of poor SRH was significantly better for those who reported having enough time to complete their tasks (OR=0.77; 95%CI 0.64-0.92), social support (OR=0.79; 95%CI 0.69-0.89) and satisfaction with their workload (OR=0.79; 95%CI 0.69-0.91). Actions on the school environment and organization and improvements in the transport of teachers to work are desirable.

O objetivo deste artigo é analisar a associação entre a autoavaliação de saúde dos professores e as condições que eles encontram para trabalhar nas escolas da Educação Básica no Brasil. Estudo transversal, realizado entre 2015 e 2016, representativo dos professores da Educação Básica do País, cuja variável desfecho foi a autoavaliação de saúde (AAS). As variáveis explicativas foram as características relacionadas ao trabalho. Para avaliar os fatores associados à AAS foi utilizado o Modelo de Regressão Logística de Chances Proporcionais. A prevalência de AAS ruim foi de 27%. A probabilidade de pior AAS foi significativamente maior para o grupo que informou episódios de violência verbal (OR=1,26; IC95% 1,09-1,44), pressão laboral (OR=1,18; IC95% 1,04-1,33), e deslocamento para escola superior a 50 minutos (OR=1,19; IC95% 1,03-1,38). A probabilidade de pior AAS foi significativamente menor para aqueles que relataram dispor de tempo suficiente para cumprir suas tarefas (OR=0,77; IC95% 0,64-0,92), apoio social (OR=0,79; IC95% 0,69-0,89) e satisfação com o próprio trabalho (OR=0,79; IC95% 0,69-0,91). Ações sobre o ambiente e a organização escolar e melhorias no transporte dos professores para o trabalho são desejáveis.

Factors Associated With the Limitation at Work Because of the Voice: Study With Teachers of Basic Education In Brazil.

INTRODUCTION: The voice disorder can cause limitations at work, as it affects the communication and the performance of the teaching function. OBJECTIVE: To analyze the limitation at work because of the voice and to examine possible associations with sociodemographic characteristics, life and health habits and work conditions among Basic Education teachers in Brazil. METHODS: Cross-sectional epidemiological study, with a representative sample, carried out between October 2015 and March 2016, with 6,324 teachers working in Basic Education in Brazil. Data collection was carried out through the application of a questionnaire via telephone with questions regarding health and working conditions. The "limitation at work because of the voice" was considered a dependent variable, whose response options were a scale with four Likert items that varied from frequently to never. The independent variables were grouped in blocks for ordinal logistic regression analysis with hierarchical entry. The magnitude of the association was assessed by the Odds Ratio (OR) with the respective confidence intervals (95% CI). RESULTS: One third of Brazilian teachers (32.7%) reported some frequency of limitation at work (sometimes; rarely, frequently) because of the voice at some moment in the month before the survey and, of these, 5% declared high frequency. The factors that increased the chance of a greater frequency of limitation at work because of the voice were: being female (OR = 1.32; 95% CI = 1.15-1.51); teaching for elementary school (OR = 1.35; 95% CI = 1.02-1.78); use anxiolytic or antidepressant medications (OR = 1.46; 95% CI = 1.20-1.78); losing sleep due to concerns (OR = 1.69; CI = 95% = 1.46-1.95); high noise at school (OR = 2.09; 95% CI = 1.78-2.46); agitated environment by students' indiscipline (OR = 1.37; 95% CI =1.15-1.63); high demands at work (OR = 1.18; 95% CI = 1.02-1.36); not having social support (OR = 1.19; 95% CI = 1.04-1.38); having suffered verbal violence by the students (OR = 1.43; 95% CI = 1.23-1.67). On the other hand, the practice of regular physical activity (OR = 0.86; 95% CI = 0.75-1.00) and the fact of having enough time to complete work tasks (OR = 0.71; 95% CI = 0,62-0.82) decreased the chance of a higher frequency of limitation at work due to vocal problems. The perception that the work limits the teaching performance because of the voice was more frequent among teachers in the North (OR=1.41; 95% CI = 1.17-1.71) and Northeast (OR=1.46; 95% CI = 1.22-1.76) compared to the Southeast region. CONCLUSION: Factors associated with an increase in the chance of higher frequency of reporting work limitations due to the voice: being female, lack of physical activity, losing sleep due to concern, using anxiolytic or antidepressant medication, school location in the North and Northeast, teaching for the elementary school stage, high noise at school and psychosocial aspects of work organization. The Brazilian educational sector needs public policies that take into account regional inequalities and the health and work conditions of teachers.

