Environmental and occupational exposure to bisphenol A and endometriosis: urinary and peritoneal fluid concentration levels.

OBJECTIVES: The study aimed to give a first data set of bisphenol A (BPA) levels in the peritoneal fluid of patients suffering from endometriosis and to investigate the relationship between BPA exposure and endometriosis. METHODS: A questionnaire investigating the occupational context, life environment, and habits was administered to 68 patients suffering from endometriosis and 60 endometriosis-free subjects (control group). Urine and peritoneal fluids samples were collected and analysed by GC/MSMS for BPA dosage. RESULTS: Some of the investigated environmental/lifestyle risk factors (closeness to industries/activities at risk) were associated with an increase in endometriosis; smoking resulted as protective factor; others (use of food plastic boxes) did not seem to influence the onset of pathology. The association between the occupational exposure summarising all examined risk factors (working activity, personal protective equipment, seniority) and endometriosis was statistically significant (χ 2 = 5.252, p = 0.02). Contrasting results were obtained when specific activities were examined. Detectable urinary BPA levels were found in all analysed samples (patients: 1.17-12.68 pg/µl; mean ± SD, 5.31 ± 3.36 pg/µl; control group: 1.28-2.35 pg/µl; mean ± SD, 1.64 ± 0.49 pg/µl; median; 1.46 pg/µl), with a statistically significant difference between patients and controls, showing an association between BPA exposure and endometriosis. Only a few subjects from the control group supplied peritoneal fluid; hence, no comparison test with patients (range 0.39-1.46 pg/µl; mean ± SD, 0.67 ± 0.30 pg/µl; median, 0.58 pg/µl) was carried out. CONCLUSIONS: Results highlight the potential association between BPA exposure and endometriosis, as well as the current lack of knowledge regarding occupational exposure to BPA and the need of epidemiological studies focused on single activities/occupations, such as housewives, cleaners, students.

Diquat Poisoning: Care Management and Medico-Legal Implications.

Acute chemical intoxication represents one of the major causes of Emergency Room admittance, and possible errors in diagnosis are extremely frequent, especially when patients present generic and non-specific symptoms. Diquat, a bipyridyl class of herbicides, exerts high intrinsic toxicity as a consequence of free oxygen radicals, leading to cellular death and organ dysfunctions. Following ingestion, with the major source of absorption for suicidal purposes, the chemical induces local irritating effects; systemic symptoms appear later, while specific symptoms can occur in the following 48 h. A smoker and hypertensive 50-year-old man arrives at the E.R., reporting that an episode of herbicide inhalation occurred few hours earlier. Physical examination evidenced alkalosis with hypoxemia, leucocytosis, mild hyperglycaemia and moderate increase in creatine kinase and myoglobin. Despite blood creatine kinase and myoglobin values that were higher than normal, he was prescribed with hydration and anti-pain therapy. During the night, the man left the hospital; he returned the next morning at 8:45 a.m., with cardiorespiratory arrest, medium fixed non-reactive mydriasis, diffused cyanosis of the skin and of the mucous membranes, as well as imperceptible pulse and peripheral pressure. Despite resuscitation attempts, the patient died at 9:30 a.m.; the body was immediately transferred to the morgue. Autopsy and toxicological analyses were carried out nine days later, evidencing paraquat ingestion for suicidal purposes. GC/MS analyses to verify the presence of diquat were performed on body fluids and gastric and colon contents; all specimens resulted positive, thus confirming the cause of death as herbicide ingestion (blood diquat concentration of 1.2 mg/L; more than twice the minimum to observe a systemic poisoning). The procedure followed for patient management resulted to be not in line with the provisions of both guidelines and good clinical practices. Staff did not perform clinical-diagnostical monitoring of the patient's condition or ask for more specific analyses (i.e., serum creatine phosphokinase monitoring). This misconduct led to a decrease in the patient's chances to survive.

Workers' health policies in Brazil: historical contradictions and possibilities for development. / Políticas de saúde do trabalhador no Brasil: contradições históricas e possibilidades de desenvolvimento.

The Workers' Health (WH) approach understands that it is necessary to expand the object of public policies to transform the work processes that determine the health-disease relationship. This broadening brings challenges that drive the development of the formulation and implementation of policies for the surveillance and prevention of diseases. This article aimed to analyze the development of Brazilian policies on WH from the perspective of historical contradictions. To this end, the analytical concept of contradiction from Cultural-Historical Activity Theory was used. This is a scoping review, including 64 theoretical and empirical studies and gray literature published between 1991 and 2019. The results of the analysis showed that: from the change of the object of prevention inserted by the WH approach, five new contradictions emerged that are related to the predominance of instruments of the previous activity model, normative and training instruments, division of labor for assistance and surveillance actions, intra and intersectoral articulations. and social control. These contradictions have driven some changes, but some limitations persist around a challenging object.

