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This study sought to analyze the influence of occupational stress on the body composition of hospital workers after one year of follow-up. This prospective cohort study included 218 workers from one of the leading private hospitals in the municipality of Santo Antônio de Jesus, Recôncavo da Bahia region, Northeast Brazil. Body composition was analyzed by proxy (Body Mass Index and Waist Circumference) and Bioelectrical Impedance Analysis. The primary exposure adopted in the present study was the perception of occupational stress, assessed with the adapted and reduced version of the Job Content Questionnaire evaluating demand and control dimensions. The covariates were work characteristics; biological characteristics; sociodemographic characteristics and lifestyle. Statistical analyses were performed using descriptive, bivariate and multivariate analysis. At the first stage of the study, we identified that 55.96% (n = 122) of workers had high work demand and 25.22% (n = 55) had low control. Among those who had high demand and low control at the beginning of the study, the majority were women, non-white, with low educational and income levels, sleeping less than 7 h/day. After 12 months of follow-up, the median value for demand continued as 13 (IQR: 5–25) and for control, it increased to 16 (IQR: 9–23). In this second moment of the study, 62.38% (n = 136) of workers showed high demand and 45.87% (n = 100) low control. The characteristics of workers with high demand and low control were similar to those of the first moment. The results indicate that high demand and low control at work are risk factors for changes in body mass index, fat mass and fat-free mass in hospital workers. This study shows the importance and need for clinical and epidemiological assessments regarding the body composition of professionals working in hospitals, since high rates of overweight and obesity are triggers of chronic health problems such as dyslipidemia, diabetes mellitus and cardiovascular diseases, among others. Therefore, managers must promote adequate working conditions and understand the need for periodic body composition assessments.

BackgroundAlthough previous reports link exposure to insulating materials with an increased risk of mesothelioma and chronic respiratory diseases, studies evaluating their associations with the risk of coronary artery diseases (CAD) are lacking.AimsWe aimed at evaluating the associations between exposure to insulating materials and the 10-year risk of CAD among insulators.MethodsIn this cross-sectional study, we recruited 643 adults (≥18 years), full-time insulators from the Local 110 Heat and Frost Insulators and Allied Workers Union in Edmonton, Alberta. We obtained demographic information, personal and family history, and job-exposure history, including experience (years) and types of exposure to insulating materials. Clinical profiling including Framingham risk scores (FRS) was assessed.ResultsOf all insulators, 89% were men (mean ± SD age: 47 ± 12 years), 27% had a parental history of cardiac diseases, and 22% had a comorbid chronic respiratory disease. In total, 53% reported exposure to asbestos, while 61, 82, and 94% reported exposure to ceramic fibers, fiberglass, and mineral fibers, respectively. In single-exposure multivariable regression models adjusted for experience, marital status, and body mass index (BMI), asbestos was found to be associated with higher FRS (β: 1.004; 95%CI: 0.003–2.00). The association remained consistent in multi-exposure models and a higher association was found between asbestos exposure and FRS among insulators with comorbid chronic respiratory disease.ConclusionOur study demonstrates that apart from cancer and chronic respiratory diseases, asbestos exposure may also have a cardiac effect, thus warranting the need for systematic surveillance to protect workers from the adverse effects of these materials.

Objective: To investigate the main causes of absenteeism in military police officers stationed in a Military Police Battalion. Methods: Descriptive, cross-sectional, quantitative approach study conducted in the archive of the Personal Section of a Military Police Battalion from Pernambuco. Data were collected from medical certificates in individual files of military police officers from 2009 to 2013 and analyzed according to the following variables: gender, age, length of service, rank or patents, activity, sick leave, number of days away and the International Classification of Diseases. Results: The sample included 599 military police officers of all ranks and patents. There was a prevalence of absenteeism in male police officers, aged 30-34 years and mostly soldiers, predominantly musculoskeletal diseases. Conclusion: This study showed the variables that characterize absenteeism and its recurrence among military police officers, which interferes with the battalion's work dynamics.

This paper presents a brief discussion about Work psychology, in Brazil, and its interfaces with the Work clinics and the Worker's health field. Our starting point is the set of papers presented by Brazilian researchers in the "France-Latin America Symposium". A methodological cut has allowed us to elect these disciplinary fields by reading titles, reviews and paper references. The texts showed a significant convergence between the following themes : social and critical orientation, keeping interest in the working subjects ; the complexity and singularities that lead their work experiences ; the processes of constitution, the psychic and political-social commitments of these workers. We believe that a synthesis of the researches presented in this colloquium reflects the current moment of the Work Psychology in Brazil, in its connections with the Work Clinics and the Worker's Health.

Objective: To analyze the health promotion actions of Specialized Services of Work Safety Engineering and Occupational Medicine from companies and the health promotion actions of companies in their official websites.Method: Qualitative, exploratory and descriptive study with 34 occupational health and safety professionals from seven companies in southern Brazil. The interviews were conducted in 2015 and documentary research was performed in 2016 for Content Analysis.Results: Two categories of analysis were constructed and named “Health promotion activities: professionals’ report” and “Health promotion activities: public communication of companies”.Final considerations: Health promotion actions are implemented by companies. The actions carried out by health and safety professionals are targeted to workers and the work environment, and the actions disseminated by the companies are focused on integrated management of the work process, personal development, environmental, social and economic responsibilities.

Objective: Gain knowledge on the experiences of pleasure and pain of nurses who work in a Pediatric Emergency Service.Method: Qualitative exploratory-descriptive study conducted in a university hospital in southern Brazil. Data was collected in April 2015 from nine nursing professionals, through Focus Groups and submitted to thematic content analysis.Results: The experiences of pleasure were associated to liking children, interacting with the children’s families, availability of time for providing care, recovery of sick children, teamwork and being recognized for their work by the patients (children) and their families. The experiences of pain were associated to the identification of the nursing worker with the role of mother, to the children’s death and suffering, to being the target at which the frustrations of the children’s families are directed and to child abuse.Conclusion: The nurses experienced dichotomous feelings of satisfaction and identification with work and frustration due to the daily difficulties and negative outcomes, and role conflicts and emotions are the challenges faced by the workers

The aim of this study was to investigate the perceived work satisfaction of nurses in a hospital in southern Brazil. This quantitative study was conducted with 144 nurses of a university hospital, from December 2014 to February 2015, using the Index of Work Satisfaction. The results showed that 79.2% (n = 114) of the nurses reported having autonomy, however, 47.9% (n = 69) need to carry out activities that went against their better judgment in some situations. For 75.7% (n=109) the interaction with the nursing staff was satisfactory, while for 70.1% (n=101) the interaction with doctors was permeated by the devaluation of their work and knowledge. Regarding the salary, 79.2% (n=114) considered it satisfactory; 93.8% (n=135) considered their work important; 88.2% (n = 127) were satisfied with the work performed and 80.6% (n = 116) considered that bureaucratic activities hampered more qualified care. The importance is highlighted of the institutions evaluating the needs of professionals and seeking strategies to increase their satisfaction.