Prevalence of flu-like syndrome in healthcare workers in Brazil: a national study, 2020.

OBJECTIVE: To evaluate the prevalence of reported symptoms of flu-like syndrome (FS) among HCW and compare HCW and non-HCW on the chance of reporting these symptoms, this study analyzed data of a population-based survey conducted in Brazil. METHODS: A cross-sectional analysis was performed with self-reported data from the Brazilian National Household Sample Survey (PNAD Covid-19) from May 2020. The authors analyzed a probability sample of 125,179 workers, aged 18 to 65, with monthly income lower than US$ 3 500. The variable HCW or non-HCW was the covariate of interest and having reported FS symptoms or not was the outcome variable. Authors tested interactions of HCW with other covariates. A logit model - when controlling for sociodemographic, employment, and geographic characteristics - investigated the chance of HCW reporting FS compared to non-HCW. RESULTS: HCW have a significant effect (odds ratio of 1.369) on reporting FS symptoms when compared to non-HCW. HCW account for 4.17% of the sample, with a higher frequency of FS (3.38%) than observed for non-HCW (2.43%). Female, non-white and older individuals had higher chance to report FS. CONCLUSIONS: The HCW had a higher chance of reporting symptoms than non-HCW aged over 18 years in the labor force. These results emphasize guidelines for preventive measures to reduce workplace exposures in the healthcare facilities. The prevalence is disproportionately affecting HCW women and HCW non-whites. In the regions North and Northeast the steeper progression is consistent with the hypothesis of socioeconomic factors, and it explains the greater prevalence in HCW and non-HCW living in those territories.

The translation into Portuguese of the 11th International Statistical Classification of Diseases and Related Health Problems (ICD-11). / Tradução para a língua portuguesa da 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-11).

The 11th International Statistical Classification of Diseases and Related Health Problems (ICD-11) represents an advance in the focus on knowledge and new disease approaches. The ICD is used for different practical purposes, enabling assessment of progress in the global health agenda, resource allocation, patient safety, health care qualification, and health insurance reimbursement. It is entirely digital, with technological resources that allow periodic updating. In early 2022, ICD-11 entered into official force, having been made available in several official ICD languages such as Arabic, Chinese, Spanish, French, and English. The translation process into Brazilian Portuguese, coordinated by the Federal University of Minas Gerais (UFMG), with support from the Brazilian Ministry of Health (MS) and PAHO/WHO, is presented here. The work was carried out in three stages between August 2021 and December 2022 by translators with different backgrounds: medical specialists (49), physiotherapists (1), pharmacologists (1), and dentists (1). This methodological article aims to broaden the discussion of perspectives on implementing the ICD-11 in Brazil and build an opportunity for its adaptation and use by other Portuguese-speaking countries.

A 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde representa um avanço no enfoque do conhecimento e em novas abordagens das doenças. A Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde é utilizada para diferentes finalidades práticas, possibilitando avaliação do avanço da agenda de saúde global, alocação de recursos, segurança do paciente, qualificação da assistência à saúde e reembolso de seguros de saúde. É inteiramente digital, com recursos tecnológicos que permitem sua atualização periódica. No início de 2022, a 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde entrou em vigência oficial, tendo sido disponibilizada em vários de seus idiomas oficiais, como o árabe, chinês, espanhol, francês e inglês. Apresenta-se aqui o processo de tradução para a língua portuguesa em uso no Brasil, coordenado pela Universidade Federal de Minas Gerais, com apoio do Ministério da Saúde do Brasil e da Organização Pan-Americana da Saúde/Organização Mundial da Saúde. O trabalho foi realizado em três etapas entre agosto de 2021 e dezembro de 2022 por tradutores com diferentes formações: médicos especialistas (49), fisioterapeuta (1), farmacologista (1) e odontologista (1). Com este artigo metodológico, almeja-se ampliar a discussão de perspectivas para implementação da 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde no Brasil e construir uma oportunidade para sua adaptação e uso por outros países de língua oficial portuguesa.