A abordagem de Saúde do Trabalhador entende que é necessário ampliar o objeto das políticas públicas para transformar os processos de trabalho que determinam a relação saúde-doença. Essa ampliação traz desafios que impulsionam o desenvolvimento da formulação e implementação das políticas para a vigilância e prevenção de agravos. O objetivo deste artigo é analisar o desenvolvimento das políticas brasileiras em saúde do trabalhador a partir das contradições históricas. Para este fim, foi usado o conceito analítico de contradição da teoria da atividade histórico-cultural. Trata-se de uma revisão de escopo que inclui 64 estudos teóricos, empíricos e literatura cinza publicados entre 1991 e 2019. Os resultados da análise mostraram que: a partir da mudança de objeto da prevenção inserida pela abordagem da Saúde do Trabalhador, emergiram cinco novas contradições que estão relacionadas ao predomínio de instrumentos do modelo de atividade anterior, instrumentos normativos e de formação, divisão do trabalho para as ações de assistência e vigilância, articulações intra e intersetoriais e controle social. Essas contradições permitiram impulsionar algumas mudanças, mas também existem limitações que persistem em torno de um objeto desafiante.

Suicide by Pesticide (Phorate) Ingestion: Case Report and Review of Literature.

It has been estimated that approximately one in seven of all global suicides is due to pesticide self-poisoning, mostly in rural areas of developing countries. Organophosphorus (OP) compounds are a group of pesticides exerting their toxicological effects through non-reversible inhibition of the enzyme acetylcholinesterase (AChE). Among these compounds, phorate (thimet) is one of the most dangerous compounds, the use of which is restricted in many countries. A case of intentional suicide after phorate ingestion in a 24-year-old Bengali male is described. This is the second case of suicidal ingestion of phorate reported in the forensic literature, and the first presenting complete toxicological findings.

An alternative gas-phase in vitro exposure system for toxicity testing: the interaction between nitrous oxide and A549 cells.

An original in vitro approach was adopted to expose cells to volatile agents. The anaesthetic nitrous oxide (N(2)O) was chosen as the model agent, and type II pneumocyte-like cells (A549 cells) were used as the target to represent the lungs. A time-lapse microscopy station was equipped with a manual gas mixer that allowed the generation of a mixture of N(2)O/air/CO(2) in the gas phase, to provide a uniform distribution of the volatile agent. The dissolution of N(2)O in the culture medium was monitored by gas chromatography-electron capture detection. Biochemical alterations, in terms of homocysteine accumulation, demonstrated that intracellular methionine synthase had been inactivated by N(2)O absorbed by the cells, a process that also occurs in vivo. Toll-like receptors, which are key molecules in inflammatory lung diseases, were also investigated at the molecular level. Our experiments indicated that biochemical and molecular alterations occurred in the cells, even under conditions where neither morphologic changes nor consistent alterations in cell proliferation were evident. This in vitro exposure system can be efficiently adopted for looking at the repeat-dose effects of volatile agents on respiratory tissues. Moreover, it could be of further benefit for identifying the wide range of specific cell targets, and for monitoring relevant endpoints in the cellular and molecular processes that occur during exposure to volatile compounds.

Forensic Toxicological and Medico-Legal Evaluation in a Case of Incongruous Drug Administration in Terminal Cancer Patients.

BACKGROUND: In most cases, palliative care is prescribed to adults diagnosed with cancer. The definition of the most suitable therapy for an effective sedation in terminal cancer patients still represents one of the most challenging goals in medical practice. Due to their poor health, the correct dosing of drugs used for deep palliative sedation in terminal cancer patients, often already on polypharmacological therapy, can be extremely complicated, also considering possible drug-to-drug interactions that could lead to an increased risk of overdose and/or incongruous administration with fatal outcomes. The case of a terminal cancer patient is presented, focusing on the "adequacy" of administered therapy. MATERIALS AND METHODS: A young male, affected by Ewing sarcoma, attending a palliative care at his own home, died soon after midazolam administration. Toxicological and histological analyses were performed on body fluids and organ fragments. RESULTS AND DISCUSSION: Morphological reliefs evidenced a neoplastic mass, composed of lobulated tissue with a lardy, pinkish-gray consistency, extending from the pleural surface to the lung parenchyma, also present at the sacrum region (S1-S5), at the anterior mediastinum level, occupying the entire left pleural cavity, and infiltrating the ipsilateral lung. Metastatic lesions diffused to rachis and lumbar structures. The brain presented edema and congestion. Toxicological analyses evidenced blood midazolam concentrations in the range of 0.931-1.690 µg/mL, while morphine was between 0.266 and 0.909 µg/mL. Death was attributed to cardiorespiratory depression because of a synergic action between morphine and midazolam. The pharmacological interaction between midazolam and morphine is discussed considering the clinical situation of the patient. The opportunity to proceed with midazolam administration is discussed starting from guidelines recommendation. Finally, professional liability outlines are highlighted.

A prospective cohort study on the challenge to return to work after hospitalisation in Brazil.