The objective of this study was to identify the impact of asbestos exposure on the health of the adult population in scientific publications. An integrative literature review was carried out in health databases in the period from 2005 to 2015. Fifteen studies were selected.The impact of asbestos exposure on the adult populationwas observed inthe onset of diseases such as malignant mesothelioma, asbestosis, and lung cancer.Mortality due to mesothelioma in workershad a significant prevalence for the study. Mortality ratesare alarming, considering that the therapeutic possibilities are limited. The impact of asbestos exposure surpasses biological aspects, bringing significant psycho-emotional changes to the health of the population. Therefore, it is important to discuss the asbestos impact on adult health, primarily in worker’s health, regarding the need for banning its use in countries that still use it in industrial and commercial scale.

Resumo Diante da gravidade da crise envolvendo graves retrocessos de políticas sociais em curso no Brasil, a proposta deste ensaio é pensar alternativas para futuras intervenções em Saúde do Trabalhador em uma perspectiva emancipatória. Trata-se de um convite à reflexão de novos horizontes teóricos e políticos que façam dialogar a Saúde do Trabalhador com os referenciais da abordagem pós-colonial e da proposição das Epistemologias do Sul (EdS). As EdS substanciam a obra do cientista social português Boaventura de Sousa Santos em torno de um pensamento alternativo de alternativas inspirado pelos saberes produzidos nas lutas sociais dos grupos subalternizados. Após apresentarmos uma síntese das EdS e do conceito de pensamento abissal, discutimos alguns limites e potencialidades para pensar novos horizontes teóricos, temáticos e políticos em trabalho e saúde. Em seguida refletimos sobre como os desastres industriais são emblemáticos por articular processos de exclusões radicais dentro e fora dos muros fabris. Por fim, discutimos a potência das EdS em abrir os termos do debate sobre possíveis intervenções em Saúde do Trabalhador, trazendo para o campo novos referenciais que fazem repensar, de forma ampla e radical, as agendas epistemológicas e políticas pela frente.

Objective: to evaluate the influence of the work ability on the quality of life of military firefighters. Method: a cross-sectional, population-based, census study, conducted from January to March 2015, with 101 firefighters from the Military Fire Brigade Group of municipalities in the South and Southwest of Bahia. Self-report instruments were used in the study to evaluate the sociodemographic and work characteristics, quality of life and work ability. Results: it was found that military firefighters with five years or less of service obtained better perceptions of quality of life in the physical and social relationships domains. Regarding the work ability, it was observed that workers with good and very good ability obtained better perceptions in the physical, psychological, social relationships and environment domains. Conclusion: the results can support interventions and improvements in the working conditions of rescue professionals such as firefighters, nurses and physicians.

Objective: to analyze the socioeconomic, epidemiological and work characteristics of contract workers of a public university in the south of Minas Gerais. Method: quantitative, descriptive and cross-sectional study, performed between December 2016 and February 2017 with 316 contract workers. A characterization questionnaire was used for the data collection and descriptive statistics for the data analysis. Results: the profile found was of female workers (54.4%), in the 30 to 39 years age group (31.3%), married/with partner (58.2%), with children (69.3%), with a family income from 1.5 to 3.5 minimum wages (51.6%), that did not practice physical activities (42.7%), did not have chronic diseases (69.9%), had performed contract work for up to 10 years (81.3%), with a workload of 44 hours per week (84.4%) and that had worked in the current institution for less than four years (63.9%). Conclusion: identifying the profile of these workers allows the adoption of promotion and prevention strategies capable of improving the quality of the work and social life.

Objective: To identify the psychological demands, control and social support in the work of Community Health Agents. Method: Descriptive study, with a quantitative approach, carried out with 212 primary health care workers from a municipality in the interior of Minas Gerais. Data was collected between July and October 2015 from Community Health Agents of Primary Health Care units. Sociodemographic and labor characteristics were the independent variables and short scale Demand-Control Model and social support at work were the dependent variables. Results: Female working-age population. Passive job and high demand were prevalent, indicating high risk of development of psychosocial stress at work. Conclusion: Interventions in living and working conditions are necessary, especially regarding psychosocial and organizational aspects.

Objective: To analyze the risk of the development of the Burnout Syndrome in military firefighters. Method: cross-sectional study using a quantitative approach with 51 military firefighters from a battalion of the state of Santa Catarina. Data was collected in March and April 2016. Associations were assessed with Fischer’s exact test or Pearson’s Chi-square with the use of SPSS software, version 24.0. Results: Emotional exhaustion was high, being reported in 51% of the participants. Having children; length of time working in the profession; better organization at work and slow or moderate work pace were considered protective factors in the development of BS. Overtime and slow or moderate work pace indicated lower levels of depersonalization. Assessment of the level of professional accomplishment (PA) revealed 49 subjects (98%) with high level of PA, which confers protection to military firefighters regarding the development of the syndrome. Conclusion:Although there were no cases of burnout among the study participants, a significant number of professionals were at a high risk of developing the syndrome.

Resumo Introdução: compreender, como premissa do ensaio, a Vigilância em Saúde do Trabalhador (VISAT) como ação pública capaz de intervir de forma mais ostensiva e eficaz nos fatores que determinam os agravos à saúde dos trabalhadores. Objetivo: estabelecer um parâmetro teórico-conceitual que balize a práxis esperada no aparelho de saúde pública responsável pela saúde do trabalhador no Brasil. Método: a metodologia fundamentou-se em duas vertentes: a produção bibliográfica sobre a VISAT e a empiria acumulada na formação de agentes públicos para a VISAT. Discussão: a partir de bases teóricas e experiências vivenciadas na formação, propõe-se estabelecer vínculos entre a episteme que acompanha a construção da VISAT, no Brasil, e a expectativa de uma práxis ainda debilmente exercida. Na análise conceitual de VISAT, cujas dimensões hermenêuticas são polissêmicas e complexas, sistematizou-se dez categorias significativas que buscam ampliar seu próprio conceito. Foram consideradas como dimensões ampliadas do conceito estudado as seguintes questões: Política; Ética; Legal; Institucional; Epidemiológica; Metodológica; Técnica; Pedagógica; Epistemológica; e Transformadora (ideológico-revolucionária).

Objectives: Describe the sociodemographic and work-related characteristics and identify the work-related injuries, reported in the Worker Health Information System of the State of Rio Grande do Sul. Method: A descriptive documentary study that gathered information by examining the records of the Individual Disease Notification Report, year 2015, at the Sistema de Análise de Negócios (SAN) of the 26 municipalities comprised by the 19th Regional Health Department of Rio Grande do Sul. Data analysis used simple and relative frequency calculation. Result: In total, 1,016 injuries were reported, mostly in men: 760 (74.8%); aged 18-29 years: 273 (26.8%). The most commonly reported injury was other occupational accidents, 787 (77.5%); 809 (79.6%) occurred in the workplace and 398 (39.2%) in the urban area. Conclusion: Most injuries (accidents and illnesses) involved young individuals, at working age, often resulting in permanent physical and mental disabilities.

