Revista Brasileira de Medicina do Trabalho
Latest articles in this journal
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 88-93; doi:10.47626/1679-4435-2021-605
COVID-19, a disease caused by a coronavirus (SARS-CoV-2), has worried health authorities in Brazil and worldwide because of its high infectivity and rapid spread. Within this context, health care workers are at greater risk of infection for being in close contact with patients, which is inherent to their work activities. To reduce the risk, protective measures must be adopted and personal protective equipment is essential. However, the process of removing personal protective equipment, named doffing, is as important as its correct use and can be a source of contamination for workers, especially when equipment is lacking in the market and lifespan is increased. Therefore, this review aimed to discuss the process of doffing personal protective equipment and its correct sequence based on data available in the literature.
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 51-59; doi:10.47626/1679-4435-2021-570
Workplace violence against health care professionals is a highly prevalent problem and is considered a public health concern by the World Health Organization. Yet most studies on the topic focus on its negative impact on the mental health of workers rather than the causes of these incidents. To describe the frequency of workplace violence and its impact on professionals working in Psychosocial Care Centers (Centros de Atenção Psicossocial [CAPS]) in a large city in the state of São Paulo. A quantitative cross-sectional study was conducted on a non-probabilistic sample of 193 health care workers across 11 Psychosocial Care Centers. Participants completed two self-administered instruments: a biosocial questionnaire and the Survey Questionnaire on Workplace Violence. The results showed that 42.4% of respondents had suffered physical violence; 64.8% had experienced psychological violence; and 29.5% had been victims of bullying/mobbing. In most cases, the victims responded to these incidents by taking no action, asking the perpetrator to stop, or speaking of the incident to a colleague or superior. A verbal warning was issued to perpetrators in only 21% of cases of physical violence. Mobbing had the greatest negative impact on respondents, followed by psychological and physical violence. Workplace violence is a part of everyday work in Psychosocial Care Centers. Though this violence is often naturalized and considered a collective defense against suffering, it did not prevent participants from reporting high levels of job satisfaction, reflecting the degree to which professionals at Psychosocial Care Centers are committed to their colleagues and to service users, as well as their search for professional recognition.
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 82-87; doi:10.47626/1679-4435-2021-598
The current pandemic of severe acute respiratory symptom coronavirus 2 (SARS-CoV-2) has had a major impact on individuals’ lives. Social isolation and the use of personal protective equipment - the latter being especially important for health care workers - emerged as two of the main methods of preventing the spread of the disease. The eye can represent a source of transmission through contaminated tears, as well as a source of infection for respiratory droplets or aerosol particles, which may come into contact with the ocular surface and migrate to the lungs and other parts of the body. To investigate the risk of ocular transmission through a literature review and identify ways of preventing it. A search of the scientific literature was conducted in the PubMed and Cochrane databases, using a combination of the following keywords: “COVID-19,” “eye,” “personal protective equipment,” “SARS-CoV-2,” “protective goggles,” “face shields,” and “workers’ health.” The mechanisms of ocular transmission have not been fully elucidated, but studies have demonstrated the presence of viral RNA in the conjunctival sac and aerosolized secretions of contaminated patients; these droplets may come into contact with the eyes of uninfected bystanders, entering the respiratory system through the nose and gaining access to the lungs. Studies show that the virus can be effectively transmitted through the eyes, underscoring the importance of protective goggles for health care workers or potential transmitters of the virus, in addition to the need for additional education measures to encourage hand hygiene and discourage touching of the eyes.
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 27-34; doi:10.47626/1679-4435-2021-551
Rural workers are exposed to various occupational risks, especially considering the exposure to pesticides. This exposure can lead to respiratory intoxications being the most frequent complaint by these professionals, which could be associated to the lack or improper use of personal protective equipment. To assess the respiratory function of rural workers exposed to pesticides in the municipality of Quilombo, state of Santa Catarina, Brazil. This study was quantitative, observational, and descriptive. Our sample consisted of 31 rural workers aged between 25 and 45 years and divided into 2 age groups; we aimed to assess the effect of the period of exposure to pesticides. The participants answered a questionnaire, followed by a respiratory function assessment including measurements of inspiratory and expiratory muscle strength using a manovacuometer, of peak expiratory flow with a peak flow meter, and of tidal volume with a ventilometer. The groups presented decreases in respiratory muscle strength, peak expiratory flow, and tidal volume. The damage to expiratory function observed in the evaluated sample presents, as a main factor, the lack of personal protective equipment use; therefore, education and health strategies are needed to instrumentalize these workers and reduce the development of occupational risks.