After hospital discharge, workers are expected to return to work (RTW). However, the ability to return and any possible limitations after returning are unclear. Will they be able to RTW? Do they face limitations? This is a prospective cohort study with descriptive analysis aimed to investigate the RTW during 1 year following hospital discharge and to identify any limitations faced by the workers. Data collection occurred between February 2017 and July 2018 in an Internal Medicine Unit at a General Hospital. Convenience sampling was used, and participation was voluntary. Participants comprised 170 adults. Participants' RTW and limitations were followed for 1 year after discharge. During hospitalisation, 95.9% of participants planned to RTW. However, only 30% and 34.1% had returned after 1 month and 1 year respectively. Initially, 57.6% did not believe that they would present any limitation after discharge. However, 85.3% experienced restrictions after 1 month, and after 1 year this percentage rose to 88.2%. A correlation was found between young adults and RTW. The presence of limitations increased non-RTW risk. Therefore, it is recommended that the worker role should not be merely replaced by that of a patient, but it deserves attention of the latter in order to RTW activities. The work-return process must focus on understanding, treating and monitoring workers' limitations over time.

Analysis of industrial tasks as a tool for the inclusion of people with disabilities in the work market.

This article describes the application of a model for analyzing industrial tasks that was developed to identify jobs that could potentially be filled by people with disabilities (DP) and to serve as a guideline for a company hiring policy. In Brazil, Law No. 8213/91 makes it obligatory to hire DP based on quotas that are established according to the number of employees in a public and private company. Using a set of methods and techniques based on ergonomic work analysis and on occupational therapy, we sought to build a model to indicate the skills required to perform industrial tasks. The model was applied at 19 workstations at a Brazilian aircraft manufacturer in 2002. The task supervisor and the operator performing the task were interviewed, the work activity was filmed, a kinesiological analysis was done, the task was observed and a checklist was applied to help recognize and systematize the skills involved in performing the job task. The last step consisted of correlating the skills required to perform the task to the potential skills of the various types of disability. It was found that 100% of the jobs could be filled by workers with low-level paraplegia, 89% by workers with general paraplegia, 0% with low-level tetraplegia, 47% with auditory impairment, 42% with hemiplegia, 68% with upper limb amputees wearing adequate prostheses, and 89% handicapped wheelchair users. The company hired 14 DP based on the results of this model. The model proved adequate for analyzing industrial tasks with a view to the inclusion of DP, and it can be applied to other sectors of industrial production.

Documentando histórias: a carreira profissional de Milton Carlos Mariotti a partir do método da história de vida / Documenting histories: the professional career of Milton Carlos Mariotti using the life-history method

Resumo Compreender a história da terapia ocupacional no Brasil por meio das trajetórias individuais e coletivas é fundamental, tanto para o avanço da produção de conhecimentos quanto para a formação e desenvolvimento profissional no campo. Este artigo baseia-se na história de vida de Milton Carlos Mariotti, terapeuta ocupacional, Professor Sênior da Universidade Federal do Paraná (UFPR). Objetiva-se documentar sua narrativa profissional, o legado de sua liderança e seu compromisso ético com o desenvolvimento da profissão terapia ocupacional no Brasil. Para tanto, quatro docentes terapeutas ocupacionais reuniram-se para formular um roteiro de entrevista semiestruturada composto por 34 questões. A partir das respostas, organizou-se o texto em quatro eixos temáticos: 1) Formação acadêmica, 2) Atuação como terapeuta ocupacional, 3) Trajetória acadêmica e 4) Militância política. Apresenta-se como resultado uma narrativa histórica que documenta a história de vida profissional do professor e sua contribuição para a institucionalização da terapia ocupacional no Estado do Paraná, Sul do Brasil.

Abstract Understanding the history of occupational therapy in Brazil through individual and collective trajectories is fundamental, both for the advancement of knowledge production and for professional training and development in the field. This article is based on the life story of Milton Carlos Mariotti, occupational therapist, Senior Professor at the Federal University of Paraná (UFPR). The objective is to document his professional narrative, the legacy of his leadership and his ethical commitment to the development of occupational therapy in Brazil. For that, four occupational therapist professors got together to formulate a semi-structured interview script composed of 34 questions. Based on the responses, the text was organized into four thematic axes: 1) Educational background, 2) Work as an occupational therapist, 3) Academic trajectory and 4) Political militancy. As a result, a historical narrative is presented that documents the history of the teacher's professional life and his contribution to the institutionalization of occupational therapy in the State of Paraná, southern Brazil.

Analytical method validation for the evaluation of cutaneous occupational exposure to different chemical classes of pesticides.

In occupational exposure to pesticides, validated methodologies are available only in regards to homogeneous chemical classes of substances and the inhaling exposure, neglecting the cutaneous one that, especially in agriculture, represents an important route of absorption. An analytical methodology for the simultaneous quantification of different chemical classes of pesticides by using pads as environmental matrix and GC-MS/SIM as detection method was developed and validated. The extraction step of analytes from pads was optimized by comparing analytes recovery percentages obtained with different extraction solvents. High recoveries were obtained with ether and, above all, with acetonitrile. Validation experiments following the Food and Drug Administration Guidelines were carried out.