Absenteeism due to voice disorders in female teachers: a public health problem.

OBJECTIVE: This study estimates the prevalence of absenteeism due to voice disorders among teachers and investigates individual and contextual factors associated with it. METHODS: The study involved 1,980 teachers from 76 municipal schools. The response rate was 85%. The survey was carried out between May 2004 and July 2005 using a self-administered structured questionnaire containing sociodemographic, lifestyle, health, and work-related questions. The dependent variable was obtained from answers to the following question: In the last 2 weeks, have you missed work because of voice problems? Logistic regression analysis was used to determine the associated factors. RESULTS: Voice-related absenteeism in the prior 2 weeks was reported by 66 teachers (3.35%). During their entire careers, approximately one-third of teachers missed work at least once due to voice problems. In the final model, factors associated with recent absenteeism were as follows: witnessing violence by students or parents one or more times (OR = 2.10; 95% CI = 1.14-3.90), presence of depression or anxiety (OR = 2.03; 95% CI = 1.09-3.78), upper respiratory problems in the prior 2 weeks (OR = 2.85; 95% CI = 1.53-5.29), and absenteeism because of voice problems during the preceding 6 months (OR = 15.79; 95% CI = 8.18-30.45). CONCLUSIONS: The results encourage new approaches to the problems of absenteeism in the educational sector and contribute to addressing the weaknesses of economic and administrative approaches to the phenomenon.

[Social invisibility of occupational diseases in Brazil (1919-2019)]. / Invisibilidade social das doenças profissionais no Brasil (1919-2019).

In Brazil, and indeed worldwide, one encounters a discrepancy between estimates of the effects of exposure to occupational risks on health and official statistics on professional diseases. Despite the innovations in the official lists, mainly in the period from 1999 to 2007, the statistical underestimation has not changed. The documentary analysis provided elements to identify the production of scientific ignorance, the current legal order and the functioning of the medical-administrative entities that produce the social invisibility of occupational diseases. It was discussed how this invisibility is produced by different logical structures and normative horizons that underlie the diagnosis, communication, and registration of these diseases. The hypotheses were developed in line with the constructs of the sociology of science and public inaction.

Verifica-se no Brasil e no mundo uma discrepância entre as estimativas dos efeitos da exposição aos riscos ocupacionais sobre a saúde e as estatísticas oficiais de doenças profissionais. Em que pese as inovações nas listas oficiais, principalmente, no período 1999-2007, a subestimação estatística não foi modificada. A análise documental forneceu elementos para identificar a produção da ignorância científica, o ordenamento jurídico vigente e o funcionamento das entidades médico-administrativas que produzem a invisibilidade social das doenças profissionais. Discutiu-se de que maneira essa invisibilidade é produzida por diferentes estruturas lógicas e horizontes normativos que fundamentam o diagnóstico, comunicação e registro dessas doenças. As hipóteses foram desenvolvidas em linha com os constructos da sociologia da ciência e inação pública.

The burden of low back pain, rheumatoid arthritis, osteoarthritis, and gout and their respective attributable risk factors in Brazil: results of the GBD 2017 study.

