Lys Esther Rocha

Trabalho, saúde e gênero: estudo comparativo sobre analistas de sistemas

OBJECTIVE To assess the health impact of working conditions among male and female systems analysts. METHODS In this cross-sectional study, 533 systems analysts of two data analysis companies located in the metropolitan area of São Paulo were studied. Data was collected using work ergonomic assessments, individual and group semi-structured interviews and a self-applied questionnaire. Data analysis was based on contingency tables, Chi-square values at 5% level, prevalence rates and ratios, and their 95% confidence intervals. RESULTS Of the participants, 40.7% were women who on average were younger that the studied men (59.6% of women and 39% of men were in the age range 25 to 34). Though fatherhood was more frequently seen among men (57.6% x 34.2% for women), women spent more time with household tasks, including children care. There were more men in leading management positions. Work-related discomfort factors were seen in both sexes at similar frequencies. Men most commonly complained of work overload due to tight deadlines, high degree of responsibility, mental strain, and work complexity. Women more frequently complained of postural discomfort, higher exposure to video display terminal, and obsolete equipment. Women reported more visual, musculoskeletal and stress related symptoms, and higher work dissatisfaction and mental fatigue. CONCLUSIONS The study suggests that the health impact on female systems analysts is associated with the work demands and the womens social role. There is a need of further studies associating health, work and gender and an assessment of the intersection between the domestic and productive roles.To assess the health impact of working conditions among male and female systems analysts. In this cross-sectional study 533 systems analysts of two data analysis companies located in the metropolitan area of Sao Paulo were studied. Data was collected using work ergonomic assessments individual and group semi-structured interviews and a self-applied questionnaire. Data analysis was based on contingency tables Chisquare values at 5% level prevalence rates and ratios and their 95% confidence intervals. Of the participants 40.7% were women who on average were younger that the studied men (59.6% of women and 39% of men were in the age range 25 to 34). Though fatherhood was more frequently seen among men (57.6% x 34.2% for women) women spent more time with household tasks including children care. There were more men in leading management positions. Work-related discomfort factors were seen in both sexes at similar frequencies. Men most commonly complained of work overload due to tight deadlines high degree of responsibility mental strain and work complexity. Women more frequently complained of postural discomfort higher exposure to video display terminal and obsolete equipment. Women reported more visual musculoskeletal and stress related symptoms and higher work dissatisfaction and mental fatigue. The study suggests that the health impact on female systems analysts is associated with the work demands and the women’s social role. There is a need of further studies associating health work and gender and an assessment of the intersection between the domestic and productive roles. (authors)OBJETIVO: Avaliar as repercussoes do trabalho de mulheres e homens analistas de sistemas na saude. METODOS: Trata-se de estudo exploratorio de delineamento transversal, abrangendo 553 analistas de duas empresas de processamento de dados da regiao metropolitana de Sao Paulo. Foram realizadas analises ergonomicas do trabalho, entrevistas semi-estruturadas e preenchimento de questionarios para auto-aplicacao. A analise dos dados baseou-se em tabelas de contingencia com qui-quadrado a 5% de significância e razoes de prevalencia e seus intervalos de confianca segundo genero. RESULTADOS: As mulheres constituiram 40,7% do grupo estudado, sendo mais jovens que os homens. A presenca de filhos foi maior entre os homens, embora o tempo diario dedicado as tarefas domesticas tenha sido maior entre as mulheres. Observou-se predominio dos homens nas funcoes de chefia. Fatores de incomodo, com frequencia semelhante entre homens e mulheres, foram: sobrecarga de trabalho devido a prazos curtos; alto grau de responsabilidade; exigencia mental do trabalho; e complexidade da tarefa. Fatores de incomodo predominantes em mulheres foram: postura desconfortavel; maior exposicao ao computador; e presenca de equipamento obsoleto. As mulheres relataram maior frequencia de sintomas visuais, musculares e relacionados a estresse; maior insatisfacao com o trabalho; maior fadiga fisica e mental. CONCLUSOES: O estudo sugere que as repercussoes na saude das analistas de sistemas estao associadas as exigencias do trabalho e ao papel da mulher na sociedade. Os resultados destacam a importância de estudos sobre saude, trabalho e genero, em analisar a intersecao entre a esfera produtiva e a domestica.