Políticas de saúde do trabalhador no Brasil: contradições históricas e possibilidades de desenvolvimento / Workers' health policies in Brazil: historical contradictions and possibilities for development

Resumo A abordagem de Saúde do Trabalhador entende que é necessário ampliar o objeto das políticas públicas para transformar os processos de trabalho que determinam a relação saúde-doença. Essa ampliação traz desafios que impulsionam o desenvolvimento da formulação e implementação das políticas para a vigilância e prevenção de agravos. O objetivo deste artigo é analisar o desenvolvimento das políticas brasileiras em saúde do trabalhador a partir das contradições históricas. Para este fim, foi usado o conceito analítico de contradição da teoria da atividade histórico-cultural. Trata-se de uma revisão de escopo que inclui 64 estudos teóricos, empíricos e literatura cinza publicados entre 1991 e 2019. Os resultados da análise mostraram que: a partir da mudança de objeto da prevenção inserida pela abordagem da Saúde do Trabalhador, emergiram cinco novas contradições que estão relacionadas ao predomínio de instrumentos do modelo de atividade anterior, instrumentos normativos e de formação, divisão do trabalho para as ações de assistência e vigilância, articulações intra e intersetoriais e controle social. Essas contradições permitiram impulsionar algumas mudanças, mas também existem limitações que persistem em torno de um objeto desafiante.

Abstract The Workers' Health (WH) approach understands that it is necessary to expand the object of public policies to transform the work processes that determine the health-disease relationship. This broadening brings challenges that drive the development of the formulation and implementation of policies for the surveillance and prevention of diseases. This article aimed to analyze the development of Brazilian policies on WH from the perspective of historical contradictions. To this end, the analytical concept of contradiction from Cultural-Historical Activity Theory was used. This is a scoping review, including 64 theoretical and empirical studies and gray literature published between 1991 and 2019. The results of the analysis showed that: from the change of the object of prevention inserted by the WH approach, five new contradictions emerged that are related to the predominance of instruments of the previous activity model, normative and training instruments, division of labor for assistance and surveillance actions, intra and intersectoral articulations. and social control. These contradictions have driven some changes, but some limitations persist around a challenging object.

Enquadramento da temática da inclusão de pessoas com deficiência no trabalho em Jornal de grande circulação do estado do Paraná de 1991 a 2006 / Framing of the theme of the inclusion of people with disabilities at work by a wide-circulation newspaper in Parana state since 1991 until 2006

Resumo Introdução A inclusão de pessoas com deficiência (PCDs) no trabalho é um processo longo, sendo resultado de movimentos sociais iniciados nos anos de 1980, cujo marco regulatório foi a Lei n. 8.213/91. Objetivo Analisar o enquadramento do fenômeno da inclusão de PCDs no trabalho nos 25 anos subsequentes à promulgação da lei, na principal mídia impressa (jornal) do estado do Paraná. Método Pesquisa documental foi realizada com textos publicados no jornal, de 1991 a 2016. Os textos foram lidos por dois pesquisadores, sendo excluídos aqueles cujo conteúdo se tratava de informes e ofertas de emprego. Para caracterizar o enquadramento do jornal, foi realizada análise de conteúdo discursivo dos textos, organizada por temas. Resultados Foram encontrados 98 textos que atendiam aos critérios de inclusão, sendo nove em 1999, ano de maior número de publicações. A análise do conteúdo discursivo mostra que o jornal enquadra a questão da inclusão mais como problema para as empresas, adotando discurso que aponta a falta de qualificação das pessoas como maior barreira à inclusão. Conclusão O jornal não trata a inclusão como um direito social, ou seja, enquanto objeto de política pública que visaria a favorecer o alcance dos plenos direitos pelas PCDs.

Abstract Introduction The inclusion of people with disabilities (PWDs) in a job is a long process, resulting from social movements initiated in the eighties, whose regulatory framework was the enactment of the Law 8213/91. Objective To analyze the framing of the phenomenon of inclusion of people with disabilities in the workplace in the twenty-five years following the enactment of the law, in the main press media of the state of Paraná. Method Documentary research was conducted based on news related to the inclusion of people with disabilities in the workplace, published in the newspaper from 1991 to 2016. The texts were read by two researchers, being excluded those whose content was about reports and job offers. To characterize the framing of the newspaper, an analysis of the discursive content of the texts was carried out, organized by themes. Results Ninety-eight journalistic texts were found in the newspaper that met the inclusion criteria, being nine in 1999, the year with the highest number of publications. The analysis of the discursive content shows that the newspaper framed the issue of inclusion more as a problem for companies, adopting a discourse that points to the lack of qualification of people as a major barrier to inclusion. Conclusion The newspaper considers inclusion neither as a social right nor as a public policy that would aim to favor the achievement of full rights by people with disabilities.