Objective: to analyze the defensive strategies that Family Health team professionals use to protect themselves from suffering at work, from the perspective of Work Psychodynamics. Method: This qualitative, descriptive and analytical study was carried out in three Health Units of the South of Brazil, which were intentionally selected, from October to December 2012. All the members of the teams participated in the study, totaling 68 professionals. The information was collected through observation and collective interviews and analyzed according to Bardin, with two categories emerging: collective and individual defense strategies. Results: in the first category, the professionals highlighted the sharing of work issues in meetings and, as individual strategies, denial, rationalization and recognition. Final considerations: theprofessionals sought strategies to cope with the suffering caused by their work using internal and collective resources to confront it and transform the work into a source of pleasure and health.

Background: Globally, access to occupational health and safety (OHS) by workers has remained at very low levels. The organization and implementation of OHS in South Africa, Zimbabwe, Zambia, and Botswana has remained at suboptimal levels. Inadequacy of human resource capital, training, and education in the field of OHS has had a major negative impact on the improvement of worker access to such services in expanding economies. South Africa, Zimbabwe, Zambia, and Botswana have expanding economies with active mining and agricultural activities that pose health and safety risks to the working population. Methods: A literature review and country systems inquiry on the organization of OHS services in the 4 countries was carried out. Because of the infancy and underdevelopment of OHS in southern Africa, literature on the status of this topic is limited. Results: In the 4 countries under review, OHS services are a function shared either wholly or partially by 3 ministries, namely Health, Labor, and Mining. Other ministries, such as Environment and Agriculture, carry small fragments of OHS function. The 4 countries are at different stages of OHS legislative frameworks that guide the practice of health and safety in the workplace. Inadequacies in human resource capital and expertise in occupational health and safety are noted major constraints in the implementation and compliance to health and safety initiatives in the work place. South Africa has a more mature system than Zimbabwe, Zambia, and Botswana. Lack of specialized training in occupational health services, such as occupational medicine specialization for physicians, has been a major drawback in Zimbabwe, Zambia, and Botswana. Discussion: The full adoption and success of OHS systems in Southern Africa remains constrained. Training and education in OHS, especially in occupational medicine, will enhance the development and maturation of occupational health in southern Africa. Capacitating primary health services with basic occupational health knowledge would be invaluable in bridging the current skills deficit. Introducing short courses and foundational tracks in occupational medicine for general medical practitioners would be invaluable.

This study aimed to ascertain the relationship of the Work Ability Index with Cardiovascular Risk in workers of the prefecture on a university campus. It is descriptive, exploratory, transversal and quantitative research undertaken in 2012 through the analysis of medical records of 226 workers who underwent regular examinations. Cardiovascular risk was calculated using the Framingham Risk Score. It was observed that 85.0% of the workers were aged over 40 years old. Regarding work capacity, 42.5% presented inadequate capacity. It was identified that 31.2% of the workers had a risk score between medium (20.8%) and high (10.4%) for developing cardiovascular diseases within 10 years. It is concluded that in spite of there being no significant association (p

This study aimed to describe occupational accidents in the nursing team of two public hospitals, and the notification of these. Transversal research was used, undertaken between March and April 2012, in the city of Arcos, in the Center-West of Minas Gerais. A structured questionnaire was applied to nurses, nursing technicians, and auxiliary nurses. The data were tabulated and analyzed descriptively and statistically using the Statistical Package for the Social Sciences software, version 13.0. The reporting of the rate of work accidents in the institutions, between 2002 and 2011, was 59.6%, of which 90% were of a biological nature, and 34% did not report the work accident. The youngest age range (20 – 29 years old/81.8%) and those with less length of experience (≤ 5 years/84.2%) reported more accidents. It is concluded that there is little adherence by the professionals to the care measures stipulated, it also being verified that a low percentage of Communication of Work Accidents forms were filled out, making educational and preventive interventions necessary in order to minimize accidents.

Abstract OBJECTIVE To report the experience of developing a workshop proposal to assist local managers with the identification, management and prevention of primary care workers' psychic and moral exhaustion. METHOD The workshop was developed through a literature review performed between November 2014 and June 2015. The temporal cut considered studies of the ten previous years. The selection included studies describing collective interventions for situations generating psychic and moral exhaustion, preferably in primary care services. RESULTS Thirty-five articles were analyzed. The workshop provides five meetings with an average duration of one hour. The themes are: awareness; recognizing personal stress; dealing with personal stress; recognizing team stress; and dealing with team stress. The workshop is based on five key principles: detection and coping; attention to interpersonal relationships; communication; self-knowledge and mindfulness. CONCLUSION Psychic and moral exhaustion may reflect negatively on workers' health, the care, and the organization. The proposal of measures to recognize, deal with and prevent psychic and moral exhaustion is relevant and strategic in the constant search for improvement of satisfaction and quality.

This study aimed to identify the factors which cause dissatisfaction in the work of nurses in a university hospital. A total of 15 nurses participated in this qualitative study with a descriptive-exploratory approach. Data collection occurred in November 2011 – May 2012 through semi-structured interviews; the accounts were subjected to Content Analysis. The category termed Experiences of dissatisfaction in the work of the nurse was obtained as a result, with the following subcategories: the lack of co-operation between colleagues, work overload, non-recognition of the work undertaken, the scarcity of human and material resources, and the work in a public institution. It is concluded that the experiences of dissatisfaction identified are related both to personal and institutional aspects.

This epidemiological study was undertaken in a philanthropic hospital in Minas Gerais, in May 2010, through the administration of a semi-structured questionnaire and consecutive analysis of the files of the Notifiable Conditions/Incidents Information System and the Notification of Occupational Accidents System. The aim was to determine the prevalence of occupational accidents involving biological material among the nursing team, and to compare the results with the records in the Notifiable Conditions Information System and Notification of Occupational Accidents, as well as to identify their characteristics. 17 (53.1%) accidents were reported involving biological material, 10 (31.2%) recorded in the Notifiable Conditions Information System and 5 (15.6%) in the Notification of Occupational Accidents System. Venepuncture and the inadequate disposal of material were associated with 52.9% and 47.1% of the accidents, respectively. The difference between the notification of the accident on the different systems can express ignorance of its flow and legal importance, and of the worker’s rights.

The study aimed to analyze the nursing team’s perceptions on the health of the Family Health Strategy worker in the South of Brazil. All the professionals from the nursing team were interviewed, totalling six workers. The data was analyzed following the steps of thematic analysis, and two categories emerged: Issues which affect the nursing team’s health and Suggestions from the nursing team for improving the worker’s health. The first category evidenced overloading with work, the physical structure, financial issues, security, and mental and physical suffering. The elements composing the second category are the creation of a place for relaxation and the setting-up of therapeutic groups, as well as the need for recognition of the work. It is concluded that workers’ health must be grounded in meetings with managers, with a view to improving work conditions which influence the workers’ health and, consequently, the quality of the care given to the population.

The inadequate management of Health Service Waste is harmful to environmental and population health and brings risks of work accidents. This study aimed to identify weak points in the process of management of this waste through questioning workers who function in environments with differing technological complexity. This qualitative, descriptive research was undertaken with 29 professionals responsible for the management of the waste produced in the institution, 20 working in hospital and 9 in Family Health Centers. It was possible to perceive that the professionals are partially familiar with the management of the waste, and that as it moves away from the service, its management is less known, constituting more evidence of the process of fragmentation of work in health. Understanding the management of Health Service Waste can contribute to reducing the risk of work accidents and the environmental impact of the health services’ actions.