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 114-118; doi:10.47626/1679-4435-2021-638
Copper is an essential trace element for homeostasis and is mostly obtained through the diet. Copper can also enter the body through occupational and accidental exposure, resulting in the elevation of serum copper levels (hypercupremia). Other factors associated with hypercupremia include smoking, use of oral contraceptives, and several clinical conditions. This case series describes the presence of hypercupremia in workers exposed to copper while also taking oral contraceptives. Serum copper levels of the sample remained high, even after participants spent time away from work, normalizing only after a change in contraceptive methods. The present results underscore the importance of considering oral contraceptives as a possible cause of hypercupremia in women with occupational exposure to copper, regardless of symptomatic status.
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 13-26; doi:10.47626/1679-4435-2020-722
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 01-02; doi:10.47626/1679-4435-2021-191
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 13-26; doi:10.47626/1679-4435-2021-525
Occupational diseases are those that may have a causal relationship with occupational activity or environment. However, this definition does not specify how this disease would be identified and acknowledged for workers with subsistence jobs. To determine sociodemographic, labor and environmental conditions that collaborate to explain the presence of eye and skin irritation among informal vendors in downtown Medellin. Descriptive cross-sectional study with analytical intention, primary sources of information, and administration of assisted survey including self-reported eye and skin irritation in 686 workers. Predominantly male population with mean age of 50 (±11.8) years. A total of 23.5 % of workers had worked as vendors for their entire life; 37.5% had worked as vendors for 11 to 20 years as vendors; and 81.5%worked for more than 8 hours a day. According to 69.8% of the sample, poor air quality affected their work, and 80.0% believed that pollution was generated by vehicle fleet. The polluted areas generated unpleasant odors (50.2%) and air pollution (89.4%). The prevalence of eye and skin irritation was 65.4%. Not having working license and having fair, poor, or very poor job tenure significantly reduced the prevalence of eye and skin irritation. Conversely, exposure to polluted water, working in the professional for more than 30 years, male sex, and age older than 60 years were associated with increased prevalence of irritation. Eye and skin irritation was mainly explained by non-modifiable sociodemographic and labor conditions and by consumption of polluted water; however, implementing public health actions could reduce workers’ socio-environmental and labor vulnerability.
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 43-50; doi:10.47626/1679-4435-2021-565
Accidents involving biological material are the main cause of occupational exposure among health care professionals. To analyze trends in the number of accidents involving exposure to biological material among health care workers in Brazil, in the period of 2010 to 2016. This was an ecological study based on secondary data on occupational accidents involving biological material reported to the Information System for Notifiable Diseases (Sistema Nacional de Agravos de Notificação). The data were analyzed using descriptive methods, followed by a calculation of incidence rates per 1,000 workers per year. Lastly, trend analysis was performed using Prais-Winsten regression. A total of 243,621 accidents involving exposure to biological materials were reported among health professionals in the study period. The highest incidence rate (16.74 accidents per 1,000 workers per year) was observed in 2014. Regional analyses showed that Midwestern, South and Southeast Brazil had higher incidence rates than other regions of the country. At the state level, the highest rates were observed in Roraima, Rio Grande do Norte, Alagoas, Goiás, Minas Gerais, São Paulo, Paraná, and Santa Catarina. National incidence rates of occupational accidents with exposure to biological material in health care workers had a stable trend over the study period. In Brazil, health care workers are disproportionately affected by occupational accidents with exposure to biological material. The present findings, together with other indicators, cast doubt on the stability of these figures over time.
Revista Brasileira de Medicina do Trabalho, Volume 19, pp 68-72; doi:10.47626/1679-4435-2021-589
Occupational accidents occur as a result of work, and can lead to bodily harm or functional impairments that lead to death, or to the reduction or loss of working capacity. Occupational accidents are associated with two possible outcomes: morbidity or mortality. Morbidity refers to the subset of a population that develops an illness over a given period of time, while mortality refers to the number of individuals who die over a specified time period. To assess occupational morbidity and mortality in Brazil in the period of 2009 to 2016. An ecological study was conducted based on secondary data collected from incident records in the Social Security database. The outcomes of all occupational accidents reported in Brazil from 2009 to 2016 were extracted from the database. These data were then classified by geographical region and category in the National Classification of Economic Activities (Classificação Nacional de Atividades Econômicas), so as to calculate the prevalence of each outcome and the accident mortality rates, and compare these values across regions and occupational categories. The data show that the outcomes of occupational accidents are directly associated with socioeconomic sectors and the sociocultural characteristics of different regions in the country. These results make an important contribution to the characterization of occupational morbidity and mortality in Brazil.