Olhar etnográfico e intervenção social na produção e uso de imagens: entrevista com José Roberto Novaes (Beto Novaes) / Ethnographic approach and social intervention in the production and use of images: interview with José Roberto Novaes (Beto Novaes)

Resumo Beto Novaes é professor aposentado do Instituto de Economia da Universidade Federal do Rio de Janeiro, onde coordena o projeto Educação através das Imagens. Desenvolve desde meados dos anos 1970 pesquisas e atividades de extensão baseadas no uso de imagens sobre trabalho e trabalhadores, em sua maioria no setor rural. Imagens são o meio que utiliza para aproximar a pesquisa e o saber acadêmico da sociedade, descontruindo hierarquia de saberes na qual o conhecimento acadêmico seria superior. Suas produções têm origem em demandas sociais para tratar de problemas com pouca visibilidade social, dentre eles: a exploração do trabalho e as migrações no mundo rural; trabalho infantil e das mulheres; resistências dos trabalhadores; agroecologia e enfrentamento aos agrotóxicos. Seu olhar etnográfico faz contraponto ao exercício da dominação por meio das narrativas dos trabalhadores, "dando voz para quem não têm voz" e, desenhando caminhos de enfrentamento e mudança da realidade. Seus documentários são ensinamentos da arte da etnografia e da prática de intervenção, não apenas para participar da mudança da realidade social, mas também para influenciar a práxis acadêmica. Seus filmes são também peças artísticas onde a beleza convive com a sensibilidade, generosidade, engajamento e esperança.

Abstract Beto Novaes is a retired professor of the Institute of Economics of the Federal University of Rio de Janeiro, where he coordinates the 'Education through Images' project. Since the mid-seventies, he has undertaken research and extension activities based on the use of images about work and workers, mostly in the rural sector. Images are the means used to bring research and academic knowledge closer to society, disrupting the hierarchy of knowledge in which academic knowledge is normally considered superior. His productions arise from social demands to deal with problems of little visibility such as: the exploitation of labor and migrations in the rural domain, child and female labor, workers' resistance, agroecology and confrontation with pesticides use. Through his ethnographic approach, he acts against the exercise of domination through workers' narratives, 'giving voice to those who have no voice', and designing ways of confronting with and changing reality. His documentaries express teachings in the art of ethnography and in the practice of intervention, not only with a view to change social reality, but also to influence academic praxis. His films are also artistic pieces where beauty coexists with sensitivity, generosity, commitment and hope.

Acidentes de trabalho e atuação do Centro de Referência em Saúde do Trabalhador nas páginas do Jornal de Piracicaba entre 2007 e 2014 / Occupational accidents and the performance of the Occupational Health Reference Center in the pages of the Jornal de Piracicaba newspaper between 2007 and 2014 / Accidentes de trabajo y actuación del Centro de Referencia en Salud del Trabajador en las páginas del periódico Jornal de Piracicaba, entre 2007 y 2014

A prevenção de acidentes de trabalho não é tema frequente na mídia impressa. A atuação do Centro de Referência em Saúde do Trabalhador de Piracicaba, estado de São Paulo, Brasil (Cerest) coloca essa problemática no centro do debate social na região. O objetivo desta pesquisa foi identificar e descrever os temas e ações do Centro que suscitaram o interesse do Jornal de Piracicaba, o principal do município, e a visão que propaga sobre o serviço e sobre o tema. Foram analisados, sob duas categorias, 146 textos publicados entre 2007 e 2014, contendo como temas "problemática dos acidentes de trabalho" e "ações de vigilância". Verificou-se que o jornal dá voz aos atores sociais envolvidos e fundamenta sua cobertura com informações e ações desenvolvidas pelo serviço, colaborando, assim, na legitimação da política pública conduzida pelo Centro e evidenciando o papel da mídia local para resolução de problemas sociais que envolvem a comunidade.(AU)

The prevention of occupational accidents is not an issue frequently covered by the print media. The aim of this study was to identify and describe the issues and actions promoted by Piracicaba Occupational Health Reference Center (Cerest), in Piracicaba, Sao Paulo State, Brazil, that attracted the interest of the local newspaper Jornal de Piracicaba and the image the newspaper promotes of the service and the issue of occupational accidents. A total of 146 texts published between 2007 and 2014 were analyzed in two categories: occupational accidents and occupational health surveillance. The findings show that the newspaper gives a voice to the actors involved and bases its coverage on the information and actions developed by the service, thus legitimizing occupational safety and health policy and the role of the local media in resolving social problems involving the community.(AU)