This article aims to reflect on the new ways of viewing those subjects who become ill in hospital work, evidencing qualitative phenomenological research’s potential for understanding not only the illness, but also the subject who falls ill. Falling ill in hospital work has been shown to be a complex phenomenon, requiring studies which consider diverse aspects and which can understand the everyday of work relationships and the experiences of the subjects who become ill. Becoming aware of the impact of becoming ill at work and valuing the subject and the experience lived through means delineating new ways of intervening in the worker’s health, minimizing harm and understanding the worker in his or her existential totality.

This descriptive, exploratory research with a qualitative approach aimed to identify the workers’ perception of biological risks in their professional practice, and was carried out between January 2008 and January 2009 in a municipality in the State of Paraná. Data collection was achieved through semi-structured interviews, recorded and transcribed, held with 18 nursing workers, observing the criteria of data saturation. Analysis was undertaken by the grouping of similarities and differences presented in the thematic accounts and which revealed three central themes: perceptions about biological risks; technical professional preparation and institutional support and work conditions, which gave rise to six categories. It was concluded that although the workers recognize the risk, nevertheless they do not take into account the possibility of suffering an accident, which contributes to the poor compliance with preventive measures; they desire to be supervised in their activities and indicate administrative aspects as contributing to the failure to comply with preventive measures.

This study aimed to verify the implantation of Regulatory Norm 32 in a hospital in the north of the Brazilian state of Paraná. An exploratory, descriptive case study was carried out through a recorded interview with a nurse from the Hospital Infection Control Committee, in June 2010. It was noticed that the institution has difficulties in relation to the implantation of the Norm, including unavailability of, and failure to use, personal protective equipment, and inadequate physical structure and overloading of containers for the disposal of sharps. It is concluded that despite these difficulties, some aspects were adopted in relation to the norm and a commission was set up with the objective of implanting it in line with governmental regulations.

Exploratory-descriptive research from 2009, with a qualitative approach in which a questionnaire for collecting data was applied to 8 community health assistants, with the aim of identifying the physical and psychological burdens resulting from the work. Thematic content analysis was used for analysis of the data. Regarding physical burdens, the category identified was inappropriate work conditions, with emphasis on an inappropriate work environment and inadequacies regarding work equipment. In relation to psychological burdens, the categories identified were lack of recognition on the part of some members of communities; inability to resolve interpersonal relationship problems and difficulties with the community and health unit team. This study indicates the need to draw up intervention strategies in collaboration with the health assistants and health service so as to promote actions which contribute to the improvement of quality of life and health among these workers.

A descriptive, quantitative study whose objective was to identify symptoms of the menopause and their interference in work processes. A stratified sample of 385 health professionals from a public university hospital was used; the data were collected via a socio-demographic questionnaire and the Woman’s Health Questionnaire between March and May 2010, and were analysed with the help of statistical programmes after double-typing. Most commonly referred to, and with the biggest interference in work practices, were arthralgia and myalgia (76.6%) inferring in 27.5%; excessive tiredness and chronic headache (62.1%) interfering in 22.9% and 21.6% respectively. In the category of anxiety, agitation was referred to by 67% of health professionals, 24.4% stating that it can influence work processes. The preparation of women for the continuation of life after 40 should by a matter for public and institutional policy, promoting the health of the menopausal woman.

Qualitative research developed with nursing professionals in a hospital in a town in the interior of Paraná State, with the objectives of identifying workers’ knowledge of biological risks and to reflect on work-related accidents which had happened. Three workshops were held, with the construction of a cause tree being utilized as a methodological reference, as a way of making reflection about exposure to biological fluids during workplace accidents possible. The meetings generated reflections about the participants’ practice, contributing to the construction of preventive attitudes.

O presente estudo objetivou verificar o impacto da sintomatologia osteomuscular na qualidade de vida dos professores da rede municipal de ensino de Natal/RN. Trata-se de uma pesquisa descritiva-analítica com corte transversal, que teve como amostra 242 docentes da rede básica. Foi utilizado o Whoqol-breve para avaliação da qualidade de vida e o questionário Nórdico para os sintomas osteomusculares. Na análise dos dados foram utilizados procedimentos da estatística descritiva e o teste de Mann-Whitney, com um nível de significância de 5%. A prevalência da referida sintomatologia foi de 63,2% entre os investigados, levando-se em consideração os sete dias anteriores ao momento da coleta dos dados. Todos os domínios da qualidade de vida apresentaram-se comprometidos entre o grupo de docentes que apresentaram os sintomas osteomusculares quando comparados ao grupo sem a sintomatologia, sendo encontrado no domínio Físico valor de p < 0,001, no Psicológico p < 0,001, Relação Social p < 0,001 e Meio Ambiente p < 0,001. Dessa forma, a presença de sintomatologia osteomuscular apresentou grande correlação estatística com o comprometimento da qualidade de vida dos professores da rede básica do município de Natal, RN.The aim of this study was to determine the impact of osteomuscular symptoms on the quality of life of public school teachers in Natal, Brazil. This is a descriptive-analytical study with a cross-sectional design, comprising a sample of 242 teachers. The WHOQOL-brief was used to assess quality of life and the Nordic questionnaire for osteomuscular symptoms. Descriptive statistical procedures and Mann-Whitney test were used in data analysis, with the significance level set at 5%. The prevalence of the aforementioned symptoms among the subjects investigated was 63.2%, considering the seven days before data collection. All quality of life domains were compromised in the group of teachers who presented osteomuscular symptoms, when compared to the asymptomatic group. The physical, psychological, social and environmental domains all had p-values smaller than 0.001. Thus, the presence of osteomuscular symptoms showed a strong statistical correlation with lower quality of life of teachers from the basic education system of Natal, Brazil.