INTRODUCTION: Musculoskeletal (MSK) disorders are a major cause of disability worldwide. Different modifiable risk factors are associated to these disorders. The objective of this study was to analyze the burden of low back pain (LBP), rheumatoid arthritis (RA), osteoarthritis (OA), and gout, attributable to risk factors, in 2017. METHODS: The burden of LBP, RA, OA, and gout, and attributable risk factors were analyzed using data extracted from the Global Burden of Disease (GBD) Brasil-2017 study. Descriptive analysis was conducted to compare disability-adjusted life years (DALY) rates between sexes and age groups (15-49 and 50-69 years), in 2017. RESULTS: The highest rates of DALY due to LBP were attributed to occupational ergonomic factors in the 15-49-year group, regardless of sex and males aged 50-69 years, whereas smoking was the major contributor in the 50-69-year female group. RA-related DALY rates were attributed to smoking and were higher among women aged 50-69 years. High body mass index (BMI) was the most relevant risk factor for the burden of OA, with higher rates detected in the 50-69-year group, and it was the most significant risk factor for DALY rate attributed to gout, regardless of sex or age group. CONCLUSIONS: Occupational surveillance measures are indicated to prevent LBP. Actions to decrease smoking and overweight, and the surveillance of weight gain are warranted to decrease the burden of LBP, RA and OA, and gout, respectively. These actions will be more effective if age and sex differentials are considered in planning.

Health and work in Brazil: physical and psychosocial demands.

This study aims to describe the prevalence and factors associated of physical and psychosocial demands among Brazilian workers. Data were obtained from the 2013 Brazilian National Health Survey. Physical demand was defined as jobs that require intense physical effort or excessive walking, whereas psychosocial demand was defined as involvement in stressful activities. Multivariate logistic regression was used to estimate the association between demands and health conditions, occupational characteristics, and work conditions. Out of 39,590 participants, 54.4% reported physical demands and 35.5% psychosocial demands at work. After adjustment for sociodemographic characteristics, health conditions, occupational characteristics, and work conditions remained significantly associated with physical or psychosocial workload. The results suggest that in Brazil the work has a high level of physical and psychosocial demands, which are associated with occupational features and health conditions. It is necessary to incorporate work activities as significant factors to investigate the causes of diseases. And the interventions and policies aimed at preventing the negative occupational exposures are urgent, and can contribute to improve physical and psychosocial health at the workplace.

Incidence of Reported Flu-Like Syndrome Cases in Brazilian Health Care Workers in 2020 (March to June).

Health care workers (HCWs) are at an increased risk of being exposed to COVID-19. This study aimed to characterize flu-like syndrome cases (FS) in HCWs notified in Brazil and compare them with FS cases in the general community (GC). In the Brazilian protocol, FS corresponds to a suspected case of COVID-19. The manuscript analyzed cases of FS in five Brazilian states, estimating the incidence rates of cases of FS and clinical and epidemiological characteristics. Registered cases (March to June 2020) totaled about 1,100,000 cases of FS. HCWs represented 17% of the registers, whose incidence was 20.41/100 vs. 2.15/100 in the GC. FS cases in HCWs concentrated the highest percentages in the age group of 30 to 49 years (65.15%) and among the nursing staff (46.86%). This study was the first interstate evaluation in Brazil to estimate suspected cases of FS by COVID-19 in HCWs. In order to control the spread of viral respiratory infections in HCWs, including COVID-19, it is necessary to review the management of health information to identify who they are, how many they are, and to what situations these workers are most frequently exposed, as well as in what professions they have. This information can guide specific, practical, and far-reaching actions.

Binge Drinking Among Public Sector Food Service Workers in Brazil: Physical and Psychosocial Demands on Focus.

OBJECTIVE: To investigate occupational risk factors associated with binge drinking (BD) among public sector food service workers in a Brazilian capital. METHODS: All workers from the Government-backed Economy Restaurant Program (GbERP) in Belo Horizonte city were evaluated. BD was defined as consumption of five or more doses (male) or four or more doses (female) of alcoholic beverages on a single occasion within 30 days. Occupational psychosocial and physical stressors were the main exposure variables; sociodemographic, health, and lifestyle variables were inserted as potential confounding factors. We performed logistic regression. RESULTS: A total of 214 people participated in the study and 30.7% reported BD. Psychosocial (violence and high demands) and ergonomic aspects were associated with the outcome. CONCLUSION: There was a high prevalence of BD among GbERP workers. Actions are necessary to reduce violence and high strain and consequently BD.