La prevención de accidentes de trabajo no es un tema frecuente en los medios impresos. La actuación del Centro de Referencia en Salud del Trabajador de Piracicaba, estado de Sao Paulo, Brasil (Cerest) pone esa problemática en el centro del debate social en la región. El objetivo de esa investigación fue identificar y describir los temas y acciones del Centro que suscitaron el interés del Jornal de Piracicaba, el principal del municipio y la visión que propaga sobre el servicio y sobre el tema. Se analizaron, bajo dos categorías, 146 textos publicados entre 2007 y 2014: problemática de los accidentes de trabajo y acciones de vigilancia. Se verificó que el periódico da voz a los actores sociales envueltos. Fundamenta su cobertura con informaciones y acciones desarrolladas por el servicio. Colabora, por lo tanto, en la legitimización de la política pública conducida por el Centro y del papel de los medios locales para la resolución de problemas sociales que envuelven a la comunidad.(AU)

Análise da inclusão de pessoas com deficiência no trabalho após 25 anos da lei de cotas: uma revisão da literatura / Analysis of the inclusion of people with disabilities at work after 25 years of the publication of Brazilian law of quotas: a literature review

Introdução: Desde a promulgação da Lei de Cotas publicada em 1991, observam-se avanços na inclusão de pessoas com deficiência no mercado de trabalho, ao mesmo tempo que persistem várias barreiras. Objetivo: Analisar as políticas e as práticas voltadas à inclusão de pessoas com deficiência no trabalho no Brasil, e discutir o papel da legislação, os avanços, impedimentos para a continuidade dessa política. Método: Revisão da literatura especializada foi realizada na biblioteca virtual SCIELO e na base de dados LILACS, redigidos em português, publicados no Brasil, entre fevereiro de 2010 e fevereiro de 2016. Resultados: Dos 41 artigos encontrados, restaram 13 que atenderam aos critérios de inclusão: 2 artigos analisam a inclusão sob a perspectiva populacional; 2, as ações de intermediação visando à inserção de PcD nas empresas; 4, a inclusão em quatro cidades brasileiras; e os 5 restantes, casos de inserção de PcD. Conclusão: A produção acadêmica sobre o processo de inclusão, analisada nesta revisão, assume posição crítica ao mostrar seus limites, ao reconhecer o papel que cabe à legislação e ao apontar as barreiras que o dificultam, embora vislumbre caminhos para sua efetivação.

Introduction: Many advances in the inclusion of people with disabilities at work have been noted since the publication of the Brazilian law of quotas in 1991; however, a series of social barriers persists. Objective: To analyze Brazilian policies and practices on inclusion of people with disabilities at work and discuss the legislation role, developments and impediments to the continuity of inclusion. Method: A literature review was performed in the LILACS database and in the Scientific Electronic Library Online (SciELO). We searched for articles in Portuguese, published in Brazil, from February 2010 to February 2016. Results: Of 41 articles identified, 13 met the inclusion criteria: 2 analyze inclusion in a population perspective, 2 discuss the intermediation practice to enable inclusion of people with disabilities at work, 4 discuss the inclusion in four Brazilian cities and 5 reported case studies. Conclusion: The scholar literature, analyzed in this review yields a critical perspective regarding inclusion showing its limits when recognizing the role of legislation, and pointing the barriers that hamper the process, even though some possibilities are adressed.

Solid-phase microextraction-gas chromatography-mass spectrometry method validation for the determination of endogenous substances: urinary hexanal and heptanal as lung tumor biomarkers.

Hexanal and heptanal are endogenous aldehydes coming from membrane lipid oxidation, found in lung cancer patients' blood, and suggested as lung tumor biomarkers. Here the urinary matrix was investigated instead of blood and the difficulties related to the determination of endogenous substances in biological matrices were faced by developing an external calibration HS-SPME/GC/MS method. The methodology was validated according to international validation procedures and it was verified analyzing unknown biological samples from cancer patients and healthy subjects. Percentage accuracy and precision, ranging from -11.25 to 10.85% and from 0.45 to 4.46%, respectively, were obtained, together with limits of detection (LODs) and lower limits of quantification (LLOQs) of 0.11 and 0.23 pg µL(-1) for hexanal and of 0.10 and 0.21 pg µL(-1) for heptanal. Analytes percentage recoveries (66.3%, hexanal and 70.5%, heptanal) and stability were evaluated. No analytes degradation was found at room temperature, while the remarkable analytes loss found after 1 month storage suggests analyzing biological samples within a week from storage. Results coming from the analysis of unknown biological samples showed no evident differences of heptanal urinary excretion between lung cancer patients and healthy subjects (0.22-0.95 and 0.21-0.69 pg µL(-1), respectively), while hexanal urinary concentrations in cancer patients (0.24-4.36 pg µL(-1)) were slightly higher than those found in control group ones (0.23-1.26 pg µL(-1)). The obtained results highly suggest to do further investigations in order to collect statistically significant biological data to discriminate between the pathological state of lung cancer patients and physiological conditions of healthy subjects, using the simple, rapid and cheap method here reported for the quantification of urinary aldehydes.