Apesar do reconhecimento da importância dos conhecimentos geográficos e do uso das ferramentas de análise espacial nos estudos da saúde coletiva, esse é um campo ainda pouco explorado pelos pesquisadores brasileiros. Em levantamento realizado nas principais revistas científicas que veiculam os resultados de pesquisa em saúde do trabalhador, verificou-se o grande predomínio do uso de tabelas e gráficos como meio de organizar e apresentar os resultados obtidos, e o número reduzido de mapas. Para isso foram examinados todos os artigos publicados em quatro periódicos (Revista de Saúde Pública, Cadernos de Saúde Pública, Revista Saúde e Sociedade e Revista Brasileira de Epidemiologia) no período de 1967 a 2009. Uma vez analisado o conjunto de artigos selecionados no estudo, aqueles que utilizaram representações cartográficas receberam atenção especial. Verificou-se que, embora ainda pouco utilizadas, as ferramentas do geoprocessamento e da geoestatística com suporte em SIG abrem um campo de novas possibilidades no uso da cartografia temática em saúde do trabalhador no Brasil. Contudo, recomenda-se para os editores das revistas científicas o detalhamento de normas técnicas para publicação de figuras cartográficas, assim como a elaboração de pareceres específicos que possam auxiliar os autores em vista das modificações necessárias para a melhoria da qualidade da comunicação visual de mapas e da correlação espacial por meio do tratamento cartográfico.Geographic studies and spatial analyses have been recognized in Brazilian public health papers. It is still, however, very little explored by researchers. In a survey of the leading scientific journals covering issues related to Brazilian worker's health, we found the predominant use of charts and tables as a way to organize and present results with a small number of maps. This survey was conducted by examining all papers published in four journals, covering the period from 1967 to 2009 (Revista de Saúde Pública, Cadernos de Saúde Pública, Revista Saúde e Sociedade, and Revista Brasileira de Epidemiologia). After analyzing the set of papers selected for the study, the papers that used maps were given special attention. The tools of geoprocessing and geostatistics with GIS support, although little used, open new possibilities to use thematic cartography in the field of workers' health. However, it is recommended that editors of scientific journals have detailed technical standards as well as specific reports for the publication of cartographic figures aimed at facilitating the modifications necessary for the improvement of the visual quality of maps and of the spatial correlations through cartography.

O setor serviço ou terciário responde atualmente por mais de dois terços do PIB nos países desenvolvidos e, no Brasil, emprega cerca de três quartos da população economicamente ativa. Muitos autores consideram que esse fenômeno expressa uma transição da sociedade industrial para a sociedade de serviços. Entretanto, os estudos sobre a saúde do trabalhador, mesmo atentos às mutações tecnológicas e à reestruturação produtiva, não se aprofundam suficientemente no conhecimento das características do setor serviço, persistindo em referências aos processos industriais. O presente ensaio tem por objetivo analisar determinados conceitos sobre os processos de trabalho no setor serviço considerados importantes para compreensão da saúde dos trabalhadores desse setor. Formula-se a hipótese da proximidade entre trabalhador e consumidor como uma das principais características das relações de trabalho desse setor com possibilidades de repercussões específicas nos processos saúde e doença. Sob essa perspectiva de análise são incorporados os conceitos de simultaneidade, co-presença, co-produção, autosserviço e gestão emocional. Conclui-se que essas peculiaridades, além de permitirem uma compreensão mais adequada do processo saúde/doença dos trabalhadores no setor serviço, indicam a necessidade da construção de uma nova interface entre a saúde do trabalhador e as práticas emergentes de proteção à saúde do consumidor.At the present time the service sector is responsible for over two thirds of the GNP in developed countries and, in Brazil, it employs nearly 75% of the economically active population. Many authors view this phenomenon as a manifestation of the transition from industrial society to a service society. Yet, in spite of considering technological changes and the restructuring of production, studies on workers' health do not search far enough for a comprehension of the characteristics of the service sector, basically keeping to references to industrial processes. The present study analyzes specific concepts related to work processes in the service sector, which are considered important for an understanding of workers' health in this sector. This analysis puts forward the hypothesis that worker-consumer physical proximity is one of the main characteristics of work relations in that sector, leading to potential impacts on health and disease processes. From this perspective, the concepts of simultaneousness, co-presence, co-production, self-service and emotional management are incorporated. Such peculiarities, besides allowing a better understanding of workers' health/illness processes in the service sector, point to the need to create a new interface between workers' health and the emerging consumer health protection practices.

O objetivo deste estudo foi traçar o perfil da produção científica referente à saúde do trabalhador, no período compreendido entre 2001 e março de 2008. A pesquisa foi operacionalizada por meio da busca eletrônica de artigos indexados na base de dados Scientific Electronic Library Online (SciELO), a partir dos descritores "saúde do(s) trabalhador(es)" e "saúde ocupacional". Foram analisados 170 artigos completos. O periódico Cadernos de Saúde Pública concentra a maior parte dos trabalhos (35.29%), seguido pela Revista Ciência & Saúde Coletiva (16,47%). Constatou-se, ainda, que o método de abordagem mais utilizado foi o quantitativo (53,52%), os objetos de estudo mais frequente foram as discussões conceituais das relações saúde-ambiente-trabalho (40,59%), e a população mais estudada foi a dos profissionais da área de saúde (20,59%). Verificou-se, ainda, que a produção científica nacional sobre o tema concentra-se na região sudeste (69,66%). O aumento da produção científica no campo da saúde do trabalhador acompanha a tendência de aumento da produção científica nacional nos últimos 8 anos. O estudo mostra o potencial de crescimento da área compatível com a demanda de conhecimento dos gestores de políticas públicas que envolvem as relações saúde-ambiente-trabalho.This study aimed to outline the profile of the scientific literature on workers' health in the period between 2001 and March 2008. The research was conducted through the electronic search of papers indexed in the database Scientific Electronic Library Online (SciELO) with the descriptors "workers' health" and "occupational health". Overall, 170 complete papers were analyzed. The journal Cadernos de Saúde Pública was the source that published most papers (35,29%), followed by Ciência & Saúde Coletiva (16,47%). The quantitative method was used by 53.52% of the papers, conceptual discussions about Health-Environment-Work relations were the most frequent object of study (40.59%), and health professionals were the most studied population (20,59%). It was also verified that Brazil's scientific production on the theme is concentrated in the Southeast (69,66%). The increase in scientific production in the field of workers' health has followed the growth tendency of the national scientific production in the last 8 years. The study shows that the potential growth of this field is compatible with the demand for knowledge of public policies managers who work with Health-Environment-Work relations.

O presente artigo visa a identificar e compreender as formas de resistências, a partir das manifestações do sofrimento, na gestão do trabalho. Empreendemos uma investigação numa empresa pública, do setor de serviços, numa metrópole da região Sudeste do Brasil. Recorremos a entrevistas abertas com trabalhadores, gestores e profissionais de saúde dessa empresa. Para a análise dos relatos obtidos, empregamos como metodologia a hermenêutica-dialética. Constatamos que algumas das concepções do sofrimento na literatura especializada relegam o trabalhador à posição de doente ou de vítima, negligenciando a sua capacidade de resistência e a positividade proporcionada pela manifestação do sofrimento. Os depoimentos evidenciaram a existência de resistência reativa, que se apresentava sob as formas catártica e ambivalente, e uma resistência ativa. Concluímos que as formas reativas criam condições mínimas para a permanência no emprego, são capazes de evitar o estigma de doente, entretanto, não conseguem evitar as situações favorecedoras do sofrimento. No âmbito da gestão não se reconhece a existência do processo de adoecimento no trabalho e seus dispositivos de atribuição da identidade de doente; os modelos teóricos que orientam as avaliações de serviços não contemplam os benefícios e avanços originários das diferentes formas de resistência.The present article aims to identify and understand resistance forms based on suffering manifestations in work management. We undertook an investigation in a public company from the services sector, located in a metropolis of the Southeastern region of Brazil. We conducted open interviews with workers, managers, and health professionals from this company. For the analysis of the obtained accounts, we used dialectical hermeneutics as the methodological strategy. We found that some of the suffering conceptions in the specialized literature relegate the worker to the position of victim or sick person, neglecting his capacity for resistance and the positiveness deriving from the suffering manifestation. The accounts revealed the existence of reactive resistance, which emerged through cathartic and ambivalent forms, and of active resistance. We concluded that the reactive forms create minimum conditions for permanence in the job, and can prevent the sick person stigma, but they are not able to prevent situations which favor suffering. In fact, in the management sphere, the existence of the illness process in the workplace is not recognized, nor are its devices of attribution of the sick person's identity. The theoretical models that guide services evaluations do not take into account the benefits and advances coming from the different forms of resistance.