Stretching and joint mobilization exercises reduce call-center operators' musculoskeletal discomfort and fatigue

AIM: We sought to evaluate musculoskeletal discomfort and mental and physical fatigue in the call-center workers of an airline company before and after a supervised exercise program compared with rest breaks during the work shift. INTRODUCTION: This was a longitudinal pilot study conducted in a flight-booking call-center for an airline in São Paulo, Brazil. Occupational health activities are recommended to decrease the negative effects of the call-center working conditions. In practice, exercise programs are commonly recommended for computer workers, but their effects have not been studied in call-center operators. METHODS: Sixty-four call-center operators participated in this study. Thirty-two subjects were placed into the experimental group and attended a 10-min daily exercise session for 2 months. Conversely, 32 participants were placed into the control group and took a 10-min daily rest break during the same period. Each subject was evaluated once a week by means of the Corlett-Bishop body map with a visual analog discomfort scale and the Chalder fatigue questionnaire. RESULTS: Musculoskeletal discomfort decreased in both groups, but the reduction was only statistically significant for the spine and buttocks (p=0.04) and the sum of the segments (p=0.01) in the experimental group. In addition, the experimental group showed significant differences in the level of mental fatigue, especially in questions related to memory Rienzo, #181ff and tiredness (p=0.001). CONCLUSIONS: Our preliminary results demonstrate that appropriately designed and supervised exercise programs may be more efficient than rest breaks in decreasing discomfort and fatigue levels in call-center operators.

Comparação do código de ética médica do Brasil e de 11 países

OBJECTIVE Compare the Code of Medical Ethics of the Federal Council of Medicine of Brazil with codes from 11 different countries, with the purpose of improving the comprehension of their structure and contribute to the achievement of their objectives. METHODS Codes from five continents and 11 countries: Argentina, Chile, Canada, United States, Portugal, United Kingdom, South Africa, Egypt, China, India, and Australia were studied. Information was obtained from the Internet, by accessing sites of regulatory agencies and medical associations. Codes were described and compared according to information about the setting-up organization, spatial scope, compulsory extent, date of enforcement, organizational rules and auxiliary documents. RESULTS The codes of ethics studied were: 59% created by the medical regulatory agency of the country, 92% of national scope, 67% compulsive for all physicians and 73% were last updated after the year 2000. A relation between the setting-up organization and the compulsory extent and spatial scope of the codes was observed. Need for systematic updating of the codes was noted. Updating is often carried out through auxiliary documents, however, there may be difficulties in making these contents known. The possibility of organizing the guidelines by topics, each followed by a small text was considered. CONCLUSION This study presented suggestions for the Code of Medical Ethics of Brazil: conduct a review and an update of the code, organize the guidelines, including explanations and justifications, separate the ethical resolutions and finally improve its divulgation.OBJECTIVE: Compare the Code of Medical Ethics of the Federal Council of Medicine of Brazil with codes from 11 different countries, with the purpose of improving the comprehension of their structure and contribute to the achievement of their objectives. METHODS: Codes from five continents and 11 countries: Argentina, Chile, Canada, United States, Portugal, United Kingdom, South Africa, Egypt, China, India, and Australia were studied. Information was obtained from the Internet, by accessing sites of regulatory agencies and medical associations. Codes were described and compared according to information about the setting-up organization, spatial scope, compulsory extent, date of enforcement, organizational rules and auxiliary documents. RESULTS: The codes of ethics studied were: 59% created by the medical regulatory agency of the country, 92% of national scope, 67% compulsive for all physicians and 73% were last updated after the year 2000. A relation between the setting-up organization and the compulsory extent and spatial scope of the codes was observed. Need for systematic updating of the codes was noted. Updating is often carried out through auxiliary documents, however, there may be difficulties in making these contents known. The possibility of organizing the guidelines by topics, each followed by a small text was considered. CONCLUSION: This study presented suggestions for the Code of Medical Ethics of Brazil: conduct a review and an update of the code, organize the guidelines, including explanations and justifications, separate the ethical resolutions and finally improve its divulgation.

Prevalência de sintomas osteomusculares entre trabalhadores de um Serviço de Nutrição Hospitalar em São Paulo, SP

Objective: To identify musculoskeletal symptoms among workers from a food service of a public cardiologic hospital located in Sao Paulo, Brazil. Method: A cross sectional study was carried out in 2007, by applying questionnaires to 115 workers (89% of total staff). The instrument was based on the Nordic Questionnaire on Musculoskeletal Symptoms by Kuorinka et al. (1987), for identification of any kind of pain or discomfort related to work, its location, type of complaint, and frequency, intensity, and duration of symptoms. Results: The workers’ average age was 37 ± 9.8 years, 81% were women, and 58% had highschool level. They had been working in the hospital for 9.3 ± 7.5 years, on a 40-hour week schedule. Most (89%) of the subjects reported pain or discomfort related to work during the last 12 months, mainly in lower limbs (65%). Other parts of the body mentioned by the workers were: shoulders (55%), lumbar region (39%), cervical region (37%), wrist/hands/fingers (29%), spine (28%), forearm (28%), and elbows (10%). The movements made while walking or carrying loads were the most reported cause of symptoms (31%). Conclusion: The study found a high prevalence of musculoskeletal symptoms among workers from the hospital food service, mainly in lower limbs and shoulders. It is recommended that future studies include assessment of environment and worker’s activities.