Influência da segurança comportamental nas práticas e modelos de prevenção de acidentes do trabalho: revisão sistemática da literatura / Influence of behavioral safety practices and models of prevention of occupational accidents: a systematic review of the literature

As taxas de acidentes de trabalho no Brasil ainda são muito altas. Paradoxalmente, o sistema nacional de prevenção não contribui para mudar esse cenário devido, principalmente, à hegemonia de abordagens de segurança comportamental (SC) que impulsiona não só a prática profissional e programas de segurança nas empresas, mas também a maneira de pensar e agir das instituições e de agentes públicos. Esta revisão sistemática tem como objetivo avaliar e discutir o impacto dessas abordagens na prática profissional enos modelos de prevenção, e foi realizada em três bases de dados (PubMed, SciELO e Science Direct) de janeiro de 2009 a julho de 2014. O descritor principal utilizado foi "acidente de trabalho", refinando-se a busca a partir dos qualificadores "análise", "legislação e jurisprudência", "prevenção e controle". Treze artigos (de 2.145 encontrados inicialmente) foram considerados e categorizados em três grupos de acordo com o posicionamento dos autores em relação à SC. Cinco estudos foram desenvolvidos com base na abordagem da SC, dois não a mencionaram eseis estudos foram baseados em quadros teóricos contrários à SC. No primeiro grupo, o uso da SC é voltado sobretudo para o treinamento ou mudança de comportamento dos trabalhadores; no terceiro grupo, a educação dos trabalhadores, os métodos de análise de acidentes e vigilância, e o modelo de desempenho de segurança foram os principais temas. Embora a revisão mostre que as abordagens comportamentais ainda possuem ampla influência no meio acadêmico e profissional, o desenvolvimento de pesquisas contrárias a elas abre novas perspectivas para a prevenção.

Occupational accident rates in Brazil are still very high. Paradoxically, the national prevention system does not contribute to change in this scenario due mainly to the hegemony of behavioral safety approaches (BSA) that drives not only professional practice and in-company safety programs, but also the way of thinking and the actions of institutionsand public agents. This systematic review aims to evaluate and discuss the impact of those approaches in professional practice and prevention models, and it was conducted in three electronic databases (PubMed, SciELO, andScience Direct) from January 2009 to July 2014. The main descriptor used was "Occupational, Accidents"and the qualifiers "analysis", "legislation and jurisprudence", "prevention and control"were used to refine the search. Thirteen papers (from the 2145 first collected) were considered and categorized in three groups according to the authors' positioning related to BSA. Five studies were developed based on thoseapproaches, two did not mentionthem, and six papers presented studies that were based on theoretical frames contrary to BSA. In the first group, BSA was used forworkers' training or behavior change; in the third group, workers education, accident analysis methods and surveillance, and the safety performance model were the main themes. Even if this review shows the still prevailing influence of behavioral approaches in the academic and professional field, the development of researches contrary to BSAopens new perspectives for prevention.

Caracterização dos tipos de acidentes de trabalho do ambulatório de Terapia Ocupacional do Hospital do Trabalhador de Curitiba, PR / Characterization of the types of work accidents in the ambulatory care Clinic of Occupational Therapy of the Workers' Hospital of Curitiba, Parana State

Os acidentes de trabalho caracterizam-se como o maior agravo à saúde dos trabalhadores brasileiros. A subnotificação dos acidentes de trabalho é ampla no país e dificulta a atuação dos serviços responsáveis pela vigilância dos ambientes de trabalho. Este estudo objetivou identificar e caracterizar a demanda de pacientes vítimas de acidentes de trabalho atendidos no ambulatório de Terapia Ocupacional do Hospital do Trabalhador do Município de Curitiba, PR. A pesquisa caracterizou-se como descritiva exploratória e baseou-se em análise documental. Realizou-se análise documental dos prontuários referentes aos atendimentos realizados no período de janeiro de 2010 a março de 2012, totalizando 1.723 prontuários. Foi adotado como critério de inclusão prontuários que indicassem que o acometimento teve origem em um acidente de trabalho e, como critério de exclusão, aqueles em que o acometimento tivesse outra origem. Dentre o total de prontuários, 497 configuraram lesões por acidentes de trabalho, o que representou 28,8% do total de atendimentos. Verificou-se a predominância da ocorrência de acidentes de trabalho no gênero masculino, que representou 86,72% dos atendimentos. Os setores de trabalho que se destacaram com altos índices de ocorrência de acidentes de trabalho foram: construção civil, metalurgia, serviços gerais, transportes e correios e alimentação e os postos de trabalho que apresentaram maiores índices de acidentes foram: auxiliar de produção e operador de máquina. O estudo ainda destacou o desafio do profissional que atua nessa perspectiva de vigilância em saúde do trabalhador, uma vez que são insuficientes os dados coletados pelos serviços de assistência ao trabalhador vítima de acidente de trabalho.