Este estudo discute a relação entre as condições e a organização do trabalho como elementos que contribuem para a ocorrência de acidentes do trabalho. Os dados foram coletados em uma indústria produtora de açúcar, álcool e derivados, situada no Estado de São Paulo. Para a coleta dos dados utilizamos a observação direta do trabalho e realizamos entrevistas semidirigidas individuais como 22 trabalhadores do setor de produção de açúcar. A produção de açúcar foi indicada pela Equipe de Segurança e Higiene no Trabalho como o setor em que havia a maior ocorrência de acidentes. Por destacar o papel que a relação homem-trabalho desempenha na saúde física e psíquica dos trabalhadores, utilizamos a Psicodinâmica do Trabalho (Dejours, 1994) como referencial teórico para a análise dos dados obtidos nas entrevistas. A análise das entrevistas envolveu três aspectos: condições e organização do trabalho e insatisfação. Os resultados revelaram que o ambiente estudado apresenta fatores físicos, químicos e biológicos desfavoráveis à saúde dos trabalhadores. Quanto à organização do trabalho, os dados revelaram que a divisão do trabalho bem como o conteúdo das tarefas determinavam sobrecarga aos trabalhadores. O relato sobre a insatisfação envolveu: ausência de perspectiva para progressão profissional, falta de treinamento técnico, dificuldade em manejar equipamentos e inadequação dos equipamentos de proteção. Destaca-se também no discurso dos trabalhadores a ineficiência das ações organizacionais para a eliminação ou a neutralização dos riscos de acidentes do trabalho e a predominância da teoria do "Ato inseguro" na apuração da causalidade dos acidentes do trabalho.The present study is about the relationship between the work conditions and organization as elements that contribute to work accidents. The data were collected in a sugar cane industry that produces sugar, alcohol and other derivates located in the State of São Paulo. For data collection we have used direct observation of work and conducted semi-directed personal interviews with 22 workers from the sugar production division. Sugar production was indicated by the Work Safety and Hygienic Team as the section where most accidents occurred. We have used the Psychodynamics of the work view (Dejours, 1994) as the theoretical framework to assess data obtained in the interview because it highlights the role the men-work relationship plays in the physical and psychological health of workers. The interviews analysis involved three aspects: working conditions, working organization and dissatisfaction. Results showed that the studied environment presents physical, chemical and biological factors that are unfavorable to workers' health. As for the working organization, data showed that the working division, as well as the tasks overloaded workers. Reports on dissatisfaction involved: lack of perspective of professional development, lack of technical training, difficulty in dealing with equipment and inappropriate protection equipment. In the workers' speech one can stand out the inefficiency of the organizational actions to eliminate or neutralize the working accident's risks and the prevalence of the "Unsafe Act" theory in the investigation of the working accidents' cause.

A theoretical conceptual study under the premise that education is something broader and more complex than training and instruction, and it intends, while reflecting on the functions of the education and its implications, to contribute for a better understanding on how education can help in the accomplishment of biosafety norms and in the improvement of workers health conditions. Biosafety is conceived as an educative action, rather than training and norm introjection. Education reminds of joint experience, common activity, something that does not occur in training. The understanding of the biosafety as an educative process implies not only a process of acquisition of abilities and contents, as the idea of educating implies action sharing, taking into consideration agents will and routine, and above all conceiving the agents as citizens of the learning, involving them in its totality, with their singularities and uniqueness. Such understanding of the biosafety also allows a significant advance, namely, the incorporation of workers knowing, one of the basic purposes of workers health.

O trabalho tem um papel importante na vida do homem, pois, além de ser fonte do seu sustento, é onde ele pode sentir-se útil, produtivo e valorizado. Entretanto, quando realizado sob condições impróprias, pode provocar diversos níveis de prejuízo à saúde, como a dor músculo-esquelética, que é caracterizada ainda por possuir origem multifatorial. Desta forma, foi realizado um estudo transversal objetivando analisar a influência dos fatores sociodemográficos e aspectos relacionados ao trabalho e às condições de saúde sobre a sintomatologia dolorosa, em profissionais do setor têxtil. A amostra foi constituída de 162 funcionários que trabalhavam com corte-costura na divisão industrial da ACT (Associação Comunitária para o desenvolvimento do Trairi) no município de Santa Cruz - RN, Brasil. Após análise bivariada e multivariada observou-se associação independente da sintomatologia dolorosa com as variáveis sexo feminino (p= 0,013), tempo de ocupação há mais de seis meses (p= 0,005), presença de outros problemas de saúde (p= 0,002) e trabalhar em pé (p = 0,001). Nesse contexto, pode-se concluir que houve uma alta prevalência de dor entre os profissionais estudados, e que esta possui associação significativa com vários aspectos relacionados ao trabalho, e alguns fatores sociodemográficos e de saúde, sendo portanto necessária uma atuação interdisciplinar, multiprofissional e intersetorial, de forma a interferir positivamente no processo de trabalho e na saúde do trabalhador.Work has an important meaning in man's life, given it is the most important way for people to support themselves and it is also the only means in which they can feel useful, productive and valuable. However, when work is carried out under inappropriate conditions, it may cause different health injuries, such as muscle-skeletal pain, which is characterized by a multifactorial origin. Thus, a cross-sectional study was carried out aimed at analyzing the influence of sociodemographic factors, work and health conditions on pain symptoms in professionals of the textile industry. The sample comprised 162 sewing machine operators from ACT's (Community Association for the Development of Trairi) industrial division in Santa Cruz - RN, Brazil. After bivariate and multivariate analyses, we found an independent association between pain symptoms and variables such as female gender (p= 0.013), more than six months in the same occupation (p= 0.005), other health problems (p= 0.002), and working in a standing position (p= 0.001). The study identified a high prevalence of pain symptoms in textile industry professionals and a significant association with many work-related aspects and some sociodemographic and health factors, making an interdisciplinary, multiprofessional and intersectorial action necessary to promote positive interference in the work process and occupational health.