Dados comparativos de morbidade hospitalar do Município de Cubatão e do Estado de São Paulo (Brasil)

Realizou-se estudo com o objetivo de caracterizar a morbidade hospitalar do Municipio de Cubatao, SP (Brasil), comparando-a com a do Estado de Sao Paulo a fim de identificar as principais patologias e subsidiar a atuacao dos servicos de saude do Municipio. A caracterizacao da morbidade hospitalar baseou-se na analise dos dados coletados no periodo de julho/1983 a junho/1984. As principais causas de internacao do Municipio de Cubatao nos tres estabelecimentos hospitalares foram: Complicacoes da Gravidez, do Parto e do Puerperio (23,63%); Doencas do Aparelho Respiratorio (22,8%); Doencas das Glândulas Endocrinas, da Nutricao e do Metabolismo e Transtornos Imunitarios (10,47%); Doencas do Aparelho Circulatorio (10,26%); Lesoes e Envenenamentos (7,63%); Doencas do Aparelho Geniturinario (7,56%) e Doencas do Aparelho Digestivo (7,16%). Comparando-se o perfil da morbidade hospitalar de Cubatao com a do Estado de Sao Paulo observou-se que as Doencas Respiratorias, Doencas das Glândulas Endocrinas, da Nutricao, do Metabolismo e Transtornos Imunitarios (compreendendo basicamente as desidratacoes) e as Lesoes e Envenenamentos sao muito mais frequentes em Cubatao, o que pode estar refletindo as pessimas condicoes do meio ambiente, do saneamento basico, o baixo nivel socioeconomico da populacao e o carater altamente industrializado do Municipio. A baixa incidencia das Doencas do Sistema Nervoso, dos Neoplasmas, Doencas do Sistema Osteomuscular e Anomalias Congenitas podem estar relacionadas com a precariedade dos servicos de saude do Municipio que levam a procura de atendimento em outro local.

0294 Cardiovascular disease as a risk factor for disability retirement

Objectives The relationship between work and some diseases that they can provide is already known for a long time. Because of these conditions some projects were created to improve conditions of work and to support the worker loses her job capacity such, among them the disability retirement. The objective of this study was to identify cardiovascular disease as risk factors for disability retirement. Method Was realised a literature review, including articles published in 2000 to 2013, being surveyed those in the period from April to November 2013, using the following descriptors: risk factors, pensions and cardiovascular diseases in databases PUBMED/MEDLINE, BIREME, SCOPUS, WEB OF SCIENCE and COCHRANE. Found, respectively, 8, 8, 27, 2 and 0 items. After deleting the duplicate items, those whom were not in English or Portuguese and non revolved around the topic of study, 7 remained. All showed a positive association between disability retirement and cardiovascular diseases. Results In the study used to compare relative risk for cardiovascular disease retirements with musculoskeletal found the same risk for both diseases. Other studies showed association between increased uric acid, poorly controlled hypertension, perceived stressful work postures and work and increased risk for this retirement. There is a huge investment in prevention campaigns for workers’ health to prevent the musculoskeletal disease, but not always the same commitment to the prevention of the cardiovascular. Conclusions In conclusion cardiovascular disease has high significance for the health of the employee, being an important risk factor for disability retirement, and should be encouraged to implement policies to prevent these.

Intervenção nas situações de trabalho em um serviço de nutrição hospitalar e repercussões nos sintomas osteomusculares