Análise ergonômica da atividade dos músicos da Orquestra Sinfônica do Paraná: fatores de risco e cargas de trabalho / Ergonomic activity analysis of the musicians of the Symphony Orchestra of Paraná state: risk factors and workloads

This study aimed to investigate the risk factors present in the work activity and their impact on the health of the musicians of the Symphony Orchestra of Parana state. It is a descriptive qualitative research based on the method of Ergonomic Workplace Analysis of Francophone strand, used as a tool by occupational therapists in the health-work interface. The following procedures were performed: bibliographical survey, documental analysis of productivity data, production and quality of the task, systematic observation of the rehearsals of the Symphony Orchestra of Parana, task and workplace analysis with the application of Ergonomic Workplace Analysis (EWA) and, confrontation of the data analyzed with an instrumental musician. As a result, the study showed significant deviations with reference to the standards described in Brazilian Norm 17 (Ergonomics), especially regarding individual cognitive and physical demands as well as demands related to work organization, considering each item evaluated by this analytical instrument. The action of ccupational therapy was grounded on the insertion in the health and illness process, health promotion, illness prevention, and training of musicians as workers and social actors, envisioning the transformation of work situations.(AU)

O presente estudo objetivou investigar os fatores de risco presentes na atividade de trabalho e seu impacto na saúde dos músicos instrumentistas da Orquestra Sinfônica do Paraná. Enquadra-se como uma pesquisa qualitativa descritiva, a partir do método da Análise Ergonômica do Trabalho francofônica, utilizado enquanto ferramenta do terapeuta ocupacional na interface saúde-trabalho. Foram realizados os procedimentos: levantamento bibliográfico; análise documental dos dados de produtividade, produção e qualidade da tarefa; observação sistemática dos ensaios da Orquestra Sinfônica do Paraná; análise da tarefa e do posto de trabalho, com a aplicação do Ergonomic Workplace Analysis (EWA); e confrontação dos dados analisados com um músico instrumentista. Como resultados, o estudo apontou desvios significativos dos padrões descritos na Norma Regulamentadora 17 (Ergonomia), especialmente quanto às exigências físicas e cognitivas individuais, bem como quanto às relacionadas à organização do trabalho, considerando cada item avaliado pelo instrumento. Fundamentou-se a ação do terapeuta ocupacional pela inserção no processo saúde e adoecimento, na promoção da saúde, prevenção do adoecimento e formação dos músicos enquanto trabalhadores e atores sociais, vislumbrando a transformação das situações de trabalho.(AU)

Análise ergonômica da atividade dos músicos da Orquestra Sinfônica do Paraná: fatores de risco e cargas de trabalho / Ergonomic activity analysis of the musicians of the Symphony Orchestra of Paraná state: risk factors and workloads

This study aimed to investigate the risk factors present in the work activity and their impact on the health of the musicians of the Symphony Orchestra of Parana state. It is a descriptive qualitative research based on the method of Ergonomic Workplace Analysis of Francophone strand, used as a tool by occupational therapists in the health-work interface. The following procedures were performed: bibliographical survey, documental analysis of productivity data, production and quality of the task, systematic observation of the rehearsals of the Symphony Orchestra of Parana, task and workplace analysis with the application of Ergonomic Workplace Analysis (EWA) and, confrontation of the data analyzed with an instrumental musician. As a result, the study showed significant deviations with reference to the standards described in Brazilian Norm 17 (Ergonomics), especially regarding individual cognitive and physical demands as well as demands related to work organization, considering each item evaluated by this analytical instrument. The action of ccupational therapy was grounded on the insertion in the health and illness process, health promotion, illness prevention, and training of musicians as workers and social actors, envisioning the transformation of work situations.

O presente estudo objetivou investigar os fatores de risco presentes na atividade de trabalho e seu impacto na saúde dos músicos instrumentistas da Orquestra Sinfônica do Paraná. Enquadra-se como uma pesquisa qualitativa descritiva, a partir do método da Análise Ergonômica do Trabalho francofônica, utilizado enquanto ferramenta do terapeuta ocupacional na interface saúde-trabalho. Foram realizados os procedimentos: levantamento bibliográfico; análise documental dos dados de produtividade, produção e qualidade da tarefa; observação sistemática dos ensaios da Orquestra Sinfônica do Paraná; análise da tarefa e do posto de trabalho, com a aplicação do Ergonomic Workplace Analysis (EWA); e confrontação dos dados analisados com um músico instrumentista. Como resultados, o estudo apontou desvios significativos dos padrões descritos na Norma Regulamentadora 17 (Ergonomia), especialmente quanto às exigências físicas e cognitivas individuais, bem como quanto às relacionadas à organização do trabalho, considerando cada item avaliado pelo instrumento. Fundamentou-se a ação do terapeuta ocupacional pela inserção no processo saúde e adoecimento, na promoção da saúde, prevenção do adoecimento e formação dos músicos enquanto trabalhadores e atores sociais, vislumbrando a transformação das situações de trabalho.