Este estudo objetivou conhecer a prevalência de sintomas de distúrbios osteomusculares em bancários de Pelotas e região e investigar fatores associados. O estudo foi transversal e os dados foram coletados através de questionário auto-aplicado no local de trabalho. O desfecho foi relato de dor osteomuscular com freqüência em três ou mais de dez regiões anatômicas (Questionário Nórdico de Sintomas Osteomusculares - QNSO). De 502 bancários estudados, 60% da amostra mencionaram dor músculo-esquelética no último ano, 43% referiram nos últimos sete dias, 19% tiveram que evitar o trabalho devido às dores e 40% relacionaram esta dor com a atividade que realiza no seu trabalho. Dor com freqüência foi relatada por 39% dos bancários. Maiores prevalências foram observadas em mulheres, pessoas que não praticavam atividade física, usuários de terminal on-line e máquinas autenticadoras, aqueles que referiram seu ritmo de trabalho como "acelerado", aqueles que trabalhavam na maior parte do tempo sentados e aqueles que classificaram seu ambiente de trabalho como "inadequado".The aim of this study was to find the prevalence of signs of musculoskeletal disorders in bank workers from the city of Pelotas and region, and to investigate major associated factors. A cross-sectional study was carried out and data were collected through a self-reported questionnaire. The main outcome was the report of frequent musculoskeletal pain in three or more of ten anatomical areas investigated (Nordic Musculoskeletal Questionnaire - NMQ). The study included 502 bank workers. Musculoskeletal pain in the past twelve months was reported by 60% and in the past seven days by 43%. Nineteen percent were not able to work due to musculoskeletal pain, and 40% associated the pain to their tasks at the bank. Frequent musculoskeletal pain was reported by 39% of bank workers. Higher prevalence of the outcome was observed for women, for those who did not exercise, for on-line terminal and authenticating machines users, for those who classified their rhythm of work as "accelerated", for those who remained seated most of the time, and for those who classified the work environment as "inappropriate'.

As relações entre saúde e ambiente e as possibilidades de uma aproximação teórica e prática entre os campos disciplinares da Saúde Ambiental e da Saúde dos Trabalhadores constituem o tema deste artigo. A primeira parte oferece uma visão panorâmica da relação saúde-ambiente, examinando algumas de suas abordagens e enfatizando o modo de produção e consumo e o modelo de desenvolvimento por ele delineado em cada sociedade como ponto-chave para a articulação entre as categorias trabalho, ambiente e saúde. Discute a identificação dos agravos à saúde relacionados ao ambiente e as dificuldades no estabelecimento destas relações, assim como alguns desafios epistemológicos e metodológicos que se apresentam para a investigação neste campo hoje. A segunda parte postula uma abordagem integrada entre produção, trabalho, ambiente e saúde, enquanto categorias fundamentais na definição do padrão de saúde e qualidade de vida da população, tendo como ponto de partida a incorporação sistêmica destas inter-relações nas políticas de desenvolvimento. A análise integrada dos processos produtivos na tríplice perspectiva de suas relações com o trabalho, o ambiente e a saúde é vislumbrada como um dos pontos de articulação das políticas públicas nestes campos, numa abordagem transetorial, transdisciplinar, democrática e participativa, em que Estado e sociedade ampliem a eficácia do controle dos processos produtivos.This paper addresses the relationships between health and environment and the possibilities of a theoretical and practical approach between the disciplinary fields of Environmental Health and Worker's Health. In the first part, it presents a panoramic view of the health-environment relation, examining some of its approaches. This overview emphasizes the production and consumption mode, and the development model it determines in each society, as a key-point to relate work, environment and health. It discusses the identification of the adverse effects to health related to the environment, and the difficulties in establishing these relations, as well as some epistemological and methodological challenges present the research in this area today. The second part suggests an integrated approach between production, work, environment and health, as basic categories to define quality of life and health standards for the population, based on the systemic incorporation of these categories into development policies. The integrated analysis of productive processes is examined from the perspective of its threefold relations with work, environment and health, as one of the points for combining public policies in these fields, in a trans-sectorial, trans-disciplinary, democratic and participative approach, in which the State and society expand the effectiveness of the control of productive processes.

Em estudo realizado na indústria da alimentação de Pelotas, utilizou-se a metodologia do Modelo Operário para elaborar mapas de riscos. Inicialmente, representaram-se os grupos de riscos por meio de figuras geométricas, com graduação de tamanho para caracterizar a intensidade. Notou-se que estas tinham pouco significado para o trabalhador. Além disso, com a agregação de riscos com diferentes impactos sobre a saúde, perdia-se o detalhamento da exposição. Como alternativa, desenvolveu-se uma iconografia, partindo da visão do trabalhador. A investigação foi qualitativa e realizou-se em três etapas com sessenta trabalhadores, que sugeriram e selecionaram os ícones mais adequados. A seguir, utilizando-se processo serigráfico, estes foram digitalizados e impressos em adesivos para que o próprio trabalhador pudesse colá-los no mapa de riscos. Cada risco é representado por um ícone e a intensidade de exposição é expressa pela sua cor. Este artigo apresenta estes ícones e o processo desenvolvido para a sua elaboração.The methodology known as the workers' model was used to design risk maps in a study performed in the food-processing industry in Pelotas, in the State of Rio Grande do Sul in southern Brazil. The various types of occupational risks were initially represented by geometric figures, with a size gradient to represent intensity. Joint investigation of these icons showed that they had little meaning for the workers. In addition, risks from a same group (physical, chemical, etc.) but with different impact on health were grouped, thus missing the specificities of exposure. As an alternative, and starting from workers' own risk perceptions, a set of risk icons was developed. The study was done in three steps involving sixty workers, who proposed and selected the most suitable symbols, which were subsequently printed on stickers using silk-screen so that the workers could glue them on the risk maps. Each risk is represented by one icon, and intensity of exposure is defined by color. This paper presents the icons and the process involved in designing them.

Se analizan las características del proceso de modernización en México y el deterioro y polarización que ha producido en las condiciones de vida y salud de la población general y de los trabajadores y sus familias. Para ello se muestran diversos indicadores socioeconómicos y de salud. Respecto a la morbilidad, las enfermedades infecciosas ocupan un porcentaje muy elevado, pero otros fenómenos como diabetes, cirrosis hepática, infarto cardiaco, tumores malignos y accidentes y violencias son también serios problemas de salud pública. En regiones del país con características socioeconómicas bien diferenciadas, como los estados de Chiapas y Nuevo León, la polarización de la salud resulta más evidente aún. Por otra parte, el deterioro de las condiciones laborales y la información existente respecto a la salud de los trabajadores, a pesar de sus limitaciones, indican que los trabajadores deben ser considerados como un grupo prioritario. Se muestra el comportamiento paradójico de los accidentes y enfermedades laborales objetos de compensación, con menos accidentes pero más graves, y detección de enfermedades en grados muy avanzados, así como diferencias significativas en la morbilidad laboral en distintas ramas de la producción manufacturera.This article analyzes the characteristics of the modernization process in Mexico and the polarization produced in living and health conditions for the general population as well as workers and their families. We studied socioeconomic and health indicators for this purpose. Infectious diseases occupy a high percentage of general morbidity, yet diseases such as diabetes, hepatic cirrhosis, myocardial infarction, malignant tumors, and accidents and violence are also serious public health problems as causes of morbidity and mortality. In some regions of the country with specific socioeconomic characteristics, polarization of health conditions is even more evident, as in the state of Chiapas as compared to Nuevo León. Deterioration of working conditions and available data on workers' health indicate that the latter should be considered a priority group for health measures. Such data also show the paradoxical trend of the more severe but less frequent work-related accidents and diseases that are subject to compensation as compared to the detection of chronic work-related diseases at an advanced stage, as well as significant differences in occupational morbidity among different branches of manufacturing.