OBJETIVO: Analisar as situacoes de trabalho em servico de nutricao hospitalar, antes e depois da implantacao de acoes de intervencoes ergonomicas, e seu impacto na prevalencia de sintomas osteomusculares relacionados ao trabalho. METODOS: Trata-se de estudo de caso desenvolvido em hospital publico especializado em cardiologia, localizado em Sao Paulo, com a participacao de 115 trabalhadores. A abordagem metodologica foi a da Analise Ergonomica do Trabalho e da ergonomia participativa. A coleta de dados foi realizada por meio da aplicacao de questionarios e da analise ergonomica do trabalho, antes e depois da intervencao. A analise dos dados incluiu testes estatisticos para verificar se houve mudanca da prevalencia de sintomas antes e depois das intervencoes, com nivel de significância de 5%, por meio dos Programas Statistical Package for Social Sciences 13.0 e Excel 2003. RESULTADOS: A populacao constitui-se, em sua maioria, de mulheres, na faixa etaria de 25 a 34 anos, com grau medio de escolaridade, casadas, com filhos, e que ocupavam o cargo de atendente de nutricao. Os principais problemas observados foram espaco fisico reduzido, equipamentos e materiais de trabalho inadequados, deficit de pessoal, volume excessivo de trabalho com elevado esforco mental e alta prevalencia de sintomas osteomusculares, principalmente nos membros inferiores e ombros. Apos as intervencoes realizadas, houve melhora na situacao de trabalho, com reducao dos sintomas osteomusculares, bem como os profissionais perceberam mudancas em termos de ambiente fisico, equipamentos e organizacao do trabalho. CONCLUSAO: As intervencoes repercutiram em melhorias, principalmente quanto ao ambiente e equipamentos, e na reducao dos sintomas osteomusculares nos membros inferiores, ombros, pescoco/regiao cervical, antebraco e regiao lombar, apesar de a reducao nao ter sido estatisticamente significativa.Trata-se de estudo de caso desenvolvido em hospital publico especializado em cardiologia, localizado em SaoPaulo, com a participacao de 115 trabalhadores. A abordagem metodologica foi a da Analise Ergonomica doTrabalho e da ergonomia participativa. A coleta de dados foi realizada por meio da aplicacao de questionariose da analise ergonomica do trabalho, antes e depois da intervencao. A analise dos dados incluiu testes estatisticospara verificar se houve mudanca da prevalencia de sintomas antes e depois das intervencoes, com nivel designificância de 5%, por meio dos Programas

0297 The prevalence of risk factors associated with Computer Vision Syndrome among computer works in São Paulo, Brazil

Objectives The aims of this study were to investigate work conditions, to estimate the prevalence and to describe risk factors associated with Computer Vision Syndrome among computer works in São Paulo. Method The methods include a quantitative cross-sectional observational study and an ergonomic work analysis, using work observation, interviews and questionnaires. The case definition was the presence of one or more specific ocular symptoms answered as always, often or sometimes. The multiple logistic regression model, were created using the stepwise forward likelihood method and remained the variables with levels below 5% (p < 0.05). Results The operators were mainly female and young (from 15 to 24 years old). The call centre was opened 24 h and the operators weekly hours were 36 h with break time from 21 to 35 min per day. The symptoms reported were eye fatigue (73.9%), “weight” in the eyes (68.2%), “burning” eyes (54.6%), tearing (43.9%) and weakening of vision (43.5%). The prevalence of Computer Vision Syndrome was 54.6%. Conclusions The organisation and psychosocial factors at work should be included in prevention programs of visual syndrome among call centres’ operators.

0292 Comparison of personal habits and baseline knowledge of health promotion among students of the Faculdade de Medicina da Universidade de São Paulo

Objectives Because of the importance given to the implementation of health promotion programs nowadays generating positive outcomes important to society and especially to businesses, employees and the financial market this study was designed to assess students’ baseline knowledge of expertise in occupational medicine on health promotion and correlate it with the students’ baseline knowledge Faculdade de Medicina da Universidade de São Paulo (internal fifth-year residents and first-year internal medicine) as well as evaluate their own health habits. Method We conducted a cross-sectional study in which we applied two questionnaires that had been used in previous studies by Ferreira Junior, 2011. The questionnaires so called 1) “Survey of attitudes and behaviour” and 2) “Questionnaire assessment of knowledge in health promotion.” Regarding the epidemiological data to submit descriptive statistics and Excel filters the table. Results The higher scores among graduate students, were related to nutrition and oral hygiene, both at present as expected in a year. Questions about professional attitude in their 13 items’ scores were higher post-graduate training in the item. In other items, students’ grades and graduation from residency and postgraduate students were equal. When comparing the mean of graduate students called in questionnaire 2, all items showed lower values in relation to the notes of interns and residents. Conclusions The loss in quality of care is undeniable, since there is awareness on the part of the respondents own lack of technical knowledge updated with regard to health promotion that contrasts with the self-perception of adequate training to do so.

Risk factors for computer vision syndrome among operators of two call centres in São Paulo, Brazil

Objectives The aim of this study was to estimate the prevalence of Computer Vision Syndrome (CVS) among operators from two call centres located in São Paulo (n=476). Methods and results The symptoms were: visual fatigue (73.9%), “heaviness” in the eyes (68.2%), “burning” eyes (54.6%), tearing (43.9%) and vision impairment (43.5%). Other associations were: being female (OR 2.6, 95% CI 1.6-4.1), lack of recognition during work (OR 1.4, 95% CI 1.1 to 1.8); organisation of work in telemarketing (OR 1.4, 95% CI 1.1 to 1.7) and work demands (OR 1.1, 95% CI 1.0 to 1.3). Conclusions This study showed the importance of organizational characteristics and psychosocial factors at work as related to the presence of CVS in telemarketing operators.