Neste artigo, discute-se a vigilância em saúde do trabalhador enquanto uma ação em saúde motivada pelo conhecimento dos trabalhadores. O trabalho parte da noção de vigilância à saúde (especialmente no conceito de problema) e de conhecimento prático, tomando por base a teoria das representações sociais. Assim ancorado, desenvolve a concepção de que a formulação de problema de saúde é uma representação social e, como tal, segue uma lógica peculiar. Essas reflexões são incorporadas à discussão da prática do mapeamento de riscos de acordo com o Modelo Operário Italiano, apontando suas implicações para a formulação dos problemas de saúde e a identificação de estratégias para atuar em seus determinantes e condicionantes.This article deals with Occupational Health Surveillance as a health action induced by the workers' knowledge. In order to develop this conception, it adopts the notion of Health Surveillance, especially the concept of problem, and the notion of common-sense knowledge under the perspective used by social psychology. Supported by these considerations, we assume that the formulation of a health problem is a social representation. These considerations are used to examine the practice of "workers' investigations" as conceived by the Italian experience, pointing to its implications for the formulation of problems and identification of strategies in order to act on its determinants.

Foram alocados aleatoriamente vinte trabalhadores expostos ocupacionalmente ao chumbo em uma indústria de acumuladores elétricos de médio porte, no interior do Estado de São Paulo, os quais apresentavam plumbemia e excreção urinária do ácido delta-aminolevulínico, nos últimos dois anos, sempre menores que 60 µg/dL e 10 mg/L, respectivamente. Os trabalhadores foram submetidos a eletroneurografia do nervo radial direito e a dosagem de plumbemia. Com estas medidas ajustou-se um modelo de regressão linear simples de primeira ordem, tendo como variável dependente a velocidade de condução e como variável independente a plumbemia. Analisando-se a regressão ajustada, infere-se que o valor preditivo negativo do limite de tolerância biológica brasileiro aplicado à plumbemia seja de apenas 0,63. O estudo sugere que o valor do referido limite de tolerância deva ser reduzido do atual valor de 60 µg/dL para 32 µg/dL, para ter um valor preditivo negativo de 0,99.We randomly selected twenty lead workers from an electric accumulator factory in the State of São Paulo, Brazil, whose blood lead level and urinary d-aminolevulinic acid level were below 60 mg/dL and 10 mg/L, respectively. The workers were submitted to a standard motor nerve conduction velocity study of the right radial nerves, in addition to blood lead dosage. Based on these measures, a first-order linear regression model was adjusted, where the dependent variable was conduction velocity and the independent variable was the blood lead level. Analyzing the fitted model, we inferred that the negative predictive value of the Brazilian biological exposure limit is 0.63. In order for the above biological exposure limit to have a negative predictive value of 0.99, the study suggests that it be reduced from its present value (60 mg/dL) to 32 mg/dL.

Este artigo objetiva identificar as associações das morbidades comuns e dos acidentes de trabalho com setor, descrevendo as cargas de trabalho e realizando um amplo controle de fatores de confusão. Através de delineamento transversal, estudou-se a totalidade dos trabalhadores de uma indústria de celulose e papel (n=671). Realizaram-se entrevistas nesta indústria, caracterizando a percepção dos trabalhadores sobre as exposições ocupacionais e a morbidade. A área industrial caracterizou-se pelo excesso de problemas auditivos (RO>2,5), respiratórios (RO>2,7) e acidentes (RO>4,7), possivelmente relacionados com ruído, poeira, mudanças bruscas de temperatura e exposições a substâncias químicas, além do trabalho físico pesado e exposições a situações de risco. A administração apresentou um aumento de problemas nos olhos, dor nas costas, irritação e nervosismo (RO>1,7), que parecem ter relação com a falta de autonomia e criatividade no trabalho, problemas ergonômicos e esforço visual. Confirmaram-se não só as altas prevalências de morbidades comuns, mas também sua relação com as particularidades do processo de trabalho sintetizadas pela categoria setor.The purpose of this study was to identify associations between common morbidity and work accidents and the respective departments in a pulp and paper industry, describing work loads and performing broad control of potential confounding factors. We studied all the workers from a specific pulp and paper industry, using a cross-sectional design and interviews at the workplace (n=671) with a standardized questionnaire. We characterized workers' perceptions of their occupational exposures and health problems. The industrial area had an excess in auditory problems (OR>2.5) and respiratory problems (OR>2.7) as well as accidents (OR>4.7). These diseases were probably related to the high prevalence of noise, dust, sudden temperature changes, exposure to various chemicals, and excessive effort and high-risk situations. Moreover, the management group showed an excess in eye problems, backache, irritation, and nervousness (OR>1.7), apparently related to lack of autonomy and creativeness at work, ergonomic problems, and strained eyesight. The study confirmed not only a high prevalence of common diseases, but also their relationship to specific features of the work process indicated by each department category.

Os acidentes envolvendo substâncias perigosas nas atividades de transporte, armazenamento e produção industrial de produtos químicos constituem um sério risco à saúde e ao meio ambiente. Objetiva-se discutir, no âmbito da saúde pública, alguns dos desafios que esses tipos de acidentes colocam, principalmente para os países de economia periférica. Através da combinação de informações quantitativas e qualitativas, foram definidos e caracterizados esses tipos de acidentes e seus diversos riscos. Esses acidentes têm se apresentado com a maior gravidade nos países de economia periférica, embora a maioria deles venha ocorrendo sem o adequado registro de informações básicas para a avaliação e vigilância, como é demonstrado no caso do Rio de Janeiro (Brasil). Além da tarefa de se avaliar as conseqüências de eventos, por vezes extremamente complexos, coloca-se também, a de formular estratégias de controle e prevenção em realidades sociais que configuram um terreno fértil para a ocorrência e agravamento dos mesmos.Chemical accidents involving explosions, large fires and leakages of hazardous substances occuring during transport, storage and industrial production of chemicals constitute a real challeng to health, environmental and industrial safety professionals. The aim of this article is to discuss the main questions that this kind of accident provokes, in terms of public helth, particularly in developing countries such as Brazil. The paper defines and characterises these accidents and the various health risk they involve excluding the leakages of hazardous substances during "normal" production in industry - through the combination of quantitative and qualitative information drawn from the international literature on the subject. From some examples of chemical accidents such as occurred in Bophal (Índia), Vila Socó (Brazil), São Paulo (México) and data of the World Health Organization (WHO), the authors seek to show that these events present a worsening, in terms of immediate deaths and injuries, in developing countries. The statistics of chemical accidents which occurred during the last ten years (1984 to 1993) in the State of Rio de Janeiro are used taken as a frame reference for the purpose of bringing to light the great number of occurrences made with no registration of basic information regarding assessment or surveillance. The complexity of causes and consequences, together with the structural problems of developing countries, present public health professionals and institutions, with some important tasks especially those os health risk assessment and the formulation of strategies to prevent and control future major chemical accidents.